Home / Health / Articles / More than half a million US households live with plumbing poverty

Most Americans consider their access to running water a given.

But according to American Community Survey (ACS) data from the Census Bureau, 522,752 US households lacked complete plumbing access in 2021. Of these households, 347,943 didn’t have a bath or a shower, 419,971 lacked hot or cold running water, and 246,884 had neither.

This lack of access is sometimes known as plumbing poverty. The term is specifically defined to refer to a household that does not have hot and cold running water and/or lacks an indoor bathtub or shower.

How has lack of plumbing changed over time?

Plumbing poverty levels have fluctuated over the past two decades. Between 2019 and 2021, an additional 50,661 American households lacked a bath or shower. Plus, 53,705 more households didn’t have hot or cold running water, and 48,351 additional households lacked both.

The last time plumbing poverty exceeded current levels was in 2011, when 499,903 households were without a bath or a shower, 536,397 households lacked hot or cold running water, and 398,435 households had neither.

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According to American Community Survey data from 2008 to 2021, the highest levels of plumbing poverty were in 2008, when 559,488 households lacked a bath or shower, 639,588 lacked hot and cold running water, and 476,922 lacked both.

Which states have the most instances of plumbing poverty?

As of 2021, Texas has the most households living in plumbing poverty, with 56,991 lacking complete plumbing. The states with the greatest number of people living in plumbing poverty are also some of the country’s most-populated.

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The picture is different when looking at the percentage, rather than the total number, of households living in plumbing poverty. Alaska had 2021’s highest percentage (3.57%) and was one of 10 states where more than 0.5% of households experienced plumbing poverty.

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What does plumbing poverty look like on a local level?

Plumbing poverty is also measured by county. Of the top 13 counties with the highest percentage of residents experiencing plumbing poverty, 12 are in Alaska. The Yukon-Koyukuk Census area had 36.1% of residents who lacked complete indoor plumbing in 2021. Another high-ranking area was Apache County in Arizona, with 12.8% of residents experiencing plumbing poverty.

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Census data shows that both of these counties, Apache and Yukon-Koyukuk, had high percentages of American Indian and Alaskan Native people. A 2018 report to Congress from the Indian Health Service (IHS) called for improved water infrastructure on tribal lands. The IHS estimated that repairs and improvements would cost $2.67 billion. More recently, the Environmental Protection Agency’s 2023 Drinking Water Infrastructure Needs Survey and Assessment included tribal systems for the first time since 2011.

Where does plumbing poverty data come from — and what does it miss?

The Census Bureau's American Community Survey asks about plumbing and running water to better understand the quality of housing in a given area and ascertain if the housing meets the needs of residents, but there are some notable data gaps. ACS data from 2016 to 2021 measures who is without a bathtub or a shower, who is without hot and cold running water, as well as households who lack both. But access to flushable toilets is only included in ACS data collected prior to 2016.

Additionally, the data focuses on people in residences. Those experiencing homelessness are not represented in this ACS data.

Learn more about how the government defines poverty and what living at the poverty line looks like, and get the data directly in your inbox by signing up for our email newsletter.

American Community Survey
2023 Drinking Water Infrastructure Needs Survey and Assessment
Last updated
April 2023