Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of City and Regional Planning, University of California, Berkeley, CA, USA.
Lancet Glob Health. 2023 Apr;11(4):e606-e614. doi: 10.1016/S2214-109X(23)00006-2.
Drinking water and sanitation services in high-income countries typically bring widespread health and other benefits to their populations. Yet gaps in this essential public health infrastructure persist, driven by structural inequalities, racism, poverty, housing instability, migration, climate change, insufficient continued investment, and poor planning. Although the burden of disease attributable to these gaps is mostly uncharacterised in high-income settings, case studies from marginalised communities and data from targeted studies of microbial and chemical contaminants underscore the need for continued investment to realise the human rights to water and sanitation. Delivering on these rights requires: applying a systems approach to the problems; accessible, disaggregated data; new approaches to service provision that centre communities and groups without consistent access; and actionable policies that recognise safe water and sanitation provision as an obligation of government, regardless of factors such as race, ethnicity, gender, ability to pay, citizenship status, disability, land tenure, or property rights.
高收入国家的饮用水和环境卫生服务通常会给其民众带来广泛的健康和其他益处。然而，由于结构性不平等、种族主义、贫困、住房不稳定、移徙、气候变化、持续投资不足以及规划不善，这一基本公共卫生基础设施仍存在差距。尽管高收入环境中归因于这些差距的疾病负担在很大程度上尚未得到描述，但来自边缘化社区的案例研究以及针对微生物和化学污染物的针对性研究数据强调了需要继续投资，以实现享有饮水和环境卫生的人权。实现这些权利需要：对这些问题采取系统方法；提供可及的、分类数据；采用以社区和缺乏持续获得服务机会的群体为中心的新服务提供方法；制定切实可行的政策，承认安全供水和环境卫生供应是政府的一项义务，而不论种族、族裔、性别、支付能力、公民身份、残疾、土地保有权或财产权等因素如何。
