In recent months, drought watches have been declared for more than half the counties in Pennsylvania and New Jersey due to below-normal precipitation combined with low water supply.

This has not made headlines on the East Coast. A "drought watch" is just one notch above normal. (Serious conditions would lead to a "drought warning" or the most severe level, a "drought emergency"). California, on the other hand, has been dealing with a drought of historic proportions. State and local policymakers here might want to look at how California has responded.

More than the environment is at stake – water conservation choices have impacts on human health. During severe drought in Australia, for example, delayed water conservation decisions led to landscape irrigation bans. These prohibitions caused public green spaces to turn brown, which in turn limited access to parks. Parks are key locations for physical activity, especially in low-income communities. Irrigation bans also impact local air quality, as the lack of green space can result in what is known as an urban heat island, when absence of vegetation  causes an area to become warmer than its surroundings. While it may not be obvious at the time, decisions by water suppliers and regulators ultimately affect the public's health.

Recognizing that human health may not be a priority in water conservation decision-making, a team at UCLA's Center for Health Advancement, with guidance from water and health experts from across California, developed a Health Impact Assessment (HIA) of California's Urban Water Conservation Alternatives in response to state legislation (I was a member of this team). The law, which mandates a 20% reduction in California's water use by water district by the year 2020, allows each district to choose a mix of water conservation options to best fit local needs. Health impact assessments, like better-known environmental impact assessments, study and predict the long-term impact of major decisions or projects. Adding a health impact assessment to the decision-making process for water conservation brings health considerations into an arena where they are not traditionally present.

We identified seven avenues through which human health could be affected by decisions involving urban water conservation:

  1. Air quality/air pollution (for example, respiratory disease emerging from air emissions generated by energy needed to pump and treat water).
  2. Surface and groundwater quality (gastrointestinal illnesses emerging from concentrated and contaminated run-off).
  3. Urban heat island effects (heat stroke and extreme heat events emerging from lack of water for irrigation, which can create "hot-spots" that otherwise would have been lessened by vegetation).
  4. Recreational opportunities (impacts on mental health due to the reduced quality of spaces for play and sports caused by a lack of water for irrigation).
  5. Household financial burden (increased stress on lower-income households as a result of higher water costs and lower availability of water)
  6. Water and wastewater infrastructure costs (gastrointestinal illnesses emerging from improperly treated recycled water).
  7. Indoor mold exposure (rises in asthma and allergy resulting from water leakage in homes and buildings, which can cause mold growth).

Specific recommendations for water suppliers involve making early and well-planned efforts to conserve water. Detailed planning well ahead of a crisis can put a priority on conservation methods that benefit both environmental and human health. Water conservation is critical. But water efficiency can be improved in ways that also maximize the benefits to health and well being.

Here are some recommendations for water policymakers in Pennsylvania and New Jersey to consider when making conservation decisions:

  • Choose water conservation methods based on a quadruple bottom line: water savings, cost, greenhouse gas emissions, and local health impact.
  • Require that water-efficient fixtures (toilets, showerheads, and faucets) be part of the home-resale process by adding a "Water Efficiency Disclosure Statement" for home sale transactions.
  • Expand recycled water use and infrastructure for recycled water. Prioritize the reviewing and updating of public health restrictions on recycled water based on the newest technologies and research.
  • Explore development of a recycled water-pricing system similar to how regulatory authorities often use pricing for pollution reductions. This creates an incentive for recycling by charging more for water discharges. Use the proceeds to fund expansion of recycled water infrastructure.

Efficient water use is necessary to support the public's health. Drawing up plans to deal with drought is a great time to bring health into the process – in California, Pennsylvania and New Jersey, and everywhere else.


Sharona Sokolow, MPH, is a doctoral candidate in the Department of Environmental Health Sciences at UCLA's Fielding School of Public Health.

More information about the work going on at UCLA's Center for Health Advancement is here. The Health Impact Assessment of California Urban Water Conservation was funded by the Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and the Pew Charitable Trusts.

Read more about The Public's Health.