Supporting the Public Health
Case for Water Security

Living without access to clean water has significant health impacts including a higher risk of waterborne disease, Type II diabetes, physical injury, and acute mental stress. Water access, affordability, and quality have long been top issues in the state of Michigan — where Altarum was founded — as well as nationwide. Yet, despite the demand and need for action following a crisis like the one in Flint, Michigan, which resulted in elevated blood lead levels for approximately a quarter of the community’s children, it can be difficult for policymakers to know where to target intervention and prevention programs. This is where Altarum has a role to play.

For more than 40 years, Altarum researchers have conducted economic analyses and research to inform decision-making in health and health care for states, federal agencies, and the private sector. Our economists are recognized national experts in modeling the costs, benefits, and returns on investments in health care, prevention, and social determinants of health. With these insights, Altarum developed a Value of Health framework that measures the long-term impacts of investments in health and details the net economic returns of those investments by type, stakeholder, and timeframe. This framework empowers policymakers and leaders with the information they need to compare and assess the potential impacts of their investments over the long term — which is particularly important when considering investments in children. 

While the framework has been applied to estimating the potential health and financial returns for many of the most serious public health issues facing our country today, in 2022 we were able to make the most meaningful progress in the areas of water access and quality. With funding from the Robert Wood Johnson Foundation (RWJF), Altarum estimated the economic and societal impacts of incomplete access to in-home water in the United States, measured the economic benefits of water shutoff protections, and continued our efforts to prevent childhood lead exposure through lead service-line replacement — among other interventions.

As part of this initiative, Altarum partnered with PeachLab to provide an analysis that aided the city of Philadelphia in measuring the economic benefits of new water shutoff protections. Disconnecting water service for nonpayment is a common practice in municipalities across the country. While the pandemic increased recognition that water access is essential for disease control, and resulted in several moratoriums, little direct quantitative evidence of the economic impacts of water shutoffs existed. As outlined in a research report entitled “The Costs of Water Insecurity in Philadelphia,” Altarum calculated the net societal loss — including financial and employment costs, educational and family costs, and physical and mental health costs — of the city restarting water shutoffs to 75,000 households. The findings of the analysis helped the Philadelphia Department of Public Health make the case for water security to the city and led to new water shutoff protections being unveiled in May 2022.

Through its analytical modeling, Altarum is helping bring about real-world changes by quantifying the full impacts of inaction and the economic benefits of interventions in water access, affordability, and quality.

“Happily, earlier this week, the City of Philadelphia announced new water shutoff protections that will allow us to avoid some of the costs of water insecurity this report explores. We are grateful for your collaboration in making the case for this progress in our city! And are excited to keep thinking with you (and any and all related partners) about how public health institutions can continue to collaborate with stakeholders within municipalities nationwide to achieve water security for all.”
-Mica Root, Nutrition and Physical Activity Program Manager, Philadelphia Department of Public Health