Which U.S. States Desperately Need Water Treatment & Why It Matters

Clean, safe drinking water is foundational to public health, economic development, and environmental justice. Yet in the United States, many states struggle with aging infrastructure, contamination, underfunded systems, and natural challenges. This post examines which states most urgently need better water treatment, what’s behind their problems, and what needs to be done.

What Metrics Tell Us Which States Need Help

To determine where water treatment is most desperately needed, here are key indicators:

• Safe Drinking Water Act (SDWA) violations — health, monitoring & reporting, or other violations.

  
  

• Number or proportion of people served by systems with serious violations.

  
  

• Financial shortfall in water infrastructure — cost to upgrade, replace pipes, and modernize treatment plants.

  
  

• Contaminant exposure — lead, PFAS (per-and polyfluoroalkyl substances, aka “forever chemicals”), arsenic, nitrates, microbial pathogens.

  
  

• Rural vs. urban disparities — many small or rural water systems have fewer resources.

  
  

• Natural stressors — drought, climate change, saltwater intrusion, flood damage, water scarcity.

States with Acute Water Treatment Needs

Based on recent data, here are the states that stand out as having particularly urgent needs, and why.

State	Why It Needs Urgent Water Treatment & Infrastructure Attention
Pennsylvania	Leads U.S. in SDWA violations — ~24,525 violations in recent reporting. High number of public water systems with violations. Aging infrastructure and widespread monitoring/reporting issues. https://www.visualcapitalist.com/mapped-water-violations-by-state/
Texas	Second in number of violations. Rapid growth stresses systems. Also huge financial need for infrastructure improvements. Many rural areas and smaller systems are under-resourced. https://www.visualcapitalist.com/mapped-water-violations-by-state/
West Virginia	Very high proportion of population connected to water systems with serious violations. Many rural and mountainous areas where treatment and distribution are challenging. https://www.inthetap.com/worst-tap-water-in-the-united-states
New Mexico	Among states with highest rate of health-related violations per capita. Also has PFAS contamination issues (military base contamination etc.). Natural water scarcity and arid climate amplify issues. https://www.newsweek.com/map-shows-drinking-water-safety-issues-state-1904506
Louisiana & Oklahoma	These states also show high rates of health-based violations per capita. Many systems are old; rural, low income communities frequently underserved. https://www.newsweek.com/map-shows-drinking-water-safety-issues-state-1904506
Alabama, Arizona, Indiana, Maryland	These show up in “worst tap water” rankings based on customer satisfaction (taste, odor, hardness, etc.), as well as violations. These issues often indicate treatment problems (or corrosion, lead plumbing, etc.). https://www.cnbc.com/2024/08/02/us-states-best-worst-tap-water-j-d-power.html
California & New York	While these states have many strong water systems, their sheer size and population mean large financial needs for upgrades. Also, certain areas (rural or disadvantaged) suffer from contamination (e.g. lead, agricultural runoff, PFAS). https://usafacts.org/articles/which-states-need-to-improve-their-drinking-water-systems/

Common Underlying Causes

Understanding why these states are struggling helps in figuring out how to fix the problems.

1. Aging Infrastructure: Many water treatment plants, distribution pipes, and lead service lines are decades old. Corrosion, leaks, structural failure, and inefficiencies increase risk and cost.

   
   

2. Underfunding / Financial Barriers: Upgrading or replacing treatment plants, adding advanced filtration (for PFAS, nitrates, etc.), and modernizing monitoring systems all cost money. States with lower tax bases, or many small systems, often can’t afford necessary investments without grants or Federal assistance.

   
   

3. Regulatory Gaps / Enforcement & Monitoring Issues: Some states lag in monitoring/reporting requirements, or their systems fail to comply with standards for contaminants. Violations sometimes go unreported or unaddressed for long periods.

   
   

4. Environmental & Climate Stressors: Droughts, more intense storms and flooding, higher temperatures, and changes in runoff patterns all stress water sources and increase vulnerability. Arid western states or drought-prone regions are especially hard hit.

   
   

5. Contamination from Industrial, Military, Agricultural Sources: PFAS (used in firefighting foam, industrial applications), agricultural runoff (nitrates, pesticides), mining, and military base pollution are serious threats. In many states, contamination has forced expensive remediation, filtration, or health warnings.

   
   

6. Inequity & Disadvantaged Communities: Rural areas, low-income neighborhoods, and communities of color often have fewer resources, less political power, and greater exposure to contaminated water or failing systems.

   
   

Consequences of Not Acting

• Public Health Impacts: Lead poisoning, PFAS exposure linked to cancer, birth defects, immune system effects; microbial pathogens causing diseases; chemical contamination causing chronic illness.

  
  

• Economic Costs: Health care expenses, lost productivity, property damage, reduced land values. Also, underperforming regions are less attractive for investment.

  
  

• Social Justice Issues: Communities already disadvantaged suffer more. Drinking water issues often overlap with environmental justice concerns.

  
  

• Longer-Term Infrastructure Backlog: Delaying maintenance or upgrades massively increases the costs later.

  
  

What Needs to Be Done

1. Targeted Investment in Infrastructure: Federal, state, and local governments need to increase funding, especially for rural water systems and disadvantaged communities. Prioritize lead service line replacement, advanced treatment for PFAS/nitrates, and reliable monitoring.

   
   

2. Improved Monitoring, Enforcement, & Transparency: Stricter enforcement of Safe Drinking Water Act violations. Regular, accessible public reporting of water quality and violations. Expanded use of real-time monitoring where feasible.

   
   

3. Regulation & Standards for Emerging Contaminants: PFAS, microplastics, and other chemicals are increasingly recognized hazards but sometimes lack uniform regulation. States should adopt stricter standards and update treatment requirements.

   
   

4. Use of Modern Treatment Technologies: Examples: membrane filtration, activated carbon, ion exchange, advanced oxidation, etc. Innovation and scalable solutions (modular or small-system) for low-density areas.

   
   

5. Community Engagement & Equity Policies: Ensure that affected communities have a voice in planning. Programs that provide assistance or subsidies to low-income households. Addressing “last mile” issues in distribution.

   
   

6. Climate Adaptation: Investing in resilience to droughts, floods, and changing water supply patterns. Protecting watersheds, conserving water, adjusting infrastructure to anticipate extreme weather.

   
   

Some U.S. states face a water treatment crisis. States like Pennsylvania, Texas, West Virginia, New Mexico, Louisiana, and others show alarming rates of violations, contamination, and infrastructure need. The good news is solutions exist, but they require investment, regulation, and political will. Without action, the costs in health, equity, and economics will only grow.