Half a Million Americans Still Live Without Indoor Plumbing

In one of the world's wealthiest nations, more than half a million households still lack complete indoor plumbing. According to the 2023 American Housing Survey, approximately 526,000 occupied U.S. homes don't have hot and cold running water, a bathtub or shower, or a flush toilet.

That's 0.4% of all occupied housing units—a small percentage, but a staggering human impact.

Where the Problem Hits Hardest

This isn't evenly distributed. Alaska leads the nation with nearly 5% of homes lacking complete plumbing, followed by New Mexico and Montana, each exceeding 1%. Nearly 70% of plumbing-deficient homes are in rural counties.

In Alaska's Native villages, many residents rely on "honey buckets"—plastic toilets that must be emptied manually—because permafrost makes conventional sewage systems impractical. On the Navajo Nation, only about 40% of residents have running water at home.

Who Gets Left Behind

The disparities are stark:

• Native American households are 18 times more likely than white households to lack indoor plumbing
• Households earning under $15,000 annually are 10 times more likely to lack plumbing than those earning over $75,000
• Rural communities face significantly higher rates than urban areas

Even in major cities, pockets of plumbing poverty exist—though New York and Los Angeles report rates below 0.1%, the sheer population means thousands of urban residents still face this challenge.

Why It Still Happens

The reasons vary by region. In Alaska, it's geography and permafrost. On tribal lands, it's often a combination of poverty, remote locations, and infrastructure neglect. In Appalachia and rural areas, it's aging housing stock and economic decline.

Some homes have partial plumbing—maybe cold water but no hot, or an outdoor privy instead of a flush toilet. Others have nothing at all, forcing residents to haul water from distant sources or use facilities at community centers.

While the percentage has dropped dramatically over the past century—from more than 45% of homes in 1940 to less than 1% today—the remaining gap reveals deep inequalities. Access to clean water and sanitation isn't just a basic human right; it's fundamental to health, dignity, and opportunity.

For half a million American households, that fundamental right remains out of reach.