Alabama violated civil rights with poor sanitation, Biden administration finds

The Biden administration has found that Alabama’s public health departments discriminated against Black residents by denying access to adequate sanitation systems.

A 2017 study, published first by the Guardian, found the hookworm parasite transmitted in fecal matter to be prevalent in a majority-Black Lowndes county. On Thursday, the Departments of Justice and Health and Human Services announced that the state and county engaged in a “consistent pattern of inaction and/or neglect concerning the health risks associated with raw sewage”.

The Department of Justice began its first ever environmental justice investigation into the state body that receives funding from the DoJ in November 2021. The agency found that, by failing to provide adequate sanitation to Lowndes county residents, the Alabama department of public health (ADPH) was in violation of Title VI of the Civil Rights Act of 1964, which prohibits recipients of federal funds from discriminating on the basis of race, color or national origin.

“Environmental justice is a public health issue, and where you live should not determine whether you get sick from basic environmental hazards not faced in other affluent and white communities,” Melanie Fontes Rainer, director of the office for civil rights at the US Department of Health and Human Services, said in a statement.

More than 70% of the Lowndes county population is African American, and over 28% of residents live in poverty. The clay-like soil found in this part of the country makes the area unsuitable for water drainage; most homes in Lowndes are not hooked up to municipal sewer lines, relying instead on costly septic systems. This lack of adequate sewage infrastructure makes a breeding ground for hookworm.

During heavy rain and floods, the rising groundwater can overwhelm the septic system, allowing raw sewage, including fecal waste, to go up to the surface of people’s backyards, or back up into the bathtubs, toilets or kitchen sinks.

“It’s a historic first step toward showing intersectionality between civil rights and environmental justice,” said Catherine Flowers, author and environmental activist who was born and raised in Lowndes county. She was instrumental in bringing attention to this issue.

In 2016, the Alabama Center for Rural Enterprise, a non-profit that Flowers founded, and National School of Tropical Medicine at Baylor College of Medicine surveyed Lowndes county residents, and the findings, first published by the Guardian, found that 34% tested positive for traces of hookworm.

“Now we have the highest levels of government trying to solve this problem,” Flowers said. “This could be a guide to helping other rural communities suffering with the same type of sanitation inequity.”

As a result of the investigation, ADPH entered into an “interim resolution agreement” which requires the ADPH to:

• Suspend fines, fees and penalties on residents who lack the means to obtain functioning septic systems.

• Measure the level of health risks that residents face from inadequate wastewater systems. The ADPH has agreed to work with the Centers for Disease Control and Prevention (CDC) and follow their public health recommendations.

• Increase public health awareness to ensure residents receive critical health and safety information related to raw sewage exposure.

• Carry out a comprehensive assessment of what an appropriate septic and wastewater management would look like in Lowndes county.

If ADPH fails to establish a long-term plan for addressing the sewage failure by May 2024, the DoJ will reopen the investigation.

“This agreement creates a path towards sustainable sanitation solutions,” said Sandra Steward, US attorney for the middle district of Alabama, in a statement. “The measures required in the agreement will improve public health and the environment for the residents of Lowndes county.”

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