More than 2 million people in the U.S. lack running water and basic Indoor Plumbing, according to a new report by the human-rights nonprofit DigDeep and the nonprofit U.S. Water Alliance — and race and poverty are key determinants of who has access to clean water and sanitation. MarketWatch reports:

Native Americans are 19 times more likely to Lack Indoor Plumbing than their white counterparts, putting them in the worst spot of any group, and African-American and Latino households lack indoor plumbing at almost twice the rate of white households, the report found.

“The United States is home to some of the most reliable water and wastewater systems on earth, and many Americans believe access is universal,” the authors wrote. “But in fact, millions of the most vulnerable people in the country — low-income people in rural areas, people of color, tribal communities, immigrants — have fallen through the cracks.”

Lacking access to safe water and sanitation “makes it difficult to stay healthy, earn a living, go to school, and care for a family,” they added.

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