Researchers have found that Alaska Natives living without access to in-homeplumbing had much higher rates of respiratory infections. The Centers for Disease Control and Prevention (CDC) led the two-year collaborative investigation of homes of families in rural Alaska.

This is the first study to show the association between lack of in-home running water and increased health risk in the United States.

Infants and the elderly were the most affected in the study. Infants in villages with the lowest numbers of in-home running water had a 11 times higher rate of hospitalization for pneumonia and a 5 times higher rate of hospitalization for lower respiratory tract infections and RSV. In addition, residents in areas of low in-home running water over the age of 65 were twice as likely to be hospitalized for pneumonia or influenza.

Researchers attribute the increased rate of serious illness to residents’ inability to wash their hands and keep up good hygiene.

“Access to clean water for hand washing and hygiene is extremely important to preventing disease,” says Tomas Hennessy, MD, author of the study and director of the Artic Investigation Program. “Without better access to in-home water for hand washing and hygiene, Alaska Natives will continue to face higher rates of largely preventable infections.”

According to the 2000 census, 99.4% of American homes had complete sanitation service, compared to Alaska’s 93.7%, with this percentage dropping greatly in rural villages.

The study was published in the American Journal of Public Health.