For many builders, producing housing at an affordable price point for entry-level buyers is hard enough with labor and materials costs rising. But for many in the country, it's not just the lack of access to affordable housing but a lack of access to simple plumbing.

According to the Census Bureau, nearly half a million households live without running water, a bathtub or shower, or a flushing toilet. It's not just a housing issue, or a poverty issue, it's a public health issue at its core. And counties like that of Lowndes County in rural Alabama are struggling most.

Crumbling infrastructure has been a theme of this country’s reinvigorated public conversation about race — for instance, a botched fix for old pipes in Flint, Mich., that contaminated the city’s drinking water with lead. But in poor, rural places like Lowndes County, there has never been much infrastructure to begin with.

“We didn’t have anything — no running water, no inside bathrooms,” said John Jackson, a former mayor of White Hall, a town of about 800 in Lowndes that is more than 90 percent black and did not have running water until the early 1980s. “Those were things we were struggling for.”

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