Ann Arbor, MI, October 27, 2021 – A new analysis finds US states that prevented utilities from turning off water service to households that were behind on their payments during the COVID-19 pandemic experienced significantly lower rates of infection and death from the pandemic while the moratoria were in effect. The study in the American Journal of Preventive Medicine, published by Elsevier, underscores the importance of water equity and the need for government actions to create more uniform protections from water shutoff across all states.

During the COVID-19 epidemic, 34 states enacted moratoria on water shutoffs from most water utilities so that people could access clean water. Among the 34 states, 20 states imposed a comprehensive moratorium covering both public and private water systems, while the rest issued moratoria covering only public water systems. Only 11 states still had an active moratorium by the end of 2020, and this number decreased to three by September 2021.

State water shutoff moratoria actions in 2020. Author analysis based on Food and Water Watch 2021 (Credit: American Journal of Preventive Medicine).
State water shutoff moratoria actions in 2020. Author analysis based on Food and Water Watch 2021 (Credit: American Journal of Preventive Medicine).

“This study shows the importance of state governments’ leadership in public health,” said lead investigator Xue Zhang, PhD, Departments of City and Regional Planning and Global Development, Cornell University, Ithaca, NY, USA. “Using modeling typical of other public health studies, we found states with moratoria on water shutoffs had lower infection and death growth rates. We hope what we learned from the pandemic can contribute to universal access to water in the future.”

The researchers used event study analysis, a common epidemiological model, to estimate the impacts of state water policy on public health. The study looked at daily infection and death growth rates from April 17 to December 31, 2020 in every state. Data from Food and Water Watch were used to determine if states had a water shutoff moratorium in place on each day of the study period. The study controlled for mask mandates, at-risk groups, and percentage of health insurance coverage.

The article is “Water Shutoff Moratoria Lowered COVID-19 Infection and Death Across U.S. States,” by Xue Zhang, PhD, Mildred E. Warner, PhD, Mary Grant, BS . The article is openly available at

The research was conducted in collaboration with Food and Water Watch, with support from a Rapid Response Fund award by the Cornell Atkinson Center for Sustainability and funding from the Cornell Center for Social Sciences.

The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women’s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials.