Ensuring equity as wastewater testing matures in the United States

Wastewater surveillance has emerged as a crucial tool for monitoring SARS-CoV-2 trends, providing insights into community health without relying on individual testing. However, as this method expands, concerns about equity have surfaced. Disparities in health outcomes among Black, Hispanic, American Indian, Alaska Native, and rural populations underscore the need for inclusive wastewater monitoring strategies. Access and affordability barriers to diagnostic testing are partially mitigated by wastewater data, yet infrastructure gaps, such as lack of sewer connections in 20% of U.S. households, pose significant challenges. Addressing these disparities is crucial to ensure that wastewater monitoring contributes equitably to public health initiatives.