The Structure of Water

Nonfiction / Julia Knox


:: The Structure of Water ::

The struc­ture of water is beau­ti­ful and sim­ple. When hydro­gen and oxy­gen bond, what was once air comes to life as water. In dynam­ic equi­lib­ri­um, earth’s most copi­ous com­pound is born. Com­pris­ing 60 per­cent of our bod­ies and 71 per­cent of our plan­et [i], water is designed per­fect­ly to sup­port our bod­ies and our plan­et. Yes: the struc­ture of water is beau­ti­ful and simple. 

In epi­demi­ol­o­gy, the method of con­tact trac­ing helps to track, and hope­ful­ly pre­vent, an out­break result­ing from path­o­gen­ic expo­sure. Dur­ing con­tact trac­ing, epi­demi­ol­o­gists and those infect­ed with a com­mu­ni­ca­ble dis­ease work to iden­ti­fy each indi­vid­ual with whom the infect­ed per­son had con­tact. I always imag­ine this to be an unimag­in­ably dif­fi­cult yet unde­ni­ably crit­i­cal task. The dif­fi­cul­ty, I imag­ine, lies not with­in the track­ing itself but in the real­iza­tion of con­tact, and then of the telling. 

I’d like all of us to take a minute to be an epi­demi­ol­o­gist today. 

What’s your trace of con­tact with water? 

I imag­ine the traces them­selves, the warm show­er, the much-appre­ci­at­ed cup of hot cof­fee, the easy, almost thought­less nature of fill­ing up a water bot­tle in the morn­ing. The water bot­tle, washed with clean tap water, with tox­i­col­o­gy lev­els freely avail­able online, and from a city pro­vid­ing free lead test­ing kits for con­sumers’ own ver­i­fi­ca­tion. At work and home, bath­rooms smell of lit­tle but recent­ly sprayed dis­in­fec­tant. The water flow­ing from the sinks by our lab, ensur­ing the clean hands of researchers, comes out eas­i­ly, clear­ly, and with adjustable tem­per­a­tures. The work per­formed by these hands is, by exten­sion, edu­cat­ed on san­i­ta­tion to ensure the ster­ile prac­tices nec­es­sary for research integri­ty. The well-per­formed research gen­er­ates data for large-scale grants, fur­ther ensur­ing the lab’s com­fort­able fund­ing sources. The lab pub­lish­es robust­ly in pub­lic health jour­nals and pro­vides a pro­fes­sion­al home to many emerg­ing sci­en­tists. Yes, this is beau­ti­ful, but per­haps not so simple. 

World­wide, 844 mil­lion peo­ple do not have access to clean drink­ing water. [ii] This is not beau­ti­ful. It escapes lan­guage with its mul­ti­fac­eted, intan­gi­ble ugli­ness, a mul­ti-ten­ta­cled mon­ster made of greed, igno­rance, cor­rup­tion, and pas­sive selfishness. 

A more sly mon­ster creeps with­in the exist­ing dia­logue on clean water, a dia­logue often invoked, and per­haps right­ful­ly so, by pic­tures in places that do not look like home to peo­ple with pow­er. This mat­ters and should mat­ter. Inequity grows where it is plant­ed. But inequity also grows in insid­i­ous ways. It grows along­side pow­er, like the cir­cum­nu­ta­tion of stems pok­ing out of the smooth­ly cement­ed side­walk. At first, it looks like—perhaps—char­ac­ter. But per­haps these wily weeds are the arms of the monster. 

The way to cap­ture the mon­ster is by under­stand­ing its nature: it can­not help but seek to expand its dom­i­nance. In its growth, it becomes rec­og­niz­able. In the weeds, it becomes visible. 

Some­times we see what is in our mem­o­ry. But some­times what we see is not what we remem­ber. Some­times what we see is no longer there. Per­haps the side­walk was smooth for a long time, and we no longer ques­tion its con­sis­ten­cy. The thing is, the weeds might not look like much now. But after some time, the side­walk will crack. The ques­tion is: who will fall through? 

The Bergen, Brooklyn’s P.S. 001 School in Sun­set Park, serves a pop­u­la­tion that is 87 per­cent His­pan­ic with 44 per­cent of stu­dents iden­ti­fied as Eng­lish Lan­guage Learn­ers. Locat­ed in one of the poor­est neigh­bor­hoods in Brook­lyn, where almost 30 per­cent of the pop­u­la­tion lives below 100 per­cent of the city’s pover­ty thresh­old, 90 per­cent of Bergen stu­dents are esti­mat­ed to be liv­ing in pover­ty. The Bergen’s water sup­ply test­ed pos­i­tive for ele­vat­ed lev­els of lead, a sub­stance known for its neu­ro­log­i­cal impact. Even in utero, expo­sure to lead con­tributes to adverse child­hood health out­comes, includ­ing high blood pres­sure, a known indi­ca­tor of lat­er life dis­ease. The Bergen was rat­ed low impact and low per­for­mance by New York City’s School Per­for­mance Dashboard. 

One exam­ple with­in a mul­ti­plic­i­tous body of research on the rela­tion­ship between inequity and poor health out­comes is a study of urban minori­ties where­by expo­sure to envi­ron­men­tal tobac­co smoke dur­ing preg­nan­cy result­ed in a neg­a­tive impact on cog­ni­tive devel­op­ment at two years of age, an out­come exac­er­bat­ed by eco­nom­ic hard­ship. The Bergen is only one of the dozens of New York City schools in which over a quar­ter of sam­ples test­ed with ele­vat­ed lead lev­els, the major­i­ty locat­ed in the Bronx and Brook­lyn, home to the most impov­er­ished house­holds in the city. Even fol­low­ing a reme­di­a­tion plan to improve drink­ing water qual­i­ty, near­ly 400 New York City pub­lic schools were clas­si­fied as “not reme­di­at­ed.” This same city is home to the most bil­lion­aires in the world and almost one mil­lion mil­lion­aires. When does the cap­i­tal­ism that funds research on inequity become respon­si­ble for the inequity itself? 

The struc­ture of water is beau­ti­ful and sim­ple. Our infra­struc­ture for pro­vid­ing it with­out harm­ful chem­i­cals is not. 

The 2020 Fis­cal Year Bud­get [iii] requests $6.1 bil­lion for EPA, a $2.8 bil­lion decrease from the 2019 esti­mate. Yet, such fund­ing is crit­i­cal for the pre­ven­tion and man­age­ment of clean water, a fun­da­men­tal neces­si­ty to ensure safe water for every­one, regard­less of socioe­co­nom­ic sta­tus. Colum­bia Uni­ver­si­ty Mail­man School of Pub­lic Health researchers demon­strat­ed that arsenic lev­els in New York City drink­ing water were decreased in response to the Envi­ron­men­tal Pro­tec­tion Agency (EPA) 2006 reg­u­la­tions. The recent bud­get pro­pos­al cites, “Launch of the Era of Ener­gy Dom­i­nance through Strate­gic Sup­port for Ener­gy Tech­nol­o­gy,” which requests a $2.3 bil­lion for an ener­gy pro­gram, empha­siz­ing the impor­tance of cap­i­tal­iz­ing on “oil, gas, coal, nuclear, and renew­ables.” While ubiq­ui­tous envi­ron­men­tal chem­i­cals such as lead and arsenic tend to receive much atten­tion, it is impor­tant for all peo­ple to rec­og­nize the emerg­ing class­es of chem­i­cals with equal­ly, if not more seri­ous, adverse effects on human health. At present, there is no lim­it on lev­els of per- and poly­flu­o­roalkyl sub­stances (PFAS), com­mer­cial­ly pro­duced indus­tri­al chem­i­cals that per­sist on an envi­ron­men­tal and phys­i­o­log­ic lev­el. Expo­sure to PFAS can result in seri­ous adverse health con­se­quences. Giv­en the syn­ony­mous decrease in EPA fund­ing, this wor­ri­some pro­pos­al exac­er­bates the link between cli­mate change and clean water. 

What pur­pose do cur­rent EPA guide­lines serve? Or rather, whom? Cli­mate change becomes a socioe­co­nom­ic and socio-polit­i­cal real­i­ty at the inter­sec­tion of water qual­i­ty and health. The World Health Orga­ni­za­tion pre­dicts 250,000 deaths every year will be attrib­uted to cli­mate change, with caus­es includ­ing heat expo­sure, malar­ia, and child­hood malnutrition. 

A uni­ver­sal sol­vent, water’s chem­i­cal nature ampli­fies its reac­tiv­i­ty. Depend­ing upon the envi­ron­ment, water can both accept and pro­vide for oth­er mol­e­cules.  In crit­i­cal­ly exam­in­ing our social, polit­i­cal, and eco­nom­ic envi­ron­ments, we, too, can both accept help and pro­vide help: To oth­er peo­ple and oth­er com­mu­ni­ties, both close to and far from home. 

This all depends on three things: The trac­ing, the real­iz­ing, and the telling. 

[i] See Perl­man, Howard. “How Much Water Is There on Earth?” U.S. Geo­log­i­cal Sur­vey, 2 Decem­ber 2016,

[ii] See WHO and UNICEF Joint Mon­i­tor­ing Pro­gramme. Progress on Drink­ing Water, San­i­ta­tion and Hygiene: 2017 Update and SDG Base­lines. World Health Orga­ni­za­tion and the Unit­ed Nations Children’s Fund, 2017,

[iii] See Trump, Don­ald J. A Bud­get for a Bet­ter Amer­i­ca: Promis­es Kept. Tax­pay­ers First. Fis­cal Year 2020 Bud­get of the U.S. Gov­ern­ment. Gov­ern­ment Pub­lish­ing Office, 2019, pp. 37 and 93,


Works Con­sult­ed 

Basic Infor­ma­tion on PFAS: Per- and Poly­flu­o­roalkyl Sub­stances.” U.S. Envi­ron­men­tal Pro­tec­tion Agency, 6 Decem­ber 2018, Accessed 1 May 2020.

Long-Chain Per­flu­o­ri­nat­ed Chem­i­cals (PFCs) Action Plan.” U.S. Envi­ron­men­tal Pro­tec­tion Agency, 12 Decem­ber 2009,–01/documents/pfcs_action_plan1230_09.pdf. Accessed 1 May 2020.

Mueller, Robert and Vir­ginia Yin­gling. “Fact Sheet: His­to­ry and Use of Per- and Poly­flu­o­roalkyl Sub­stances (PFAS).” Agency for Tox­ic Sub­stances and Dis­ease Reg­istry, April 2020, https://pfas‑ Accessed 1 May 2020.

Olsen, Geary W., et al. “A Com­par­i­son of the Phar­ma­co­ki­net­ics of Per­flu­o­robu­tane­sul­fonate (PFBS) in Rats, Mon­keys, and Humans.” Tox­i­col­o­gy, vol. 256, 2009, pp. 65–74.

Olsen, Geary W., et al. “Half-Life of Serum Elim­i­na­tion of Per­flu­o­rooc­tane­sul­fonate, Per­flu­o­ro­hexa­ne­sul­fonate, and Per­flu­o­rooc­tanoate in Retired Flu­o­ro­chem­i­cal Pro­duc­tion Work­ers.” Envi­ron­men­tal Health per­spec­tives, vol. 115, no. 9, Sep­tem­ber 2007, pp. 1298–1305, Accessed 1 May 2020.

Overview: Per- and Poly­flu­o­roalkyl Sub­stances (PFAS) and Your Health.” Agency for Tox­ic Sub­stances and Dis­ease Reg­istry, Accessed 1 May 2020.

Perl­man, Howard. “How Much Water Is There on Earth?” U.S. Geo­log­i­cal Sur­vey, 2 Decem­ber 2016, Accessed 1 May 2020.

Trump, Don­ald J. A Bud­get for a Bet­ter Amer­i­ca: Promis­es Kept. Tax­pay­ers First. Fis­cal Year 2020 Bud­get of the U.S. Gov­ern­ment. Gov­ern­ment Pub­lish­ing Office, 2019, pp. 37 and 93, Accessed 1 May 2020.

Wang, Zhanyun, et al. “A Nev­er-End­ing Sto­ry of Per- and Poly­flu­o­roalkyl Sub­stances (PFASs)?” Envi­ron­men­tal Sci­ence & Tech­nol­o­gy, vol. 51, no. 5, 22 Feb­ru­ary 2017, pp. 2508–2518, Accessed 1 May 2020.

WHO and UNICEF Joint Mon­i­tor­ing Pro­gramme. Progress on Drink­ing Water, San­i­ta­tion and Hygiene: 2017 Update and SDG Base­lines. World Health Orga­ni­za­tion and the Unit­ed Nations Children’s Fund, 2017, Accessed 1 May 2020. 



From the writer


:: Account ::

Through a per­spec­tive that inter­weaves epi­demi­ol­o­gy with dai­ly life, “The Struc­ture of Water” is a styl­is­ti­cal­ly cre­ative piece that pro­vides sci­en­tif­ic facts with a poet­ic twist. Using pub­licly avail­able data, a sim­ple analy­sis of New York City Pub­lic Schools’ per­for­mance reviews and lead test­ing reports was per­formed. The schools locat­ed in the poor­est areas also tend­ed to have the high­est lev­els of lead, and notably, sev­er­al of these schools were flagged for low per­for­mance. This exam­ple is used to exem­pli­fy the inequities both reflect­ed in and per­pet­u­at­ed by access to clean water. With the inten­tion to inspire the read­er to reflect, this piece sit­u­ates the glob­al clean water cri­sis as a mir­ror for sys­temic inequity. I write as both a stu­dent in the Colum­bia Uni­ver­si­ty Nar­ra­tive Med­i­cine pro­gram and as an employ­ee of the Colum­bia Uni­ver­si­ty Mail­man School of Pub­lic Health in the Depart­ment of Envi­ron­men­tal Health Sci­ences, one of the largest such depart­ments nation­wide and among the top research and aca­d­e­m­ic cen­ters for envi­ron­men­tal health sci­ences globally.

Julia Knox, MPH, is a researcher at the Colum­bia Mail­man School of Pub­lic Health, an M.S. Can­di­date in Nar­ra­tive Med­i­cine in the Colum­bia Depart­ment of Med­ical Human­i­ties and Ethics, and Fel­low at the Pre­ci­sion Med­i­cine Ethics, Pol­i­tics, Cul­ture Project at Columbi­a’s Cen­ter for Social Dif­fer­ence. She is inter­est­ed in the meth­ods by which data takes nar­ra­tive form in our soci­ety. The focus of her research includes expo­sure to envi­ron­men­tal mix­tures, mater­nal/­pa­ter­nal-child health, and trans­gen­er­a­tional epi­ge­net­ics. An Ameri­Corps alum­na who earned her Master’s of Pub­lic Health in 2016, she is ded­i­cat­ed to men­tor­ship and sus­tain­able com­mu­ni­ty invest­ments. She is pas­sion­ate about mak­ing space in aca­d­e­m­ic sci­ence for peo­ple with dis­ad­van­taged back­grounds, and hopes that this will reflect in a more com­pre­hen­sive set of research inter­ests in genomics, and even­tu­al­ly, in a bet­ter world.