The following three studies found that a lack of in-home piped water service is associated with higher incidence of respiratory tract and skin infections among rural Alaska Natives.

• The Relationship Between In-Home Water Service and the Risk of Respiratory Tract, Skin, and Gastrointestinal Tract Infections Among Rural Alaska NativesThe 2008 study by Hennessy and colleagues found substantially higher rates of acute respiratory infections and skin infections (ARIs) among those without access to piped services.
• Lack of Piped Water and Sewage Services is Associated with Pediatric Lower Respiratory Tract Infections in Alaska The 2008 study by Gessner also linked the lack of access to piped water and sanitation with higher rates of ARIs. ARIs are the most common cause of child death worldwide and perhaps the greatest health challenge for rural Alaskans.
• Invasive Pneumococcal Disease in Alaskan Children A 2010 study by Wenger and colleagues that found higher rates of invasive pneumococcal disease (IPD) among Alaskan children who did not have access to piped water. Invasive pneumococcal disease is a class of diseases that includes very serious infections of the brain, blood and lungs. Residents of Southwest Alaska suffer rates of invasive pneumococcal disease (IPD) that are among the highest in the world.

These three studies were performed by different researchers using different analytical methods but still arrived at the same conclusion – access to modern water and sanitation services is necessary to prevent epidemics of infectious disease in Alaska.