Access to clean, affordable water is a human right that goes unrealized in many communities. It is also a social determinant of health that when unrealized, compounds environmental and economic disadvantage to weaken immunity and exacerbate health conditions. Prevention Institute’s efforts to improve water resilience and security focus on community participation in water system decisions, linking infrastructure benefits to health and environmental disparities, climate change adaptation and local water self-reliance. Our approach to water equity connects a range of environmental and social issues whose challenges and solutions are interwoven, from drinking water quality and stormwater management to urban greening and fiscal equity. It also recognizes the full spectrum of disparate environmental conditions that negatively impact the health of low-income communities of color—including air, soil and water pollution and disparities in natural and recreational amenities—and considers how system-level solutions may address or compound inequities.