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Emerging literature notes that 10s of millions lack access to consistent quality water and sanitation. Further, according to new modelling, the effects of climate change may well jeopardize water security in marginalized communities across the United States. Water and sanitation insecurity in US communities has been shown to exacerbate chronic poverty, social precarity, distress, physical and mental illness, which illuminates the depth of this wicked problem. This presentation explores not only the negative impacts of lack of water and sanitation security, but also community action to improve conditions. Following an overview of the statistics about US water and sanitation insecurity, we use analysis of interviews from case studies in three rural US communities (35 in total from case studies in New Mexico, Ohio, and Texas) to better understand not only the impacts of water and sanitation insecurity, but also how assets were mobilized in each case to address water and sanitation infrastructure shortcomings, including the process of problem recognition, options for improving the situation, and decision to pursue resources to address the problem. Our findings indicate the extent to which water and sanitation infrastructure must be approached as intricately connected to broader community development politics and processes. Water insecurity in marginalized communities results from political marginalization, Improving material conditions involves contested engagement of community assets.