Nocturnal convenience: the problem of securing universal sanitation access in Alabama's black belt

On-site sanitation (OSS) is not universal in the rural United States: access to and function of available options are limited by geological, economic, regulatory, and policy constraints. In Alabama's rural Black Belt region, widespread impermeability of soils and a lack of locally accepted, cost-effective technical solutions contribute to limited access to functional OSS. Despite the existence of federal and state financial assistance programs intended to increase access to sanitation, potential beneficiaries may not be able to readily access assistance. Based on structured interviews with local stakeholders, this article provides an overview of the problem and perceived barriers to securing universal sanitation. Promising options that may increase OSS access include technical innovation, improving sanitation literacy, increasing the accessibility of financial assistance programs, and policy initiatives that proactively engage with underserved communities. These and other measures should be explored to create an enabling environment for the provision of universal sanitation coverage in the Black Belt.