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Kim Knowlton, MS

Correspondence: Requests for reprints should be sent to Kim Knowlton, MS, Mailman School of Public Health, Division of Environmental Health Sciences, 60 Haven Ave, B-1, New York, NY 10032 (e-mail: kmk47{at}columbia.edu).

Over the course of the 20th century, the United States became an urban nation: 80% of Americans now live in metropolitan areas. Supplying basic sanitary services—drinking water, sewers, and garbage removal—to these cities is a gargantuan task, yet most people have little understanding of urban infrastructure systems and their enormous regional ecologic impacts.

Municipalization of sanitary services, especially since 1880, distanced people from their wastes and gave city dwellers a simplistic experience of one-way material flow through cities, without knowledge of the environmental costs. Most sanitary infrastructures were built primarily for durability and lack the elasticity to meet changing needs. The challenge now is to adapt sanitary systems for flexibility and simultaneously move from unchecked material consumption toward resource-based thinking.

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