In light of 2014–2016 media coverage about the inadequate water and sanitation services for households in places like Flint and Detroit, Michigan and the Central Valley of California, this paper asks whether places with majority non-White residents in the United States disproportionately lack access to these most basic of services. Investigating this issue through the combined lenses of structural racism, environmental justice, and the human right to water and sanitation, we analyze U.S. Census American Community Survey household data at the county level. Our findings indicate strong White versus non-White racial effects at the national and county levels (R2 = 0.0462, P < 0.05). When the non-White population is broken down into racial categories, places with higher percentages of American Indians and Alaska Native households are significantly associated with lack of access to complete plumbing facilities. Lacking access to complete plumbing does correlate with lower educational attainment and higher percentages of unemployment, and less robustly, it also correlates positively with median household income. The implication is the existence of a pattern of structural environmental racism in terms of the practical accessibility of water and sanitation infrastructure. We suspect, however, that the U.S. Census, while considered the most comprehensive national data source on this issue right now, significantly undercounts those lacking access to water and sanitation services. We argue that better data will be essential in order to carry out a more in-depth analysis of water access conditions and to develop strategies that address this issue of growing importance.