At least 2 million Americans don’t have running water or a working toilet at home, a crisis that costs the U.S. economy $8.58 billion each year, according to a report by California-based nonprofit DigDeep.

These water access issues disproportionately impact Indigenous tribes, people of color, immigrants, low-income people and those living in rural areas.

The study found households without water and sanitation access spend an average of $15,800 a year more than other households in healthcare costs, lost productivity at work and at school and other issues.

Purchasing bottled drinking water costs a family an average of $1,350 a year.