While public health is most often considered a responsibility of the government, the significant impacts of wastewater pollution require that we call it out separately from other government roles in order to highlight the importance and unique role of those working in the public health sector. The public health domain includes ensuring adequate public health infrastructure (including public and nonpublic water supplies), promoting healthy communities and behavior, preventing the spread of communicable disease, protecting against environmental health hazards, and preparing for and responding to emergencies. Given all of this, the impacts of wastewater pollution in coastal and other receiving waters are of prime concern to those working in the public health sector. Polluted water is associated with a range of health concerns beyond diarrheal disease, including cancer linked to nitrate exposure in drinking water, liver disease associated with contaminated seafood, neurological illnesses caused by toxic harmful algal blooms, and violence against women and girls who do not have access to safe sanitation. Many of the solutions to the problems we face both in environmental and human health will come either directly from or in collaboration with those responsible for public health in a community. The public health sector is an absolutely critical partner in any effort to address the challenges of wastewater pollution in coastal areas.