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Under pressure from climate change and other drivers, the risks of water-related infectious and chronic diseases seem poised to increase. Addressing these risks requires shared work in the fields of public health and water resources management. To help in risk assessment, the paper presents a comprehensive conceptual model of water-related health effects and the potential barriers that can be established by water management actions. The model does not indicate unique solution strategies because multiple water management factors cause multiple types of water-related diseases. It uses the water-health nexus to conceptualize the pathways to diseases and help clarify health-related responsibilities for water management and public health officials. Experiences of the U.S. are presented as an exemplar of the links between water management and disease incidence. However, parts of the water management system are not regulated effectively and many countries lack organized utilities and effective water governance.