Households with septic systems are more economically advantaged than households on public sewers. Septic users have higher median household income, higher educational attainment, and greater food security. Wastewater surveillance in rural areas likely oversamples economically disadvantaged populations. This is a desirable feature because economic stability is an important social determinant of health and because economically disadvantaged populations may be underrepresented in public health surveillance systems that rely on interactions with healthcare People living in homes that use septic systems can still contribute to public wastewater when they use restrooms in public buildings, like workplaces, schools, restaurants, libraries, and shopping malls. Septic systems need not be a barrier to wastewater surveillance programs nationwide.