University of NSW experts and medical researchers from the George Institute for Global Health warned that the content of Walgett's water supply is 15 times higher in sodium than medical practitioners recommend for long-term consumption by people with severe hypertension or renal and heart issues.
Walgett Aboriginal Medical Service chief executive Christine Corby said blood pressure, heart disease, kidney disease and diabetes were common health issues in the region.
"Unfortunately in our community there is a high incidence of chronic disease," she said.
"I believe this is going to worsen given the very real risks we know are associated with high sodium intake.
"I worry about people who have no choice but to drink straight from the tap and I worry about how many people are not having enough nutritious food to eat and how this will impact on their long-term health."
In their report, the research team found that the combination of climate change and systematic water mismanagement across the Murray-Darling Basin has threatened both the quality and quantity of Walgett's surface waters.
"While drought impacts overall flow, upstream industry threatens river quality and quantity through over-extraction and pollution," the report says.
"When the rivers run dry or are unsafe, the town switches its supply to bore water from the Great Artesian Basin, which has high sodium levels."
A survey conducted by the research team, in partnership with Walgett Aboriginal Medical Service and the Dharriwaa Elders Group, found that more than half of the respondents adjusted what they ate so they could buy bottled water, with some people paying up to $50 a week to avoid using water from the tap.
Dharriwaa Elders Group secretary Virginia Robinson called for a multi-agency taskforce to improve Walgett's water quality and security.
"These threats to our public health would not be tolerated in Sydney so why is it acceptable that we have to live with them in Walgett?" she said.
Keziah Bennett-Brook, head of Guunu-maana (Heal) Aboriginal & Torres Strait Islander Health at the George Institute, said water and food insecurity in Walgett was at unacceptable levels.
"The findings from the community survey paint a clear picture of why we need to work in partnership with Aboriginal community members and organisations to bring together local knowledge and leadership with best evidence around what is needed to address the unacceptable levels of food and water insecurity being experienced in Walgett," she said.
Ms Corby said governments needed to work in partnership with Aboriginal organisations to help Walgett.
"We are doing all we can to address the social determinants of health in our community, but we also need governments to do their bit to improve these shocking levels of water and food insecurity and support our local efforts," she said.
Comment has been sought from the NSW Department of Primary Industry and Environment.
Survey of 250 people in the Walgett region:
* 83 per cent relied on bottled water in at least one month in the past 12 months
* 90 per cent said they were concerned by the quality, smell, contamination of water
* 42 per cent reported no usable or drinkable water whatsoever in at least one month
* 36 per cent reported going to sleep thirsty in at least one month
* 67 per cent worried about not having enough water
* 54 per cent changed what they ate due to not having enough water
