Many rivers and lakes are in good health, but declines elsewhere are limiting progress.
Water quality remains unsatisfactory in many areas, with little overall improvement recorded last year, according to the Environmental Protection Agency.
It says the Midlands region recorded excess nitrogen and phosphorus from agriculture and wastewater which continues to damage rivers and lakes.
More than half of monitored rivers and lakes are in good condition, but progress is being offset by declines elsewhere.
Jenny Deacon, water program manager of the EPA wants faster action to reduce pollution and restore water quality.
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