A Systematic Literature Review on Water Insecurity from an Oregon Public Health Perspective

Abstract

This paper systematically reviews existing United States-based water insecurity literature with the goal of understanding the evidence base for developing public health water insecurity intervention strategies in Oregon. The authors conducted the systematic literature review using an adjusted PRISMA reporting checklist to document the review process. Results find 11 public health-related water insecurity interventions including surveillance practices and indicator and policy development. Research on water insecurity health impacts and solutions is still an emerging field. Nevertheless, state agencies perceive a risk to communities from inadequate safe water and are taking steps to assess and reduce these risks. From the review, strategies include improving water affordability, carrying out community education events, documenting drought risk and water loss, and tracking improvements in safe drinking water compliance. The review finds opportunities to take varied approaches that are community-specific, partnership-based and culturally relevant. Recommendations for Oregon include characterizing communities experiencing water insecurity, assessing community needs, tracking regional water scarcity and recognizing the human right to water in Oregon.

Our Relationship to Water and Experience of Water Insecurity among Apsáalooke (Crow Indian) People, Montana

“…Affordable access to safe drinking water is essential to community health [ 1 , 2 , 3 ], yet research to understand water insecurity and effective interventions in the United States (US) is still an emerging field [ 4 ]. Multiple definitions of “water insecurity” exist, ranging from the utilitarian, “inadequate or inequitable access to clean, safe and affordable water for drinking, cooking, and sanitation and hygiene” [ 4 ] to broader, but still material definitions that encompass human and ecosystem health, sustainability, productive capacity, and more. This material approach to defining water security is exemplified by the United Nation’s Sustainable Development Goal #6 (UN SDG 6): “Ensure access to water and sanitation for all” [ 5 ].…”

“…A current, systematic literature review of water insecurity in the US finds that a variety of community-engaged, culturally relevant policy and intervention strategies are being piloted, from implementing health education and improving affordability of public water service to mapping water scarcity and safe drinking water violations [ 4 ]. These authors recommend four key strategies as a basis for reducing water insecurity disparities: (a) Assessment of communities impacted by water scarcity, (b) identification of water scarce regions, (c) recognition of the human right to water, and (d) the elucidation of how communities experience water insecurity [ 4 ].…”

“…A current, systematic literature review of water insecurity in the US finds that a variety of community-engaged, culturally relevant policy and intervention strategies are being piloted, from implementing health education and improving affordability of public water service to mapping water scarcity and safe drinking water violations [ 4 ]. These authors recommend four key strategies as a basis for reducing water insecurity disparities: (a) Assessment of communities impacted by water scarcity, (b) identification of water scarce regions, (c) recognition of the human right to water, and (d) the elucidation of how communities experience water insecurity [ 4 ]. To address this last recommendation, these authors suggest that household level needs and experiences of water insecurity be assessed to “understand the impacts water insecurity has on daily life, health perceptions, and psychosocial well-being,” and to provide qualitative data complementary to more commonly used quantitative measures [ 4 ].…”

“…These authors recommend four key strategies as a basis for reducing water insecurity disparities: (a) Assessment of communities impacted by water scarcity, (b) identification of water scarce regions, (c) recognition of the human right to water, and (d) the elucidation of how communities experience water insecurity [ 4 ]. To address this last recommendation, these authors suggest that household level needs and experiences of water insecurity be assessed to “understand the impacts water insecurity has on daily life, health perceptions, and psychosocial well-being,” and to provide qualitative data complementary to more commonly used quantitative measures [ 4 ].…”

“…Our research to identify and quantify contaminant levels and assess cumulative health risks has been tremendously helpful in community education and mitigation efforts. However, while we have quantitatively “assess[ed] […] communities impacted by water scarcity” (as recommended by [ 4 ]), we realized the impacts of water insecurity on community health and wellbeing were far broader than our quantitative methods captured. For our people, the changes in and deterioration and contamination of local ecosystems, including traditional water sources, are impacting not only our physical health, but also Tribal emotional and spiritual health, as environmental, tribal, and individual wellbeing are entirely interrelated [ 32 , 39 , 40 , 41 ].…”