Cross-sectional study to measure household water insecurity and its health outcomes in urban Mexico

Abstract

ObjectiveTo assess the links between structural and household determinants of household water insecurity and test three water insecurity measures against self-reported diarrhoea, dengue fever and perceived stress in the middle-income and low-income urban areas of Torreón, Mexico.DesignCross-sectional household survey conducted in two waves (rainy and dry seasons).Participants500 households selected via multistage cluster sample in selected communities. Socioeconomic status determined the selection of participant neighbourhoods; five were identified in low socioeconomic status neighbourhoods and five in low-medium socioeconomic status neighbourhoods. We examine how the context of urban water provision is related to a new cross-culturally valid Household Water Insecurity Experiences (HWISE) Scale.Primary outcome measuresThe HWISE Scale, self-reported diarrhoea, dengue fever and the Perceived Stress Scale.ResultsWater system intermittency (adjusted OR (AOR) 3.96, 95% CI 2.40 to 6.54, p<0.001), unpredictability (AOR 2.24, 95% CI 1.34 to 3.74, p=0.002) and the dry season (AOR 3.47, 95% CI 2.18 to 5.52, p<0.001) were structural correlates of the HWISE Scale. This study also found that the HWISE Scale was associated with two health outcomes, self-reported diarrhoea (AOR 1.09, 95% CI 1.03 to 1.15, p=0.002) and perceived stress (β=0.28, SE=0.07, t=4.30, p<0.001), but not self-reported dengue fever (AOR 1.02, 95% CI 0.98 to 1.06). A 3-item hygiene subscore and a 3-item water worry subscore were also both positively associated with self-reported diarrhoea and perceived stress.ConclusionShort-form screeners of water insecurity may be useful for assessing certain health risks by lay survey workers in settings with limited healthcare resources, particularly in lieu of more expensive microbiological tests that require specialised training and facilities.

The Household Water Insecurity Experiences (HWISE) Scale: comparison scores from 27 sites in 22 countries

“…Several HWISE-RCN-affiliated studies have focused on how these new metrics are associated with water governance (Miller et al 2020), water sharing (Rosinger et al 2020), financial expenditures on water , injuries (Venkataramanan et al 2020), and self-reported health (Jepson et al 2021). Research on the measurement of water insecurity, however, has not fully considered how the HWISE scale varies within and across sites.…”

Water insecurity, self‐reported physical health, and objective measures of biological health in the Peruvian Amazon

“…Existing studies, primarily conducted by biocultural anthropologists, indicate that water insecurity is associated with elevated blood pressure (Brewis et al, 2019), dehydration (Rosinger, 2018), diarrhea (Jepson et al, 2021; Rosinger, 2018), physical trauma/injuries (Geere et al, 2018; Rosinger et al, 2021), mental health (reviewed in Wutich et al, 2020), and gender‐based violence (reviewed in Tallman et al, in press).…”

Explaining Neighbourhood Variations in the Incidence of Dengue Fever in Jeddah City, Saudi Arabia

“…With respect to the physical environment, a common theme has been water insecurity. The shortage of water and unpredictability of supply in many areas, both urban and rural [3], deems it essential for inhabitants to keep water in large containers which, under the right temperature conditions, provide a suitable habitat for mosquitoes to breed [4,5]. For instance, found in Mexico and Nicaragua that, while the presence of a regular water 2 of 15 supply was a protective factor against dengue, even people with a regular supply still stored water [6].…”