More Like this

1. Exploring energy insecurity and health impacts among low-income households in Pennsylvania

   https://doi.org/10.1007/s10669-026-10091-0  

   Mirhosseini, Homeira; Obonyo, Esther; Beck, Olivia; Gomez-Fonseca, Diana; Mbih, Richard (June 2026, Environment Systems and Decisions)

   Abstract This study presents exploratory evidence on energy insecurity, heating and cooling hardships, and related self-reported health impacts among low-income household respondents in Pennsylvania. It responds to community members’ interest in work that concurrently explores resilience to extreme weather events from both an engineering and a non-engineering lens. Insights gathered through the community engagement studio and focus group discussions identified energy insecurity as a viable entry point for examining resilience through a systems-thinking lens. We collected and analyzed survey responses from 1,006 participants living in Pennsylvania and benchmarked key indicators against the U.S. Energy Information Administration’s Residential Energy Consumption Survey (RECS) statewide estimates. Our findings indicate that energy insecurity is a key aspect of resilience to extreme weather events that requires an exploration of a broader set of interacting constraints, including poor building envelope performance, aging or inefficient systems, deferred maintenance, limited repair pathways, and barriers to accessing support. Reducing vulnerability, therefore, requires coordinated action across these multiple factors rather than a single intervention alone. These results point to the need for resilience strategies developed across disciplines and sectors that concurrently address household conditions and program access. Our findings have identified health challenges that can help strengthen the case for pre-disaster investments in partnership with the health sector. We have also generated additional qualitative data through semi-structured interviews of 20 professionals who work closely with low-income communities in areas such as housing, energy access, public health, and community services. The results are currently being validated and will be included in a subsequent publication. 

   more » « less
2. Health impacts of water and sanitation insecurity in the Global North: a scoping literature review for U.S. colonias on the Mexico border

   https://doi.org/10.2166/wh.2022.085  

   Zheng, Madeleine; Wutich, Amber; Brewis, Alexandra; Kavouras, Stavros (September 2022, Journal of Water and Health)

   Abstract U.S. border colonias are peri-urban settlements along the U.S.–Mexico border. Residents often face substandard housing, inadequate septic and sewer systems, and unsafe or inadequate household water. As of 2015, an estimated 30% of over 5 million U.S. colonia residents lacked access to clean drinking water, suggesting health complications. This scoping review identifies a very limited existing set of research on water and sanitation insecurity in U.S.–Mexico border colonias, and suggests value in additional focused research in this specific context to address health challenges. Preliminary health data indicates that due to water insecurity, colonia residents are more likely to contract gastrointestinal diseases, be exposed to carcinogenic compounds from contaminated water, and experience psychosocial distress. These widespread health issues in colonias are exacerbated by historical and ongoing socioenvironmental injustices in the U.S.–Mexico border region and their relation to the poor health outcomes. 

   more » « less
3. Household Water and Food Insecurity Are Positively Associated with Poor Mental and Physical Health among Adults Living with HIV in Western Kenya

   https://doi.org/10.1093/jn/nxab030  

   Miller, Joshua D; Frongillo, Edward A; Weke, Elly; Burger, Rachel; Wekesa, Pauline; Sheira, Lila A; Mocello, A Rain; Bukusi, Elizabeth A; Otieno, Phelgona; Cohen, Craig R; et al (March 2021, The Journal of Nutrition)

   null (Ed.)

   ABSTRACT Background Household food insecurity (FI) and water insecurity (WI) are prevalent public health issues that can co-occur. Few studies have concurrently assessed their associations with health outcomes, particularly among people living with HIV. Objectives We aimed to investigate the associations between FI and WI and how they relate to physical and mental health. Methods Food-insecure adult smallholder farmers living with HIV in western Kenya were recruited to participate in a cluster-randomized controlled trial of a multisectoral agricultural and asset loan intervention. We used baseline data on experiences of FI (using the Household Food Insecurity Access Scale, range: 0–27) and WI (using a modified scale developed for this region, range: 0–51) in the prior month (n = 716). Outcomes included probable depression (using the Hopkins Symptom Checklist), fatigue and diarrhea in the prior month, and overall mental and physical health (using the Medical Outcomes Study HIV Health Survey, range: 0–100). We first assessed Pearson correlations between FI, WI, and sociodemographic characteristics. We then developed 3 regressions for each health outcome (control variables and FI; control variables and WI; control variables, FI, and WI) and compared model fit indexes. Results Correlations between household FI, WI, and wealth were low, meaning they measure distinct constructs. FI and WI were associated with numerous physical and mental health outcomes; accounting for both resource insecurities typically provided the best model fit. For instance, when controlling for FI, each 10-point higher WI score was associated with a 6.42-point lower physical health score (P < 0.001) and 2.92 times greater odds of probable depression (P < 0.001). Conclusions Assessing both FI and WI is important for correctly estimating their relation with health outcomes. Interventions that address food- and water-related issues among persons living with HIV concurrently will likely be more effective at improving health than those addressing a single resource insecurity. This trial was registered at clinicaltrials.gov as NCT02815579. 

   more » « less
4. Exploring rural food insecurity in North Carolina: Debunking an urban myth

   Mulrooney, T.; Mulrooney, E.; McGinn, C. (April 2022, Sociation today)

   The United States Department of Agriculture (USDA) has utilized the term food desert to highlight regions within low-income communities located far from fresh and healthy sources of food such as supermarkets and farmers markets. Most research on food deserts has revolved around urban areas, which bring about other considerations such as sidewalks, pedestrian access, rideshares, and public transportation, typically not viable options in rural regions. Rural food insecurity is also a problem in North Carolina. Utilizing data provided by the United States Department of Agriculture’s Food Access Atlas, this paper explored if and to what extent rural food insecurity exists, with findings showing 1) a higher percentage of people living in rural areas live in food insecurity compared to non-rural areas 2) counties in the eastern part of the state are more prone to food insecurity and 3) racial, ethnic minorities, as well as the young (age under 17), are more subjected to food insecurity compared to the majority and older cohorts. This research highlights the need for a rigorous and comprehensive understanding of rural food security that transcends the economic, cultural, and sociological reasons of differential food access with long-term health outcomes that have multi-generational consequences. 

   more » « less
5. Water, economic systems, and mental health: A review of theorized relationships

   https://doi.org/10.1079/cabireviews202217042  

   Choudhary, Neetu; Brewis, Alexandra; Beresford, Melissa; Workman, Cassandra; Wutich, Amber (October 2022, CABI Reviews)

   Abstract Water insecurity—the lack of access to sufficient, safe water to meet all household needs—is an escalating challenge in all world regions. It is also associated with unfavorable mental health outcomes, like anxiety and depression. Often situated in the context of drought or general water scarcity, connections between water and mental health often manifest out of the unique characteristics of water—as an important economic and household resource, and one managed primarily by women. This article identifies recognized and theorized pathways between water insecurity and common mental health conditions, as mediated by broader socioeconomic systems in which households are embedded. To this end, we synthesize and connect different literature sets, including limited economic studies in a resource insecurity framework and a small but authoritative body of ethnographic literature. Our review identifies multiple proximate candidate pathways connecting water insecurity with mental health outcomes including community conflicts and/or perceived injustice around water sharing and upkeep, agricultural decline and unemployment, food insecurity or distress migration, decreased water intake, non-exposure to blue spaces, and stress around water management. The gendered role of water management is an overlapping theme across pathways, exposing women disproportionately to forms of conflict, violence, and injustice associated with the risk of common mental illness. In general, there are varied forms of marginalization that people experience within water-insecure contexts. Greater engagement between economics and other disciplines can lend additional theoretical pathways to empirically test the water and mental health connections, associated with people’s water insecurity experiences. 

   more » « less