skip to main content
US FlagAn official website of the United States government
dot gov icon
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
https lock icon
Secure .gov websites use HTTPS
A lock ( lock ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

Explore Research Products in the PAR
It may take a few hours for recently added research products to appear in PAR search results.


  • NSF Public Access
  • Search Results
  • Household water insecurity experiences and their perceived determinants in a low-income community of Cartagena, Colombia, during a water service expansion project
Title: Household water insecurity experiences and their perceived determinants in a low-income community of Cartagena, Colombia, during a water service expansion project
Traditional water indicators primarily focus on water quantity and quality, but emergent research demonstrates that measurement of lived experiences with water availability, accessibility, and use is important for understanding how household water insecurity impacts health and well-being. Few empirical studies have explored which household water insecurity experiences are most salient, or their potential causes, in Latin American cities. We analyzed data from 266 households in a low-income settlement of Cartagena, Colombia, to identify correlates and perceived determinants of water insecurity. The most prevalent household water insecurity experiences were water supply interruptions (96%), water worry (94%), and anger about the water situation (90%). Unexpected water interruptions and use of non-piped primary drinking water sources were associated with greater household water insecurity scores, water worry subscores, and hygiene subscores. Respondents perceived water issues in their community to be caused by deficiencies in gray infrastructure (49%), which included deficiencies in water distribution, treatment, or storage technologies. Social infrastructure (36%), including issues with political, economic, or administrative systems, was also cited as a barrier to water security. We did not detect significant relationships between water insecurity scores and the attribution of these problems to gray or social infrastructure, but there may be relationships between these factors and duration of residency and using a non-piped water source. These findings underscore the importance of socio-political factors and community engagement for improving urban water insecurity through slum-upgrade projects.  more » « less
Award ID(s):
1759972
PAR ID:
10552188
Author(s) / Creator(s):
; ;
Editor(s):
Rivera-Salazar, Diego
Publisher / Repository:
PLOS
Date Published:
Journal Name:
PLOS Water
Volume:
2
Issue:
9
ISSN:
2767-3219
Page Range / eLocation ID:
e0000154
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. ; ; ; (, Journal of Water, Sanitation and Hygiene for Development)
    Abstract Improving water governance is a top priority for addressing the global water crisis. Yet, there is a dearth of empirical data examining whether better water governance is associated with lower water insecurity and improved well-being. We, therefore, pooled household data from two Sustainable Water Effectiveness Reviews conducted by Oxfam GB in Zambia (n = 997) and the Democratic Republic of Congo (DRC, n = 1,071) to assess the relationship between perceived water governance (using a 12-item indicator), water insecurity [using the Household Water Insecurity Experiences (HWISE) Scale], and four indicators of well-being: life satisfaction, drinking unsafe water, diarrhea, and resilience to cholera outbreak. Using generalized structural equation models controlling for wealth and primary water source, each point increase in water governance score was associated with a 0.69-point decrease in HWISE Scale scores. Good water governance was also directly associated with greater odds of life satisfaction (aOR 1.24) and lower odds of both drinking unsafe water (aOR 0.91) and severe cholera impact (aOR 0.92). Furthermore, the relationships between water governance and drinking unsafe water, diarrhea, and cholera impact were mediated by household water insecurity. Improving water governance has the potential to meaningfully impact entrenched public health issues through changes in water insecurity. 
    more » « less
  2. ; ; ; ; ; ; ; ; ; ; et al (, WIREs Water)
    Abstract We extend the conceptualization of the social and health burdens of household water insecurity on children beyond the traditional narrow lens of microbiological pathogens and diarrhea. The global burden of disease associated with water insecurity has traditionally focused on diarrheal disease as the most significant driver of infant and child mortality. However, there are many other pathways through which children experience adverse health and social consequences from inadequate or unsafe household water. We synthesize evidence of a broad range of health impacts, affecting children from infancy to late adolescence, across four domains: exposure to unsafe water; interruptions to growth and development through poor nutrition and hydration; negative social effects such as school absenteeism and interpersonal violence; and other non‐communicable health issues such as mental health, injuries, and reproductive health. The growing burden and urgency of these issues is implicated by forecasted increases in climate‐ and conflict‐induced water scarcity, human displacement, and environmental contamination in the decades ahead. This article is categorized under:Engineering Water > Water, Health, and SanitationHuman Water > Rights to Water 
    more » « less
  3. ; ; ; ; ; (, BMJ Open)
    null (Ed.)
    Objective To 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. Design Cross-sectional household survey conducted in two waves (rainy and dry seasons). Participants 500 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 measures The HWISE Scale, self-reported diarrhoea, dengue fever and the Perceived Stress Scale. Results Water 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. Conclusion Short-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. 
    more » « less
  4. ; ; ; ; ; ; ; ; ; (, BMJ Global Health)
    Objective Progress towards equitable and sufficient water has primarily been measured by population-level data on water availability. However, higher-resolution measures of water accessibility, adequacy, reliability and safety (ie, water insecurity) are needed to understand how problems with water impact health and well-being. Therefore, we developed the Household Water InSecurity Experiences (HWISE) Scale to measure household water insecurity in an equivalent way across disparate cultural and ecological settings. Methods Cross-sectional surveys were implemented in 8127 households across 28 sites in 23 low-income and middle-income countries. Data collected included 34 items on water insecurity in the prior month; socio-demographics; water acquisition, use and storage; household food insecurity and perceived stress. We retained water insecurity items that were salient and applicable across all sites. We used classical test and item response theories to assess dimensionality, reliability and equivalence. Construct validity was assessed for both individual and pooled sites using random coefficient models. Findings Twelve items about experiences of household water insecurity were retained. Items showed unidimensionality in factor analyses and were reliable (Cronbach’s alpha 0.84 to 0.93). The average non-invariance rate was 0.03% (threshold <25%), indicating equivalence of measurement and meaning across sites. Predictive, convergent and discriminant validity were also established. Conclusions The HWISE Scale measures universal experiences of household water insecurity across low-income and middle-income countries. Its development ushers in the ability to quantify the prevalence, causes and consequences of household water insecurity, and can contribute an evidence base for clinical, public health and policy recommendations regarding water. 
    more » « less
  5. ; (, WIREs Water)
    Abstract Water is imperative for nutrition and health, economic productivity, and political stability; it also holds cultural and symbolic meanings and functions. Household water insecurity is an emerging construct that captures lived experiences with water access, use, and acceptability. Although the plausibility of household water insecurity to “get under the skin” and shape human biology is high, these relationships have not been systematically investigated. Therefore, in this article, we set out to examine how household water insecurity and allied concepts affect health and human biology throughout the life course. We first lay out the various ways that water insecurity can act as a deleterious exposure, that is, through problematic quality, excess, and shortage. Next, we posit how water insecurity directly shapes human biology, as well as indirectly, via psychosocial stress precipitating cortisol exposure, with potential intergenerational effects. We highlight a range of established and plausible biological consequences using evidence from human and animal model studies. These include diarrheal prevalence, dehydration, stunting, food insecurity, gut microbiome alteration, malnutrition, psychosocial stress, adverse birth outcomes, lower cognitive function and performance, hypertension, and chronic kidney disease. We also discuss the mechanisms by which household water insecurity may shape human biology across the life course; however, these pathways are just beginning to be understood. Longitudinal studies that simultaneously quantify household water insecurity and biological outcomes using comparable metrics in diverse environments and across generations will provide necessary evidence to establish causal relationships. Given the current global water crisis and its potential health consequences, such studies are urgently needed. This article is categorized under:Engineering Water > Water, Health, and SanitationScience of Water > Water Quality 
    more » « less
  • Citation Formats
  • MLA
  • APA
  • Chicago
  • BibTeX
  • Save / Share this Record
  • Send to Email