Jepson WE, Stoler J, Baek J, Morán Martínez J, Uribe Salas FJ, Carrillo G. Cross-sectional study to measure household water insecurity and its health outcomes in urban Mexico.
BMJ Open 2021;
11:e040825. [PMID:
33674365 PMCID:
PMC7938997 DOI:
10.1136/bmjopen-2020-040825]
[Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 01/24/2021] [Accepted: 02/10/2021] [Indexed: 12/13/2022] Open
Abstract
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.
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