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Chakraborty R, Armijos RX, Beidelman ET, Rosenberg M, Margaret Weigel M. Household food and water insecurity and its association with diarrhoea, respiratory illness, and stunting in Ecuadorian children under 5 years. MATERNAL & CHILD NUTRITION 2024:e13683. [PMID: 38873704 DOI: 10.1111/mcn.13683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 04/22/2024] [Accepted: 05/29/2024] [Indexed: 06/15/2024]
Abstract
Household food and water insecurity has been previously associated with adverse health consequences in children. However, these relationships are understudied in middle-income Latin American populations such as in Ecuador, where a high prevalence of food and water insecurity has been reported. Using cross-sectional data from 2018 Ecuadorian National Health and Nutrition Survey, we examined the association of household food insecurity (HFI), household water insecurity (HWI), and concurrent HFI-HWI with diarrhoea, respiratory illness (RI), and stunting in 20,510 children aged ≤59 months. HFI was measured using the Food Insecurity Experience Scale. HWI was defined when households responded negatively to one or more of four drinking water indicators. Maternal caregivers reported on child diarrhoea and RI episodes during the previous 2 weeks. Measured length or height was used to assess stunting. We constructed log-binomial regression models to estimate the associations of HFI, HWI, and concurrent HFI-HWI with child outcomes. Moderate-severe HFI was associated with a higher prevalence of diarrhoea (PR = 1.39; 95% CI: 1.18, 1.63) and RI (PR = 1.34; 95% CI: 1.22, 1.47), HWI with a higher prevalence of RI (PR = 1.13; 95% CI: 1.04, 1.22), and concurrent HFI-HWI with a higher prevalence of diarrhoea (PR = 1.30; 95% CI: 1.05, 1.62) and RI (PR = 1.45; 95% CI: 1.29, 1.62). Stunting was not associated with HFI, HWI nor concurrent HFI-HWI. These findings suggest that HFI and HWI can independently and jointly act to negatively affect children's health. Policies and interventions aimed at alleviating both food and water insecurity are needed to bring sustained health improvements in Ecuadorian children.
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Affiliation(s)
- Rishika Chakraborty
- Department of Environmental and Occupational Health, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA
- Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA
| | - Rodrigo X Armijos
- Department of Environmental and Occupational Health, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA
- Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA
- Center for Latin American & Caribbean Studies, Indiana University, Bloomington, Indiana, USA
- Center for Global Health Equity, Indiana University, Indianapolis, Indiana, USA
| | - Erika T Beidelman
- Department of Epidemiology and Biostatistics, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA
| | - Molly Rosenberg
- Department of Epidemiology and Biostatistics, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA
| | - M Margaret Weigel
- Department of Environmental and Occupational Health, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA
- Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA
- Center for Latin American & Caribbean Studies, Indiana University, Bloomington, Indiana, USA
- Center for Global Health Equity, Indiana University, Indianapolis, Indiana, USA
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Workman CL, Miller JD, Shah SH, Maes K, Tesfaye Y, Mapunda KM. Frequency and perceived difficulty of household water experiences in Morogoro, Tanzania: Evidence of the psychosocial burden of water insecurity. SSM - MENTAL HEALTH 2024; 5:100295. [PMID: 39099889 PMCID: PMC11293490 DOI: 10.1016/j.ssmmh.2023.100295] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2024] Open
Affiliation(s)
- Cassandra L. Workman
- Department of Anthropology, University of North Carolina Greensboro, United States
| | - Joshua D. Miller
- Department of Nutrition, University of North Carolina Chapel Hill, United States
| | - Sameer H. Shah
- School of Environmental and Forest Sciences, University of Washington, United States
| | - Kenneth Maes
- Anthropology Program, School of Language, Culture & Society, Oregon State University, United States
| | - Yihenew Tesfaye
- Department of Social Anthropology, Bahir Dar University, Ethiopia
| | - Kenneth M. Mapunda
- Department of Agricultural Extension and Community Development, Sokoine University of Agriculture, Tanzania
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Mata MMD, Sanudo A, Medeiros MATD. [Food insecurity and household water insecurity: a population-based study in a municipality in the Amazon River basin, Brazil]. CAD SAUDE PUBLICA 2024; 40:e00125423. [PMID: 38775576 PMCID: PMC11105344 DOI: 10.1590/0102-311xpt125423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 12/16/2023] [Accepted: 12/27/2023] [Indexed: 05/25/2024] Open
Abstract
This study analyzed food insecurity and associated factors in the urban area of a municipality in the Amazon River basin, Western Amazon. This is a cross-sectional population-based study conducted from August to November 2021 with 983 households selected by stratified probability sampling. A multinomial logistic regression model was used, adopting the following criteria: p-value < 20% in the bivariate analysis and p-value < 5% for the multivariate adjustment. The results of the analyses were described as odds ratio (OR) and 95% confidence interval (95%CI). The following variables were significantly associated with mild or moderate food insecurity: household water insecurity; number of residents ≥ 5 in the household; belonging to socioeconomic class D or E; having a father, mother or another as the head of the family; and having any resident as a beneficiary of the Brazilian Income Transfer Program. The analysis model for severe food insecurity showed that living with household water insecurity; belonging to socioeconomic class D or E; having a father, mother or another as the head of the family; age of the head of the family < 55 years; and family income lower that two minimum wages increased the chances of severe food insecurity when compared to those with food security. In conclusion, this study found a high prevalence of food insecurity in the Municipality of Itapiranga, State of Amazonas, North Region of Brazil, associated with social and economic vulnerability, lack of public services, and household water insecurity.
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Affiliation(s)
- Mayline Menezes da Mata
- Instituto Saúde e Sociedade, Universidade Federal de São Paulo, Santos, Brasil
- Universidade Federal do Amazonas, Manaus, Brasil
| | - Adriana Sanudo
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil
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Murphy N, Rarama T, Atama A, Kauyaca I, Batibasaga K, Azzopardi P, Bowen KJ, Bohren MA. Changing climates, compounding challenges: a participatory study on how disasters affect the sexual and reproductive health and rights of young people in Fiji. BMJ Glob Health 2023; 8:e013299. [PMID: 38103898 PMCID: PMC10729163 DOI: 10.1136/bmjgh-2023-013299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/28/2023] [Indexed: 12/19/2023] Open
Abstract
Pacific youth are at the forefront of the climate crisis, which has important implications for their health and rights. Youth in Fiji currently bear a disproportionate burden of poor experiences and outcomes related to their sexual and reproductive health and rights (SRHR). There is limited information about how the increasing climate impacts may affect their SRHR, and what the implications may be for climate action and disaster risk reduction. We aimed to explore the experiences of 21 Fijian youth in fulfilling their SRHR when living through multiple natural hazards. We conducted 2 workshops and 18 individual semistructured interviews using visual and storytelling methods. Irrespective of the type of hazard or context of disasters, participants identified limited agency as the main challenge that increased SRHR risks. Through reflexive thematic analysis, we identified four themes centred around 'youth SRHR agency'; (1) information and knowledge, (2) community and belonging, (3) needs and resources, and (4) collective risks. These themes encompassed multiple factors that limited youth agency and increased their SRHR risks. Participants highlighted how existing challenges to their SRHR, such as access to SRHR information being controlled by community gatekeepers, and discrimination of sexual and gender diverse youth, were exacerbated in disasters. In disaster contexts, immediate priorities such as water, food and financial insecurity increased risks of transactional early marriage and transactional sex to access these resources. Daily SRHR risks related to normalisation of sexual and gender-based violence and taboos limited youth agency and influenced their perceptions of disasters and SRHR risks. Findings offer important insights into factors that limited youth SRHR agency before, during and after disasters. We underscore the urgency for addressing existing social and health inequities in climate and disaster governance. We highlight four key implications for reducing youth SRHR risks through whole-of-society approaches at multiple (sociocultural, institutional, governance) levels.
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Affiliation(s)
- Nabreesa Murphy
- Gender and Women's Health Unit, Nossal Institute for Global Health, The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | - Tamani Rarama
- Fiji Youth Sexual and Reproductive Health and Rights Alliance (FYSA), Nadi, Fiji
| | - Alanieta Atama
- Fiji Youth Sexual and Reproductive Health and Rights Alliance (FYSA), Nadi, Fiji
| | - Ilaisa Kauyaca
- Fiji Youth Sexual and Reproductive Health and Rights Alliance (FYSA), Nadi, Fiji
| | - Kelera Batibasaga
- Reproductive and Family Health Association of Fiji (RFHAF), Nadi, Fiji
| | - Peter Azzopardi
- Centre for Adolescent Health, Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Adolescent Health and Wellbeing Program, Telethon Kids Institute, Adelaide, South Australia, Australia
| | - Kathryn J Bowen
- Melbourne Climate Futures, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Research Institute for Sustainability-Helmholtz Centre Potsdam, Potsdam, Brandenburg, Germany
| | - Meghan A Bohren
- Gender and Women's Health Unit, Nossal Institute for Global Health, The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
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Chen L, Jiao J, Liu S, Liu L, Liu P. Mapping the global, regional, and national burden of diarrheal diseases attributable to unsafe water. Front Public Health 2023; 11:1302748. [PMID: 38125838 PMCID: PMC10731288 DOI: 10.3389/fpubh.2023.1302748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023] Open
Abstract
Background Diarrheal diseases are major contributors to deaths. Data on global and country-specific levels and trends of diarrheal diseases resulting from unsafe water are essential for policymakers to allocate resources. Aims This study aimed to describe the global, regional, and national spatiotemporal burden of diarrheal diseases resulting from unsafe water exposure. Methods According to the Global Burden of Disease (GBD) 2019 dataset, deaths, disability-adjusted life years (DALYs) of diarrheal diseases, and their age-standardized rates (ASRs) were analyzed by age and sex in 204 countries and territories. Moreover, the average annual percentage change (AAPC) was estimated by a log-linear regression model to reflect the time trend. The association between ASR of diarrheal diseases due to unsafe water and socio-demographic index (SDI) levels was also analyzed. Results From 1990 to 2019, the number of deaths and DALYs of diarrheal diseases resulting from unsafe water decreased by 50 and 59%, respectively. Moreover, the ASR of deaths and DALYs also decreased during the study period, with AAPCs of -3.69 (95% CI [95% confidence interval]: -3.91 to -3.47) and - 3.66 (95% CI: -3.8 to -3.52), respectively. High diarrheal diseases resulting from unsafe water occurred mainly in low SDI regions and Africa. Males exhibited greater diarrheal deaths attributable to unsafe water than females, which was contrary to the condition in terms of DALYs. The age-specific burden of diarrheal deaths attributable to unsafe water is concentrated in children younger than 5 years. The AAPCs of the ASR of both deaths and DALYs showed a strong negative correlation with the SDI levels. Conclusion The current study indicated that the global burden of unsafe water exposure-related diarrheal diseases decreased from 1990 to 2019 and varied significantly according to age, sex, and geographical location. Effective health promotion and health communication strategies and policies should be adopted to prevent and control diarrheal diseases resulting from unsafe water exposure.
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Affiliation(s)
- Ling Chen
- Department of Pharmacy, General Hospital of Benxi Iron and Steel Industry Group of Liaoning Health Industry Group, Benxi, China
| | - Jinghua Jiao
- Department of Anesthesiology, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Shunming Liu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Lei Liu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Pengliang Liu
- Department of Gastroenterology and Endoscopy, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
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Slotnick MJ, Leung CW. Water Insecurity Indicators Are Associated with Lower Diet and Beverage Quality in a National Survey of Lower-Income United States Adults. J Nutr 2023; 153:3308-3316. [PMID: 37619920 DOI: 10.1016/j.tjnut.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/27/2023] [Accepted: 08/11/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Tap water distrust and avoidance, indicators of water insecurity, are prevalent in marginalized United States populations. As future environmental challenges stress water resources, further understanding of the scope of water insecurity and its impact on diet quality is needed, particularly in vulnerable United States populations. OBJECTIVES To evaluate associations between 3 potential indicators of water insecurity-1) perception of tap water safety for drinking, 2) perception of tap water safety for cooking, and 3) tap water avoidance-and dietary quality and beverage intake in lower-income United States adults. METHODS A cross-sectional, web-based survey was fielded to 1798 lower-income (<250% federal poverty guidelines) United States adults. Participants answered questions detailing tap water safety perceptions and avoidance, beverage intake, dietary intake (30-d prime diet quality score), and sociodemographic covariates. Sociodemographic differences in drinking water insecurity measures were evaluated using chi-square and Fisher-Freeman-Halton tests. Associations between water insecurity measures and dietary outcomes were assessed using generalized linear models adjusted for sociodemographic covariates, and effect modification by sociodemographic covariates was assessed. RESULTS Over half of the adults surveyed experienced some aspect of water insecurity. Measures of water security differed significantly by sociodemographic covariates (Ps < 0.05), with higher percentages of women and gender-nonconforming persons, minoritized racial and ethnic groups, lower-income groups, and food-insecure adults reporting indicators of water insecurity. Presence of any water insecurity was associated with lower diet quality (β = -1.07; 95% CI: -2.11, -0.03; P = 0.04), lower tap water intake (relative difference [RD] = 0.35; 95% CI: 1.28, 2.12; P < 0.0001), higher bottled water intake (RD = 1.64; 95% CI: 1.28, 2.12; P = 0.0001), and higher sugar-sweetened beverages intake frequency (frequency ratio = 1.13; 95% CI: 1.01, 1.27; P = 0.03). CONCLUSIONS Water insecurity indicators are associated with poorer diet quality and beverage intake in a population of United States adults with lower-incomes. Addressing the intersection of water insecurity, food security, environmental impacts, and nutrition may help to improve the well-being and resiliency of vulnerable populations.
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Affiliation(s)
- Melissa J Slotnick
- Department of Nutritional Sciences, The University of Michigan School of Public Health, Ann Arbor, MI, United States.
| | - Cindy W Leung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Stoler J, Jepson WE, Brewis A, Wutich A. Frontiers of household water insecurity metrics: severity, adaptation and resilience. BMJ Glob Health 2023; 8:bmjgh-2023-011756. [PMID: 37137537 PMCID: PMC10163551 DOI: 10.1136/bmjgh-2023-011756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/21/2023] [Indexed: 05/05/2023] Open
Abstract
The measurement of household-level and individual-level water insecurity has accelerated over the past 5 years through innovation and dissemination of new survey-based experiential psychometric scales modelled after food insecurity scales. These measures offer needed insight into the relative frequency of various dimensions of water problems experienced by households or individuals. But they currently tell us nothing about the severity of these experiences, mitigating behaviours (ie, adaptation) or the effectiveness of water-related behaviours (ie, resilience). Given the magnitude of the global challenge to provide water security for all, we propose a low-cost, theoretically grounded modification to common water insecurity metrics in order to capture information about severity, adaptation and resilience. We also discuss ongoing challenges in cost-effective measurement related to multidimensionality, water affordability and perception of water quality for maximising the impact and sustainability of water supply interventions. The next generation of water insecurity metrics promises better monitoring and evaluation tools-particularly in the context of rapid global environmental change-once scale reliability across diverse contexts is better characterised.
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Affiliation(s)
- Justin Stoler
- Department of Geography and Sustainable Development, University of Miami, Coral Gables, Florida, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Wendy E Jepson
- Department of Geography, Texas A&M University College Station, College Station, Texas, USA
- Texas Water Resources Institute, Texas A&M AgriLife Research, College Station, Texas, USA
| | - Alexandra Brewis
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, USA
| | - Amber Wutich
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, USA
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Frongillo EA. Intersection of Food Insecurity and Water Insecurity. J Nutr 2023; 153:922-923. [PMID: 36848987 PMCID: PMC10101199 DOI: 10.1016/j.tjnut.2023.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023] Open
Affiliation(s)
- Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, United States.
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