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Wutich A, Thomson P, Jepson W, Stoler J, Cooperman AD, Doss-Gollin J, Jantrania A, Mayer A, Nelson-Nuñez J, Walker WS, Westerhoff P. MAD Water: Integrating Modular, Adaptive, and Decentralized Approaches for Water Security in the Climate Change Era. WIRES. WATER 2023; 10:e1680. [PMID: 38162537 PMCID: PMC10756426 DOI: 10.1002/wat2.1680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 06/17/2023] [Indexed: 01/03/2024]
Abstract
Centralized water infrastructure has, over the last century, brought safe and reliable drinking water to much of the world. But climate change, combined with aging and underfunding, is increasingly testing the limits of-and reversing gains made by-these large-scale water systems. To address these growing strains and gaps, we must assess and advance alternatives to centralized water provision and sanitation. The water literature is rife with examples of systems that are neither centralized nor networked, but still meet water needs of local communities in important ways, including: informal and hybrid water systems, decentralized water provision, community-based water management, small drinking water systems, point-of-use treatment, small-scale water vendors, and packaged water. Our work builds on these literatures by proposing a convergence approach that can integrate and explore the benefits and challenges of modular, adaptive, and decentralized ("MAD") water provision and sanitation, often foregrounding important advances in engineering technology. We further provide frameworks to evaluate justice, economic feasibility, governance, human health, and environmental sustainability as key parameters of MAD water system performance.
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Affiliation(s)
- Amber Wutich
- School of Human Evolution & Social Change, Cady Mall, Tempe, AZ 85281, Arizona State University
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Assessing the relationship between domestic work experience and musculoskeletal health among rural Nigerian women. PLoS One 2022; 17:e0276380. [PMID: 36512538 PMCID: PMC9747006 DOI: 10.1371/journal.pone.0276380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 10/06/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Women performing strenuous domestic tasks (especially those in developing countries) are at risk of experiencing musculoskeletal pain (MSP). Physical, psychosocial, and social conditions of work in rural environments contribute to women's domestic work experiences (DWEs) and the risk of MSP. The impact of DWEs on women's health is especially severe in water-insecure countries like Nigeria. This study examines the relationship between a recently developed measure of DWEs and self-reported pain in the lower back (LBP), neck/shoulder (NSP), and elbow/hand/wrist regions (EHWP) among rural Nigerian women. METHODS Interviewer-administered survey data were collected from 356 women in four rural communities of Ibadan, Nigeria. Binary and ordinal logistic regression models were used to examine the relationship between DWE factor scores, sociodemographic characteristics, and musculoskeletal pain symptoms and severity after controlling for sociodemographic covariates. Effect estimates of association were presented using the odds ratio (OR), and the corresponding 95% confidence interval (CI) at p-value of 0.05. FINDINGS Among 356 participants, the 2-month prevalence of LBP was 58%, NSP was 30%, and EWHP 30%. High DWE scores were significantly associated with higher odds of experiencing and having more severe LBP, NSP, and EHWP. Specifically, the odds of LBP [(OR = 2.88; 95% CI = 1.64-5.11), NSP (OR = 4.58; 95% CI = 2.29-9.40) and EHWP (OR = 1.88; 95% CI = 1.26-3.77)] were significantly higher among women who perceived their domestic work responsibilities as very stressful (i.e., 'high stress appraisal') compared to those with lower stress appraisal scores. Those who were time-pressured and had less autonomy over familial duties (i.e., 'high demand/low control') had significantly higher odds of LBP [(OR = 2.58; 95% CI = 1.64-4.09) and NSP (OR = 1.49; 95% CI = 1.24-2.58)]. Frequently fetching and carrying water over long distances and time (i.e., 'high water sourcing and carriage') was also associated with higher odds of LBP [(OR = 1.31; 95% CI = 1.09-1.79) and NSP (OR = 1.20; 95% CI = 1.08-1.76). CONCLUSION Strenuous and stressful DWEs were associated with MSP among rural Nigerian women. This study provides new evidence on how the physical, social, and psychosocial factors of domestic work can increase women's risk of MSP.
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Koyratty N, Ntozini R, Mbuya MNN, Jones AD, Schuster RC, Kordas K, Li CS, Tavengwa NV, Majo FD, Humphrey J, Smith LE. Growth and growth trajectory among infants in early life: contributions of food insecurity and water insecurity in rural Zimbabwe. BMJ Nutr Prev Health 2022; 5:332-343. [PMID: 36619329 PMCID: PMC9813639 DOI: 10.1136/bmjnph-2022-000470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 11/07/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Stunting or linear growth faltering, measured by length-for-age Z-score (LAZ), remains a significant public health challenge, particularly in rural low-income and middle-income countries. It is a marker of inadequate environments in which infants are born and raised. However, the contributions of household resource insecurities, such as food and water, to growth and growth trajectory are understudied. Methods We used the cluster-randomised Sanitation Hygiene and Infant Nutrition Efficacy trial to determine the association of household-level food insecurity (FI) and water insecurity (WI) on LAZ and LAZ trajectory among infants during early life. Dimensions of FI (poor access, household shocks, low availability and quality) and WI (poor access, poor quality, low reliability) were assessed with the multidimensional household food insecurity and the multidimensional household water insecurity measures. Infant length was converted to LAZ based on the 2006 WHO Child Growth Standards. We report the FI and WI fixed effects from multivariable growth curve models with repeated measures of LAZ at 1, 3, 6, 12 and 18 months (M1-M18). Results A total of 714 and 710 infants were included in our analyses of LAZ from M1 to M18 and M6 to M18, respectively. Mean LAZ values at each time indicated worsening linear growth. From M1 to M18, low food availability and quality was associated with lower LAZ (β=-0.09; 95% -0.19 to -0.13). From M6 to M18, poor food access was associated with lower LAZ (β=-0.11; 95% -0.20 to -0.03). None of the WI dimensions were associated with LAZ, nor with LAZ trajectory over time. Conclusion FI, but not WI, was associated with poor linear growth among rural Zimbabwean infants. Specifically, low food availability and quality and poor food access was associated with lower LAZ. There is no evidence of an effect of FI or WI on LAZ trajectory.
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Affiliation(s)
- Nadia Koyratty
- Department of Poverty, Health and Nutrition, International Food Policy Research Institute, Washington DC, Washington DC, USA
| | - Robert Ntozini
- Statistics, Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Mduduzi NN Mbuya
- Knowledge Leadership, Global Alliance for Improved Nutrition, Geneva, Switzerland
| | - Andrew D Jones
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Roseanne C Schuster
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, USA
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York, USA
| | - Chin-Shang Li
- School of Nursing, University at Buffalo, Buffalo, NY, USA
| | - Naume V Tavengwa
- Statistics, Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Florence D Majo
- Statistics, Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Jean Humphrey
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Laura E Smith
- Statistics, Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe,Department of Public and Ecosystem Health, Cornell University, Ithaca, New York, USA
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Ford L, Bethancourt HJ, Swanson Z, Nzunza R, Wutich A, Brewis A, Young S, Almeida D, Douglass M, Ndiema EK, Braun DR, Pontzer H, Rosinger AY. Water Insecurity, Water Borrowing, and Psychosocial Stress Among Daasanach Pastoralists in Northern Kenya. WATER INTERNATIONAL 2022; 48:63-86. [PMID: 38800511 PMCID: PMC11126231 DOI: 10.1080/02508060.2022.2138050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/17/2022] [Indexed: 05/29/2024]
Abstract
This article quantifies Daasanach water insecurity experiences in Northern Kenya, examines how water insecurity is associated with water borrowing and psychosocial stress, and evaluates if water borrowing mitigates the stress from water insecurity. Of 133 households interviewed in 7 communities, 94% were water insecure and 74.4% borrowed water three or more times in the prior month. Regression analyses demonstrate water borrowing frequency moderates the relationship between water insecurity and psychosocial stress. Only those who rarely or never borrowed water reported greater stress with higher water insecurity. The coping mechanism of water borrowing may help blunt water insecurity-related stress.
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Affiliation(s)
- Leslie Ford
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA
| | - Hilary J Bethancourt
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA
- Department of Anthropology, Northwestern University, Evanston, IL
- Institute for Research Policy, Northwestern University, Evanston, IL
| | - Zane Swanson
- Department of Evolutionary Anthropology, Duke University, Durham, NC
| | | | - Amber Wutich
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ
| | - Alexandra Brewis
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ
| | - Sera Young
- Department of Anthropology, Northwestern University, Evanston, IL
- Institute for Research Policy, Northwestern University, Evanston, IL
| | - David Almeida
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA
| | - Matthew Douglass
- College of Agricultural Sciences and Natural Resources, University of Nebraska-Lincoln, Lincoln, NE
| | | | - David R. Braun
- Center for the Advanced Study of Human Paleobiology, Department of Anthropology, The George Washington University, Washington, DC
- Department of Human Evolution, Max Planck Institute of Evolutionary Anthropology, 04103 Leipzig, Germany
| | - Herman Pontzer
- Department of Evolutionary Anthropology, Duke University, Durham, NC
- Global Health Institute, Duke University, Durham, NC
| | - Asher Y. Rosinger
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA
- Department of Anthropology, Pennsylvania State University, State College PA
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Wutich A, Rosinger AY, Brewis A, Beresford M, Young SL. Water Sharing Is a Distressing Form of Reciprocity: Shame, Upset, Anger, and Conflict Over Water in Twenty Cross-Cultural Sites. AMERICAN ANTHROPOLOGIST 2022; 124:279-290. [PMID: 36108326 PMCID: PMC9455904 DOI: 10.1111/aman.13682] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Anthropological theories of reciprocity suggest it enhances prestige, social solidarity, and material security. Yet, some ethnographic cases suggest that water sharing-a form of reciprocity newly gaining scholarly attention-might work in the opposite way, increasing conflict and emotional distress. Using cross-cultural survey data from twenty global sites (n=4,267), we test how household water reciprocity (giving and receiving) is associated with negative emotional and social outcomes. Participation in water sharing as both givers and receivers is consistently associated with greater odds of reporting shame, upset, and conflict over water. Water sharing experiences in a large, diverse sample confirm a lack of alignment with predictions of classic reciprocity theories. Recent ethnographic research on reciprocity in contexts of deepening contemporary poverty will allow development of ethnographically informed theories to better explain negative experiences tied to water reciprocity.
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Affiliation(s)
- Amber Wutich
- School of Human Evolution and Social Change, Phoenix, Arizona State University, Tempe, AZ 85287,Corresponding author: Amber Wutich, ; Phone: 480-965-9010, P.O. Box 872402, Tempe, AZ 85287
| | - Asher Y. Rosinger
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, 16802.,Department of Anthropology, Pennsylvania State University, University Park, PA, 16802
| | - Alexandra Brewis
- School of Human Evolution and Social Change, Phoenix, Arizona State University, Tempe, AZ 85287
| | - Melissa Beresford
- Department of Anthropology, San José State University, San José, CA, 95192
| | - Sera L. Young
- Department of Anthropology & Institute for Policy Research, Northwestern University, Evanston, IL, 60208
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Kumpel E, Billava N, Nayak N, Ercumen A. Water use behaviors and water access in intermittent and continuous water supply areas during the COVID-19 pandemic. JOURNAL OF WATER AND HEALTH 2022; 20:139-148. [PMID: 35100161 DOI: 10.2166/wh.2021.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
More than one billion people worldwide receive intermittent water supply (IWS), in which water is delivered through a pipe network for fewer than 24 h/day, limiting the quantity and accessibility of water. During the COVID-19 pandemic, stay-at-home orders and efforts to limit contact with others can affect water access for those with unreliable home water supplies. We explored whether water service delivery and household water-use behaviors changed during the COVID-19 pandemic in Hubballi-Dharwad, India, and whether they differed if households had IWS or continuous (24×7) water supply through a longitudinal household survey in 2020-2021. We found few perceived differences in water service delivery or water access, although one-quarter of all households reported insufficient water for handwashing, suggesting an increased demand for water that was not satisfied. Many households with 24×7 supply reported water outages, necessitating the use of alternative water sources. These findings suggest that water demand at home increased and households with IWS and 24×7 both lacked access to sufficient water. Our findings indicate that water insecurity negatively affected households' ability to adhere to protective public health measures during the COVID-19 pandemic and highlight the importance of access to uninterrupted, on-premise water during public health emergencies.
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Affiliation(s)
- Emily Kumpel
- Department of Civil and Environmental Engineering, University of Massachusetts Amherst, 130 Natural Resources Road, Amherst, MA 01003, USA E-mail:
| | - Nayaran Billava
- Centre for Multi-Disciplinary Development Research, Dr B.R. Ambedkarnagar, Near Yalakki Shettar Colony, Dharwad- 580 004 Karnataka, India
| | - Nayanatara Nayak
- Centre for Multi-Disciplinary Development Research, Dr B.R. Ambedkarnagar, Near Yalakki Shettar Colony, Dharwad- 580 004 Karnataka, India
| | - Ayse Ercumen
- Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC 27695, USA
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Brewis A, Roba KT, Wutich A, Manning M, Yousuf J. Household water insecurity and psychological distress in Eastern Ethiopia: Unfairness and water sharing as undertheorized factors. SSM - MENTAL HEALTH 2021. [DOI: 10.1016/j.ssmmh.2021.100008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Osinuga A, Janssen B, Fethke NB, Story WT, Imaledo JA, Baker KK. Understanding Rural Women's Domestic Work Experiences (DWE) in Ibadan, Nigeria: Development of a Measurement Tool Using Confirmatory Factor Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111043. [PMID: 34769564 PMCID: PMC8582860 DOI: 10.3390/ijerph182111043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022]
Abstract
Gender norms prescribe domestic labor as primarily a female's responsibility in developing countries. Many domestic tasks depend on access to water, so the physical, emotional, and time demands of domestic labor may be exacerbated for women living in water-insecure environments. We developed a set of domestic work experience (DWE) measures tailored to work in rural areas in developing countries, assessed rural Nigerian women's DWE, and examined relationships among the measures. Interviewer-administered survey data were collected between August and September from 256 women in four rural Nigerian communities. Latent factors of DWE were identified by analyzing survey items using confirmatory factor analysis. Pearson's correlation was used to examine relationships among latent factor scores, and multivariate linear regression models were used to determine if factor scores significantly differed across socio-demographic characteristics. The DWE measures consisted of latent factors of the physical domain (frequency of common domestic tasks, water sourcing and carriage, experience of water scarcity), the psychosocial domain (stress appraisal and demand-control), and the social domain (social support). Significant correlations were observed among the latent factors within and across domains. Results revealed the importance of measuring rural Nigerian women's DWE using multiple and contextual approaches rather than relying solely on one exposure measure. Multiple inter-related factors contributed to women's DWE. Water insecurity exacerbated the physical and emotional demands of domestic labor DWE varied across age categories and pregnancy status among rural Nigerian women.
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Affiliation(s)
- Abisola Osinuga
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA; (B.J.); (N.B.F.); (K.K.B.)
- Correspondence: ; Tel.: +1-3195126701
| | - Brandi Janssen
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA; (B.J.); (N.B.F.); (K.K.B.)
| | - Nathan B Fethke
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA; (B.J.); (N.B.F.); (K.K.B.)
| | - William T Story
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA;
| | - John A Imaledo
- Department of Health Promotion and Education, University of Ibadan, Ibadan 200212, Nigeria;
| | - Kelly K Baker
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA; (B.J.); (N.B.F.); (K.K.B.)
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Wunderlich S, St George Freeman S, Galindo L, Brown C, Kumpel E. Optimizing Household Water Decisions for Managing Intermittent Water Supply in Mexico City. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:8371-8381. [PMID: 34086449 DOI: 10.1021/acs.est.0c08390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
One billion people worldwide experience intermittent water supply (IWS), in which piped water is delivered for limited durations. Households with IWS must invest in water storage infrastructure and often rely on multiple sources of water; therefore, these household-level purchasing and infrastructure decisions is a critical component of water access. Informed by interviews with IWS households, we use radial basis function networks, a type of artificial neural network, to determine optimal household water management decisions that maximize reliability of water supply while minimizing costs for a representative household in Mexico City that uses municipal piped water, trucked water, and rainwater. We find that securing reliable water supply for IWS households is greatly assisted by installation of household storage tanks of at least 2500 L. In the case of IWS households with limited storage options, the overall cost for water supply is reduced by scheduling water deliveries on nonconsecutive days. Rainwater harvesting systems were shown to be economically viable for households with limited water supply. This study demonstrates the importance of considering the management of multiple sources and household storage infrastructure when evaluating water investments in cities with IWS.
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Affiliation(s)
- Savannah Wunderlich
- Department of Civil and Environmental Engineering, University of Massachusetts Amherst, Amherst, Massachusetts 01003, United States
| | - Sarah St George Freeman
- Department of Civil and Environmental Engineering, University of Massachusetts Amherst, Amherst, Massachusetts 01003, United States
| | - Luisa Galindo
- Department of Civil and Environmental Engineering, University of Massachusetts Amherst, Amherst, Massachusetts 01003, United States
| | - Casey Brown
- Department of Civil and Environmental Engineering, University of Massachusetts Amherst, Amherst, Massachusetts 01003, United States
| | - Emily Kumpel
- Department of Civil and Environmental Engineering, University of Massachusetts Amherst, Amherst, Massachusetts 01003, United States
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Koyratty N, Jones AD, Schuster R, Kordas K, Li CS, Mbuya MNN, Boateng GO, Ntozini R, Chasekwa B, Humphrey JH, Smith LE. Food Insecurity and Water Insecurity in Rural Zimbabwe: Development of Multidimensional Household Measures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6020. [PMID: 34205143 PMCID: PMC8199942 DOI: 10.3390/ijerph18116020] [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] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 11/26/2022]
Abstract
Background: With millions of people experiencing malnutrition and inadequate water access, FI and WI remain topics of vital importance to global health. Existing unidimensional FI and WI metrics do not all capture similar multidimensional aspects, thus restricting our ability to assess and address food- and water-related issues. Methods: Using the Sanitation, Hygiene and Infant Nutrition Efficacy (SHINE) trial data, our study conceptualizes household FI (N = 3551) and WI (N = 3311) separately in a way that captures their key dimensions. We developed measures of FI and WI for rural Zimbabwean households based on multiple correspondence analysis (MCA) for categorical data. Results: Three FI dimensions were retained: 'poor food access', 'household shocks' and 'low food quality and availability', as were three WI dimensions: 'poor water access', 'poor water quality', and 'low water reliability'. Internal validity of the multidimensional models was assessed using confirmatory factor analysis (CFA) with test samples at baseline and 18 months. The dimension scores were associated with a group of exogenous variables (SES, HIV-status, season, depression, perceived health, food aid, water collection), additionally indicating predictive, convergent and discriminant validities. Conclusions: FI and WI dimensions are sufficiently distinct to be characterized via separate indicators. These indicators are critical for identifying specific problematic insecurity aspects and for finding new targets to improve health and nutrition interventions.
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Affiliation(s)
- Nadia Koyratty
- Department of Epidemiology and Environmental Health, The State University of New York, University at Buffalo, Buffalo, NY 14214, USA; (N.K.); (K.K.)
| | - Andrew D. Jones
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Roseanne Schuster
- Center for Global Health, School of Human Evolution and Social Change, Arizona State University, Tempe, AZ 85281, USA;
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, The State University of New York, University at Buffalo, Buffalo, NY 14214, USA; (N.K.); (K.K.)
| | - Chin-Shang Li
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, NY 14214, USA;
| | | | - Godfred O. Boateng
- Department of Kinesiology, College of Nursing and Health Innovations, The University of Texas at Arlington, Arlington, TX 76019, USA;
| | - Robert Ntozini
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; (R.N.); (B.C.); (J.H.H.)
| | - Bernard Chasekwa
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; (R.N.); (B.C.); (J.H.H.)
| | - Jean H. Humphrey
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; (R.N.); (B.C.); (J.H.H.)
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Laura E. Smith
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; (R.N.); (B.C.); (J.H.H.)
- Department of Population Medicine and Diagnostics, Cornell University, Ithaca, NY 14853, USA
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Stoler J, Miller JD, Brewis A, Freeman MC, Harris LM, Jepson W, Pearson AL, Rosinger AY, Shah SH, Staddon C, Workman C, Wutich A, Young SL. Household water insecurity will complicate the ongoing COVID-19 response: Evidence from 29 sites in 23 low- and middle-income countries. Int J Hyg Environ Health 2021; 234:113715. [PMID: 33735823 PMCID: PMC7894133 DOI: 10.1016/j.ijheh.2021.113715] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/25/2021] [Accepted: 02/11/2021] [Indexed: 12/17/2022]
Abstract
In March 2020, the World Health Organization (WHO) issued a set of public guidelines for Coronavirus Disease 2019 (COVID-19) prevention measures that highlighted handwashing, physical distancing, and household cleaning. These health behaviors are severely compromised in parts of the world that lack secure water supplies, particularly in low- and middle-income countries (LMICs). We used empirical data gathered in 2017-2018 from 8,297 households in 29 sites across 23 LMICs to address the potential implications of water insecurity for COVID-19 prevention and response. These data demonstrate how household water insecurity presents many pathways for limiting personal and environmental hygiene, impeding physical distancing and exacerbating existing social and health vulnerabilities that can lead to more severe COVID-19 outcomes. In the four weeks prior to survey implementation, 45.9% of households in our sample either were unable to wash their hands or reported borrowing water from others, which may undermine hygiene and physical distancing. Further, 70.9% of households experienced one or more water-related problems that potentially undermine COVID-19 control strategies or disease treatment, including insufficient water for bathing, laundering, or taking medication; drinking unsafe water; going to sleep thirsty; or having little-to-no drinking water. These findings help identify where water provision is most relevant to managing COVID-19 spread and outcomes.
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Affiliation(s)
| | - Joshua D Miller
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | | | | | | | | | | | | | - Sameer H Shah
- University of British Columbia, Vancouver, BC, Canada.
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Sohns A, Ford JD, Adamowski J, Robinson BE. Participatory Modeling of Water Vulnerability in Remote Alaskan Households Using Causal Loop Diagrams. ENVIRONMENTAL MANAGEMENT 2021; 67:26-42. [PMID: 33165646 DOI: 10.1007/s00267-020-01387-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 10/20/2020] [Indexed: 06/11/2023]
Abstract
Despite perceptions of high water availability, adequate access to sufficient water resources remains a major challenge in Alaska. This paper uses a participatory modeling approach to investigate household water vulnerability in remote Alaska and to examine factors that affect water availability and water access. Specifically, the work asks: how do water policy stakeholders conceptualize the key processes that affect household water vulnerability in the context of rural Alaska? Fourteen water policy stakeholders participated in the modeling process, which included defining the problem of household water vulnerability and constructing individual causal loop diagrams (CLDs) that represent their conceptualization of household water vulnerability. Individual CLDs were subsequently combined and five sub-models emerged: environmental, economic, infrastructure, social, and health. The environmental and economic sub-models of the CLD are explored in depth. In the environmental sub-model, climate change and environmental barriers due to geography influence household water vulnerability. In the economic sub-model, four processes and one feedback loop affect household water vulnerability, including operations and maintenance funding, the strength of the rural Alaskan economy, and the impact of regulations. To overcome household water vulnerability and make households more resilient, stakeholders highlighted policy solutions under five themes: economics, social, regulatory, technological, and environmental.
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Affiliation(s)
- Antonia Sohns
- Department of Geography, McGill University, Montreal, QC, Canada.
| | - James D Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
| | - Jan Adamowski
- Department of Bioresource Engineering, McGill University, Montreal, QC, Canada
| | - Brian E Robinson
- Department of Geography, McGill University, Montreal, QC, Canada
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MacDonald MC, Elliott M, Langidrik D, Chan T, Saunders A, Stewart-Koster B, Taafaki IJ, Bartram J, Hadwen WL. Mitigating drought impacts in remote island atolls with traditional water usage behaviors and modern technology. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 741:140230. [PMID: 32886988 DOI: 10.1016/j.scitotenv.2020.140230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/12/2020] [Accepted: 06/13/2020] [Indexed: 06/11/2023]
Abstract
Adaptation to drought is particularly challenging on remote island atolls, such as those found in the Republic of the Marshall Islands (RMI), a nation of 58,000 populating 29 low-lying coral atolls spread over >2 million km2. Exposure to consecutive atmospheric hazards, such as meteorological floods and droughts diminish scarce water resources and erode the resilience of island communities. Drought impact mitigation measures must supply emergency drinking water to stricken communities, while simultaneously conserving natural sources in order to reduce their vulnerability to subsequent events. Household surveys (n = 298) and focus group discussions (n = 16) in eight RMI communities revealed that 86% of households have experienced drought and 88% reported using multiple water sources to meet normal household needs. With no surface water and a thin freshwater lens (FWL), rainwater collected from rooftops is the most common household water source. The traditional use of carved hollows in the base of coconut trees to collect rainwater ("Mammaks") appears to have been displaced by large rainwater tanks. However, rationing of rainwater for consumption only during drought was widely reported, with private wells supporting non-consumptive uses. Reverse osmosis (RO) desalination units have provided relief during drought emergencies but concerns have been raised around dependency, maintenance challenges, and loss of traditional water practices. Most notably, RO use has the potential to change the anthroposhpere by adversely affecting the FWL; 86% of RO units were installed at island-centre where excessive pumping can cause upconing, making the FWL brackish. Balancing the introduction of desalination technology to mitigate water shortages with maintenance of traditional water conservation practices to preserve the quantity and quality of the FWL is a promising strategy on island atolls that requires further investigation.
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Affiliation(s)
- Morgan C MacDonald
- Australian Rivers Institute, Griffith University, Nathan, Queensland 4111, Australia.
| | - Mark Elliott
- Department of Civil, Construction and Environmental Engineering, University of Alabama, Box 870205, Tuscaloosa, AL 35407, USA
| | - Dustin Langidrik
- University of the South Pacific, Marshall Islands Campus, P. O. Box 3537, Majuro, MH 96960, Marshall Islands
| | - Terry Chan
- Monash Sustainability Institute, Monash University, Clayton, Victoria 3800, Australia
| | - Angela Saunders
- International Organization for Migration, Majuro, MH 96960, Marshall Islands
| | - Ben Stewart-Koster
- Australian Rivers Institute, Griffith University, Nathan, Queensland 4111, Australia
| | - Irene J Taafaki
- University of the South Pacific, Marshall Islands Campus, P. O. Box 3537, Majuro, MH 96960, Marshall Islands
| | - Jamie Bartram
- The Water Institute, Department of Environmental Sciences and Engineering, University of North Carolina, CB#7431, Chapel Hill, NC 27599, USA; School of Civil Engineering, University of Leeds, UK
| | - Wade L Hadwen
- Australian Rivers Institute, Griffith University, Nathan, Queensland 4111, Australia; Griffith Climate Change Response Group, Griffith University, Nathan, Queensland 4111, Australia
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14
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Rosinger AY, Brewis A, Wutich A, Jepson W, Staddon C, Stoler J, Young SL. Water borrowing is consistently practiced globally and is associated with water-related system failures across diverse environments. GLOBAL ENVIRONMENTAL CHANGE : HUMAN AND POLICY DIMENSIONS 2020; 64:102148. [PMID: 33071475 PMCID: PMC7566692 DOI: 10.1016/j.gloenvcha.2020.102148] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Water problems due to scarcity, inaccessibility, or poor quality are a major barrier to household functioning, livelihood, and health globally. Household-to-household water borrowing has been posited as a strategy to alleviate unmet water needs. However, the prevalence and predictors of this practice have not been systematically examined. Therefore, we tested whether water borrowing occurs across diverse global contexts with varying water problems. Second, we tested if household water borrowing is associated with unmet water needs, perceived socio-economic status (SES), and/or water-related system failures, and if water access moderated (or changed) these relationships. Using survey data from the Household Water Insecurity Experiences (HWISE) study from 21 sites in 19 low- and middle-income countries (n = 5495 households), we found that household-to-household water borrowing was practiced in all 21 sites, with 44.7% (11.4-85.4%) of households borrowing water at least once the previous month. Multilevel mixed-effect logistic regression models demonstrate that high unmet water needs (odds ratio [OR] = 2.86], 95% confidence interval [CI] = 2.09-3.91), low perceived SES (OR = 1.09; 95% CI = 1.05-1.13), and water-related system failures (23-258%) were all significantly associated with higher odds of water borrowing. Significant interactions (all p < 0.01) between water access, unmet water needs, and water-related system failures on water borrowing indicate that water access moderates these relationships. These data are the first to demonstrate that borrowing water is commonly used by households around the world to cope with water insecurity. Due to how prevalent water borrowing is, its implications for social dynamics, resource allocation, and health and well-being are likely vast but severely under-recognized.
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Affiliation(s)
- Asher Y. Rosinger
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA 16802, USA
- Department of Anthropology, Pennsylvania State University, University Park, PA 16802, USA
- Corresponding author at: 219 Biobehavioral Health Building, University Park, PA 16802, USA. (A.Y. Rosinger)
| | - Alexandra Brewis
- School of Human Evolution and Social Change, Phoenix, Arizona State University, Tempe, AZ 85287, USA
| | - Amber Wutich
- School of Human Evolution and Social Change, Phoenix, Arizona State University, Tempe, AZ 85287, USA
| | - Wendy Jepson
- Department of Geography, Texas A&M University, College Station, TX 77843, USA
| | - Chad Staddon
- Centre for Water, Communities and Resilience, University of the West of England, Bistol BS161QY, UK
| | - Justin Stoler
- Department of Geography, University of Miami, Coral Gables, FL 33146, USA
| | - Sera L. Young
- Department of Anthropology & Institute for Policy Research, Northwestern University, Evanston, IL 60208, USA
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15
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Stoler J, Jepson WE, Wutich A. Beyond handwashing: Water insecurity undermines COVID-19 response in developing areas. J Glob Health 2020; 10:010355. [PMID: 32509286 PMCID: PMC7242881 DOI: 10.7189/jogh.10.010355] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Justin Stoler
- Department of Geography, University of Miami, Coral Gables, Florida, USA
- Department of Public Health Sciences, Miller School of Medicine, Miami, Florida, USA
| | - Wendy E Jepson
- Department of Geography, Texas A&M University, College Station, Texas, USA
| | - Amber Wutich
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, USA
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16
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Stoler J, Pearson AL, Staddon C, Wutich A, Mack E, Brewis A, Rosinger AY. Cash water expenditures are associated with household water insecurity, food insecurity, and perceived stress in study sites across 20 low- and middle-income countries. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 716:135881. [PMID: 31874751 PMCID: PMC9988664 DOI: 10.1016/j.scitotenv.2019.135881] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/27/2019] [Accepted: 11/30/2019] [Indexed: 05/06/2023]
Abstract
Billions of people globally, living with various degrees of water insecurity, obtain their household and drinking water from diverse sources that can absorb a disproportionate amount of a household's income. In theory, there are income and expenditure thresholds associated with effective mitigation of household water insecurity, but there is little empirical research about these mechanisms and thresholds in low- and middle-income settings. This study used data from 3655 households from 23 water-insecure sites in 20 countries to explore the relationship between cash water expenditures (measured as a Z-score, percent of income, and Z-score of percent of income) and a household water insecurity score, and whether income moderated that relationship. We also assessed whether water expenditures moderated the relationships between water insecurity and both food insecurity and perceived stress. Using tobit mixed effects regression models, we observed a positive association between multiple measures of water expenditures and a household water insecurity score, controlling for demographic characteristics and accounting for clustering within neighborhoods and study sites. The positive relationships between water expenditures and water insecurity persisted even when adjusted for income, while income was independently negatively associated with water insecurity. Water expenditures were also positively associated with food insecurity and perceived stress. These results underscore the complex relationships between water insecurity, food insecurity, and perceived stress and suggest that water infrastructure interventions that increase water costs to households without anti-poverty and income generation interventions will likely exacerbate experiences of household water insecurity, especially for the lowest-income households.
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Affiliation(s)
- Justin Stoler
- Department of Geography and Regional Studies, University of Miami, Coral Gables, FL 33146, USA; Department of Public Health Sciences, University of Miami, Miami, FL 33136, USA.
| | - Amber L Pearson
- Department of Geography, Environment & Spatial Sciences, Michigan State University, East Lansing, MI 48824, USA; Department of Public Health, University of Otago, Wellington 6242, New Zealand.
| | - Chad Staddon
- Centre for Water, Communities and Resilience, University of the West of England, Bristol BS161QY, UK.
| | - Amber Wutich
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ 85287, USA.
| | - Elizabeth Mack
- Department of Geography, Environment & Spatial Sciences, Michigan State University, East Lansing, MI 48824, USA.
| | - Alexandra Brewis
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ 85287, USA.
| | - Asher Y Rosinger
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA 16802, USA; Department of Anthropology, Pennsylvania State University, University Park, PA 16802, USA.
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17
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Rosinger AY, Brewis A. Life and death: Toward a human biology of water. Am J Hum Biol 2019; 32:e23361. [PMID: 31782854 DOI: 10.1002/ajhb.23361] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 11/12/2019] [Indexed: 12/15/2022] Open
Affiliation(s)
- Asher Y Rosinger
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania.,Department of Anthropology, Pennsylvania State University, University Park, Pennsylvania
| | - Alexandra Brewis
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona
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18
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Wutich A. Water insecurity: An agenda for research and call to action for human biology. Am J Hum Biol 2019; 32:e23345. [PMID: 31697009 DOI: 10.1002/ajhb.23345] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/28/2019] [Accepted: 09/30/2019] [Indexed: 12/21/2022] Open
Abstract
Water insecurity-the lack of adequate and safe water for a healthy and productive life-is one of the greatest threats facing humans in the coming century. By 2030, half of the world is expected to be living in water-stressed conditions, given current climate change scenarios. A key goal of the UN Water Action Decade and Sustainable Development Goal 6 is to improve water security for the three billion people globally affected, but the future looks grim. For many communities, from Cape Town, South Africa to Flint, United States, the imagined dystopian future of severe water shortages has already arrived-shaped not so much by lack of water, but by aging infrastructure, underfunded utilities, social exclusion, politicized commodification, and environmental racism. Stepping off from my biocultural research in Cochabamba, Bolivia, I discuss how recent research is dramatically advancing our understanding of water insecurity, such as new findings around the biocultural causes and consequences of dehydration, contamination, and water stress. But, much more needs be done to support local communities in creating fair and just water systems. I discuss how human biologists can make crucial contributions toward the advancement of a much-needed science of water insecurity, while highlighting some practical and ethical challenges to advancing a core mission of providing safe, sufficient water to all.
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Affiliation(s)
- Amber Wutich
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona
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