Water Supply Interruptions Are Associated with More Frequent Stressful Behaviors and Emotions but Mitigated by Predictability: A Multisite Study.

Water supply interruptions contribute to household water insecurity. Unpredictable interruptions may particularly exacerbate water insecurity, as uncertainty limits households' ability to optimize water collection and storage or to modify other coping behaviors. This study used regression models of survey data from 2873 households across 10 sites in 9 middle-income countries to assess whether water supply interruptions and the predictability of interruptions were related to composite indicators of stressful behaviors and emotional distress. More frequent water service interruptions were associated with more frequent emotional distress (ß = 0.49, SE = 0.05, P < 0.001) and stressful behaviors (ß = 0.39, SE = 0.06, P < 0.001). Among households that experienced interruptions, predictability mitigated these respective relationships by approximately 25 and 50%. Where the provision of continuous water supplies is challenged by climate change, population growth, and poor management, water service providers may be able to mitigate some psychosocial consequences of intermittency through scheduled intermittency and communication about water supply interruptions. Service providers unable to supply continuous water should optimize intermittent water delivery to reduce negative impacts on users, and global monitoring regimes should account for intermittency and predictability in post-2030 water service metrics to better reflect household water insecurity experiences.

Water insecurity is associated with gender-based violence: A mixed-methods study in Indonesia.

Gender Based Violence (GBV) is a global pandemic and water insecurity is increasing in intensity and extent. This study explores the association between these two global health threats. Cross-sectional, quantitative data were collected via surveys (n = 365 adult women) to measure household water insecurity (HWI) and women's experiences of GBV in the last year. Qualitative data were collected from semi-structured interviews (n = 24 men and women), two focus group discussions (n = 25 men and women) and a multi-stakeholder meeting (n = 35 men and women) to explore experiences, attitudes and risk factors associated with HWI and GBV. Multivariate logistic regression analysis showed that women in water insecure households were more than twice as likely to report experiencing GBV in the last year (OR = 2.2, CI: 1.0-4.9, p = 0.051). Examining household water insecurity scores as a continuous variable revealed an increased odds of reporting GBV with each increase in the HWISE score (OR = 1.1, CI: 1.0; 1.1, p < 0.001). Qualitative data indicates that the intersection between HWI, a patriarchal social organization and a caste system produced water-related conflicts between intimate partners, between daughters-in-law and their in-laws, and between masters and enslaved women. These results are presented using an integrated theoretical framework - a Feminist Political Ecology of Health (FPEH) - to illustrate the many ways women encounter and experience multi-dimensional forms of violence across scales in connection to water insecurity. The combination of robust qualitative and quantitative data presented in this study suggests that HWI may be causally related to GBV in this context.

Research needs for loss and damage.

The 28th Conference of the Parties (COP28) of the United Nations (UN) climate negotiations concluded in December against a backdrop of shattered climate records, extreme weather, and climate events in 2023 that resulted in substantial loss of life, impacts on health and wellbeing, climate-related mobility, food and water insecurity, and other socioeconomic effects worldwide. In this context, the importance of addressing loss and damage (L&D)-the negative impacts of climate change that persist despite mitigation and adaptation efforts-was paramount. With countries having agreed at the opening plenary to operationalize the L&D fund that was established in 2022 at COP27, inputs from the scientific community will be essential as the global community now seeks to bring the fund online.

Blueing green water from forests as strategy to cope with climate change in water scarce regions: The case of the Catalan river basin District.

Water scarcity in Mediterranean basins is a critical concern exacerbated by climate change and afforestation of abandoned lands. This study addresses the impact of forest management on water availability, specifically blue water, at a regional scale. Utilizing the SWAT + model, we assess water yield increases resulting from various forest thinning scenarios (light, moderate, heavy) and compare benefits to costs. Our approach incorporates site-specific marginal values of water yield, accounting for urban water supply abstractions. The findings reveal the efficacy of hydrological-oriented forest management in alleviating water scarcity. Thinning intensity positively correlates with water yield, with coniferous forests exhibiting the greatest response and deciduous forests the least. Emphasizing blue water enhancement as a significant co-benefit in forest management planning, our study underscores the economic advantages. Particularly valuable in certain areas, this approach can offset a substantial portion of associated costs. Spatially explicit results enable optimal resource allocation, facilitating efficient planning and prioritization of intervention areas for successful hydrological-oriented strategies. In conclusion, our study not only highlights the economic benefits of forest management in enhancing water availability but also offers actionable insights for sustainable and effective hydrological-oriented planning amid escalating water scarcity.

Water insecurity among seasonal agriculture workers: perspectives from Spanish professionals.

BACKGROUND: Migrant seasonal agricultural workers face conditions of material vulnerability such as inadequate housing difficulties prevent access to running water supplies. The purpose of this study is to explore the perceptions of professionals involved in the care and support of seasonal migrant agricultural workers, as it relates to water access and water consumption and their impact on these workers' health, in a context of COVID-19 pandemic. METHODS: A qualitative exploratory and descriptive study was conducted in 2021 as part of a larger research project, based on 63 personal semi-structured interviews with professionals who provided support to seasonal migrant agricultural workers in three Spanish autonomous regions. COREQ checklist was used for reporting. The interviews were recorded, transcribed, and imported into ATLAS.ti-9 for an inductive thematic analysis. RESULTS: The results have been structured into two main themes: (1) Accessing and obtaining water; and (2) Health problems related to water consumption. Seasonal migrant agricultural workers experience barriers to obtaining safe water for hygiene, cleaning, food preparation and drinking. The implementation of regulations to reduce COVID-19 transmission resulted in improved hygiene levels in the migrants' quarters, including access to safe drinking water. CONCLUSION: This study suggests that water insecurity experienced by migrant seasonal agricultural workers in Spain results from their poor living conditions and causes health problems related to a lack of hygiene and the use of unsafe water. Sustainable solutions are needed beyond the pandemic in order to provide migrant workers with adequate living conditions and ensure their water needs are fulfilled.

Exploring China's water scarcity incorporating surface water quality and multiple existing solutions.

Water scarcity has threatened the sustainability of human life, ecosystem evolution, and socio-economic development. However, previous studies have often lacked a comprehensive consideration of the impact of water quality and existing solutions, such as inter-basin water transfer and unconventional water resources, on water scarcity. In this paper, an improved approach was proposed to quantify water scarcity levels by comprehensively considering surface water quality and multiple solutions. China's water scarcity was first assessed at a high spatial resolution on a monthly basis over the 5-year period from 2014 to 2018. Then, the driving factors including water quality and solutions were identified by a geographic detector model. Finally, an in-depth investigation was conducted to unravel the effects of water quantity solutions (i.e., inter-basin water transfer and unconventional water use), and water quality solutions (i.e., improving surface water quality) on alleviating water scarcity. Based on monthly assessments considering water quality and multiple existing solutions, the results showed that over half of the national population (∼777 million) faced water scarcity for at least one month of the year. Agricultural water use and inadequate water quality were the main driving factors responsible for China's water scarcity. Over four-fifths of the national population (∼1.10 billion) could benefit from alleviated water scarcity through a combination of water quantity and quality solutions. However, the existing solutions considered were insufficient to completely resolve water scarcity in China, especially in Northern China, persisting as a challenging issue. The results obtained from this study provided a better understanding of China's water scarcity, which could contribute to guiding future efforts aimed at alleviating water scarcity and ensuring water security in China.

Evaluating Losses from Water Scarcity and Benefits of Water Conservation Measures to Intercity Supply Chains in China.

The severe water scarcity in China poses significant economic risks to its agriculture, energy, and manufacturing sectors, which can have a cascading effect through the supply chains. Current research has assessed water scarcity losses for global countries and Chinese provinces by using the water scarcity risk (WSR) method. However, this method involves subjective functions and parameter settings, and it fails to capture the adaptive behaviors of economies to water scarcity, compromising the reliability of quantified water scarcity loss. There is a pressing need for a new method to assess losses related to water scarcity. Here, we develop an agent-based complex network model to estimate the inter-regional and intersectoral impacts of water scarcity on both cities and basins. Subsequently, we evaluate the supply chain-wide economic benefits of four different water conservation measures as stipulated by the 14th Five-Year Plan for the Construction of a Water-Saving Society. These measures include increasing the utilization rate of recycled water in water-scarce cities, reducing the national water consumption per industrial value-added, and implementing agricultural and residential water conservation measures. Results show that direct losses constitute only 9% of the total losses from water scarcity. Approximately 37% of the losses can be attributed to interregional impacts. Among the water-scarce cities, Qingdao, Lanzhou, Jinan, and Zhengzhou pose a significant threat to China's supply chains. Agricultural water conservation yields the highest amount of water savings and economic benefits, while residential water conservation provides the highest economic benefit per unit of water saved. The results provide insights into managing water scarcity, promoting cross-regional cooperation, and mitigating economic impacts.

HIV Vulnerabilities Associated with Water Insecurity, Food Insecurity, and Other COVID-19 Impacts Among Urban Refugee Youth in Kampala, Uganda: Multi-method Findings.

Food insecurity (FI) and water insecurity (WI) are linked with HIV vulnerabilities, yet how these resource insecurities shape HIV prevention needs is understudied. We assessed associations between FI and WI and HIV vulnerabilities among urban refugee youth aged 16-24 in Kampala, Uganda through individual in-depth interviews (IDI) (n = 24), focus groups (n = 4), and a cross-sectional survey (n = 340) with refugee youth, and IDI with key informants (n = 15). Quantitative data was analysed via multivariable logistic and linear regression to assess associations between FI and WI with: reduced pandemic sexual and reproductive health (SRH) access; past 3-month transactional sex (TS); unplanned pandemic pregnancy; condom self-efficacy; and sexual relationship power (SRP). We applied thematic analytic approaches to qualitative data. Among survey participants, FI and WI were commonplace (65% and 47%, respectively) and significantly associated with: reduced SRH access (WI: adjusted odds ratio [aOR]: 1.92, 95% confidence interval [CI]: 1.19-3.08; FI: aOR: 2.31. 95%CI: 1.36-3.93), unplanned pregnancy (WI: aOR: 2.77, 95%CI: 1.24-6.17; FI: aOR: 2.62, 95%CI: 1.03-6.66), and TS (WI: aOR: 3.09, 95%CI: 1.22-7.89; FI: aOR: 3.51, 95%CI: 1.15-10.73). WI participants reported lower condom self-efficacy (adjusted ß= -3.98, 95%CI: -5.41, -2.55) and lower SRP (adjusted ß= -2.58, 95%CI= -4.79, -0.37). Thematic analyses revealed: (1) contexts of TS, including survival needs and pandemic impacts; (2) intersectional HIV vulnerabilities; (3) reduced HIV prevention/care access; and (4) water insecurity as a co-occurring socio-economic stressor. Multi-method findings reveal FI and WI are linked with HIV vulnerabilities, underscoring the need for HIV prevention to address co-occurring resource insecurities with refugee youth.

The Household Water Insecurity Experiences Scale: answer patterns and cutoffs in Mexico.

OBJECTIVE: To investigate the degree in which answer patterns in the Household Water Insecurity Experiences Scale (HWISE) relate to scores aiming at identifying latent groups with different water insecurity levels in a nationwide representative sample of the Mexican population. MATERIALS AND METHODS: Based on data from the 2021 National Survey on Health and Nutrition (Estudio Nacional de Salud y Nutrición 2021, Ensanut 2021), sequence data representations, and a latent class analysis (LCA), in this article we estimate the likely misclassification errors of different cutoffs proposed for the HWISE scoring system. RESULTS: The main results suggest that a 5-item subset of the HWISE may exhibit a more reliable and cost-effective behavior than the complete 12-item set for a 2-level partition of the sample. CONCLUSIONS: Our methodological approach provides new insights regarding the efficiency and likely errors in distinguishing between levels of water insecurity based on the Mexican chapter of the HWISE.

Mapping the virtual water trade in water-scarce basin: an environmentally extended input-output analysis in the Yellow River Basin of China.

China's Yellow River, the nation's second-longest, grapples with severe water scarcity, impeding the high-quality development of its basin. Our study meticulously examines the intricate virtual water trade network inside and outside the basin, providing essential insights to combat its acute water scarcity. We calculated water consumption coefficients for seven pivotal sectors across diverse Chinese provinces, forming the foundational data for quantifying virtual water trade both inside and outside the basin. Utilizing the 2015 Multi-Regional Input-Output Table, we assessed the Yellow River Basin's reliance on external water resources. Despite enduring chronic water scarcity, the basin annually exports a substantial 27.2 billion m3 of virtual water, equivalent to half of its yearly runoff. This outflow predominantly flows to the economically advanced eastern coastal region, with Agriculture and Manufacturing sectors dominating. Significantly, an irrational industrial layout leads to a substantial transfer of virtual water from economically disadvantaged areas to more affluent regions, exacerbating water scarcity in the basin's less privileged areas. Our study yields critical insights for mitigating water shortages in the Yellow River Basin and provides a transferrable framework for regions worldwide grappling with analogous challenges.

Perceived difficulties in maintaining menstrual hygiene practices among indigenous adolescents during seasonal water scarcity periods in Bandarban hill district of Bangladesh: A cross-sectional study.

BACKGROUND: Access to clean water is important for menstrual hygiene practices, an important aspect of health for adolescent girls. In Bangladesh, adolescent girls represent poor menstrual hygiene practices, whereas the practice is worse among vulnerable population groups living in areas experiencing seasonal water scarcity. This study portrays perceived difficulties in menstrual hygiene practices among indigenous adolescent girls during the period of seasonal water scarcity in Bandarban Hill District, Bangladesh. METHOD: Data was collected from 242 indigenous adolescent girls through interviews during the period of water scarcity. Backward stepwise regression model was used to identify factors associated with perceived difficulty in maintaining menstrual hygiene (PD) practices. RESULT: The study participants, mainly living in hard-to-reach areas, reported difficulty in getting adequate water during the water scarcity period, and the quality of water was reported to be poor. PD due to water scarcity was found to be significantly associated with water source degradation (ß = 0.247, < 0.001), the need for boiling/purifying water before use for menstrual hygiene (ß = 0.203, p = 0.005), and experience of water availability when it was necessary to maintain their optimal menstrual hygiene practice (ß = 0.449, p < 0.001), time required to collect water (ß = 0.209, p < 0.001), taking a bath every day (ß = -0.228, p < 0.001), and frequency of washing genitals per day (ß = - 0.094, p = 0.040). CONCLUSION: Indigenous adolescents perceive difficulty in menstrual hygiene practices during the period of water scarcity. Further research could be carried out to observe to what extent the seasonal water scarcity could be attributable to worsen the menstrual hygiene practices and to identify the need for addressing the problems.

Envisaged methodologies for sustainable food labelling policies might worsen water scarcity.

To reduce the current billions of people facing water scarcity, which is a dedicated Sustainable Development Goal (SDG) target, different actions and measures are required. This includes food labelling which accounts for water scarcity, to help consumers make informed choices when purchasing food products. The European Commission is considering the proposal of a "Sustainable food labelling framework" in the last quartal of 2023, within its ambitious Farm to Fork strategy. Implementing such a food label in the EU has a potential reach of 447 million consumers. Most prominent label candidate is its own developed PEF (Product Environmental Footprint), a tool already implemented by some retailers in the EU. However, this paper argues that the category water scarcity in the PEF has two major flaws. First, it does not account for water efficiency of a product, which is essential to solve global water stress. Second, the spatial resolution for water stress is much too coarse. The current PEF tool makes comparisons between products useless and even misleading. Its use might worsen global water scarcity, as it provides producers and consumers the wrong incentives. Urgent revision of the category water stress in the PEF is required. This can be done by using the indicators water stress and water efficiency in a complementary way, as well as using the most detailed spatial resolution science can provide.

A declaration on the value of experiential measures of food and water insecurity to improve science and policies in Latin America and the Caribbean.

BACKGROUND: Water security is necessary for good health, nutrition, and wellbeing, but experiences with water have not typically been measured. Given that measurement of experiences with food access, use, acceptability, and reliability (stability) has greatly expanded our ability to promote food security, there is an urgent need to similarly improve the measurement of water security. The Water InSecurity Experiences (WISE) Scales show promise in doing so because they capture user-side experiences with water in a more holistic and precise way than traditional supply- side indicators. Early use of the WISE Scales in Latin American & the Caribbean (LAC) has revealed great promise, although representative data are lacking for most of the region. Concurrent measurement of experiential food and water insecurity has the potential to inform the development of better-targeted interventions that can advance human and planetary health. MAIN TEXT: On April 20-21, 2023, policymakers, community organizers, and researchers convened at Universidad Iberoamericana in Mexico City to discuss lessons learned from using experiential measures of food and water insecurity in LAC. At the meeting's close, organizers read a Declaration that incorporated key meeting messages. The Declaration recognizes the magnitude and severity of the water crisis in the region as well as globally. It acknowledges that traditional measurement tools do not capture many salient water access, use, and reliability challenges. It recognizes that the WISE Scales have the potential to assess the magnitude of water insecurity more comprehensively and accurately at community, state, and national levels, as well as its (inequitable) relationship with poverty, poor health. As such, WISE data can play an important role in ensuring more accountability and strengthening water systems governance through improved public policies and programs. Declaration signatories express their willingness to promote the widespread use of the WISE Scales to understand the prevalence of water insecurity, guide investment decisions, measure the impacts of interventions and natural shocks, and improve public health. CONCLUSIONS: Fifty-three attendees endorsed the Declaration - available in English, Spanish and Portuguese- as an important step to making progress towards Sustainable Development Goal 6, "Clean Water and Sanitation for All", and towards the realization of the human right to water.

Exploring the nexus of water insecurity and psychological distress in Windhoek's informal settlements, Namibia.

Water insecurity has long been a pressing issue, particularly in the informal settlements of Windhoek. The current study aims to investigate the relationship between water insecurity and residents' psychological distress in Windhoek's informal settlements. The study draws upon secondary data collected by Future Resilience for African Cities and Lands in 2017. Confirmatory factor analysis was used to establish the relationship between water insecurity, psychological distress, and three manifest variables (source of income, housing type, and household structure). The study findings revealed a positive association between housing type and psychological distress (ß = 0.056, p < 0.001). Household structure was negatively associated with psychological distress (ß = -0.035, p < 0.001) and water insecurity (ß = -0.054, p < 0.001). In addition, a positive association (ß = 0.595, p < 0.001) was found between water insecurity and psychological distress, suggesting that water scarcity negatively impacts residents' mental well-being. The study highlights the need to address the issue of water insecurity in informal settlements across Windhoek. This can be achieved by setting measures to make water and essential sanitation services more accessible and affordable to residents in these communities. Such approaches would help mitigate the effect of water insecurity on the psychological distress of persons living in informal settlements and create more resilient and sustainable settlements.

Water Insecurity Indicators Are Associated with Lower Diet and Beverage Quality in a National Survey of Lower-Income United States Adults.

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 (ß = -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.

Water Insecurity and Maternal Health Among Haudenosaunee Women in Canada.

Water is central to Haudenosaunee knowledge, philosophy, and culture. The health of Haudenosaunee mothers is tied to that of water. Today, the lack of access to reliable drinking water for Six Nations is a significant health concern. Technical measurement of water advisories in Canada fails to understand the interwoven relationship that Haudenosaunee women have with water. Highlighting the voices of 55 Haudenosaunee women, we provide expanded definitions of water insecurity and maternal health to include more-than-human beings. This comprehensive understanding of water insecurity and health shapes SN mothers' experiences with water in a settler colonial state, affecting their holistic wellbeing.

Managing menstruation with dignity: Worries, stress and mental health in two water-scarce urban communities in India.

An emerging body of literature examines multiple connections between water insecurity and mental health, with particular focus on women's vulnerabilities. Women can display greatly elevated emotional distress with increased household water insecurity, because it's them who are primarily responsible for managing household water and uniquely interact with wider water environments. Here we test an extension of this proposition, identifying how notions of dignity and other gendered norms related to managing menstruation might complicate and amplify this vulnerability. Our analysis is based on systematic coding for themes in detailed semi-structured interviews conducted with twenty reproductive-age women living in two water insecure communities in New Delhi, India in 2021. The following themes, emerging from our analysis, unfold the pathways through which women's dignity and mental health is implicated by inadequate water: ideals of womanhood and cleanliness; personal dignity during menstruation; hierarchy of needs and menstruation management amidst water scarcity; loss of dignity and the humiliation; expressed stress, frustration and anger. These pathways are amplified by women's expected roles as household water managers. This creates a confluence of gendered negative emotions - frustration and anger - which in turn helps to explain the connection of living with water insecurity to women's relatively worse mental health.

Frontiers of household water insecurity metrics: severity, adaptation and resilience.

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.

Water scarcity can be a critical limitation for the poultry industry.

Water is essential for various physiological functions and the productive performance of animals. However, with climatic uncertainties exacerbated by climatic changes, water could become a scarce nutrient shortly. This is already the case in one-third of the world's countries, which are under medium to high levels of water stress. Accordingly, with the growth of poultry production, the availability of water at ad libitum level may not be guaranteed, and birds can be under water restriction for variable periods. Thus, this article aims at attracting the attention of animal scientists to the freshwater shortage challenge, as well as shedding light on (1) the effects of climate change on the freshwater resources; (2) the effects of limited access to water, either by water restriction (WR) or water deprivation (WD), on the growth, feed efficiency, and meat quality of broilers; (3) the effects of different levels of WR or WD on egg production and egg quality traits; (4) the effects of limited access to water on the health, behavior, and welfare status of chickens; and (5) suggested solutions to overcome future water shortage challenges. In conclusion, severe water shortage/restriction might negatively influence the productivity, behavior, and welfare status of the chickens. Genetic background and environmental conditions may interact with the WR effects. The tolerance level of indigenous chicken breeds to limited water access could provide the knowhow to potential solutions to overcome water shortage problems. Selection of chicken strains with high tolerance capacity to thirst and limited water access regimens may be a sustainable solution for solving water scarcity problems.