ArticleThe Science of the total environment2020
Cash water expenditures are associated with household water insecurity, food insecurity, and perceived stress in study sites across 20 low- and middle-income countries.
Article in The Science of the total environment, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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Who cites it
31 citing papers in PubMed.
- Socioecological drivers and dimensions of household water insecurity among people with HIV in the Lake Victoria region, Kenya.Journal of water and health · 2026Article
- Socioecological drivers of water, sanitation, and hygiene (WASH) choices: A qualitative analysis of maternal perspectives in northwest Ecuador.PLOS water · 2026Article
- Implications of water insecurity for food practices and health in contexts of migration and displacement: evidence from the US-Mexico borderlands.Frontiers in nutrition · 2026Article
- The Water Insecurity Experiences (WISE) Scales are suitable for use in high-income settings: findings from cognitive interviews and nationally representative surveys.International journal for equity in health · 2025Article
- A study of the link between food-water insecurities and self-reported psychotic experiences among young adults in Gaza Strip: What role does social support play under conditions of war and extreme suffering?International journal for equity in health · 2025Article
- Household-related stress, intimate partner violence and mental health: exploring the syndemic in urban slum women in Bangladesh during Covid-19 pandemic.International journal for equity in health · 2025Article
- The Well-Being of Slum Dwellers Are Associated With WaSH-Related Factors: A Cross-Sectional Study From India.Health science reports · 2025Article
- The Water Insecurity Experiences (WISE) Scales are suitable for use in high-income settings: findings from cognitive interviews and nationally representative surveys.Research square · 2025Article
- Interacting Water Insecurity and Food Insecurity: Recent Advances in Theory and Application.American journal of human biology : the official journal of the Human Biology Council · 2025Article
- How water intermittency and water perceptions influence household coping strategies in northwestern Ecuador.PLOS water · 2025Article
- A protocol for the development of a validated scale of household water insecurity in the United States: HWISE-USA.PloS one · 2025Article
- Water insecurity may exacerbate food insecurity even in water-rich environments: Evidence from the Bolivian Amazon.The Science of the total environment · 2024Article
- Estimating effects of monsoon flooding on household water access.Environmental research letters : ERL [Web site] · 2024Article
- Trends and disparities in concurrent tap water avoidance and household food insecurity among US children.Nature water · 2024Article
- Frequency and perceived difficulty of household water experiences in Morogoro, Tanzania: Evidence of the psychosocial burden of water insecurity.SSM. Mental health · 2024Article
- Associations between water insecurity and mental health outcomes among lesbian, gay, bisexual, transgender and queer persons in Bangkok, Thailand and Mumbai, India: Cross-sectional survey findings.Global mental health (Cambridge, England) · 2024Article
- [Food insecurity and household water insecurity: a population-based study in a municipality in the Amazon River basin, Brazil].Cadernos de saude publica · 2024Article
- Article
- Variations in household water affordability and water insecurity: An intersectional perspective from 18 low- and middle-income countries.Environment and planning. F, Philosophy, theory, models, methods and practice · 2023Article
- Frontiers of household water insecurity metrics: severity, adaptation and resilience.BMJ global health · 2023Review
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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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