Water Insecurity and Public Health Outcomes in Urban Mexico


Principal Investigator: Dr. Genny Carrillo, TAMU Public Health; Co-PIs, Dr. Felipe Uribe, COLEF, Dr. Javier Moran, UAC,  and Dr. Wendy Jepson, TAMU Geosciences

Status: This study has been completed with one manuscript submitted for review to the British Medical Journal Open; data analysis ongoing. We want to thank colleagues Dr. Justin Stoler (University of Miami) and Dr. Juha Baek (TAMU Public Health) for their collaborative efforts in our data analysis.

Funding: TAMU-CONACYT Collaborative Grant

Overview. Public health workers have estimated that approximately 1.8 billion people drink unsafe water, because, although their water source is “improved,” its microbial quality is poor due to delivery system or storage. We understand water security as the ability to access and benefit from affordable, adequate, reliable and safe water for wellbeing and a healthy life. Water insecurity is a condition when at least one of these variables (affordability, reliability, adequacy, and safety) is significantly reduced or unattainable. Using an existing and valid household water insecurity survey developed by Dr. Jepson (Co-PI), we can assess affordability, reliability, adequacy of water provision to place households on a water security scale. However, we have yet to link this assessment to a specific health outcome. This pilot project proposal, therefore, seeks to fill that critical gap.

Our research question is: what is the relationship between water insecurity and water-related disease? Our hypothesis is that higher levels of water insecurity will result in higher levels of water-borne disease.  We have chosen to work in Torreon, Mexico, because it is a city with chronic water problems and we have institutional connections with the School of Medicine, Universidad Autónoma de Coahuila and COLEF.

Project’s objectives.

  1. Develop a stratified sample of households based on neighborhoods classified by socio-economic status for the survey administration in Torreon, Mexico
  2. Conduct a repeat (dry/rainy season), 30-day recall survey on household water insecurity and health (gastrointestinal disease) in Torreon, Mexico (N=250, repeat)
  3. Measure the prevalence of GI disease and level of household water insecurity in surveyed households.
  4. Employ exploratory forward and backward stepwise regression models to introduce independent measures in the model-building process and to test several hypotheses that relate water insecurity and public health.

Methodology. The survey is divided into several parts: (1) a household WASH (water and sanitation) inventory, (2) household water insecurity questionnaire, (3) a socio-economic inventory, and (4) water borne-illness survey.  Parts 1-3 are based on a version that is used (or will be used) in multiple sites where Co-PI Jepson has ongoing projects. Therefore, it will allow for maximum cross-regional, cross-cultural comparisons. The unique aspect of this project is the public health census (Part 4), which will allow us to explicitly measure the relationship between water insecurity and public health. Our Mexican partners will select a neighborhood(s) in which distribution, consumption and quality of drinking water in developing countries are related to material living conditions of populations.