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Explore the relationship between water insecurity (WI) and food security and their covariates in Mexican households. A cross-sectional study with nationally representative data from the National Health and Nutrition Survey-Continuous 2021 (in Spanish, ENSANUT-Continua 2021), collected data from 12 619 households. WI was measured using the Household Water Insecurity Experiences (HWISE) Scale in Spanish and adapted to the Mexican context. Food security was measured using the Latin American and Caribbean Food Security Scale. A generalised path model was used to produce two simultaneous logistical regression equations - WI (HWISE ≥ 12) and moderate-to-severe food insecurity (FI) - to understand key covariates as well as the contribution of WI to FI. The head of the household, an adult of >18 years of age, consented to participate in the survey. Households experiencing WI were more likely to experience moderate-to-severe FI (OR = 2·35; 95 % CI: 2·02, 2·72). The odds of WI were lower in households with medium (OR = 0·74; 95 % CI: 0·61, 0·9) to high (OR = 0·45; 95 % CI: 0·37, 0·55) asset scores. WI also depended on the region of Mexico. FI is more prevalent in indigenous people (OR = 1·29; 95 % CI: 1·05, 1·59) and rural households (OR = 0·42; 95 % CI: 1·16, 1·73). Notably, wealth and household size did not contribute directly to FI but did so indirectly through the mediating factor of WI. Our study shows that there are structural factors that form part of the varied determinants of WI, which in turn is closely linked to FI.

Currently, the management, availability, and equitable access to water are some of the most critical environmental challenges in many countries, including Mexico. The Household Water Insecurity Experience Scale (HWISE) offers a more comprehensive and accurate assessment of water insecurity (WI) as well as its relationship to poverty, at the local, state, and national levels, than traditional usage indicators do. Therefore, this study aims to estimate the association between water insecurity and household wellbeing in Mexico, as well as the role of geographic factors. Methods: We analyzed data from 11,512 households that had previously participated in a representative survey at the national, regional, and urban/rural levels. We conducted descriptive and bivariate analyses on the variables of interest according to household WI status. Multivariate logistic regression models were used to determine the association between WI and the geographic, household, and household head variables of interest. Results: The factors associated with a greater odds ratio of household WI were low wellbeing conditions (OR = 1.74, p < 0.01), no running water in the home (OR = 2.71, p < 0.01), a monthly household income less than 6000 Mexican pesos (less than 352 dollars) (OR = 2.31, p = 0.006), living in an urban area (OR = 1.93, p = 0.001), and living in the Mexico State (OR = 3.92, p < 0.01), Mexico City (OR = 3.19, p < 0.01), or Central Pacific (OR = 3.27, p < 0.01) regions. Conclusions: Currently, multiple factors threaten household water security. These findings can inform decision-makers about the driving factors behind gaps in water access, availability, and use in Mexican households, thereby ensuring the “availability and sustainable management of water and sanitation for all”.

Background Evidence suggests that disordered eating behaviors can result in eating disorders, which is already a reality for the Mexican population, representing an increasingly complex public health problem. Early detection is therefore essential. Aim of the study To obtain the sensitivity, specificity, and cut-off points of the Brief Questionnaire for Measuring Disordered Eating Behaviors to identify eating disorders in Mexican women. Methods The Eating Disorders Examination-Questionnaire and the Brief Questionnaire for Disordered Eating Behaviors were applied to patients diagnosed with eating disorders at two public health institutions and university students. ROC analysis was performed to determine sensitivity, specificity, predictive values, and cut-off points. Results Three cut-off points were obtained: first: eight points (Sensitivity = 60.7%, Specificity = 92.2%), showing low risk; second: 11 points (sensitivity = 24.1%; specificity = 98.9%), detecting moderate risk; and, finally, 15 points and over (sensitivity = 4.46%; specificity = 100%), indicating high risk. Conclusions The instrument adequately identifies those individuals who are not at risk for eating disorders, making it possible to channel prevention efforts towards those who do have DEB, thus optimizing resources. Level of evidence Level III: case–control analytic study.

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 America & 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.