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Safe, reliable, and equitable water access is critical to human health and livelihoods. In the United States, an estimated 471,000 households or 1.1 million individuals lack a piped water connection and 73% of households are located in cities, close to networked supply. In this study, we undertake a nationwide analysis of urban water access in the United States, with the aim of explaining the drivers of infrastructural inequality in the 50 largest metropolitan areas. Drawing on statistical analysis and regression modeling of census microdata at the household scale, our analysis reveals spatial and sociodemographic patterns of racialized, class-based, and housing disparities that characterize plumbing poverty. Among unplumbed households, we show that households headed by people of color are almost 35% more likely to lack piped water as compared to white, non-Hispanic households. Precarious housing conditions are an equally strong predictor: Renter-occupied households in the 50 largest US metros were 1.61 times more likely than owner-occupied households to lack piped water. We argue that insecure domestic water access in the United States should be understood as a housing issue that reflects structural inequalities of race and class, particularly in cities with widening wealth gaps. The article concludes with a call for research and action at the intersection of water provision, housing, and social inequality—a paradigm we call the housing–water nexus.

This study examined access to water, food, and nutrition programs among marginalized communities in Southern Punjab, Pakistan, and their effects on nutrition. Both qualitative and quantitative data were used in this study. We held two focus group discussions (one with 10 males and one with 10 females) and conducted in-depth interviews with 15 key stakeholders, including 20 mothers and 10 healthcare providers. A survey of 235 households was carried out to evaluate water and food insecurity, with the data analyzed using Wilcoxon’s rank-sum test, t-test, and Pearson’s chi-square test. The results revealed that 90% of households experienced moderate-to-severe water insecurity, and 73% faced moderate-to-severe food insecurity. Household water and food insecurity were positively correlated with each other (correlation coefficient = 0.205; p = 0.004). Greater household water (p = 0.028) and food insecurity (p < 0.001) were both associated with higher perceived stress. Furthermore, lower socioeconomic status was strongly related to higher levels of water (p < 0.001) and food insecurity (p < 0.001). Qualitative findings highlight the impact of colonial and post-colonial policies, which have resulted in water injustice, supply issues, and corruption in water administration. Women face significant challenges in fetching water, including stigma, harassment, and gender vulnerabilities, leading to conflicts and injuries. Water scarcity and poor quality adversely affect sanitation, hygiene, and breastfeeding practices among lactating mothers. Structural adjustment policies have exacerbated inflation and reduced purchasing power. Respondents reported a widespread lack of dietary diversity and food quality. Nutrition programs face obstacles such as the exclusion of people with low social and cultural capital, underfunding, weak monitoring, health sector corruption, and the influence of formula milk companies allied with the medical community and bureaucracy. This study concludes that addressing the macro-political and economic causes of undernutrition should be prioritized to improve nutrition security in Pakistan.

This paper systematically reviews existing United States-based water insecurity literature with the goal of understanding the evidence base for developing public health water insecurity intervention strategies in Oregon. The authors conducted the systematic literature review using an adjusted PRISMA reporting checklist to document the review process. Results find 11 public health-related water insecurity interventions including surveillance practices and indicator and policy development. Research on water insecurity health impacts and solutions is still an emerging field. Nevertheless, state agencies perceive a risk to communities from inadequate safe water and are taking steps to assess and reduce these risks. From the review, strategies include improving water affordability, carrying out community education events, documenting drought risk and water loss, and tracking improvements in safe drinking water compliance. The review finds opportunities to take varied approaches that are community-specific, partnership-based and culturally relevant. Recommendations for Oregon include characterizing communities experiencing water insecurity, assessing community needs, tracking regional water scarcity and recognizing the human right to water in Oregon.

The objective is to evaluate the validity and reliability of the Household Water Insecurity Experiences (HWISE) Scale as a tool to assess the experiences of households and the Argentine population regarding insecurity of access to water. Addressing water insecurity is critical for advancing several Sustainable Development Goals (SDGs), particularly SDG 6 (Clean Water and Sanitation), SDG 3 (Good Health and Well-Being), and SDG 1 (No Poverty), given the strong links between access to safe water, health, and poverty reduction. The scale was administered as part of the Argentine Social Debt Survey (EDSA), on a probabilistic sample of 5799 households. The HWISE Scale demonstrated high reliability both overall and at the item level (Cronbach’s alpha of 0.95 at a total level and greater than 0.94 for each of the items) and criterion validity in terms of correlation with a broad set of indicators: social deprivations, sanitary infrastructure, food insecurity, and psychological health. Finally, the scale showed internal consistency, with a total omega coefficient value of 0.96, suggesting that all scale indicators refer to the same concept of deprivation in water access. In sum, the HWISE Scale applied to the case of Argentina is deemed appropriate for estimating household water insecurity.

This study aimed to examine the association between household water insecurity (HWIS), mother's handwashing practices, and childhood diarrhea in the peri-urban and informal settlements of Hosanna town. A community-based cross-sectional study involving 424 mothers was carried out in Hosanna town, and the data were collected using a pretested structured questionnaire, HWISE Scale, and an observational checklist. Bivariate and multivariable logistic regression models were used to analyze the data. The study revealed that the prevalence of HWIS and diarrhea among under-five children was 68.6% and 16%, respectively. Only 42.2% of the mothers had good handwashing practices. Good knowledge of handwashing, positive attitudes toward handwashing, household water security (HWS), and the presence of handwashing facilities were significantly associated with good handwashing practices. Children aged 6–11 months, HWIS, uncovered and wide-mouthed water storage containers, unsafe child's stool disposal practices, and hands not washed with soap after defecation, before preparing food, and feeding a child were significantly associated with the occurrence of diarrhea. The prevalence of diarrhea and HWIS was very high. The majority of the mothers had poor handwashing practices. Therefore, findings suggest interventions to improve HWS and mother's handwashing practices, which could reduce the risk of diarrheal diseases.

Pastoralist communities in Northern Kenya face increasing water security risks attributable to disruptions in their socio-ecological environments. Sedentarized pastoralists, women, and children are most vulnerable to spatial-temporal variations in water availability. This vulnerability is exacerbated by embedded power relations within existing socio-cultural and water governance systems. A preliminary study carried out in 2016 examined pastoralist women’s disempowerment in relation to the domestic water security constraints they face. The research found anecdotal evidence that women with diversified livelihoods and social capital are more resilient to water stress. The follow-on study was carried out in 2018 and aimed to provide empirical evidence on factors behind water security and to identify factors that enhance resilience for vulnerable pastoralist communities. The study covered both urban and rural communities in Samburu County and applied a mixed-methods research methodology incorporating quantitative and qualitative research approaches. The study was also used to test a scale for measuring household water insecurity which could potentially improve the methodology for assessing shock-related stress in these high-risk communities. Results show extreme levels of water insecurity, especially in rural areas, and indicate a close relationship between water security and social capital as indicated in the earlier study. Livelihood diversity does not appear to influence water security but households with higher numbers of livestock tend to be more water insecure than households with smaller herds. This is supported by reports from women that the additional burden of watering homestead-based livestock makes them more vulnerable.

Household water insecurity is a global threat to human health and development, yet existing metrics lack a systematic consideration of geographic inequality and spatial variation. In this article, we introduce the notion of plumbing poverty as a conceptual and methodological heuristic to examine the intersectional nature of infrastructure, space, and social inequality. Plumbing poverty is understood in a dual sense: first, as a material and infrastructural condition produced by social relations that fundamentally vary through space and, second, as a methodology that operationalizes the spatial exploration of social inequality. Drawing on millions of census records, we strip household water security down to a single vital measure-the presence of complete household plumbing-to assess its spatial and sociodemographic trends. We identify distinct hot spots (geographic clusters of higher than average values) of plumbing poverty, track its social and spatial variance, and expose its fundamentally racialized nature. Our study finds that plumbing poverty is neither spatially nor socially random in the United States. Rather, plumbing incompleteness is spatially clustered in certain regions of the country and is clearly racialized: Living in an American Indian or Alaskan Native, black, or Hispanic household increases the odds of being plumbing poor, and these predictors warp and woof through space. In considering who experiences the slow violence of infrastructural dysfunction, a geography that is simultaneously ignored and unevenly expressed in the United States, we argue that analyses of space and social difference are central to understanding household water insecurity and must be prioritized in the development of cross-comparable metrics and global measurement tools. Key Words: census microdata, hot spot analysis, household water insecurity, infrastructural geographies, IPUMS. 家户水资源不安全，是对人类健康与发展的全球危害，但既有的度量，却缺乏对地理不均和空间变异的系统性考量。我们于本文中引入\"配管贫穷\"一词，作为概念与方法论上的启发，以检视基础建设、空间与社会不均之间的相互交织本质。配管贫穷以双重观念进行理解：首先作为由根本上具有空间变异的社会关系所生产的物质与基础建设条件，再者，作为操作社会不均的空间探索之方法。运用数以百万计的人口普查纪录，我们将家户水资源安全拆解成单一的重要测量--完整家户配管的存在--以评估其空间和社会人口趋势。我们指认配管贫穷的显着热点（较平均值为高的地理群聚), 追溯其社会和空间变异，并揭露其根本上的种族化本质。我们的研究发现，在美国，配管贫穷在空间或社会上并非具任意性。反之，配管不全在空间上集中于美国的若干区域，并明显是种族化的：居住于美国印地安人或阿拉斯加原住民族、黑人或西裔的家户中，增加了配管不足的机会，且这些预测指标随着空间经纬而异。在考量什麽人经历基础建设功能障碍的慢性暴力中--一种在美国同时受到忽略并不均展现的地理--我们主张，空间与社会差异的分析，是理解家户水资源不安全的核心，并且必需在建立横跨可比较的度量和全球测量工具时给予优先顺序。关键词：人口普查微观数据，热点分析，家户水资源不安全，基础建设地理学，微观共享整合数据库（IPUMS）。 La inseguridad en la disponibilidad de agua potable para uso doméstico es una amenaza global para la salud y el desarrollo humano, aunque las métricas existentes adolecen de la falta de consideración sistemática de la desigualdad geográfica y la variación espacial. En este artículo presentamos la noción de pobreza de plomería como heurística conceptual y metodológica para examinar la naturaleza interseccional de la infraestructura, el espacio y la desigualdad social. La pobreza de plomería se entiende en un sentido dual: primero, como una condición material e infraestructural producida por las relaciones sociales que fundamentalmente varían a través del espacio, y, segundo, como una metodología que operacionaliza la exploración espacial de la desigualdad social. Basándonos en millones de registros censales, desnudamos la seguridad del agua para uso doméstico, hasta convertirla en una sencilla medida vital-la presencia de una cabal plomería en el hoga-para evaluar sus tendencias espaciales y sociodemográficas. Identificamos puntos calientes perceptibles (agrupamientos geográficos con valores más altos que el promedio) de pobreza de plomería, rastreamos su varianza social y espacial, y exponemos su naturaleza fundamentalmente racializada. Nuestro estudio establece que la pobreza de plomería en los Estados Unidos no es ni espacial ni socialmente aleatoria. En vez de eso, la plomería deficiente se presenta agrupada espacialmente en ciertas regiones del país y es claramente racializada: Vivir en un hogar de indígenas americanos o nativos de Alaska, negro o hispánico, incrementa las posibilidades de ser pobre en plomería, y tales predictores campean a través del espacio. Al considerar quién experimenta la lenta violencia de la disfunción estructural, una geografía que es simultáneamente ignorada y expresada de manera desigual en los Estados Unidos, consideramos que los análisis de espacio y de diferencia social son centrales para entender la inseguridad del agua para uso doméstico y debe tener prioridad en el desarrollo de métricas comparables y herramientas de medición de uso global. Palabras clave: análisis de puntos calientes, geografías infraestructurales, inseguridad de agua potable, microdatos censales, IPUMS.

Fruit is important for human health, and applying deficit irrigation in fruit production is a strategy to regulate fruit quality and support environmental sustainability. Responses of different fruit quality variables to deficit irrigation have been widely documented, and much progress has been made in understanding the mechanisms of these responses. We review the effects of water shortage on fruit water accumulation considering water transport from the parent plant into the fruit determined by hydraulic properties of the pathway (including xylem water transport and transmembrane water transport regulated by aquaporins) and the driving force for water movement. We discuss water relations and solute metabolism that affect the main fruit quality variables (e.g. size, flavour, nutrition, and firmness) at the cellular level under water shortage. We also summarize the most recent advances in the understanding of responses of the main fruit quality variables to water shortage, considering the effects of variety, the severity of water deficit imposed, and the developmental stage of the fruit. We finally identify knowledge gaps and suggest avenues for future research. This review provides new insights into the stress physiology of fleshy fruit, which will be beneficial for the sustainable production of high-quality fruit under deficit irrigation.

ObjectiveProgress towards equitable and sufficient water has primarily been measured by population-level data on water availability. However, higher-resolution measures of water accessibility, adequacy, reliability and safety (ie, water insecurity) are needed to understand how problems with water impact health and well-being. Therefore, we developed the Household Water InSecurity Experiences (HWISE) Scale to measure household water insecurity in an equivalent way across disparate cultural and ecological settings.MethodsCross-sectional surveys were implemented in 8127 households across 28 sites in 23 low-income and middle-income countries. Data collected included 34 items on water insecurity in the prior month; socio-demographics; water acquisition, use and storage; household food insecurity and perceived stress. We retained water insecurity items that were salient and applicable across all sites. We used classical test and item response theories to assess dimensionality, reliability and equivalence. Construct validity was assessed for both individual and pooled sites using random coefficient models.FindingsTwelve items about experiences of household water insecurity were retained. Items showed unidimensionality in factor analyses and were reliable (Cronbach’s alpha 0.84 to 0.93). The average non-invariance rate was 0.03% (threshold <25%), indicating equivalence of measurement and meaning across sites. Predictive, convergent and discriminant validity were also established.ConclusionsThe HWISE Scale measures universal experiences of household water insecurity across low-income and middle-income countries. Its development ushers in the ability to quantify the prevalence, causes and consequences of household water insecurity, and can contribute an evidence base for clinical, public health and policy recommendations regarding water.

Water plays a critical role in the production of food and preparation of nutritious meals, yet few studies have examined the relationship between water and food insecurity. The primary objective of this study, therefore, was to examine how experiences of household water insecurity (HWI) relate to experiences of household food insecurity (HFI) among a pastoralist population living in an arid, water-stressed region of northern Kenya. We implemented the twelve-item Household Water Insecurity Experiences (HWISE, range 0-36) Scale and the nine-item Household Food Insecurity Access Scale (HFIAS, range 0-27) in a cross-sectional survey to measure HWI and HFI, respectively. Data on socio-demographic characteristics and intake of meat and dairy in the prior week were collected as covariates of interest. Northern Kenya, June-July 2019. Daasanach pastoralist households ( 136) from seven communities. In the prior 4 weeks, 93·4 % and 98·5 % of households had experienced moderate-to-severe HWI and HFI, respectively. Multiple linear regression analyses indicated a strong association between HWI and HFI. Each point higher HWISE score was associated with a 0·44-point (95 % CI: 0·22, 0·66, = 0·003) higher HFIAS score adjusting for socio-economic status and other covariates. These findings demonstrate high prevalence and co-occurrence of HWI and HFI among Daasanach pastoralists in northern Kenya. This study highlights the need to address HWI and HFI simultaneously when developing policies and interventions to improve the nutritional well-being of populations whose subsistence is closely tied to water availability and access.