Department of Geography and Regional Studies, University of Miami, Coral Gables, FL 33146, USA; Department of Public Health Sciences, University of Miami, Miami, FL 33136, USA.
Department of Geography, Environment & Spatial Sciences, Michigan State University, East Lansing, MI 48824, USA; Department of Public Health, University of Otago, Wellington 6242, New Zealand.
Sci Total Environ. 2020 May 10;716:135881. doi: 10.1016/j.scitotenv.2019.135881. Epub 2019 Dec 2.
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.
全球数十亿人在不同程度上面临着用水不安全的问题，他们的家庭用水和饮用水来自各种不同的水源，这些水源可能会消耗家庭收入的很大一部分。从理论上讲，存在着与缓解家庭用水不安全问题相关的收入和支出阈值，但关于这些机制和阈值在低收入和中等收入国家的实证研究却很少。本研究利用来自 20 个国家 23 个用水不安全地区的 3655 户家庭的数据，探讨了现金水费支出（以 Z 分数、收入百分比和收入百分比的 Z 分数衡量）与家庭用水不安全得分之间的关系，以及收入是否调节了这种关系。我们还评估了水费支出是否调节了用水不安全与食物不安全和感知压力之间的关系。使用 Tobit 混合效应回归模型，我们观察到多种水费支出衡量指标与家庭用水不安全得分之间存在正相关关系，控制了人口特征，并考虑了邻里和研究地点的聚类。即使在调整了收入之后，用水支出与用水不安全之间的正相关关系仍然存在，而收入与用水不安全呈负相关。水费支出也与食物不安全和感知压力呈正相关。这些结果突显了用水不安全、食物不安全和感知压力之间的复杂关系，并表明增加家庭水费支出而不采取扶贫和增收干预措施的水基础设施干预措施可能会加剧家庭用水不安全问题，尤其是对收入最低的家庭而言。
