{"id":46099,"date":"2024-01-19T10:00:00","date_gmt":"2024-01-19T18:00:00","guid":{"rendered":"https:\/\/foodrevolution.org\/?p=46099"},"modified":"2026-09-14T05:52:26","modified_gmt":"2026-09-14T12:52:26","slug":"americas-water-insecurity-crisis","status":"publish","type":"post","link":"https:\/\/foodrevolution.org\/blog\/americas-water-insecurity-crisis\/","title":{"rendered":"Why America\u2019s Food Security Crisis Is a Water Security Crisis, Too"},"content":{"rendered":"

By Lela Nargi \u2022 A version of this article was originally published by the Food & Environment Reporting Network<\/a><\/strong><\/p>\n

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Deepak Palakshappa became a pediatrician to give poor kids access to good medical care. Still, back in his residency days, the now-associate professor at Wake Forest University School of Medicine in Winston-Salem was shocked to discover that a patient caring for two young grandchildren was food insecure. \u201cOur clinic had set up one of those food drive boxes, and near the end of a visit, she asked if she could have any of the cans because she didn\u2019t have food for the holidays,\u201d he recalls.<\/p>\n

Thirteen years later, Palakshappa\u2019s clinic team now asks two simple questions<\/a> of every patient to ascertain whether they\u2019ll run out of food in a given month. But there are some critical questions they don\u2019t ask: Do you drink your tap water<\/a>? Is it potable and ample? Can you cook food with it, and use it to mix infant formula and cereal? Such questions could uncover some of the millions of Americans who are water insecure \u2014 a circumstance directly connected to food insecurity.<\/strong><\/p>\n

There\u2019s no health care screener for water insecurity. The issue is not even on most public health professionals\u2019 radar, although recent water disasters in Flint, Michigan<\/a>, and Jackson, Mississippi<\/a>, are starting to change that. Clinicians who are aware of water insecurity \u201care thinking, \u2018If I screen for this, what am I going to do about it?\u2019\u201d says Palakshappa, noting the dearth of resources available to mitigate it.<\/p>\n

Researchers know water insecurity isn\u2019t confined to one region or population. But \u201cwe don\u2019t know how big of a problem it is,\u201d says Sera Young, an associate professor of anthropology and health at Northwestern University. \u201cAnd it\u2019s going to keep biting us in the ass because we\u2019re not measuring these things correctly.\u201d Public health researchers talk about food and nutrition, while water researchers are siloed in infrastructure circles, and it\u2019s rare for the two worlds to overlap. Says Young, \u201cWe need to build a bridge between those two disciplines.\u201d<\/p>\n

The Link Between Food Insecurity and Water Insecurity<\/h2>\n
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Most estimates put US water insecurity at 2.2 million residents. Asher Rosinger, director of the Water, Health, and Nutrition Laboratory at Pennsylvania State University, says this is probably a \u201chuge\u201d undercount, and the actual number might be closer to 60 million<\/a>.<\/strong> There are no official estimates of combined food and water insecurity, which makes it tough to understand the scope of the problem, let alone to propose solutions.<\/p>\n

\u201cWe\u2019re measuring water by how many cubic meters there are and dividing it across the land,\u201d says Northwestern\u2019s Young. \u201cOr we\u2019re measuring infrastructure, which is like, \u2018Where do you get your drinking water from? Is it from a tap? Is it from a well? Is it from a borehole?\u2019 But you can imagine 99 scenarios where you have a tap, but you can\u2019t pay for water to flow through it, or you don\u2019t trust the water that comes out of it, or the infrastructure upstream of the tap has gone to shit. There are lots of reasons why measuring physical availability or infrastructure only gives you a pinhole peek of what the real problem is.\u201d<\/p>\n

The only way to truly understand water insecurity, Young says, is to consider people\u2019s lived experiences as clinicians have learned to do with food access.<\/p>\n

Accurate data is essential to closing the water gap because food insecurity increases the probability<\/a> of water insecurity. In a study published last July in the Journal of the Academy of Nutrition and Dietetics<\/i>, Young, Rosinger, and a third coauthor tracked 13 years\u2019 worth of tap water avoidance among more than 31,000 US residents. They found that people who didn\u2019t drink their tap water had 21% greater odds of also being food insecure than those who did.<\/strong> \u201cEfforts to mitigate food insecurity should simultaneously address water insecurity issues, including tap water availability and quality,\u201d the researchers concluded.<\/p>\n

Addressing Water Poverty<\/h3>\n

As with hunger, there are myriad reasons a person might be water insecure \u2014 some financial, some structural, and others having to do with quality and access. Still others are short-term predicaments brought on by disaster or a failure of local government.<\/p>\n

You might think access to ample potable water is a basic human right. Legally, in the US, it isn\u2019t<\/a> (although California has taken a stab at making it so).<\/strong> Still, many Americans<\/a> spend more than 12%<\/a> of their income on water and sewer service. Others have lead pipes that contaminate tap water (Newark<\/a>), or have bacteria seeping into wells (Iowa<\/a>), or have sewage backing up into pipes during storms (Milwaukee<\/a>), or nitrates running off farm fields (Las Vegas<\/a>). A storm may knock out the electricity that pumps water (Puerto Rico<\/a>), or knock out the pump itself (Jackson<\/a>). Residents of the Navajo Nation<\/a> lack basic water infrastructure. Then there are regions where aquifers are running dry, such as in California\u2019s Central Valley<\/a>.<\/p>\n

Water poverty has a lot to do with health beyond the primary need to drink a couple of liters<\/a> a day. Perhaps most consequentially, research shows<\/a> that children exposed to lead can suffer developmental delays and brain damage. Rosinger also found that people who avoid tap water are more likely to drink sugar-sweetened beverages<\/a> (SSBs, in public health parlance).<\/strong> This alternative increases their risk for obesity, diabetes, and other diet-related diseases, with the implications most long-lasting for children<\/a>.<\/p>\n

Prioritizing Water Access for Public Health<\/h2>\n
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SSBs are one of the few issues that public health researchers track that combines both food and water insecurity. Christina Hecht, a senior policy adviser at the University of California\u2019s Nutrition Policy Institute, helped found the National Drinking Water Alliance in 2015, with a mission to improve access to potable water and educate people on the importance of drinking water instead of sugary drinks. \u201cWe discussed whether we needed to prioritize making sure that tap water was safe, but in 2015, we really didn\u2019t think that that was a big issue,\u201d she says. \u201cThen Flint happened.\u201d<\/p>\n

Flint is just one in a long line of high-poverty communities now recognized for catastrophically unsafe water infrastructure. The city has a 29% food insecurity rate<\/a> among its majority-Black population. In rural McDowell County, West Virginia, which will receive federal assistance to pilot wastewater infrastructure<\/a> improvements, almost 32% <\/a>of its (majority white) residents live below the federal poverty line. Century-old pipes, in some cases made of wood, bring in water so foul that residents capture creek water and store it in tanks. The most requested item at a local food bank<\/a>? Bottled water.<\/strong><\/p>\n

The consequences ripple out from here. Someone who is water insecure can\u2019t prepare food. Says Rosinger, \u201cIf your tap is dry, your water has been shut off, or you\u2019re just avoiding it because you think it\u2019s dangerous, you\u2019re more likely to go out to eat. And research shows you consume a greater number of calories and have a lack of dietary diversity. So, it\u2019s nutrition insecurity, too.\u201d<\/p>\n

Examining Tap Water Avoidance<\/h2>\n

Spending money on bottled water, which Rosinger says is \u201corders of magnitude more expensive than tap water,\u201d might eat up $100 of a monthly food budget. For context, the maximum monthly SNAP benefits are $835 for a family of four. A water-insecure mother might pay for bottled water to mix infant formula or cereal; women inclined to breastfeed might skimp on their own hydration.<\/p>\n

A colleague of Palakshappa\u2019s, Dr. Kimberly Montez, recently met with a food-insecure mother from Latin America whose baby was failing to gain weight. She didn\u2019t trust the tap water enough to drink it, so she was under-hydrated, which made breastfeeding difficult. Instead, she turned to formula, but that presented problems, too, because she thought she had to buy expensive bottled water to make it, says Montez.<\/p>\n

If researchers can understand why people avoid their taps, they might better address fears and educate about the need for water over soda.<\/strong><\/p>\n

Young says questions about water trust and SSBs are a great start. \u201cBut don\u2019t forget about cooking food. People are afraid of boiling pasta, so we should be asking, Are you drinking your water? Are you cooking with your water? Are you bathing with your water? And are you pissed about your water situation?\u201d There\u2019s some legislative interest in requiring the National Health and Nutrition Examination Survey<\/a>, which collects data on things like the prevalence of diabetes<\/a> and fruit and vegetable consumption, to add questions about water insecurity. \u201cIf we want humans to be healthy, we need to realize that\u2019s a product of a lot of things, and water is generally not on that list,\u201d she says.<\/p>\n

Water Is a Lifeline for Hunger and Hydration<\/h2>\n
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As to the question of how clinicians can assist people identified as water insecure, there are a few initiatives in the works. SNAP recipients<\/a> can already use benefits to purchase bottled water, although it comes out of their broader food allotment.<\/strong> Nourish California, an anti-hunger nonprofit, ran a pilot this year to see what happens when water-insecure households get extra SNAP bucks to cover half their monthly water expenditures<\/a>. The results are still being analyzed. \u201cWe know we got to fix the welds, and we got to fix the pipes, but in the meantime, let\u2019s not have people going hungry,\u201d says Jared Call, a senior advocate at the organization.<\/p>\n

The Environmental Protection Agency offers grants<\/a> to help disadvantaged communities fund drinking water projects, test for lead, and conduct remediation in schools. Some states, like New York, offer assistance<\/a> in paying overdue water bills.<\/p>\n

Meanwhile, Young and her colleagues devised the Water Insecurity Experiences (WISE) Scales<\/a>, which prompts researchers to ask questions about water availability, access, and reliability for domestic use. It\u2019s similar to the Food Insecurity Experience Scale<\/a>, which asks about access to nutritious food. Young says WISE provides common language to the food and water insecurity camps since they rely on common measures and indicators.<\/p>\n

\u201cEvidence is growing \u2014 and plus it just makes sense \u2014 that water security underpins food security, so when you \u2018fix\u2019 water, a major driver of food insecurity is handled,\u201d<\/strong> Young says. \u201cBy giving people the language to talk across the aisle, the beautiful thing is, this can be a win-win.\u201d<\/p>\n

Editor\u2019s Note:<\/b> For insight on the pros and cons of various home water treatment options, see our article, here<\/a>.<\/div>\n

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