Understanding the synergistic roles of water insecurity and food insecurity in the health of Mexican adults

了解水不安全和粮食不安全对墨西哥成年人健康的协同作用

• 批准号: 10647464
• 负责人: Sera Lewise Young
• 金额: $ 8万
• 依托单位: NORTHWESTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10647464
• 关键词: Address; Adult; Area; Attention; Blood Pressure; Characteristics; Child; Communities; Country; Data; Diabetes Mellitus; Dietary intake; Distal; Economics; Epidemiology; Floods; Food; Frequencies; Fruit; Growth; HIV; Health; Health Status; Health Surveys; Heterogeneity; Household; Human; Hydration status; Hypertension; Income; Individual; Inequity; Infant; Infrastructure; Intake; Intervention; Knowledge; Learning; Measurement; Measures; Mediation; Mental Depression; Mental Health; Mexican; Mexico; Modeling; National Health and Nutrition Examination Survey; North America; Nutrition Surveys; Nutritional; Obesity; Outcome; Pathway interactions; Personal Satisfaction; Physiological; Population; Population Growth; Process; Public Health; Resolution; Resources; Risk; Role; Sampling; Security; Severities; Shapes; Ships; Site; Socioeconomic Status; Statistical Models; Surveys; Testing; Time; Vegetables; Vulnerable Populations; Water; Work; antiretroviral therapy; climate change; depressive symptoms; dietary; experience; feeding; food insecurity; health inequalities; improved; innovation; insight; low and middle-income countries; novel; nutrition; physical conditioning; poor health outcome; psychosocial stressors; resilience; sugar; sweetened beverage; symptomatology; synergism; therapy adherence; water quality; waterborne illness

PROJECT SUMMARY As Kamala Harris proclaimed in June 2022 when she launched the White House Action Plan on Water Security, the global water crisis is among the most urgent issues of our time. Water insecurity, or the lack of stable access to safe and acceptable water, has been identified as a threat to human well-being that is plausibly on par with that of food insecurity. Further, emerging evidence suggests that the impacts of water insecurity are surprisingly far-reaching, including suboptimal nutrition, physical health, and mental health. We are, however, early on in our understanding of the role of water insecurity in human health, in part because we have lacked precise measures of water insecurity. Therefore, the core scientific objective of this R03 application is to understand the roles of water and food insecurity experiences on key health outcomes among a nationally representative sample of Mexican adults from Mexico's 2021 National Health and Nutrition Survey [Encuesta Nacional de Salud y Nutrición (ENSANUT)]. Our central hypothesis is that water insecurity will be negatively associated with health measures, even when controlling for known key covariates. In Aim 1, we will investigate the associations between water insecurity and indicators of nutrition (intake of sugar- sweetened beverages, ultra-processed foods, fruits, vegetables), physical health (adiposity, blood pressure, diabetes), and mental health (depressive symptomatology). In Aim 2, we will examine if concurrent water and food insecurity have a synergistic (multiplicative) relationship with health measures, i.e., if those experiencing both insecurities have worse health than expected from the additive associations with water and food insecurity. Increasing our knowledge about how water insecurity shapes health is highly significant because global problems with water quantity (both flooding & shortages) and quality are occurring with increasing frequency and severity due to climate change, population growth, and crumbling infrastructure. This project is innovative for its precise measurement of water insecurity. Before 2019, global indicators of water captured only the physical availability of water or water infrastructure; these are far more distal predictors of human health. It is also innovative because ENSANUT 2021 is the first national health and nutrition survey in which experiences of water insecurity have been measured. Finally, the concurrent measurement of water and food insecurity will bring unprecedented insights into their potential synergisms in North America. Expected outcomes include a clearer picture of the epidemiology of water insecurity in Mexico and a more precise understanding of how experiences with problematic water access, use, and stability can act as barriers to optimal health. This information will likely reveal novel ways to intervene to reduce resource inequities and the risk of poor health outcomes among vulnerable populations. This work will also set the precedent for inclusion of experiential measures of water insecurity in other large nutrition and health surveys in low-, middle-, and high-income countries, including the US.

项目摘要 正如卡马拉·哈里斯（Kamala Harris）在2022年6月启动白宫行动计划时宣布的那样 安全，全球水危机是我们这个时代最紧迫的问题之一。水不安全感或缺乏 稳定获取安全且可接受的水，已被确定为对人类福祉的威胁 与粮食不安全感相当。此外，新兴的证据表明水的影响 不安全感是深远的，包括次优营养，身体健康和心理健康。我们 但是，在我们对水不安全感在人类健康中的作用的理解很早就是因为我们 缺乏对水不安全感的精确度量。因此，该R03的核心科学目标 应用是了解水和粮食不安全经验在关键健康结果中的作用 来自墨西哥2021年国家健康和营养的墨西哥成年人的全国代表性样本 调查[Encuesta nacional de salud y Nutrician（ensanut）]。我们的中心假设是水不安全感 即使控制已知的关键协变量，也将与健康措施负相关。在AIM 1中， 我们将研究水不安全感与营养指标之间的关联（糖摄入糖 - 甜味卧室，超级加工食品，水果，蔬菜），身体健康（肥胖，血压， 糖尿病）和心理健康（抑郁症状）。在AIM 2中，我们将检查是否并发水和 粮食不安全性与健康措施有协同（乘法）关系，即如果这些经验 这两种不安全感的健康状况都比与水和食物的增加相关的健康状况要差 不安全感。提高我们对水不安全感如何塑造健康的了解非常重要，因为 随着水量（洪水和短缺）和质量的全球问题，随着增加的质量 由于气候变化，人口增长和崩溃的基础设施而引起的频率和严重程度。这个项目是 创新的水对水不安全感的测量。 2019年之前，全球水指标被捕获 只有水或水基础设施的物理可用性；这些是人类的更加张别的预测指标 健康。这也是创新的，因为Ensanut 2021是首次国家健康和营养调查 水经历已经衡量。最后，同时测量水和食物 不安全感将使他们对北美潜在的协同作用的史无前例的见解。预期的 结果包括墨西哥水不安全感流行病学的清晰图表和更精确的 了解有问题的水的经验，使用和稳定性如何成为障碍 最佳健康。这些信息可能会揭示干预以减少资源不平等和 脆弱人群中健康状况不佳的风险。这项工作还将为包容性树立先例 在低，中和 高收入国家，包括美国。