1. Introduction
Water security is defined as “access by all people, at all times, to sufficient safe drinking water for a healthy and productive life” [1]. In this context, frameworks for measuring and analyzing water security have expanded to include aspects beyond water availability and infrastructure. These frameworks now consider equity in access to water, addressing social, cultural, economic, and geographic disparities, including those between urban and rural areas, as well as those related to climate change [2,3].
The stable availability, access, and use of water play a vital role in the health, nutrition, and wellbeing of individuals, as well as in the social and economic development of populations [4]. For humans, water is essential for adequate hydration and for various other critical activities, such as food production, personal hygiene, and domestic or recreational use [2].
Currently, an estimated 2.2 billion people worldwide lack access to potable water, and this number is projected to increase at an accelerated rate [5]. By 2050, the agricultural sector will require more water to produce just 60% of the crops needed to feed an estimated nine billion people [6], and water use is expected to increase by 20–30% as a result of population growth, economic development, and changes in consumption patterns, which, coupled with the severe effects of climate change, will lead to severe water scarcity [7]. In this scenario, poor and marginalized populations are expected to be even more affected. Therefore, the management, availability, and equitable access to water are currently among the most pressing environmental challenges in many countries, including Mexico.
The theme of Sustainable Development Goal 6 is to “ensure the availability and sustainable management of water and sanitation for all” [8,9,10]. However, many factors affect access, quality, availability, management, and sustainability of water. Social determinants are closely related to water security. For example, 30–40% of water supply systems in low-income countries are non-functional [11], and the level of fecal or chemical contamination has a significant impact on water availability and quality. In this context, approximately 1000 children die every day from diarrheal diseases related to a lack of hygiene or consumption of contaminated water [8]. There are also age and gender disparities, with girls and women responsible for collecting water in 80% of households without access to running water, with all the associated impacts on their physical and mental health [5,11].
Access to water supply infrastructure in Mexico is unequal. In 2019, over two million households (5.6%) lacked access to a water supply within their homes. The highest proportions of households without water infrastructure were observed in rural areas and among households with members who speak an indigenous language (15% and 12.8%, respectively). Per capita water availability in Mexico also varies significantly by region. Semi-arid and arid areas in the north receive only 9% of renewable water per year, compared to 67.2% in the south and southeast [12].
The presence of water supply infrastructure in the home does not guarantee effective access to drinking water for families, as marginalized sectors in low- and middle-income countries often lack a continuous water supply [13]. In this sense, 50.5% of Mexican households lack a constant water supply. Approximately one-third of these households receive water only one to three days per week [14].
Although the amount of available water and coverage of drinking water services help assess availability and quality at the regional level, they do not allow us to determine if households have sufficient water to meet their basic needs. The Household Water Insecurity Experience Scale (HWISE) provides a more comprehensive and accurate assessment of water insecurity and its relationship to poverty and poor health at the local, state, and national levels than traditional usage indicators do [14,15]. Latin America has widely adopted the HWISE to promote equitable access to quality water for consumption, personal hygiene, and sanitation, guide investment decisions, measure the impact of interventions, and improve public health [16]. Additionally, they also help to recognize the extent of water insecurity and the factors that threaten it. This information is essential for identifying vulnerable areas that may require intervention [17].
Therefore, the HWISE was first applied in Mexico in 2021 as part of a national health and nutrition survey [18]. In Mexico, we utilized the version of HWISE, which had been previously validated in low- and middle-income countries. There, it demonstrated its ability to measure water insecurity and explore its determinants in different cultural and geographical contexts [19]. In Latin America, water insecurity has multiple causes [20,21]. Understanding these causes at both the individual and household levels is crucial for tailoring interventions to local needs, fostering community participation, and enhancing the sustainability of water management projects [22]. In Mexico, however, little is known about these causes and their impact on water insecurity. Therefore, the objective of this work is to estimate the association between water insecurity in Mexican households and household wellbeing, as well as geographic factors.
2. Materials and Methods
2.1. Study Design and Population
We analyzed data collected from 12,619 households with the Mexican National Health and Nutrition Survey 2021 (in Spanish, ENSANUT 2021). ENSANUT 2021 is a probabilistic, stratified, cluster survey with national and regional representativeness. Further details on the calculation and sample design have been reported elsewhere [23].
The ENSANUT 2021 data collection was conducted from July to November 2021. The present study analyzed data from 11,512 Mexican households, all of which had complete data for the variables of interest, as described in the following subsection.
2.2. Variable of Interest
Household water insecurity. This variable was measured using the Household Water Insecurity Experience Scale (HWISE), which has been previously validated and standardized for use in Mexico [15,18]. This scale consists of 12 questions that assess the frequency with which household members experienced water problems in the four weeks before the survey. These experiences include feeling worried, annoyed, or ashamed about water, going to sleep thirsty, and changing daily activities due to water problems. The interviewer applied the scale to the person identified as the head of the household or to any adult household member familiar with the household conditions. To score the frequency of the experiences, the HWISE has the following points: never (0 times) = 0; rarely (1–2 times) = 1; sometimes (3–10 times) = 2; often (11–20 times) = 3 and always (more than 20 times) = 4. The score ranges from 0 to 36 points, and the cut-off point to classify a household as water-insecure was set at 12 or higher, because households within this score reported lower satisfaction with their water situation and a higher perception of insecurity and stress compared to households classified as water secure [4,14].
2.3. Household Head Variables
Indigenous language. This variable was defined as the fact that the head of the household reported speaking an indigenous language.
Level of education completed. This refers to the level of formal education completed, as follows: basic (primary or secondary education), intermediate (high school, basic teacher training college, or technical degree), advanced (bachelor’s, master’s, doctorate, or higher), or no formal education (none or pre-school education).
2.4. Household Variables
Household Wellbeing Conditions (HWC). An index was constructed by principal component analysis, as used in previous ENSANUTs [24], using a polychoric correlation matrix and including eight variables: floor material, wall material, ceiling material, number of rooms used for sleeping, water supply, car ownership, number of appliances (including refrigerator, washing machine, microwave, stove, hot water heater), and number of electronic devices (including television, cable, radio, mobile phone, computer) [25]. The first component explained 47.7% of the total variability. The index was described in tertiles: I = low, II = medium, III = high.
Crowding. An index was created by calculating the ratio of the total number of household members to the number of rooms used for sleeping in the dwelling. Crowding was defined as ≥2.5 [26].
Running water. Refers to water supplied through pipes to a house or building. This variable was classified as running water inside the dwelling, running water to the property but not into the dwelling, or no running water.
Main source of water. The main source was classified into one of five categories: public utility, well, water truck, other household or property, or no running water.
Monthly household income. This variable was described in Mexican pesos and classified into six ranges: 1 to 5999; 6000 to 9999; 10,000 to 13,999; 14,000 to 21,999; 22,000 or more, or no income reported.
2.5. Geographic Variables
Area type. The area in which the household was located and classified by population size as rural (<2500 inhabitants), urban (≥2500 to 99,999 inhabitants), or metropolitan (≥100,000 inhabitants).
Region. The country was divided into nine regions based on state boundaries and population density: North Pacific, Border, Central Pacific, North Central, Center, Mexico City, State of Mexico, South Pacific, and Peninsula [23].
2.6. Statistical Analysis
Proportions (%) and 95% confidence intervals (CI95%) were calculated to analyze the distribution of household characteristics and geographic variables by household status: water secure or insecure. We performed X2 tests between water-secure and water-insecure households to estimate differences in proportions among selected characteristics of Mexican households.
These selected characteristics were analyzed as independent variables potentially related to water insecurity. We ran a multiple logistic regression model to assess the association of the selected characteristics with water insecurity in our sample households, with a significance level of p < 0.05. The goodness of fit test indicates that the model fits our data well. The F-statistics are adjusted for the survey design in order to improve the precision of the estimates, taking into account the characteristics of the population [27]. For this purpose, the SVY module for complex samples in Stata version 14.0 was used [28].
2.7. Ethical Considerations
The ENSANUT 2021 study protocol (CI:1750) and procedures were reviewed and approved by the Research Ethics Committee and the Research and Biosafety Committees of the National Institute of Public Health (in Spanish, INSP), located in Morelos, Mexico. The participating population provided both verbal and written informed consent.
3. Results
The general characteristics of the population studied are presented in Table 1. The final sample consisted of 11,512 households, representing 33,117,900 Mexican households. Water insecurity was present in 16.6% of the households. Of the household heads, 66.3% were male, 49.2% were between the ages of 40 and 62, and 57.3% had a basic education (primary or secondary). Only 5.2% of the population spoke an indigenous language. In terms of household characteristics, 79.1% of households had running water at home. Almost half of all households were located in metropolitan areas (49.1%).
Table 2 shows the distribution of geographic, household, and household head characteristics by water security status. Most households with water insecurity had household heads with no formal education (18.6%), were in tertile I (low) of wellbeing (21.6%), had crowding (20.3%), had no running water (33.4%), and obtained water from a water truck as their main source (52.4%).
Table 3 shows that the odds ratio of experiencing water insecurity was higher for households with low (OR = 1.74, p < 0.01) or medium wellbeing (OR = 1.44, p < 0.01). Households without running water were 2.7 times more likely to experience water insecurity than those with running water at home (OR = 2.71, p < 0.01). Monthly household income was associated with water insecurity in the following income categories: <6000 Mexican pesos (OR = 2.31, p = 0.006), from 6000 to <10,000 pesos (OR = 1.95, p = 0.029), from 10,000 to <14,000 (OR = 1.90, p = 0.044), or from 14,000 to <22,000 (OR = 1.98, p = 0.041), as compared to households with incomes above 22,000 Mexican pesos. Households in urban areas showed an odds ratio of 1.93 (p = 0.001) as compared to median rural households. The highest odds ratios were concentrated in the following regions of Mexico: State of Mexico (OR = 3.92, p < 0.01), Mexico City (OR = 3.19, p < 0.01), Central Pacific (OR = 3.27, p < 0.01), North Central (OR = 2.53, p < 0.01), North Pacific (OR = 2.44, p = 0.002), South Pacific (OR = 2.10, p = 0.018), and Peninsula (OR = 2.03, p = 0.025).
Figure 1 shows the adjusted prevalence of water insecurity in households across Mexico’s regions. The State of Mexico has the highest proportion of water-insecure households (23.9%), while the border region has the lowest proportion (6.5%).
4. Discussion
Our study reveals a positive association between reported water insecurity in Mexican households and specific variables, including low or medium wellbeing, lack of access to running water, and residence in the central Pacific or peninsular regions of the country. Some of these have been reported previously, highlighting the threat of these co-occurring factors to household water security [29,30].
Regarding drinking water infrastructure, over 95% of Mexican households reported having access to it either in their homes or on their properties. Our results show that over 15% of these households were classified as water-insecure. This suggests that the mere presence of drinking water infrastructure does not guarantee availability and access. Currently, methods for measuring water security rely on the relatively simple and comparable indicator of public water systems coverage. However, differences in these figures demonstrate the importance of combining indicators at the regional level to improve the understanding of the determinants of water insecurity in different geographical, demographic, and economic contexts [31].
Furthermore, our results indicate that households in urban areas are more likely to experience water insecurity than those living in rural or metropolitan areas. Similar patterns have been observed in other regions of the world, where urban development, population growth, and lifestyle changes have significantly increased industrial and domestic water demand, putting growing pressure on water resources [32]. Furthermore, marginalized urban areas often lack adequate water and sanitation services due to the absence of infrastructure, inadequate budgets, and ineffective development planning, which in turn puts the population’s health at risk [33].
Geographical and financial constraints also contribute to water scarcity [34]. In the case of Mexico, the most densely populated states in the center of the country, such as the regions of Mexico City and the State of Mexico, had the highest odds ratio of household water insecurity [35]. These results are consistent with the regional patterns of water availability per capita: In 2018, the region that includes Mexico City and the State of Mexico had only 144 cubic meters per person per year, while the South Pacific and Peninsula regions had 18776 cubic meters [36]. Previous evidence shows that densely populated cities concentrate the water demand of millions of people in a small area, increasing the need for water supply, as is the case in Mexico City and the State of Mexico. These regions are characterized by urbanization trends, including the expansion of low-density peripheries, resulting in greater intensity, duration, and frequency of water scarcity, inefficient land use, highly fragmented urban structures, and inequitable service provision, including water, leading to unsustainable costs [37,38]. These urbanization patterns also affect regions with the most significant economic disparities, less developed health systems, and inequalities in access to sufficient and appropriate food, resulting in lower health and wellbeing for the population [39]. Other factors, such as latitude and precipitation levels, influence water availability in each region of Mexico. For example, two-thirds of Mexico’s territory is considered arid or semi-arid, with an annual rainfall of less than 500 mm. In contrast, the South Pacific and Peninsula regions are characterized by high humidity, with annual rainfall exceeding 2000 mm.
In the case of Mexican households, the factors that increased the likelihood of encountering water insecurity were having a lower income and the absence of water infrastructure within the household. Poor households without access to public services or water infrastructure are forced to pay higher costs for drinking water, resulting in an imbalance in their income [40]. These costs can represent up to 15% of household income, exceeding the World Bank’s recommended international water affordability parameters of 3 to 5% of household income. Only high-income households can overcome water insecurity by employing a variety of coping strategies, such as purchasing water or storage containers, constructing cisterns, or installing filters to improve water quality [41,42]
Concerning limitations, we first recognize the transversal design of the data source. In addition, the data analyzed were collected during the rainy season in the central and southern regions of the country, while the north experienced moderate to severe droughts during the same period [43]. This factor made it impossible to observe variations in water insecurity during the dry season, when we hypothesize that water insecurity would be expected to be greater. Another limitation may be a lack of information about household coping mechanisms or water management strategies that could prevent experiences of water insecurity. These mechanisms could include rainwater capture, water storage, filters, water purification strategies, and purchasing bottled water for specific food purposes [44,45]. Despite these limitations, a strength of this study is its representative sample of households from all regions of Mexico, including urban and rural areas.
Future projections indicate a progressive deterioration of water security, which will affect the most socially, economically, and politically marginalized individuals [46].
Our findings contribute to our understanding of the key factors that create disparities in household water access and availability. Policymakers should consider geographic, economic, and demographic factors when designing context-specific policies that best serve those most affected [47]. Finally, our findings also lay the groundwork for future studies to explore the relationship between water insecurity and health outcomes. Additionally, future research could examine coping mechanisms across different sociodemographic and geographic characteristics.
5. Conclusions
This study highlights the association between water insecurity and socioeconomic and geographic inequalities among Mexican households. These inequalities include low or medium wellbeing, lack of running water, monthly income below approximately USD 1200, and residence in the Central, Pacific, or Peninsular regions of Mexico. The results show that access to water infrastructure alone does not guarantee water security. By identifying these risk factors, the study provides policymakers with helpful information for developing targeted, equitable, and sustainable water management strategies. For example, the water insecurity indicator could be included as an official measurement alongside the current infrastructure to provide a broader, more comprehensive view of household water insecurity. With this indicator, strategies to guarantee water security for all households could include designing, monitoring, and implementing programs for adequate water supply infrastructure, rainwater harvesting, community treatment plants, and protection of natural water sources. Furthermore, the formation of public–private partnerships could enhance the water supply through the use of cutting-edge technology. Addressing these disparities is essential to achieving the Sustainable Development Goals and ensuring the human right to safe, sufficient water for all.
Conceptualization, V.M.-R., M.G.-L., C.G.-G., and A.G.G.; methodology, V.M.-R., M.G.-L., C.G.-G., and A.G.G.; formal analysis, V.M.-R., M.G.-L., C.G.-G., and A.G.G.; investigation, V.M.-R., M.G.-L., C.G.-G., A.G.G., A.M.-E., C.H.-P., and N.I.V.-V.; writing—original draft preparation, V.M.-R., M.G.-L., C.G.-G., and A.G.G.; writing—review and editing, V.M.-R., M.G.-L., C.G.-G., and A.G.G.; visualization, V.M.-R., M.G.-L., C.G.-G., and A.G.G. All authors have read and agreed to the published version of the manuscript.
The Research Ethics Committee of the Instituto Nacional de Salud Pública has given ethical approval. CI:1750.
Data Availability Statements are available in ENSANUT at URL
The authors declare that they have no conflicts of interest.
Footnotes
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Figure 1 Adjusted prevalence of water insecurity according to logistic regression model by geographical region. Mexican National Health and Nutrition Survey (ENSANUT 2021), Mexico, 2021.
Sociodemographic and geographic characteristics of Mexican households and household heads.
| Characteristic | Sample | Expansion ¥ | % | CI 95% |
|---|---|---|---|---|
| Head of household | ||||
| Sex | ||||
| Male | 7729 | 21,940.7 | 66.3 | 64.9–67.6 |
| Female | 3783 | 11,177.2 | 33.7 | 32.4–35.1 |
| Age group (years) | ||||
| 15 to 39 | 3002 | 8715.1 | 26.3 | 25.0–27.7 |
| 40 to 62 | 5685 | 16,293.4 | 49.2 | 48.0–50.4 |
| ≥63 | 2825 | 8109.4 | 24.5 | 23.3–25.7 |
| Indigenous language speaker | ||||
| Yes | 641 | 1731.5 | 5.2 | 4.2–6.5 |
| Level of education completed | ||||
| No formal | 858 | 2265.7 | 6.8 | 6.2–7.6 |
| Basic | 6994 | 18,993.3 | 57.3 | 55.6–59.1 |
| Intermediate | 2129 | 6541.7 | 19.8 | 18.7–20.9 |
| Advance | 1531 | 5317.2 | 16.1 | 14.5–17.7 |
| Household | ||||
| Water insecurity | ||||
| Secure | 9615 | 27,633.0 | 83.4 | 81.5–85.2 |
| Insecure | 1897 | 5484.9 | 16.6 | 14.8–18.5 |
| Wellbeing conditions tertile | ||||
| Tertile I (low) | 3898 | 10,456.7 | 31.6 | 29.8–33.4 |
| Tertile II (medium) | 3884 | 10,782.2 | 32.6 | 31.0–34.1 |
| Tertile III (high) | 3730 | 11,879.0 | 35.8 | 33.9–37.8 |
| Crowding | ||||
| No crowding | 9477 | 27,634.1 | 83.4 | 82.3–84.5 |
| Crowding | 2035 | 5483.8 | 16.6 | 15.5–17.7 |
| Running water | ||||
| Inside the dwelling | 8950 | 26,198.5 | 79.1 | 77.4–80.7 |
| Inside the property but not the dwelling | 2114 | 5468.3 | 16.5 | 15.0–18.1 |
| No running water | 448 | 1451.1 | 4.4 | 3.4–5.7 |
| Main source of water | ||||
| Public utilities | 9974 | 28,803.3 | 86.9 | 85.3–88.4 |
| Well | 851 | 2057.3 | 6.2 | 5.4–7.2 |
| Water truck | 114 | 382.0 | 1.2 | 0.7–1.8 |
| Other dwelling or property | 125 | 424.1 | 1.3 | 0.8–2.0 |
| No running water | 448 | 1451.2 | 4.4 | 3.4–5.7 |
| Monthly household income (Mexican pesos) | ||||
| 1–5999 | 6509 | 18,116.3 | 54.7 | 53.2–56.2 |
| 6000–9999 | 2841 | 8290.0 | 25.0 | 24.0–26.1 |
| 10,000–13,999 | 1286 | 3959.4 | 12.0 | 11.0–12.9 |
| 14,000–21,999 | 457 | 1473.8 | 4.5 | 3.9–5.0 |
| 22,000 or more | 204 | 744.5 | 2.2 | 1.8–2.8 |
| No income reported | 215 | 533.9 | 1.6 | 1.4–1.9 |
| Geographic | ||||
| Area type | ||||
| Rural | 2700 | 6853.6 | 20.7 | 19.4–22.0 |
| Urban | 3590 | 10,008.5 | 30.2 | 29.1–31.3 |
| Metropolitan | 5222 | 16,255.8 | 49.1 | 47.9–50.3 |
| Region | ||||
| North Pacific | 1470 | 3310.4 | 10.0 | 9.0–11.1 |
| Border | 791 | 3797.5 | 11.5 | 10.6–12.4 |
| Central Pacific | 1029 | 3888.6 | 11.7 | 11.0–12.6 |
| North Central | 2582 | 4106.9 | 12.4 | 11.9–12.9 |
| Central | 883 | 3518.1 | 10.6 | 9.9–11.4 |
| Mexico City | 1013 | 2513.5 | 7.6 | 7.2–8.0 |
| State of Mexico | 1118 | 4434.6 | 13.4 | 12.8–14.0 |
| South Pacific | 1124 | 4125.6 | 12.5 | 11.5–13.5 |
| Peninsula | 1502 | 3422.7 | 10.3 | 9.7–11.0 |
Notes: % (Proportions). CI 95%(Confidence Intervals at 95%). ¥ Thousands.
Characteristics of Mexican households and household heads by category of water insecurity.
| Characteristic | Water Secure | Water Insecure | p * | ||||
|---|---|---|---|---|---|---|---|
| n | % | CI 95% | n | % | CI 95% | ||
| Head of household | |||||||
| Sex | |||||||
| Male | 6469 | 83.9 | 82.1–85.5 | 1260 | 16.1 | 14.5–17.9 | 0.281 |
| Female | 3146 | 82.6 | 79.6–85.3 | 637 | 17.4 | 14.7–20.4 | |
| Age group (years) | |||||||
| 15 to 39 | 2486 | 82.6 | 79.6–85.2 | 516 | 17.4 | 14.8–20.4 | 0.365 |
| 40 to 62 | 4732 | 83.4 | 81.3–85.3 | 953 | 16.6 | 14.7–18.7 | |
| ≥63 | 2397 | 84.5 | 82.1–86.6 | 428 | 15.5 | 13.4–17.9 | |
| Indigenous language speaker | |||||||
| Yes | 531 | 81.7 | 75.8–86.5 | 110 | 18.3 | 13.5–24.2 | 0.467 |
| Level of education completed | |||||||
| No formal | 709 | 81.4 | 77.1–85.0 | 149 | 18.6 | 15.0–22.9 | <0.01 |
| Basic | 5808 | 82.3 | 80.1–84.3 | 1186 | 17.7 | 15.7–19.9 | |
| Intermediate | 1776 | 83.3 | 80.3–85.9 | 353 | 16.7 | 14.1–19.7 | |
| Advance | 1322 | 88.6 | 86.4–90.5 | 209 | 11.4 | 9.5–13.6 | |
| Household | |||||||
| Wellbeing conditions tertile | |||||||
| Tertile I (low) | 3087 | 78.4 | 75.4–81.1 | 811 | 21.6 | 18.9–24.6 | <0.01 |
| Tertile II (medium) | 3248 | 82.6 | 79.7–85.2 | 636 | 17.4 | 14.8–20.3 | |
| Tertile III (high) | 3280 | 88.7 | 87.0–90.1 | 450 | 11.3 | 9.9–13.0 | |
| Crowding | |||||||
| No crowding | 7972 | 84.2 | 82.3–85.9 | 1505 | 15.8 | 14.1–17.7 | <0.001 |
| Crowding | 1643 | 79.7 | 76.5–82.5 | 392 | 20.3 | 17.5–23.5 | |
| Running water | |||||||
| Inside the dwelling | 7641 | 85.3 | 83.2–87.2 | 1309 | 14.7 | 12.8–16.8 | <0.01 |
| Inside the property but not the dwelling | 1664 | 79.0 | 75.7–81.9 | 450 | 21.0 | 18.1–24.3 | |
| No running water | 310 | 66.6 | 57.2–74.9 | 138 | 33.4 | 25.1–42.8 | |
| Main source of water | |||||||
| Public utilities | 8406 | 84.5 | 82.7–86.2 | 1568 | 15.5 | 13.8–17.3 | <0.01 |
| Well | 743 | 86.6 | 81.9–90.3 | 108 | 13.4 | 9.7–18.1 | |
| Water truck | 51 | 47.6 | 33.6–62.0 | 63 | 52.4 | 38.0–66.4 | |
| Other dwelling or property | 105 | 84.6 | 72.8–91.8 | 20 | 15.4 | 8.2–27.2 | |
| No running water | 310 | 66.6 | 57.2–74.9 | 138 | 33.4 | 25.1–42.8 | |
| Monthly household income (Mexican pesos) | |||||||
| 1–5999 | 5326 | 80.8 | 78.3–83.1 | 1183 | 19.2 | 16.9–21.7 | <0.01 |
| 6000–9999 | 2419 | 85.3 | 82.9–87.4 | 422 | 14.7 | 12.6–17.1 | |
| 10,000–13,999 | 1102 | 87.4 | 84.4–89.9 | 184 | 12.6 | 10.1–15.6 | |
| 14,000–21,999 | 393 | 87.7 | 83.7–90.9 | 64 | 12.3 | 9.1–16.3 | |
| 22,000 or more | 186 | 94.0 | 89.6–96.6 | 18 | 6.0 | 3.4–10.4 | |
| No income reported | 189 | 87.0 | 79.9–91.9 | 26 | 13.0 | 8.1–20.1 | |
| Geographic | |||||||
| Area type | |||||||
| Rural | 2279 | 84.6 | 81.2–87.4 | 421 | 15.4 | 12.6–18.8 | 0.004 |
| Urban | 2898 | 78.8 | 74.2–82.8 | 692 | 21.2 | 17.2–25.8 | |
| Metropolitan | 4438 | 85.8 | 83.4–87.9 | 784 | 14.2 | 12.1–16.6 | |
Notes: * Test of X2 for difference in proportions between water-secure and water-insecure households. Statistically significant comparisons (p < 0.05).
Multiple logistic regression model for water insecurity with individual, household, and geographic variables in Mexico.
| Characteristic | Odds Ratio | CI 95% | p-Value | |
|---|---|---|---|---|
| Head of household | ||||
| Female a | 1.07 | 0.92 | 1.25 | 0.399 |
| Age group, b (years) | ||||
| 40 to 62 | 1.00 | 0.85 | 1.17 | 0.994 |
| ≥63 | 0.90 | 0.72 | 1.13 | 0.370 |
| Household | ||||
| Wellbeing condition tertile, c | ||||
| Tertile I (low) | 1.74 | 1.37 | 2.21 | <0.01 |
| Tertile II (medium) | 1.44 | 1.20 | 1.74 | <0.01 |
| Crowding Index | 1.06 | 1.00 | 1.13 | 0.038 |
| Running water, d | ||||
| To the property but not the dwelling | 1.22 | 0.97 | 1.54 | 0.088 |
| No running water | 2.71 | 1.67 | 4.39 | <0.01 |
| Monthly household income, e (Mexican pesos) | ||||
| 1–5999 | 2.31 | 1.28 | 4.19 | 0.006 |
| 6000–9999 | 1.95 | 1.07 | 3.55 | 0.029 |
| 10,000–13,999 | 1.90 | 1.02 | 3.55 | 0.044 |
| 14,000–21,999 | 1.98 | 1.03 | 3.82 | 0.041 |
| No income reported | 1.45 | 0.67 | 3.15 | 0.344 |
| Geographic | ||||
| Area type, f | ||||
| Urban | 1.93 | 1.32 | 2.81 | 0.001 |
| Metropolitan | 1.44 | 0.98 | 2.11 | 0.066 |
| Region, g | ||||
| North Pacific | 2.44 | 1.40 | 4.26 | 0.002 |
| Central Pacific | 3.27 | 1.93 | 5.53 | <0.01 |
| North Central | 2.53 | 1.61 | 3.98 | <0.01 |
| Central | 2.10 | 0.89 | 4.96 | 0.091 |
| Mexico City | 3.19 | 1.87 | 5.45 | <0.01 |
| State of Mexico | 3.92 | 2.35 | 6.53 | <0.01 |
| South Pacific | 2.10 | 1.13 | 3.90 | 0.018 |
| Peninsula | 2.03 | 1.09 | 3.77 | 0.025 |
Notes: Sample n = 11,512, Expansion N = 33,117.9 (thousands). Reference categories a Sex: male, b Age group: 15 to 39 years, c Tertile III (high), d Inside the dwelling, e 22,000 or more, f Rural, g Border.
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Details
; Galarde-López Miguel 2 ; Galindo-Gómez, Carlos 3
; García Guerra Armando 4
; Muñoz-Espinosa, Alicia 1
; Hernández-Palafox Corin 1
; Vizuet-Vega, Norma Isela 1 1 Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca 62100, Mexico; [email protected] (V.M.-R.); [email protected] (A.M.-E.); [email protected] (C.H.-P.); [email protected] (N.I.V.-V.)
2 National Center for Disciplinary Research in Animal Health and Safety, National Institute of Forestry, Agricultural and Livestock Research, Mexico City 05110, Mexico
3 Department of Applied Nutrition and Nutritional Education, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Tlalpan, Mexico City 14080, Mexico
4 Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca 62100, Mexico; [email protected]