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.

项目总结 正如卡玛拉·哈里斯在2022年6月发起白宫水问题行动计划时所宣布的那样 安全，全球水危机是我们这个时代最紧迫的问题之一。水的不安全，或缺乏 稳定获得安全和可接受的水，已被确定为对人类福祉的威胁，即 看似可以与粮食不安全问题相提并论。此外，新出现的证据表明，水的影响 不安全感的影响令人惊讶，包括营养不良、身体健康和心理健康。我们 然而，在我们对水不安全对人类健康的作用的早期理解中，部分原因是我们 缺乏准确的水不安全措施。因此，R03的核心科学目标是 应用是了解水和粮食不安全经验对关键健康结果的作用 在墨西哥2021年国民健康和营养调查中具有全国代表性的墨西哥成年人样本中 调查[Encuesta National de Salud y Nudición(ENSANUT)]。我们的中心假设是水的不安全 将与卫生措施负相关，即使在控制已知的关键协变量时也是如此。在目标1中， 我们将调查水不安全与营养指标(糖的摄入量-- 含糖饮料、超加工食品、水果、蔬菜)、身体健康(肥胖、血压、 糖尿病)和精神健康(抑郁症状学)。在目标2中，我们将研究同时存在的水和 粮食不安全与卫生措施具有协同(乘性)关系，即，如果那些经历 由于与水和食物有关的添加剂，这两种不安全感的健康状况都比预期的要差 不安全感。增加我们关于水不安全如何影响健康的知识具有非常重要的意义，因为 全球范围内的水量(洪水和短缺)和水质问题正在日益增多。 气候变化、人口增长和基础设施破败造成的频率和严重程度。这个项目是 其创新之处在于精确测量水的不安全状况。在2019年之前，全球水指标 只有水或水基础设施的实际可获得性；这些都是对人类 健康。它也是创新的，因为ENSANUT 2021是第一个全国性的健康和营养调查， 对水不安全的经历进行了评估。最后，水和食物的并行测量 不安全将使人们对它们在北美的潜在协同效应有前所未有的洞察力。预期 结果包括更清晰地了解墨西哥水不安全的流行病学情况，以及更精确的 了解有问题的水的获取、使用和稳定性方面的经验如何成为 最佳健康状态。这些信息可能会揭示新的干预方法，以减少资源不平等和 易受伤害人群健康状况不佳的风险。这项工作也将开创收录的先例 在其他大型营养和健康调查中对水不安全的经验衡量方法 包括美国在内的高收入国家。