Survey highlights rising rates of food and water insecurity among U.S. children

Between 2005 and 2020, the number of children facing simultaneous water and food insecurity in the United States more than doubled. Additionally, Black and Hispanic children are several times more likely to experience simultaneous water and food insecurity than white children, according to a new study by Asher Rosinger, associate professor of biobehavioral health and anthropology at Pennsylvania State University, and Sera Young, associate professor of anthropology at Northwestern University.

In a study published today (June 7) in the journal Nature Water, researchers looked at water insecurity, food insecurity, and their co-occurrence among children in the U.S. They analyzed data on 18,252 children using the National Health and Nutrition Examination Survey (NHANES), a nationally representative assessment of health and nutrition that has been conducted annually since 1999 and sporadically since the 1960s.

According to the researchers, water scarcity and food insecurity — the lack of stable and safe access to food and water — can have devastating effects on healthy development. Water scarcity is associated with problems in mental health, physical health, nutrition and economic well-being. Food insecurity is associated with mental health problems, diabetes, malnutrition, obesity, cardiovascular disease and premature death.

Around the world, food and water insecurity is often caused by poverty, inadequate access to resources, and climate-related issues, according to the researchers. In high-income countries like the United States, food and water insecurity can be caused by a variety of circumstances, including a sudden loss of income, family instability, and infrastructure problems. While much more common in lower-income groups, the researchers said water and food insecurity is occurring far more frequently in the United States than expected.

Growing concerns

In 2005-2006, 4.6% of all children in the U.S. experienced both water and food insecurity. By the 2017-2020 survey cycle, the percentage of children facing both issues had risen to 10.3% nationwide, researchers found.

Rates of food and water insecurity improved overall over the course of the 20th century, said Rosinger, who directs the Environmental Health Sciences Program in Penn State’s College of Health and Human Development and the Water, Health and Nutrition Institute. But over the study period, the researchers found a steady, gradual increase in household food insecurity.

Water insecurity fluctuated from 2005 to 2013. Then, in 2013, the water crisis in Flint, Michigan made national news. Between 2013 and 2020, the odds of water insecurity (measured by whether a child did not drink tap water) increased by 88%.

According to the researchers, water and food issues are intrinsically linked: their previous work has documented a link between water and food insecurity in adults, and this paper demonstrates that children who avoid tap water are also more likely to experience food insecurity.

Avoiding tap water is associated with other issues that can negatively impact food and water intake, Rosinger said. People who avoid tap water are less likely to prepare nutritious food for their children because they don’t have a reliable source of water at their kitchen tap. People who avoid tap water also have higher intakes of sugary beverages. Plus, they may have less money to buy nutritious food because they buy bottled water, which is much more expensive.

“By 2020, nearly one in 10 children were experiencing food insecurity in their household and avoiding running water, and we know that the COVID-19 pandemic has only made food insecurity more widespread. That means millions of children in this country face potential negative impacts to their mental health, physical health and economic futures.”

Asher Rosinger, associate professor of biobehavioral health and anthropology at Pennsylvania State University

Huge racial disparities

The numbers are much higher for Hispanic children when compared to the national average, according to the researchers. Findings show that black children are 3.5 times more likely to experience simultaneous food and water insecurity than white children. Meanwhile, Hispanic children are more than seven times more likely to experience simultaneous food and water insecurity than white children.

While access to safe, reliable water is a crucial part of water security, trust in tap water is also an important factor for both children and their parents. The researchers said that if parents don’t trust the water, they are less likely to give it to their children for fear of making them sick.

“Most people know that Flint, Michigan, had water safety issues, and Flint is a majority-black community,” Rosinger said. “Since then, majority-minority communities, such as Newark, New Jersey, and Jackson, Mississippi, have seen notable water system problems. When people see people who look like them on the news getting sick from their water, it intensifies distrust. Additionally, minorities often have less access to services, especially those who live in low-income areas.”

Rosinger described reports of people with brown water coming out of their taps being told it was safe to drink.

“But smell, taste and color influence whether people trust water,” he said. “This distrust is rational and needs to be addressed.”

Understanding water scarcity

While the NHANES data included a measure of food insecurity, water insecurity was not directly assessed in the survey. To understand when children faced water insecurity, the researchers found a variable that could serve as a proxy for water insecurity: tap water avoidance. Rosinger’s previous work has demonstrated that tap water avoidance can be a window into understanding water insecurity.

“Not drinking tap water increased the likelihood that children would be food insecure for all income groups except the lowest income groups,” Rosinger said. “Low- and lower-middle-income children were affected the most, but even households with incomes several times the national poverty level had increased odds of their children being food insecure if they didn’t drink tap water.”

The analysis found that children from families below the poverty line were significantly more likely to experience food insecurity, regardless of whether they had tap water or not.

The researchers said water scarcity is expected to increase globally in the coming years due to pressures from climate change, population growth and aging infrastructure. While they said water avoidance data is useful, they believe it is important to directly measure the experience of water scarcity.

“You can’t manage what you can’t measure,” Young said. “The first step is to understand the scope of the problem. Avoidance of tap water is a strong indicator of water scarcity, but we clearly need to better understand who is struggling and the extent of their struggle.”

Advance

While there are no direct metrics to measure water scarcity in the U.S., the researchers agreed that a lot can be done right now to address water and food security in the country. Government programs that have proven effective in reducing food insecurity, such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP), could be expanded, the researchers said.

“Currently, in the United States, the existence of water infrastructure is considered water security,” Young said, “but piped water can be expensive, contaminated, depleted, or unavailable. And we must not forget that there are millions of people in the United States who live without piped water.”

The researchers said policy changes could reverse the trend of water scarcity. Other researchers said they found that providing water filters to Hispanic households reduced mistrust of tap water, increased tap water consumption and reduced reliance on bottled water. The researchers also recommended home water testing to assess water safety.

“While millions of people lack safe, reliable drinking water, 99 percent of American households have access to water through pipes in their homes, and the vast majority of that water is clean and drinkable,” said Rossinger, noting that the United States has one of the best water systems in the world. “To restore confidence in our system, we must implement testing that shows the water is safe, replace lead pipes, and install filters where the water is unsafe. These steps will help ensure that American children have access to the clean water they need to grow and thrive, and ensure that families do not suffer the added financial and emotional stress that uncertainty about water quality can cause.”

The study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Pennsylvania State University Population Research Institute, which is supported by the Institute for Social Science Studies.