(LB03-11-26) Correlates of Household Water Insecurity in a Sample in Puerto Rico

Objectives: Previous studies suggest an association between household water insecurity and sugary drink consumption. This study is the first to describe correlates of household water insecurity in Puerto Rico (PR).

Methods: Data was collected using an online survey sent to families with children under 5 through a community-academic partnership with public schools in PR. It included household water source, HWISE 12-item household water insecurity scale, beverage consumption (BEVQ, BEVQ-PS), socio-demographics etc. Kruskal-Wallis tests with Dunn-Bonferroni post-hoc comparisons were used to assess group differences. Spearman correlations examined associations between HWISE score and select variables. Two multivariable linear regression models was fitted with HWISE score as dependent variable to assess independent predictors of water insecurity.

Results: We received 248 responses from 42 municipalities, representing five Puerto Rico Aqueduct and Sewer Authority (PRASA) service regions. Respondents were mostly female, ages 25-44 years, and from Metro or East regions (60.8%). 65.3% of respondents HWISE classification was low to moderate, with 16.3% at high or extreme. The water insecurity measures most experienced were tap water source interruptions (89.6%) and concern about insufficient water (80.7%). Bottled water intake was the highest out of all categories (mean=44.4 fl oz/day). Sweetened beverages most consumed were soda (mean=11.1 fl oz/day), sweetened juice drinks (mean=9.7 fl oz/day) and coffee or tea with sugar (mean=10.2 fl oz/day). Reliance on bottled water (p=0.042) and unfiltered tap water (p=0.034) was associated with higher reported water insecurity. Water insecurity was significantly associated with consumption of flavored milk (p < 0.001), flavored water (p < 0.001), low fat milk (p < 0.001), and sweetened juice drinks (p=0.001).

Conclusions: Water insecurity was notable in this sample, with higher insecurity faced by those who were unemployed, ages 55 or older, cistern users, and those relying on bottled or unfiltered tap water. The association between water insecurity and beverage consumption may imply sugary beverage consumption in response to water insecurity.

Funding Sources: Sumner M. Redstone Global Center for Prevention and Wellness at The George Washington University Milken Institute School of Public Health