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(PTFS09-07-26) Water Insecurity Among WIC Participants in Louisiana, an Overlooked Determinant of Maternal and Child Health

Sunday, July 26, 2026
2:54 PM - 2:58 PM ET
Location: Prince George's Hall B-E (The Hub) - Poster Theater 1 / Poster Board Number: PT1-7

    Presenting Author(s)

  • SC

    Shalean M. Collins, PhD, MPH, RD/LDN (she/her/hers)

    Assistant Professor
    Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University
    New Orleans, Louisiana, United States

    Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

Disclosure(s):
Shalean M. Collins, PhD, MPH, RD/LDN: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: Water insecurity (WI) is an underrecognized determinant of maternal and child health (MCH) in the United States, especially in the Deep South where MCH outcomes are disproportionately adverse. The objective was to estimate the prevalence of WI among families enrolled in the Louisiana Women, Infants, and Children (WIC) Special Supplemental Nutrition Program, describe perceived effects of WI on infant feeding and caregiving, and determine where WI was most prevalent.

Methods: Statewide cellphone surveys were sent to families enrolled in WIC (n=65,675). Surveys assessed sociodemographics, WI using the 4-item Household Water Insecurity Experiences Scale (HWISE-4), and impacts of WI on infant feeding and care using an open-ended question. Analyses were conducted in Stata18. Descriptive statistics characterized the sample and WI prevalence/severity; open-ended responses were summarized and thematically coded; bivariate analyses evaluated WI by parish (county).

Results: Surveys were completed by 3,379 individuals; most (99.2%) were female, with a household income ≤$40,000/year (80.6%), (mean±SD) 30.3±7.5 years old, with 2.14±1.40 children. Approximately half (50.6%) had ≤high school education, were married or living with a partner (52.1%), and employed (46.3%). Overall 10.6% were WI; 23.0% worried about not having enough water for all needs, 18.9% had insufficient drinking water, 13.8% changed plans because of water problems, 7.2% were unable to wash hands after dirty activities. Mean WI was highest in the New Orleans metro (β 0.41; 95% CI: 0.13, 0.70) and in north Louisiana (β 0.43; 95% CI: 0.10, 0.76). Respondents described poor water quality, service interruptions, and plumbing failures that disrupted maternal and infant hygiene, bottle preparation, infant formula reconstitution, and meal preparation (including complementary foods and purees).

Conclusions: WI affected 1 in 10 Louisiana WIC participants surveyed and commonly disrupted infant feeding and caregiving. Findings suggest that WI is a meaningful, understudied challenge among low-income families in Louisiana, and highlight the need for broader screening for WI among similar populations.

Funding Sources: Tulane University Phyllis M. Taylor Center for Social Innovation and Design Thinking. Tulane University Center for Public Service.