IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0286146.html
   My bibliography  Save this article

Evidence on the links between water insecurity, inadequate sanitation and mental health: A systematic review and meta-analysis

Author

Listed:
  • Joan J Kimutai
  • Crick Lund
  • Wilkister N Moturi
  • Seble Shewangizaw
  • Merga Feyasa
  • Charlotte Hanlon

Abstract

Background: Water insecurity and inadequate sanitation have adverse impacts on the mental health of individuals. Objective: To review and synthesize evidence on the relationship between water insecurity, inadequate sanitation, and mental health globally. Data sources: Relevant studies were identified by searching PubMed, PsycINFO, and EMBASE databases from inception up to March 2023. Study eligibility criteria: Only quantitative studies were included. The exposure was water insecurity and or inadequate sanitation. The outcome was common mental disorders (CMD: depression or anxiety), mental distress, mental health or well-being. There was no restriction on geographical location. Participants: General population or people attending health facilities or other services. Exposure: Water insecurity and/ or inadequate sanitation. Risk of bias: The effective Public Health Practice Project (EPHPP) assessment tool was used to assess quality of selected studies. Synthesis of results: A meta-analysis was conducted using a random effects statistical model. Results: Twenty-five studies were included, with 23,103 participants from 16 countries in three continents: Africa (Kenya, Ethiopia, Ghana, Uganda, South Africa, Malawi, Mozambique, and Lesotho), Asia (Nepal, Bangladesh, India, and Iran) and the Americas (Brazil, Haiti, Bolivia and Vietnam). There was a statistically significant association between water insecurity and CMD symptoms. Nine studies reported a continuous outcome (5,248 participants): overall standardized mean difference (SMD = 1.38; 95% CI = 0.88, 1.87). Five studies reported a binary outcome (5,776 participants): odds ratio 5.03; 95% CI = 2.26, 11.18. There was a statistically significant association between inadequate sanitation and CMD symptoms (7415 participants), overall SMD = 5.36; 95% CI = 2.51, 8.20. Limitations: Most of the included studies were cross-sectional which were unable to examine temporal relationships. Conclusions: Water insecurity and inadequate sanitation contribute to poorer mental health globally. Implications of key findings: Interventions to provide basic water, sanitation and psychosocial support, could substantially contribute to reducing the burden of CMD alongside other health and social benefits. Trial registration: PROSPERO registration number: CRD42022322528.

Suggested Citation

  • Joan J Kimutai & Crick Lund & Wilkister N Moturi & Seble Shewangizaw & Merga Feyasa & Charlotte Hanlon, 2023. "Evidence on the links between water insecurity, inadequate sanitation and mental health: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 18(5), pages 1-22, May.
    • Handle: RePEc:plo:pone00:0286146
    DOI: 10.1371/journal.pone.0286146
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0286146
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0286146&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0286146?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Shin Kue Ryu, 2019. "Variation in Access to Safe Drinking Water across Different Countries: An Explanatory Framework," Social Sciences, MDPI, vol. 8(2), pages 1-31, February.
    2. Brewis, Alexandra & Choudhary, Neetu & Wutich, Amber, 2019. "Household water insecurity may influence common mental disorders directly and indirectly through multiple pathways: Evidence from Haiti," Social Science & Medicine, Elsevier, vol. 238(C), pages 1-1.
    3. Boateng, Godfred O. & Workman, Cassandra L. & Miller, Joshua D. & Onono, Maricianah & Neilands, Torsten B. & Young, Sera L., 2022. "The syndemic effects of food insecurity, water insecurity, and HIV on depressive symptomatology among Kenyan women," Social Science & Medicine, Elsevier, vol. 295(C).
    4. Wutich, Amber & Ragsdale, Kathleen, 2008. "Water insecurity and emotional distress: Coping with supply, access, and seasonal variability of water in a Bolivian squatter settlement," Social Science & Medicine, Elsevier, vol. 67(12), pages 2116-2125, December.
    5. repec:plo:pone00:0153432 is not listed on IDEAS
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Willow Leahy & Meshack Achore & Florence Dery, 2024. "“In the dry season, our suffering doubles”: Barriers to water access in poor urban settlements in Ghana," PLOS Water, Public Library of Science, vol. 3(9), pages 1-14, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Nadia Koyratty & Andrew D. Jones & Roseanne Schuster & Katarzyna Kordas & Chin-Shang Li & Mduduzi N. N. Mbuya & Godfred O. Boateng & Robert Ntozini & Bernard Chasekwa & Jean H. Humphrey & Laura E. Smi, 2021. "Food Insecurity and Water Insecurity in Rural Zimbabwe: Development of Multidimensional Household Measures," IJERPH, MDPI, vol. 18(11), pages 1-23, June.
    2. Winter, James C. & Darmstadt, Gary L. & Davis, Jennifer, 2021. "The role of piped water supplies in advancing health, economic development, and gender equality in rural communities," Social Science & Medicine, Elsevier, vol. 270(C).
    3. Holly Vins & Jesse Bell & Shubhayu Saha & Jeremy J. Hess, 2015. "The Mental Health Outcomes of Drought: A Systematic Review and Causal Process Diagram," IJERPH, MDPI, vol. 12(10), pages 1-25, October.
    4. Angela M Parcesepe & Kathryn E L Grimes & Peter Vanes Ebasone & Anastase Dzudie & Milton L Wainberg & Eric Pefura & Marcel Yotebieng & Kathryn Anastos & Denis Nsame & Annereke Nyenti & Denis Nash, 2025. "Mental health-related help-seeking and the role of HIV care providers: A qualitative study with people with HIV in Cameroon," PLOS Global Public Health, Public Library of Science, vol. 5(5), pages 1-13, May.
    5. Anna Yusa & Peter Berry & June J.Cheng & Nicholas Ogden & Barrie Bonsal & Ronald Stewart & Ruth Waldick, 2015. "Climate Change, Drought and Human Health in Canada," IJERPH, MDPI, vol. 12(7), pages 1-54, July.
    6. Priscila Neves-Silva & Juliana Aurora de Oliveira Lopes & Léo Heller, 2020. "The right to water: Impact on the quality of life of rural workers in a settlement of the Landless Workers Movement, Brazil," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-13, July.
    7. Mushavi, Rumbidzai C. & Burns, Bridget F.O. & Kakuhikire, Bernard & Owembabazi, Moran & Vořechovská, Dagmar & McDonough, Amy Q. & Cooper-Vince, Christine E. & Baguma, Charles & Rasmussen, Justin D. & , 2020. "“When you have no water, it means you have no peace”: A mixed-methods, whole-population study of water insecurity and depression in rural Uganda," Social Science & Medicine, Elsevier, vol. 245(C).
    8. Korzenevica, Marina & Fallon Grasham, Catherine & Johnson, Zoé & Gebreegzabher, Amleset & Mebrahtu, Samrawit & Zerihun, Zenawi & Ferdous Hoque, Sonia & Charles, Katrina Jane, 2022. "Negotiating spaces of marginality and independence: On women entrepreneurs within Ethiopian urbanization and water precarity," World Development, Elsevier, vol. 158(C).
    9. Kay Jowers & Christopher Timmins & Nrupen Bhavsar & Qihui Hu & Julia Marshall, 2021. "Housing Precarity & the COVID-19 Pandemic: Impacts of Utility Disconnection and Eviction Moratoria on Infections and Deaths Across US Counties," NBER Working Papers 28394, National Bureau of Economic Research, Inc.
    10. Brewis, Alexandra & Choudhary, Neetu & Wutich, Amber, 2019. "Household water insecurity may influence common mental disorders directly and indirectly through multiple pathways: Evidence from Haiti," Social Science & Medicine, Elsevier, vol. 238(C), pages 1-1.
    11. Juliana Marcal & Blanca Antizar-Ladislao & Jan Hofman, 2021. "Addressing Water Security: An Overview," Sustainability, MDPI, vol. 13(24), pages 1-18, December.
    12. Bethany A Caruso & Amelia Conrad & Madeleine Patrick & Ajilé Owens & Kari Kviten & Olivia Zarella & Hannah Rogers & Sheela S Sinharoy, 2022. "Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis," PLOS Water, Public Library of Science, vol. 1(6), pages 1-48, June.
    13. Namrata Chindarkar & Yvonne Jie Chen & Yogendra Gurung, 2019. "Subjective Well-Being Effects of Coping Cost: Evidence from Household Water Supply in Kathmandu Valley, Nepal," Journal of Happiness Studies, Springer, vol. 20(8), pages 2581-2608, December.
    14. Joseph Kangmennaang & Elijah Bisung & Susan J. Elliott, 2020. "‘We Are Drinking Diseases’: Perception of Water Insecurity and Emotional Distress in Urban Slums in Accra, Ghana," IJERPH, MDPI, vol. 17(3), pages 1-17, January.
    15. Farooq Ahmed & Muhammad Shahid & Yang Cao & Madeeha Gohar Qureshi & Sidra Zia & Saireen Fatima & Jing Guo, 2021. "A Qualitative Exploration in Causes of Water Insecurity Experiences, and Gender and Nutritional Consequences in South-Punjab, Pakistan," IJERPH, MDPI, vol. 18(23), pages 1-14, November.
    16. Juan Espinosa-Montero & Eric A Monterrubio-Flores & Marcela Sanchez-Estrada & Inmaculada Buendia-Jimenez & Harris R Lieberman & François-Andre Allaert & Simon Barquera, 2016. "Development and Validation of an Instrument to Evaluate Perceived Wellbeing Associated with the Ingestion of Water: The Water Ingestion-Related Wellbeing Instrument (WIRWI)," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-14, July.
    17. Beresford, Melissa & Brewis, Alexandra & Choudhary, Neetu & Drew, Georgina & Garcia, Nataly Escobedo & Garrick, Dustin & Hossain, Mohammed Jobayer & Lopez, Ernesto & Nébié, Elisabeth Ilboudo & Pacheco, 2023. "Justice and Moral Economies in Modular, Adaptive, and Decentralized (MAD) Water Systems," SocArXiv 6ywp7, Center for Open Science.
    18. Tolulope O. Odimayomi & Caitlin R. Proctor & Qi Erica Wang & Arman Sabbaghi & Kimberly S. Peterson & David J. Yu & Juneseok Lee & Amisha D. Shah & Christian J. Ley & Yoorae Noh & Charlotte D. Smith & , 2021. "Water safety attitudes, risk perception, experiences, and education for households impacted by the 2018 Camp Fire, California," Natural Hazards: Journal of the International Society for the Prevention and Mitigation of Natural Hazards, Springer;International Society for the Prevention and Mitigation of Natural Hazards, vol. 108(1), pages 947-975, August.
    19. repec:osf:socarx:6ywp7_v1 is not listed on IDEAS
    20. Bach, Vanessa & Finogenova, Natalia & Berger, Markus & Winter, Lisa & Finkbeiner, Matthias, 2017. "Enhancing the assessment of critical resource use at the country level with the SCARCE method – Case study of Germany," Resources Policy, Elsevier, vol. 53(C), pages 283-299.
    21. Ramnath Subbaraman & Laura Nolan & Kiran Sawant & Shrutika Shitole & Tejal Shitole & Mahesh Nanarkar & Anita Patil-Deshmukh & David E Bloom, 2015. "Multidimensional Measurement of Household Water Poverty in a Mumbai Slum: Looking Beyond Water Quality," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-19, July.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0286146. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.