America’s Food-Security Crisis Is a Water-Security Crisis, Too

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The most requested item at one food bank? Bottled water.

This story was originally published by the Food & Environment Reporting Network.

Deepak Palakshappa became a pediatrician to give poor kids access to good medical care. Still, back in his residency days, the now-associate professor at Wake Forest University School of Medicine in Winston-Salem was shocked to discover that a patient caring for two young grandchildren was food insecure. “Our clinic had set up one of those food drive boxes, and near the end of a visit, she asked if she could have any of the cans because she didn’t have food for the holidays,” he recalls.

Thirteen years later, Palakshappa’s clinic team now asks two simple questions of every patient to ascertain whether they’ll run out of food in a given month. But there are some critical questions they don’t ask: Do you drink your tap water? Is it potable and ample? Can you cook food with it, and use it to mix infant formula and cereal? Such questions could uncover some of the millions of Americans who are water insecure—a circumstance directly connected to food insecurity.

There’s no healthcare screener for water insecurity. The issue is not even on most public health professionals’ radar, although recent water disasters in Flint, Michigan, and Jackson, Mississippi, are starting to change that. Clinicians who are aware of water insecurity “are thinking, ‘If I screen for this, what am I going to do about it?’” says Palakshappa, noting the dearth of resources available to mitigate it.

Researchers know water insecurity isn’t confined to one region or population. But “we don’t know how big of a problem it is,” says Sera Young, an associate professor of anthropology and health at Northwestern University.  “And it’s going to keep biting us in the ass, because we’re not measuring these things correctly.” Public health researchers talk about food and nutrition, while water researchers are siloed in infrastructure circles, and it’s rare for the two worlds to overlap. Says Young, “We need to build a bridge between those two disciplines.”

Most estimates put US water insecurity at 2.2 million residents. Asher Rosinger, director of the Water, Health, and Nutrition Laboratory at Pennsylvania State University, says this is probably a “huge” undercount, and the actual number might be closer to 60 million. There are no official estimates of combined food and water insecurity, which makes it tough to understand the scope of the problem, let alone to propose solutions.

“We’re measuring water by how many cubic meters there are and dividing it across the land,” says Northwestern’s Young. “Or we’re measuring infrastructure, which is like, ‘Where do you get your drinking water from? Is it from a tap? Is it from a well? Is it from a borehole?’ But you can imagine 99 scenarios where you have a tap but you can’t pay for water to flow through it, or you don’t trust the water that comes out of it, or the infrastructure upstream of the tap has gone to shit. There are lots of reasons why measuring physical availability or infrastructure only gives you a pinhole peek of what the real problem is.” 

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