Water insecurity is associated with higher prevalence of self-reported diet-related noncommunicable disease outcomes in adults from the Mexican National Health and Nutritional Survey 2021–22

Addressing the growing burden of noncommunicable disease (NCD) across Latin America requires identifying modifiable risk factors that can be targeted through policy and programmatic action. While water insecurity – the inability to reliably access sufficient water for domestic uses – has been found to be associated with diet-related NCD risk factors, few studies have quantified its association with NCDs. We therefore estimated the association between household water insecurity and six self-reported NCDs and NCD risk factors among adults in Mexico. Data are from 24, 920 adults (≥ 20 y) who participated in the 2021 or 2022 round of the nationally representative Mexican National Health and Nutrition Survey and provided information about NCDs diagnosed by a medical doctor. Household water insecurity in the prior month (no-to-marginal, low, moderate, or high) was measured using the Household Water Insecurity Experiences (HWISE) Scale. Survey-weighted multivariable log-Poisson regression models were used to estimate prevalence ratios (PR) between household water insecurity and NCDs, adjusting for confounders. Nationally, 16.9% of adults experienced moderate-to-high household water insecurity in the prior month. On average, participants in households with greater water insecurity were younger, less educated, and of lower socioeconomic status compared to participants in households with lower water insecurity. Relative to no-to-marginal water insecurity, moderate water insecurity was associated with higher prevalence of self-reported high cholesterol (PR: 1.15; 95% CI: 1.01, 1.30) and self-reported cardiovascular events (PR: 1.37; 95% CI: 1.02, 1.84), while high household water insecurity was associated with higher prevalence of self-reported diabetes (PR: 1.23; 95% CI: 1.01, 1.50) and hypertension (PR: 1.28; 95% CI: 1.10, 1.48). Greater household water insecurity was associated with a higher prevalence of self-reported NCDs and NCD risk factors among Mexican adults. Improving water access and sufficiency may therefore represent an under-recognized strategy to reduce NCD burden, but further research is needed to identify causal mechanisms and guide effective policy responses.