Water Insecurity and Psychosocial Distress: A Case Study of the Impacts of the Detroit Water Shutoff

Water insecurity poses a significant global challenge to health and development. While the

biophysical and economic impacts of inadequate water and sanitation are well documented, the complex emotional and social tolls of water insecurity are less understood – particularly in

countries of the global North. In this article, we advance understandings of the psychosocial

dimensions of water insecurity in Detroit, Michigan, where an estimated 100,000 households

have been disconnected from the public water and sewer system since the city declared

bankruptcy in 2013. Because this water insecurity is not attributable to resource scarcity or to

inadequate infrastructural development, it is not captured by the World Health Organization’s

standard water and sanitation metrics. Our approach follows recent scholarship in anthropology and public health in developing an ethnographically-grounded scale of water insecurity, designed and administered in partnership with community-based researchers. This scale was compared by statistical regression to respondents’ scores on the Kessler Psychological Distress scale in order to examine the relationship between water insecurity and psychosocial distress. Our estimates reveal a substantial, statistically significant effect of water insecurity on psychological distress. We find also that resident’s self-assessment of water unaffordability is significantly associated with psychosocial distress, independent of water supply status. The escalating rates of water and wastewater services across the United States in contrast to stagnating and declining incomes underscores the urgency of addressing the complex, intersecting effects of water affordability and water insecurity. The present study is the first we know of in the United States to examine the relationship between water insecurity and psychosocial distress.

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