Edward Frongillo:

Document Type


Subject Area(s)

Data Collection; Family Characteristics; Humans; Sensitivity and Specificity; Socioeconomic Factors; Surveys and Questionnaires; Water Insecurity; Water Supply


We sought to determine whether a shortened version of the 12-item Household Water Insecurity Experiences (HWISE) Scale, which measures water insecurity equivalently in low- and middle-income countries (LMICs), is valid for broad use. Using data from 9,261 households in 25 LMICs, subsets of candidate items were evaluated on their predictive accuracy, criterion validity, and sensitivity-specificity. A subset with items assessing "worry," "changing plans," "limited drinking water," and "inability to wash hands" because of problems with water (range: 0-12) were highly correlated with full HWISE Scale scores (correlation coefficient: 0.949-0.980) and introduced minimal additional error (root mean square error: 2.13-2.68). Criterion validity was demonstrated, and a cut point of ≥ 4 correctly classified more than 91% of households as water secure or insecure. The brief HWISE-4 can be used in LMICs to inform decisions about how to most effectively target resources and evaluate public health interventions.

Digital Object Identifier (DOI)

APA Citation

Young, S., Miller, J., Frongillo, E., Boateng, G., Jamaluddine, Z., & Neilands, T. (2021). Validity of a Four-Item Household Water Insecurity Experiences Scale for Assessing Water Issues Related to Health and Well-Being. The American Journal Of Tropical Medicine And Hygiene, 104(1), 391-394.


© 2021 by The American Society of Tropical Medicine and Hygiene

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