Water Resources Research - 2024 - Drakes

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Vulnerability to Water Insecurity, Hazards Planning and Response

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RESEARCH ARTICLE
10.1029/2023WR036284
Key Points:

• This study determines the influence
and uncertainty associated with
indicators of social vulnerability to
water insecurity
• There is substantial uncertainty about
the strength and/or direction of many
indicator relationships to water
insecurity conditions
• Integrated studies are vital as
conceptual framing of social
vulnerability and water security define
which indicators are measured

Supporting Information:
Supporting Information may be found in
the online version of this article.

Correspondence to:
O. Drakes,
odrakes@usgs.gov

Citation:
Drakes, O., Restrepo‐Osorio, D., Powlen,
K. A., & Hines, M. (2024). Social
vulnerability and water insecurity in the
western United States: A systematic
review of framings, indicators, and
uncertainty. Water Resources Research,
60, e2023WR036284. https://doi.org/10.
1029/2023WR036284
Received 24 SEP 2023
Accepted 23 JUL 2024
Author Contributions:
Conceptualization: Oronde Drakes,
Kathryn A. Powlen
Data curation: Oronde Drakes,
Diana Restrepo‐Osorio, Kathryn
A. Powlen
Formal analysis: Oronde Drakes,
Diana Restrepo‐Osorio, Megan Hines

Published 2024. This article is a U.S.
Government work and is in the public
domain in the USA. Water Resources
Research published by Wiley Periodicals
LLC on behalf of American Geophysical
Union.
This is an open access article under the
terms of the Creative Commons
Attribution‐NonCommercial‐NoDerivs
License, which permits use and
distribution in any medium, provided the
original work is properly cited, the use is
non‐commercial and no modifications or
adaptations are made.

DRAKES ET AL.

Social Vulnerability and Water Insecurity in the Western
United States: A Systematic Review of Framings, Indicators,
and Uncertainty
Oronde Drakes1

, Diana Restrepo‐Osorio1

, Kathryn A. Powlen2

, and Megan Hines1

U.S. Geological Survey, Water Mission Area, Integrated Information Dissemination Division, Reston, VA, USA, 2U.S.
Geological Survey, Oklahoma‐Texas Water Science Center, Denver, CO, USA

Abstract

Water insecurity poses a complex challenge for the western United States. Large populations are
exposed and susceptible to physical and social factors that can leave them with precarious access to sufficient
water supplies. Consideration of social issues by water managers can help ensure equitable supply. However,
how social factors affect water insecurity conditions remains unclear. This paper reviews literature on how
social vulnerability influences water insecurity in the western United States. Through a meta‐analysis,
indicators measuring how dimensions of social vulnerability influence water insecurity were classified and
hierarchical clustering was used to characterize the relationships among these vulnerability dimensions for the
largest water‐users—the agricultural and municipal sectors. The study then assessed uncertainty associated with
social vulnerability dimensions and their indicators. There is greatest evidence for the influence of demographic
characteristics, socioeconomic status, and exposure. Indicators of these determinants were mainly significant
and exacerbated conditions of water insecurity. Evidence for indicators of social dependence and special needs
populations was limited, although studies assessing these factors showed significant agreement on their
influence on water insecurity. Conceptual framings of social vulnerability and water security determined which
indicators were measured, whereas studies of the water‐use sectors focused on differing associations of social
vulnerability. These findings indicate the importance of recognizing the different contexts posed by water‐use
sectors and diverse conceptual framings. Further, some determinants such as living conditions remain important
but underexplored drivers of a community's experience of water insecurity. Understanding the uncertainty
associated with these measures has implications to equitable decision making.

Plain Language Summary

Water security ensures sustainable access to adequate quantities of safe
water to sustain livelihoods and economic and social well‐being. Rapidly growing populations and changing
climatic conditions make this a challenging task for the western United States. This study reviews previous
academic literature to identify how they measured socioeconomic factors that impact water access, quality, and
quantity for the largest water‐users ‐ the agricultural and municipal sectors ‐ in the western US. Which social
factors were measured depended on which water‐use sector was studied, and whether the authors viewed
vulnerability and water security as preexisting or emergent conditions. We found most studies measured
characteristics of demographics, socioeconomics, or exposure. Characteristics of risk perception or health were
studied less often, with less agreement on their relationship to conditions of water security. There are therefore
different levels of surety associated with the available measures of social vulnerability to water insecurity.
Water resources managers need to be aware of these differing amounts of surety in the measures used to assist
their decision making. Our study explores what is known about different indicators of social vulnerability to
water security. Further, we provide a framework comparing otherwise disparate research on the complex subject
of water insecurity.

1. Introduction
Water insecurity exists where populations cannot maintain access to adequate quantities of water at an acceptable
quality in order to sustain livelihoods, development, and human and ecosystem health (Bakker, 2012; Grey &
Sadoff, 2007; Scott et al., 2013; United Nations, 2013). The result is a multifaceted social‐environmental issue
characterized by physical shortages, conflicts of access, and concerns over degrading water quality (Bakker, 2012; Bureau of Reclamation, 2021; Gerlak et al., 2018). Physical shortages occur where there is not enough
water to meet water‐user demands. Conflicts of access can develop where the legal authority to utilize water
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Investigation: Oronde Drakes,
Diana Restrepo‐Osorio, Kathryn
A. Powlen
Methodology: Oronde Drakes, Kathryn
A. Powlen
Project administration: Oronde Drakes
Resources: Oronde Drakes
Software: Oronde Drakes, Megan Hines
Supervision: Oronde Drakes
Validation: Oronde Drakes,
Diana Restrepo‐Osorio, Kathryn
A. Powlen
Visualization: Oronde Drakes,
Megan Hines
Writing – original draft: Oronde Drakes,
Diana Restrepo‐Osorio, Kathryn
A. Powlen
Writing – review & editing:
Oronde Drakes, Diana Restrepo‐Osorio,
Kathryn A. Powlen

10.1029/2023WR036284

resources (i.e., water‐rights) prioritizes the needs of one water‐user group over another, or where costs prohibit
some users from adequate access. Water quality issues stem from contamination in water that is unsuitable for its
intended use. Protection against water‐related hazards, and maintenance of political and social stability further
influence water security concerns (Gerlak et al., 2018; Grey & Sadoff, 2007). All these characteristics can be
exacerbated by prevailing socio‐political conditions, meaning water insecurity is as much a social challenge as a
physical one (Brooks & Brandes, 2011; Jepson, Budds, et al., 2017; Jepson, Wutich, et al., 2017).
Water insecurity is a growing challenge in the United States where increasing demands for water resources
conflict with a decreasing supply exacerbated by droughts and a warming climate. Specific factors of water
insecurity vary from place to place and can change over time; however, locations in the western United States
commonly experience some combination of shortage, access, quality, and socio‐political issues. Megadrought
(Williams et al., 2020), less reliable rain and snowfall patterns (Dettinger et al., 2015; Garfin et al., 2018),
increasing number of extreme heat days (Dahl et al., 2019; Vose et al., 2017), and shifts in peak and low‐flow
timing (Bureau of Reclamation, 2021) all affect the availability of water. Increased water demands to support
growing populations and urbanization can compound issues of reduced availability and increase competition with
agricultural water demands.
Although concerns of water insecurity are prevalent across the western United States, they do not affect all
populations equally (Deitz & Meehan, 2019; Jepson, 2012, 2014; Meehan, Jepson, et al., 2020; Meehan, Jurjevich, et al., 2020; Roller et al., 2019). Social vulnerability frameworks have been used to provide insight into the
factors contributing to water insecurity by describing the conditions via which societal factors shape exposure to
danger, susceptibility to harm, and the ability to respond to harm (Adger, 2006; Birkmann, 2013; Burton
et al., 2018; Cutter et al., 2003). An integrated understanding of how social vulnerability is measured across
multiple views of water insecurity and water use would be helpful. This study aims to derive vital information on
the societal conditions that contribute to water insecurity across the western United States by summarizing
existing evidence on the link between social vulnerability and water insecurity. Specifically, we seek to identify
the dimensions of social vulnerability inherent to water insecurity, the relative importance of indicators representing these dimensions, the degree of agreement on their level of importance across literature, and gaps in
empirical knowledge on the influence of these indicators of social vulnerability to water insecurity. Findings are
summarized by major water‐use sectors in the western United States. By identifying relevant dimensions of social
vulnerability and appropriate indicators representing them this study can provide two major benefits. First, the
results can help direct future scholarship to close knowledge gaps around social vulnerability to water insecurity.
Second, the study can guide water‐resources decision makers to better understand the limitations associated with
using indicator‐based tools to define vulnerability as they work to help resolve water insecurity issues.

2. Water and the Western United States
West of the Mississippi River, millions of people suffer water insecure conditions as competing water‐uses
intensify with population growth and a changing climate in the already water scarce region (Bureau of Reclamation, 2021). This situation is predicted to worsen as increasing drought, floods, heat, and fires are expected to
further degrade water quality and availability, affecting some communities more than others (Gartin et al., 2020;
Harlan et al., 2006; Hoehne et al., 2018; Jenerette et al., 2011). Water insecurity in this region is exemplified by a
23‐year megadrought in the Colorado River Basin. The Colorado River Basin provides water for substantial areas
of Arizona, Utah, and Colorado, and partial areas of California, New Mexico, Nevada, Wyoming, and Mexico.
The megadrought is the driest period in the basin within the past 100 years, and one of the driest within the past
1,200 years (Bureau of Reclamation, 2021). However, drought is not exclusive to the Colorado River Basin.
States in the central and southern areas of the western United States are also enduring water shortages from severe
drought (Chen et al., 2012; Janssen et al., 2021).
Other climate trends are predicted to vary regionally. For example, increased average temperatures and decreased
precipitation in the West and Southwest are expected to diminish water supply. In the Northwest, flooding from
more intense storms may reduce water quality for the Columbia River Basin (Idaho, Oregon, Washington,
Wyoming, Montana, and Canada) and Missouri River Basin (Montana, Wyoming, Colorado, Kansas, Nebraska,
South Dakota, North Dakota) (Bureau of Reclamation, 2021; Queen et al., 2021). For river basins with headwaters in the Rocky Mountains, annual snowpack substantially contributes to streamflow. Higher temperatures
will melt snow earlier, increasing seasonal streamflow from December through March and decreasing streamflow
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from April through July (Bureau of Reclamation, 2021; Janssen et al., 2021). The outcome is a discrepancy
between water availability and time of highest demand for agriculture, one of the largest water‐use sectors
(Herman‐Mercer et al., 2023).
Increasing temperatures, drought, and decreased streamflow combine to create optimal conditions for wildfires by
increasing fuel availability and the probability of ignition (Engström et al., 2020; NOAA & NIDIS, 2021).
Wildfires threaten water security in several ways. First, fire suppression is extremely water intensive. In 2020, the
worst wildfire season in the modern history of California, 10,000 fires burned about 4% (4.2 million acres) of the
state’s 100 million acres of land (CalFire, 2023). The Department of Forestry and Fire Protection of California
used up to 132 aircraft daily, delivering 11 million gallons of retardant and 18 million gallons of water
(Cart, 2021). Second, water quality is also threatened post‐fire by increased erosion and risk of flash floods.
Contaminants, ash, large debris, and sediment can wash into water bodies for years after a fire (Bureau of
Reclamation, 2021; Kinoshita et al., 2016).
Flooding can also jeopardize access to and quality of water resources. Huang and Wang (2020) and Hong and
Chang (2020) noted the significant economic cost of floods, amounting to billions of dollars in losses over the last
decade nationally. Such loss limits the ability to maintain critical water‐infrastructure, over time, affecting water
quality. Even in areas where precipitation is forecasted to decrease, the frequency and magnitude of flood events
are expected to increase as annual precipitation becomes concentrated in fewer, more intense storms, and as flows
linger above flood stage longer than usual, stressing water control infrastructure (Blum et al., 2020; Bureau of
Reclamation, 2021; Hodgkins et al., 2019).
Reservoirs and dams established to control flooding, serve as sources for irrigation, drinking water, and energy
providers are expected to experience reduced flows, intensifying tensions between water‐use sectors. The Colorado River Basin megadrought has resulted in Lake Mead’s lowest recorded levels. Although 75% of the reservoir’s water is used for agricultural irrigation (Bennett, 2022), Lake Mead provides drinking water to 20 million
people, and energy to 8 million people (Herman‐Mercer et al., 2023). Temperatures are expected to continue
increasing in this region, and runoff is predicted to occur earlier in the year, depleting water and energy supplies in
the summer when demand is highest (Bureau of Reclamation, 2021). A 0.5 to 2.5% loss of power generation is
predicted for the Hoover Dam every year for the next 5 years (Bureau of Reclamation, 2021). The future of this
and other similar water bodies is uncertain as climate change affects the efficiency, timing, and magnitude of
natural recharge, while growing population leads to increased demands on the resource.
Conflicts of water access have also surfaced during the Colorado River Basin megadrought. The Doctrine of Prior
Appropriation is a unique legal structure guiding water‐resource use in the western United States (Macdonnell, 2015; Tarlock, 2000). Under this legal system, the first person to divert water for a “beneficial” use has
priority over anyone subsequently granted access. “Senior” water‐rights holders can use all their legal allocation,
even if it disrupts or eliminates water availability for those with “junior” rights. This prioritization can be upheld
regardless of the detrimental social or economic impacts for those with reduced access (Macdonnell, 2015;
Tarlock, 2000). This results in management decisions that are, at times, misaligned with current or future socio‐
ecological system needs.
Some municipalities in arid and semiarid regions are actively promoting inter‐basin water transfers, and purchasing water rights meant for future agricultural irrigation, repurposing them for municipal and industrial use
(Gober et al., 2016). However, water management strategies to secure the resource are often not reflected in
community behaviors. Up to 65% of residential water use is directed to outdoor purposes like pools and lawn
irrigation (DeOreo et al., 2016). Water demand for lawn maintenance is a human determinant that culturally
represents socioeconomic status and is typically reinforced by homeowners’ association rules (Herman‐Mercer
et al., 2023; Robbins, 2012; Vine, 2018). This creates conditions where per capita water use in suburban, higher
income, and predominantly White areas is significantly higher than more densely populated urban cores. Greater
ability to pay for access to the resource and higher influence on policymakers also incentivizes Community Water
Systems to prioritize expansion and service provision in higher income and often suburban areas (Mullin, 2020).
The result is that older and inner‐city developments where the elderly, poor, and minorities are often overrepresented tend to experience higher instances of interrupted supply and water quality disruptions associated
with deteriorating infrastructure (London et al., 2021; Mullin, 2020). These competing uses and increasing land
use changes from agriculture to urban areas indicate that reevaluation of current and future water‐use priorities in
this already water‐deficient area would be beneficial.
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2.1. The Social Vulnerability‐Water Insecurity Nexus
Mullin (2020); Yellow Horse et al. (2020) London et al. (2021); Mendez‐Barrientos et al. (2022); and Wutich
et al. (2022) all indicate that sociodemographic characteristics are correlated with vulnerability to water insecurity
in the western United States. Social vulnerability describes the societal factors that shape the ability of individuals, communities, or populations to resist impacts from external stresses, cope with impacts, or recover
from their losses (Adger, 2006; Adger & Kelly, 1999; Blaikie et al., 2003; Cutter et al., 2003). In theory, individuals, households, or communities with higher social vulnerability are more likely to experience harm from a
hazard or external threat (e.g., drought) and may be less able to cope with resulting effects. Age, race, income,
wealth, and gender are commonly cited determinants of social vulnerability (Cutter et al., 2003; Flanagan
et al., 2011; Karaye & Horney, 2020; Rivera & Fothergill, 2021; Wutich et al., 2022). In our theoretical framing,
we include exposure as an additional element of social vulnerability because the characteristics of vulnerability
associated with marginalization lead some people to be disproportionately exposed to external stressors or
hazards (Blaikie et al., 2003; Marino & Faas, 2020; Pulido, 2000; Smith, 2006; Wutich et al., 2022). Exposure
represents contact with an external source of harm and has long been associated with the social and structural
characteristics which produce inequities in sensitivity and adaptive or coping capacity (Adger, 2006; Cutter, 1996; Turner et al., 2003). Social, political, and economic processes often result in vulnerable populations
occupying places which experience higher frequency and intensity of hazards events, making them less desirable
to other groups (Best et al., 2023; Wutich et al., 2022). Socially vulnerable groups are therefore more likely to be
situated in harm’s way. For example, renters are more likely than homeowners to live in places exposed to flash
flooding, with lower income and African American renters more likely to reside in locations with higher hazard
exposure (Oke et al., 2023; Peacock & Girard, 1997). Similarly, individuals occupying manufactured housing or
mobile homes suffer higher exposure to heat and wildfire hazards (Pierce et al., 2022) and are also more overrepresented in flood‐prone areas (Tate et al., 2021).
Infrastructure and institutional factors are major determinants of access to and reliability of water delivery in the
United States. Native American, Black, and Hispanic households are more likely to lack adequate plumbing, with
much of this “plumbing poverty” clustered in the western United States (Deitz & Meehan, 2019; Tanana
et al., 2021). As an example, the Navajo Nation, a senior water‐rights holder, lacks the financial and infrastructural resources to adequately access the water, reinforcing water insecure conditions (Tanana et al., 2021).
The challenge of inadequate infrastructure is not unique to the Navajo, and although this lack of adequate
plumbing is often considered a rural problem, a substantial proportion of the population exposed to water
insecurity live in urban areas. Meehan, Jepson, et al. (2020); Meehan, Jurjevich, et al. (2020) found 471,000
households or 1.1 million people lacked piped water access between 2013 and 2017, with the majority (73%) of
these households located in metropolitan areas, and nearly half (47%) in the 50 largest urban areas. Thus, although
water‐deserts can be physical features of climate, they are often unintentionally manufactured outcomes of social
and institutional features.
Water insecurity places substantial stress on livelihoods and well‐being. Social inequities produce conditions
where the compound effects of chronic or long‐term water stress, and the shorter‐term cascading effects of more
sudden and extreme events disproportionately fall on those most exposed to, most susceptible to, and/or least able
to mitigate the effects of water‐insecure conditions. Without sufficient support structures (both physical and
institutional), households that lack safe, reliable, sufficient, and affordable water can therefore be pushed into
more precarious conditions of water insecurity (Jepson, Budds, et al., 2017; Jepson, Wutich, et al., 2017).
However, the lack of such support structures is often characteristic of being socially vulnerable (Blaikie
et al., 2003; Rivera, 2022). Without consideration of social equity, programs designed to aid disaster afflicted
communities can themselves perpetuate and exacerbate conditions of social vulnerability (Domingue &
Emrich, 2019; Drakes et al., 2021; Hooks & Miller, 2006; Howell & Elliott, 2019; Kamel & Loukaitou‐Sideris, 2004). Lastly, few programs are designed to support communities facing long‐term effects of water insecurity.
Existing support programs, such as the Federal Emergency Management Agency’s (FEMA’s) Building Resilient
Infrastructure and Communities (BRIC) Program, do not focus on household needs. Most are designed to alleviate crop and livestock losses (through the U.S. Department of Agriculture e.g., Livestock Forage Disaster
Program, Emergency Loan Program (Farm Loans), Noninsured Disaster Assistance Program, and Emergency
Watershed Protection Program) or to help institutions with decision‐making authority improve infrastructure
(through Bureau of Reclamation e.g., WaterSMART Water and Energy Efficiency Grants, and WaterSMART

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Drought Response Program) and so have limited capacity to reduce conditions of household vulnerability (NOAA
& NIDIS, n.d.).
In effect, many of the factors that contribute to social vulnerability create environments in which those who
experience conditions of water insecurity are likely to remain water insecure. Compounding factors such as
population growth and changing climate may further exacerbate vulnerability in water‐insecure populations while
expanding water insecurity to other, previously unaffected, groups (Gleick & Iceland, 2018; O’Keefe et al., 1976;
Tate, 2019). Without an understanding of how social vulnerability influences precarious conditions, decision
makers cannot adequately combat the water security challenge.
2.2. The Opacity of Indicators
Over the past two decades, researchers and decision makers have increasingly relied on indicators to identify
social vulnerability drivers and understand the intensity of their effects. Indicators are measurable variables, such
as the size of the average household, representing determinants (concepts known or suspected to be contributing
factors e.g., family structure) of vulnerabilities to a particular condition such as water insecurity (Tate, 2012).
Composite indices, such as the Social Vulnerability Index (SoVI) of Cutter et al. (2003) and Social Vulnerability
Index (SVI) of Flanagan et al. (2011) are combinations of indicators commonly used to represent generic
vulnerability. These indices are valuable tools for large scale analyses (e.g., nationally). However, they lack
important detail to fully understand hazard‐specific exposures or other variations in vulnerability across livelihoods, populations, water‐use sectors, or specific locations.
Composite indices of social vulnerability targeted at water insecurity often vary widely in the specific factors
examined, the ways those factors are combined to represent common determinants of social vulnerability, or
examine distinct types of water insecurity. For example, in determining socioeconomic aspects of vulnerability to
drought, Naumann et al. (2014) used 17 indicators and proportional weighting of vulnerability dimensions
(thematic groupings of determinants e.g., the “demographic characteristics” dimension includes the determinants
“age” and “family structure”), whereas Naumann et al. (2019) used 15 indicators and simple arithmetic aggregation of the individual indicators. Nkiaka (2022) utilized six indicators to discuss access to water resources
whereas Rosinger (2022) used four indicators to identify issues of water quality. This variability in indicators and
modalities of their use make it challenging to determine true relationships between specific vulnerability indicators and water insecure conditions. Opacity associated with directionality and strength of indicator influence
on vulnerability outcomes (such as water insecurity) has led to general criticism of indicator‐based research on
several grounds including statistical inconsistency (Spielman et al., 2020), failure to acknowledge unequal influence of determinants across different populations (Hinkel, 2011; Saltelli, 2007), and omission of complex
interaction effects on vulnerability outcomes (Drakes et al., 2021; Rufat, 2013). Similar uncertainty in causal
relationships between indicators of social vulnerability and conditions of water insecurity is a critical barrier to
improving decision‐support tools for water security.
This paper addresses the above concerns through a systematic review and meta‐analysis of empirical research that
identifies (a) the dimensions of social vulnerability essential to water insecurity in the western conterminous
United States; (b) the relative importance of these social vulnerability dimensions to conditions of water insecurity in the agricultural, municipal, and ecological water‐use sectors of this region; (c) the indicators used to
measure these dimensions; and (d) the extent of agreement on the direction and importance of indicator influence
to water insecurity. The goal for this synthesis is a framework for better understanding the relationship between
social vulnerability and water insecurity that is actionable, rather than conceptual. For this reason, we focused on
studies measuring aspects of this relationship, and excluded those discussing social vulnerability as a theoretical
concept.

3. Data and Methods
3.1. Study Selection
This study is based on the PRISMA guidelines for systematic reviews (Page et al., 2021). To gather relevant
studies, we conducted keyword searches of the Web of Science Core Collection, SCOPUS, and Geo Deep Dive
databases using the search terms in Figure 1. These were applied to titles, abstracts, and keywords of articles
published from 2000 to 2022, a period that saw a boom in water security research (Cook & Bakker, 2012). Use of
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Boolean operators allowed the return of a broad selection of studies
(n = 4,735), across multiple contexts, which were then reviewed by the
research team. Results from each database were downloaded in BibTeX
format. Because both social vulnerability and water insecurity are highly
dynamic phenomena influenced by the interplay of physical conditions and
socio‐institutional factors (Adger, 2006; Gerlak et al., 2018), the assessment
was limited to the conterminous United States west of the Mississippi River.
A custom R script (R Core Team, 2022) was used to retain only titles or
abstracts with keywords “United States,” “USA,” or “US,” and abstracts were
then manually screened to remove studies on areas outside the geographic
scope of interest. Duplicate results were removed using BibTeX‐tidy V 1.8.5
(West, 2021), a cleaning and formatting utility for bibliographic data. A
custom script was then used to exclude reviews and editorials. A total of 203
articles were retained for review.

Figure 1. Data collection flowchart.

The article inclusion/exclusion procedure was performed in a multi‐step
process following Romero‐Lankao et al. (2012). In step 1, abstracts were
reviewed to identify articles suitable for full‐text assessment. Suitable articles
had to have been peer reviewed, published on or after 1 January 2000, and
must have addressed some factor of water security (resource access, physical
shortage, or degraded quality) and social vulnerability (exposure, susceptibility, or coping). During abstract screening, we excluded articles measuring
only physical vulnerability, resilience, or adaptation, which we consider
separate concepts from social vulnerability, narrowing the included articles to
85. This study seeks to identify how social vulnerability is measured in studies of water insecurity. We therefore
excluded 32 additional articles that lacked specific focus measuring elements of social vulnerability. One article
contained three distinct water insecurity models and was therefore included as three separate entries. After full
article screening, a total of 53 studies containing 55 models remained for review and data extraction. The first
three co‐authors completed step 1. The co‐authors met to define the inclusion/exclusion criteria and conducted a
training session to code articles from a test sample. In each case the co‐authors agreed on inclusion of the same
articles. Each co‐author was assigned one third of the data set and independently reviewed those abstracts for
inclusion. Any abstracts for which there was uncertainty were reviewed by both remaining co‐authors, and the
first co‐author then reviewed a random sample from the entire data set.
3.2. Meta‐Analysis
In step 2, the first three co‐authors reviewed the full text of selected articles. Due to time constraints, co‐authors
independently reviewed one third of the sample. Co‐authors coded each article into the same data‐collection
matrix using a co‐developed codebook (Table S1 in Supporting Information S1). The data collection used
dropdown menus constructed in a Microsoft Excel spreadsheet to standardize inputs. The dropdown menus coded
for elements such as thematic area of water insecurity, study scale, setting, natural hazards, dimension and
determinant of social vulnerability, and direction and significance of indicator influence. In addition to the
dropdown lists, the exact name/title of each indicator identified was entered for each study. The research team had
two training sessions before beginning the process. During Step 2, co‐authors were able to flag elements for which
there was uncertainty about coding, and in regular team discussions the first three co‐authors determined the best
action for each point of uncertainty.
Following the approaches of Misselhorn (2005) and Romero‐Lankao et al. (2012), we created a data extraction
matrix based on our conceptual understanding of social vulnerability and water insecurity. This matrix helped
analyze the articles in a systematic and standardized manner. Two training sessions helped to ensure intercoder
reliability among the three co‐authors completing this step. As previously outlined coding was done in a single
spreadsheet and the first three co‐authors met regularly to review coding decisions and clarify points of ambiguity.
Each article was classified based on both the dominant sector of water use and the component of water insecurity
considered. We then coded social vulnerability indicators measured in each paper, and the direction and significance of influence on water insecurity (Figure 2). Significance was coded as “statistically significant” if

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Figure 2. Classification and coding hierarchy of social vulnerability indicators from articles.

identified as such in studies using quantitative methods or “important” for studies using qualitative methods. See
Literature Results Summary of Indicators in Hines et al. (2023) for a full list of coded indicators.
For the direction of influence, indicators were labeled as “positive” if they intensified conditions of water insecurity, “negative” if they alleviated conditions of water insecurity, “unrelated” if they showed no influence, and
“unknown” in cases where no indication of influence was given. Closely related indicators were aggregated to
reflect the broader concept, for example, population >65 years, percentage of population >65 years, and population >75 years were aggregated as “elderly.” To further aid analysis, aggregated indicators were grouped into
determinants representing related concepts such as “age” or “family structure.” This process produced 358 variations of 106 indicators covering 55 determinants of social vulnerability (See Literature Results Summary of
Indicators in Hines et al. (2023) for a full list of coded indicators). These determinants were then assigned to one of
seven dimensions or themes commonly found in the social vulnerability literature (Bankoff et al., 2006; Birkmann, 2013; Ranci, 2010; Rufat et al., 2015; Thomas et al., 2013). These seven dimensions were demographic
characteristics, land tenure, living conditions, socioeconomic status, health, risk perception, and exposure.
An example of the nested structure used in this study is shown in Figure 3.
To identify associations between the indicators measured, we computed co‐occurrence matrices and hierarchical
clusters using the corroplot R package (Wei & Simko, 2021). Co‐occurrence matrices identified how often
different dimensions of social vulnerability were measured together, and the statistical strength of these correlations. Clustering identified statistically significant groupings of social
vulnerability dimensions based on the frequency at which indicators of
different dimensions were measured together. The within cluster sums of
squares was used to determine the appropriate number of clusters for each
water‐use sector.

Figure 3. Example of the nested structure of indicators, determinants, and
dimensions of vulnerability.

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A vote‐counting methodology was used to synthesize results from the 55
models presented across the 53 articles studied. Each study, quantitative or
qualitative, was regarded as a model. For each model, the measure of any
variation of an indicator was recorded with a value of 1. Each measured
variable was therefore given a single “vote” in the overall data set. This
simple process facilitated the calculation of the frequency with which specific indicators and determinants were used. Attributes of each aggregated
indicator were tallied across all models. This vote‐counting approach has
found growing application in meta‐analyses as a way to assess related attributes across disparate study designs (Misselhorn, 2005; Romero‐Lankao

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Figure 4. Geographic distribution of studies included in the meta‐analysis.

et al., 2012). We assessed uncertainty for each social vulnerability determinant and associated indicators
following the Intergovernmental Panel on Climate Change (IPCC) method of summarizing the level of agreement in directional influence across all evidence (refer to Mastrandrea et al. (2011) for greater detail). The level
of statistical significance was not considered at this step because the quantitative studies used different
thresholds of statistical significance and reliance on this method would exclude qualitative studies from the
analysis. An indication of the strength of indicator relationships to water insecurity outcomes is reported in the
Uncertainty Summary by Determinant of Water Vulnerability table within Hines et al. (2023) to allow readers
insight into statistical significance.

4. Results
The number of studies included in the meta‐analysis was greatest in the coastal and southern border states
(Figure 4). The studies examined were typically conducted at the local scale, focused on mitigation, and primarily
addressed challenges of water quantity (Table 1). Most studies assessed at least one hazard. Floods were most
often examined (41% of studies), almost exclusively within the municipal context. Drought and climate variability were more commonly represented across all water‐use sectors.
4.1. Typologies of Water Insecurity
Identifying typologies helped to understand the contexts in which social vulnerability and water insecurity were
assessed in the literature. The water insecurity themes, and water‐use sectors covered (Table 1) constrain how
social vulnerability is conceptualized and measured in individual studies, and by extension the understanding of
Table 1
Focal Areas of Studies Addressing Social Vulnerability to Water Insecurity
Water insecurity theme
na

Agriculture

Municipal

Environmental

Water
access

Spatial scale

Sector

Water
quality

Management phase

Water
quantity

National studies including sites outside
Preparedness Mitigation Response Recovery Local Regional
study area

n may total more than 55 as some studies covered multiple sectors and issues.

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Table 2
Natural Hazard Context of Studies Included in Meta‐Analysis
Hazard
Sector

Climate variability

Drought

Flood

Surface water contamination

Groundwater contamination

Heat

Wildfires

Agriculture

Municipal

Environmental
a

n may total more than 55 as some studies covered multiple sectors.

how social vulnerability influences water insecurity. Table 1 shows the frequency at which studies included in the
meta‐analysis covered specific focal areas. We found social vulnerability to water insecurity in the western United
States has been examined mainly through the lens of the municipal water‐use sector (78% of included studies;
Table 1). These studies focused on mitigation and local scale issues, below county level. Water quantity issues
were most often tied to flooding and water quality studies primarily focused on surface water contamination,
although groundwater contamination and floods were also highlighted (Table 2). Water access was linked to
water contamination, surface water, groundwater, and extreme heat.
Studies in the agricultural water‐use sector primarily assessed drought (Table 2). Studies focused on issues of
water quantity address preparedness and mitigation management phases, whereas studies examining issues of
water quality focused on mitigation only. Studies focused on issues of water access examined climate variability
in addition to drought.
The environmental water‐use sector received the least attention from studies in our analysis (9%). It had relatively
even coverage of water insecurity issues, management phase, and analysis scale. Due to the limited coverage of
this water‐use sector, we focus on the municipal and agricultural water‐use sectors for our analysis.
4.2. Dimensions of Social Vulnerability to Water Insecurity
The studies in our meta‐analysis examined water insecurity in the western United States using 106 indicators
across 55 determinants. These determinants covered seven dimensions of social vulnerability: demographic
characteristics, land tenure, living conditions, socioeconomic status, health, risk perception, and exposure (refer
to Hines et al. (2023): Literature Results Summary of Indicators for full list of determinants and their measured
indicators). Demographic characteristics, such as age and family structure, describe the structure, size, and dynamics of populations (Clark et al., 1998). These statistics provide information on the population, or specific
subset thereof. Land tenure describes the conditions, such as ownership, under which property is occupied. Land
tenure is often linked to the ability to cope with and recover from events because conditions of occupancy are tied
to legal protections and can affect residents’ access to assistance programs (Drakes et al., 2021; Lee & Van
Zandt, 2019). Living conditions include determinants such as housing quality and population density, which
describe mainly physical circumstances that populations occupy. Socioeconomic status describes the sociocultural and economic interactions (e.g., education and employment) that govern access to physical and political
resources (McCoy & Dash, 2013). Health is associated with factors of mortality and morbidity and includes
determinants of access to health resources and mortality rates. Risk perception describes how people understand
their likelihood to suffer harm in a specific event (Sullivan‐Wiley & Short Gianotti, 2017). Risk perception includes determinants such as risk denial/acceptance and prior experience with hazards. Exposure, which includes
losses suffered and hazard extent, describes conditions of contact with external stressors (Kelman et al., 2017).
Exposure, demographic characteristics, and socioeconomic status were each evaluated in over 65% of the models
included in the review (Table 3 and Hines et al. (2023): Sector Summary of Water Vulnerability). Health (21.8%),
risk perception (30.9%) and land tenure (34.5%) were the least studied dimensions. Exposure, the most studied
dimension (included in 71% of models), contributed 22% of total indicators measured. Demographic characteristics had the most indicators measured (28% of all indicators). Demographic characteristics and socioeconomic status were studied less frequently in agricultural than municipal water‐use studies. Exposure and living
conditions were the dominant dimensions of social vulnerability examined in agriculture sector studies.

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Figure 5. Clustered associations of social vulnerability dimensions in water‐use sectors. Note: Colors get darker as correlations increase. Green circles indicate
positively correlated dimensions. Negative correlations are represented in purple shades. Correlation represents how often indicators were measured together in the
same study. Circle size is proportional to frequency of measurement.

4.3. Relative Importance of Social Vulnerability Dimensions to Water‐Use Sectors
Through hierarchical clustering, we examined associations between social vulnerability dimensions determined
by the frequency of indicators being measured together in the same study (Figure 5). The agricultural sector had
two clusters (Figure 5a). The living conditions and exposure dimensions were positively associated in the first
cluster, meaning that when the frequency of indicators measuring one dimension increased, so did the other. The
second cluster contained the remaining five dimensions of social vulnerability. All were positively correlated,
with demographic characteristics and socioeconomic status almost always measured together.

Figure 6. Determinants of social vulnerability to water insecurity; levels of confidence. Note: (1) Amount of Evidence:
“small” if indicator measured less than 5 times, “medium” is indicator measured 5–9 times, “large” if indicator measured 10
or more times. (2) Level of Agreement: “low” if direction of influence category with highest tally has <50% of indicator total,
“medium” if direction of influence category with highest tally has 51%–74% of indicator total, and “high” if direction of
influence category with highest tally has >74% of indicator total. (3) Text color denotes different dimensions of social
vulnerability; Green = Demographic Characteristics, Brown = Land Tenure, Blue = Living Conditions,
Orange = Socioeconomic status, Purple = Health, Light Blue = Risk Perception, Pink = Exposure. Refer to Hines
et al. (2023): Uncertainty Summary by Determinant for full data set on uncertainty.

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In the municipal sector we found four clusters: (a) exposure; (b) land tenure‐risk perception; (c) socioeconomic
status‐demographic characteristics; and (d) health‐living conditions (Figure 5b). Exposure was typically
measured by itself. Measures of demographic characteristics and socioeconomic status were usually co‐occurrent.
Across the entire data set, studies examining exposure were less likely to examine other dimensions of social
vulnerability, except living conditions, which had a weak positive correlation to exposure (Figure 5c). This likely
reflects the weight of studies on the municipal sector. Land tenure and risk perception comprised a second cluster
and were positively correlated with each other. This second cluster co‐occurred infrequently with socioeconomic
status and living conditions with which it was negatively correlated. The third cluster comprised demographic
characteristics, socioeconomic status, living conditions and health. These dimensions were all positively associated with each other, and demographic characteristics and socioeconomic status were almost always measured
together.
4.4. Areas of Surety and Uncertainty: Agreement on Significance of Indicators
Demographic characteristics (11 determinants, 28 indicators) and living conditions (11 determinants, 26 indicators) were the social vulnerability dimensions with most determinants assessed, and most heavily correlated
with water insecurity. However, infrequent measurement meant evidence was limited for many of the individual
indicators within every dimension. We identified 106 indicators related to the 55 determinants of social
vulnerability. Demographic characteristics had the highest level of certainty among its determinants, 45% of its
determinants had a large amount of evidence and high level of agreement on their influence (Figure 6). Eight
determinants were measured only once: life expectancy, food insecurity, mortality, and sanitation determinants
(health), group facilities (demographic characteristics), private property (land tenure), socially isolated populations (living conditions), and access to basic needs (socioeconomic status). Therefore, we could not estimate
agreement level for these determinants. We organize the remainder of this section by social vulnerability dimensions. Because of the limited sample size of most indicators, we present a description of the entire data set.
See Uncertainty Summary of Water Vulnerability in Hines et al. (2023) for full data set on uncertainty.
4.4.1. Demographic Characteristics
The measured demographic characteristics appeared mostly aligned to susceptibility, where some populations are
more sensitive to shocks, and therefore are more likely to suffer harm. These studies found mostly positive
correlations between indicators measured and conditions of water insecurity, for example, indicators “elderly”
and “% households receiving social security or public assistance” were always positively associated with water
insecure conditions. These relationships were mostly statistically significant/important (Hines et al. (2023):
Uncertainty Summary of Water Vulnerability). Indicators of the age determinant were measured 36 times across
24 models. Elderly was most often measured as a sensitive group, with a high amount of agreement on this
statistically significant relationship.
Ethnicity & race was the social vulnerability determinant most frequently included as a measurement of water
insecurity in the reviewed literature. Measured 58 times across 30 models, ethnicity & race may be considered one
of the most important social vulnerability determinants contributing to water insecurity. There was a large amount
of evidence for the influence of Hispanic and Black populations, although for Black populations there was only a
moderate amount of agreement on the direction and significance of this influence. There was high agreement that
measures of Hispanic populations were significant and positively correlated to water insecure conditions. The
reviewed studies showed medium amounts of evidence for the influence of Native American populations.
However, all studies agreed conditions of water insecurity were more severe in places with higher Native
American populations.
We recorded large amounts of evidence and high agreement for both gender and family structure. However,
evidence on both determinants was limited at the indicator level, and both were only examined in studies on the
municipal sector. The reviewed literature showed indicators of household size, female‐headed households, female
population, and percentage of females in the labor force were all predominantly positively related and statistically
significant/important to water insecurity conditions (Figure 6; Hines et al. (2023): Uncertainty Summary by
Determinant).

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4.4.2. Land Tenure
Land tenure was one of the least studied dimensions of social vulnerability in both agricultural and municipal
sectors. There was a large amount of evidence for the influence of renters, but inconclusive agreement on the
direction of this indicator’s influence (Figure 6; Hines et al. (2023): Uncertainty Summary by Determinant).
Further, the influence of renter status was found to be significant in only half of the cases studied (Hines
et al., 2023: Uncertainty Summary of Water Vulnerability).
4.4.3. Living Conditions
The dimension with the most determinants measured in the reviewed literature was living conditions. Specific
indicators were infrequently measured by the studies assessed, resulting in a small amount of evidence for most
indicators (Figure 6; Hines et al. (2023): Uncertainty Summary by Determinant) within this dimension. However,
when measured multiple times, agreement on the direction of influence of these indicators was medium to high.
Population density was the only specific indicator for which there was a large amount of evidence and was
positively linked to conditions of water insecurity in all cases where the direction of influence was reported. There
was a medium amount of evidence where rurality was linked to reduced conditions of water insecurity, mainly in
the municipal sector.
4.4.4. Socioeconomic Status
Socioeconomic status was the third most often measured dimension of social vulnerability in the reviewed
literature (Figure 6; Hines et al. (2023): Uncertainty Summary by Determinant). The amount of evidence was
large for the education, income, and wealth determinants, although only the influence of wealth had a high level of
agreement. We found high levels of agreement aligned with medium amounts of evidence for the influence of
employment, occupation type, median rent costs, and house value. At the indicator level, there was a large amount
of evidence and high level of agreement that populations with less than 12 years of education were more socially
vulnerable and more water insecure. However, the statistical significance of this relationship was inconclusive.
Higher levels of unemployment were always linked to increased water insecurity. The level of agreement was
high that persons working in primary industries and the service sector were more likely to be water insecure, but
for half of those studies we could not determine the significance of this relationship (Figure 6; Hines et al. (2023):
Uncertainty Summary by Determinant). Median rent and house value were both negatively correlated with water
insecurity, probably reflecting greater access to resources for wealthier populations.
4.4.5. Health
Health was the least often measured dimension of social vulnerability in both water‐use sectors studied in the
reviewed literature. Most indicators in this dimension were measured less than five times, four of them only once.
The level of agreement was high that lower access to health care was correlated with conditions of water
insecurity.
4.4.6. Risk Perception
Risk perception was the second least often studied social vulnerability dimension in the assessed studies. The
amount of evidence for awareness of risk was large, although the amount of agreement was medium for its direction of influence. The amount of evidence was medium for the effect of prior experience, which was found to
positively influence water insecurity in about 66% of studies where measured (Figure 6; Hines et al. (2023):
Uncertainty Summary by Determinant).
4.4.7. Exposure
Exposure was measured in 70% of the models and was the second highest contributor of indicators measured in
the literature. The amount of evidence was large for the influence of exposed facilities, hazard extent, physical
considerations, and mitigation measures. However, of these, only hazard extent showed high levels of agreement
on the direction of influence on water insecurity.

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5. Determinants, Social Vulnerability, and Water Insecurity: What Do We Know?
5.1. A Question of Framing
5.1.1. Social Vulnerability
Academic literature reflects specific research paradigms and their ways of framing the cause of social vulnerability and water insecurity. The water‐use sectors covered, and the pathways of influence investigated are tied to
these frames, leaving some dimensions of this relationship poorly examined. We found two important ways of
framing the causal connection between social vulnerability and water insecurity frequently asserted in the papers
studied. The first presents social vulnerability as emergent from events associated with water insecurity. In this
more commonly used approach, social vulnerability is but one outcome of events produced by external stressors.
Studies taking this approach are more likely to focus on indicators of exposure and socioeconomics (Bixler
et al., 2021; Shao et al., 2020). In the second framing, social vulnerability is presented as a preexisting condition
from which water insecurity arises as an outcome of inequitable social conditions. As a root cause of unequal
societal and environmental burdens, social equity and justice themes are more directly examined. Studies using
this framing reduce focus on exposure but more frequently examine indicators related to health, risk perception,
and living conditions (Carrão et al., 2016; Derner et al., 2018).
The choice of framing determines how much emphasis is placed on social vulnerability, and which determinants
are assessed. Previous research by Romero‐Lankao et al. (2012) on temperature related hazards and by Drakes
and Tate (2022) on multihazard social vulnerability indicate this dual framing vulnerability is not limited to water
insecurity. Multiple framings mean the context for understanding the social factors of water insecurity are
different. This context is often shrouded as the underlying framing is not explicitly stated. This dichotomy
presents a challenge for comparing results across studies, and for upscaling results from multiple (and more
common—Table 1) local studies to understand larger regional patterns useful for designing water‐use policy
(O’Brien et al., 2007).
5.1.2. Water Insecurity
The water insecurity themes covered also frame which determinants of social vulnerability are studied and which
locations are included, therefore influencing how the concept is applied using different metrics and geographic
scales (Chang et al., 2013; Gerlak et al., 2018; Janssen et al., 2021). These operational features in turn influence
who are considered decision makers, whose interests are addressed, and make some adaptations actionable while
precluding others. Thematic framing determines who or which sectors are considered vulnerable. Our findings
affirm this vulnerability‐defining role of water insecurity themes. The water insecurity studies emphasize water
quantity and access—how much water is physically available, and legal and operational hurdles to obtaining it
(Table 1). This emphasis likely reflects the unique way water is managed in the West, primarily through the
Doctrine of Prior Appropriation and the Bureau of Reclamation. Table 1 also indicates an imbalance in the water
insecurity components examined by different water‐use sectors. Water quality is mainly reported as a municipal
issue. Studies in this metanalysis reported agricultural irrigation is less affected by high levels of nitrates or
dissolved organic compounds, which tend to concern household water quality. Therefore, vulnerability in the
agricultural sector is focused on water quantity and access for farms, with limited attention given to how irrigation
needs limit municipal water use. However, municipal water quality is often affected by upstream activities. Industrial agriculture often has substantial effects on water quality (e.g., Neibergall, 2021) yet this spatial and often
causal relationship was infrequently addressed in the sampled literature. Only 6 studies assessed both agricultural
and municipal sectors, and these focused on the availability of adequate quantities of the resource.
5.1.3. Geographies of Assessments
This “geography of water insecurity” reveals two issues that received limited attention in the sampled literature:
(a) scale of analysis and (b) spatial arrangement of what is being measured. The problem of scale is well known
(Fekete et al., 2010; Ivory & Stevenson, 2019). At different spatial resolutions, data aggregation often produces
measurably divergent results for the same location (Bisaro et al., 2010; Hinkel, 2011; Machado & Ratick, 2018).
Indicator use may also be limited by data availability at the scale associated with individual water insecurity
themes, resulting in different indicators representing the same conceptual determinant of vulnerability or ignoring
some determinants entirely.
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Table 3
Representation of Social Vulnerability Dimensions Across Water‐Use Sectors
Agriculture sector
Dimension

Totala

Municipal sector

Measured Indicators Models Measured Indicators Models Measured Indicators Models

Demographic characteristics

141

147

Land tenure

Living conditions

Socioeconomic status

100

Health

Risk perception

Exposure

115

Totals may be less than sum of indicators or models in agricultural and municipal sectors as some studies covered multiple
sectors.

Further dissonance exists with conceptualizing areas of measurement as political units versus drainage‐basin
boundaries. Although decision‐making for water quality criteria occurs at municipal and institutional levels,
water dynamics are watershed dependent. Political and drainage basin units seldom align, meaning decision‐
making and the social‐ecological processes addressed are often spatially misaligned (Barham, 2001). Recent
efforts in western states to consider downstream effects in addition to established water‐rights reflect attempts at
amending this incongruity (Bureau of Reclamation, 2023). Operational definitions of water insecurity are likely
spatially diverse and based on locally salient issues (Cook & Bakker, 2012). Social vulnerability as an outcome
appears to be more easily measured at larger geographic units, but the aggregation needed to achieve this may
dilute important local context (Cook & Bakker, 2012; Hinkel, 2011; Saltelli, 2007). Similarly, water quantity and
access appear most studied at municipal or higher aggregations. Integrated watershed management using nested
scales approaches is a functional approach that would balance these competing scalar needs. Watershed based
approaches complemented by analyses at municipal, regional, and other political/administrative based scales
(Bakker, 2012) would facilitate integration with “soft path” approaches. “Soft paths” consider social and cultural
dimensions of water use in decision‐making, and have been proposed as an additional component to future
western water policy (Brooks & Brandes, 2011). Ensuring equitable and just access to sufficient quantities of
high‐quality water is helped by understanding inequities at household and community level in addition to
municipal, county, and irrigation districts.
The spatial arrangement of measurement units is also important for understanding water insecurity. Upstream
activities exert considerable influence on water quality and quantity downstream. Doeffinger and Hall (2021) and
Flores et al. (2020) illustrate this downstream effect. Climate variability and drought contribute to reduced water
quantity and quality at locations downstream (Upton & Nielsen‐Pincus, 2021; Vasquez‐Leon et al., 2003). Industrial agriculture and large urban populations have similar negative effects on downstream areas (Chang
et al., 2013; Harlan et al., 2006) but may also affect upstream locations as their water uses result in more of the
resource being removed from the system (Herman‐Mercer, Bair, Restrepo‐Osorio et al., 2023; Hong &
Chang, 2020). This patchwork of interrelated water insecurity issues further indicates the usefulness of an integrated, multiscale approach to address them.
5.2. What Is Important in the Context of the Western US?
The water‐use sectors present distinct patterns in the dimensions of social vulnerability studied (Figure 5).
Exposure (included in 85% of models) and living conditions (62% of models) were the dominant dimensions
measured in the agricultural water‐use sector (Hines et al. (2023): Sector Summary). Studies of the municipal
sector focused on demographic characteristics (79% of models), socioeconomic status (77% of models), and
exposure (72% of models) (Table 3). These differences are likely due to the distinct concerns for water insecurity
themes across the two sectors and indicates an understanding of western water insecurity would benefit from an
approach combining the different sectors.

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Studies in the agricultural water‐use sector were event centric and associated with water quantity. Measures of
living conditions and exposure were dominant in this sector (Table 3, Figure 5) probably because they allow
exploration of the physical conditions people occupy, and the extent to which people interact with the water
insecurity condition (mainly water quantity). The frequency of indicators for poor living conditions increased
along with those of exposure. As living conditions and exposure worsened, water insecure circumstances were
more likely in the agricultural sector. This relationship was constant in all three water insecurity themes.
The municipal sector had greater disaggregation of social vulnerability dimensions with four clusters (Figure 5)
indicating a broader, yet fractured approach to understanding water insecurity. The single dimension exposure
cluster indicates many studies focused on determinants of exposure almost exclusively. The exposure heavy focus
identifies where water insecurity conditions exist. Ignoring other determinants of social vulnerability produces a
limited view of who disproportionately suffers conditions of water insecurity. Where other social vulnerability
dimensions were measured, demographic characteristics and socioeconomic status were most often assessed. This
combination provides a more balanced view of which populations suffer disproportionate burdens of water
insecurity.
Within each dimension, most determinants measured were linked to the susceptibility and exposure components
of social vulnerability. Framing social vulnerability as the likelihood to suffer harm and extent of contact with
dangerous conditions is common in the natural hazards literature (e.g., Cutter et al., 2003; Emrich et al., 2020;
Flanagan et al., 2011; Frazier et al., 2014). Its use here indicates a hazard centric view being applied to water
insecurity. The hazard centric view is commonly applied to study single events in isolation. Such an approach may
have limited utility for water insecurity, which exists in a compound context, where the interplay of prolonged
and/or multiple overlapping events produces the unique conditions faced (Balch et al., 2020; Drakes &
Tate, 2022; Zscheischler et al., 2018). Further, reliance on event centric indicators can obscure underlying social
conditions producing vulnerability (Chmutina et al., 2021). This event focus may underlie the preference for
vulnerability as an outcome frame over vulnerability as an underlying factor.
5.2.1. Gaps in Western Context
There was limited consideration of the coping capacity element of social vulnerability, which addresses the ability
to withstand the effects of harm suffered. This limited utilization of short‐term coping capacities indicates the
understanding of water insecurity in the western United States is unbalanced and incomplete. This underbounding
of vulnerability is common in the empirical literature which overwhelmingly relies on available census‐derived
variables associated with susceptibility (for examples see Cutter et al., 2003; Flanagan et al., 2011; Frazier
et al., 2014; Kuhlicke et al., 2023; Shah et al., 2023; Tee Lewis et al., 2023). Communities experiencing conditions of heightened susceptibility and repeated exposures to hazards can develop extensive means of coping
with these conditions (van der Geest & Warner, 2015; Venkataramanan et al., 2020). Reliance on the body of
knowledge studied, with its limited consideration of the ability to cope, risks misrepresenting the true nature of
relationships between social vulnerability and water insecurity. Such a mischaracterization can result in
misalignment of policies and resource allocation with community needs. Communities with greater access to
resources, particularly social and political capital, are likely to also have increased opportunity and ability to
respond to the physical implications of their exposure. They are also more likely to have capacities (e.g., senior
water‐rights, purchasing, or storage) for coping with harm suffered due to their conditions of water insecurity
(Venkataramanan et al., 2020). Facets of this concern may be captured in the long‐term adaptation of resilience
literature, which is outside the scope the current study, but the understanding of short‐term coping remains
underexamined. Without consideration of coping capacities, such communities may be portrayed as being more
water insecure than they actually are. Workman and Shah (2023) have demonstrated how affluent communities
can rely on these enhanced capacities to remain segregated from municipal water systems, maintaining conditions
of higher susceptibility, as a tradeoff to sustaining political and social homogeneity and power. Conversely,
communities with fewer resources to cope may exist in more precarious conditions than a susceptibility focused
water policy may identify. The result can be inequity and compounding of water insecure conditions on already
burdened populations (i.e., unjust, and unequitable water security outcomes). See Arcaya et al. (2020);
Collins (2010); and Jerolleman et al. (2024) for a deeper discussion on how policy interventions can compound
conditions of vulnerability. Policy approaches that combine the physical, economic, and social aspects of water
insecurity are more likely to address these imbalances.

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Demographic characteristics are a key dimension of social vulnerability, but unevenly applied in studies of water
insecurity. Half of determinants associated with demographic characteristics were only applied in studies of the
municipal sector. Studies of the agricultural sector did not consider family structure, gender, special needs/disabilities, or dependence on social services. Each of these is an important contributor to social vulnerability
(Birkmann, 2013; Clark et al., 1998; Cutter et al., 2003). Although corporate‐run, industrialized agriculture may
be the dominant form in the western United States, small holder, family, and community operated farms are still
an important part of the vulnerability picture in this region. By not considering these factors, water insecurity
research in this part of the country may be missing key elements of social vulnerability.
With the possible exception of floods, it remains unclear how land tenure affects access to resources designed to
reduce water insecurity. Land tenure is often linked to the ability to cope with and recover from events. Long‐term
coping and adaption are particularly important in repeat, or slow onset/long duration stressors such as water
insecurity. Resource and recovery programs are often tied or heavily skewed to property ownership (Burby
et al., 2003; Peacock et al., 2015; Rodriguez‐Dod & Duhart, 2007). Such programs are important factors
bolstering the ability to withstand, recover from, and adapt to the stressors inherent in water insecurity. Domingue
and Emrich (2019), Drakes et al. (2021), and Peacock et al. (2015) have shown disaster recovery programs place
renters at a disadvantage versus homeowners. Do similar inequities exist in programs targeting water insecurity?
The limited research on the effects to renters (Table 3 n = 19; Hines et al. (2023): Sector Summary) indicates a
critical knowledge gap between land tenure and water insecurity.
5.3. Uncertainty
Determinants with large amounts of evidence and high levels of agreement are ideal for assessing relationships
between social factors and conditions of water insecurity. In theory, researchers could be assured of the scientific
consensus on the use of these determinants (Figure 6) and incorporating them into decision‐support tools only
requires following norms established in the literature. Substantially more care is warranted when using determinants associated with lower levels of confidence. Empirical evidence remains limited for determinants with
small amounts of evidence and lower levels of agreement (Figure 6). Before using the determinants in the lower
third of Figure 6, more work could be done to validate the effects on water insecurity conditions, and to
communicate the uncertainty associated with their use. This need for validating vulnerability measures at the
index and indicator levels has been underscored by Painter et al. (2024), and Tate (2013). Further areas of uncertainty stemming from underlying data quality and accuracy are beyond the scope of this review but have been
addressed elsewhere by Folch et al. (2016); Spielman et al. (2020); Spielman and Singleton (2015); and Tuccillo (2023). Decision makers are encouraged to understand the limitations of tools incorporating determinants
with moderate to low levels of confidence, and to account for the associated higher levels of uncertainty in their
policymaking processes.
Several social dimensions have limited evidence of measurement in the literature. Though renters in urban areas
more likely to lack piped water (Meehan, Jepson, et al., 2020; Meehan, Jurjevich, et al., 2020) or be served by
community water systems delivering water with unsafe lead content (Cade et al., 2023), land tenure was infrequently studied in the articles sampled by this meta‐analysis. Where measured, land tenure showed mostly
significant effects on water insecurity conditions. Given the importance of tenure for resource access (Burby
et al., 2003; Lee & Van Zandt, 2019), further study on the relationship to water insecurity is vital. Likewise,
limited research hinders understanding the relationship between health factors and water insecurity. Although
health factors are known to be associated with water insecure conditions (see Karaye & Horney, 2020; Tippin, 2021; Yellow Horse et al., 2020), more research would be beneficial to understand the form of this relationship, and to build evidence for the utility of these indicators. Risk perception was among the least measured
dimensions. This is unexpected given its importance in understanding and mounting a response to danger. For
example, understanding indicators of social vulnerability to water insecurity associated with the prolonged and
slow onset effects of droughts or burdens of increased costs of water access could be improved by understanding
perceived risk.
The agricultural water‐use sector lacks coverage of important social vulnerability determinants. This gap extends
across all dimensions of social vulnerability but was most pronounced in demographic characteristics and socioeconomic status. Studies of this sector may be focused on effects surrounding industrial agriculture, with
limited attention given to smaller family‐owned farms or household level impacts of agricultural water use. The

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limited attention to demographics and socioeconomic status is also a plausible result of the sector’s reduced focus
on water quality. There is certainly a need for water quality related studies of social vulnerability as disadvantaged
communities in agricultural settings are more likely to be served by unmonitored wells or out‐of‐compliance
community water systems (Doeffinger & Hall, 2021; London et al., 2021; Wutich et al., 2022) and are at
higher risk of interrupted water supplies (Mullin, 2020). The higher levels of uncertainty in indicators associated
with the agricultural water‐use sector may result from the small number of studies covering this sector.
Across all sectors, demographic characteristics were the most studied and understood dimension of social
vulnerability. We found indicator use in this dimension had highest levels of confidence, with good evidence for,
and agreement on use. The emphasis on susceptibility may be the reason for this dominance as the commonly
employed social vulnerability models, SoVI (Cutter et al., 2003) and SVI (Flanagan et al., 2011) both assess the
susceptibility component as does the water security index (Nkiaka, 2022). Demographic characteristics are a
traditional focus for identifying susceptibility factors of vulnerability. However, attention to social dependence
and special needs populations was limited in these studies, yet the factors represented by these indicators can
substantially inhibit individuals’ ability to withstand events. Limited research on their relationship to water
insecurity may also mean limited consideration is being given to the requirements of these populations. This
example highlights the uneven attention given to, and corresponding levels of uncertainty associated with indicators measuring different determinants of social vulnerability in the water insecurity literature. The significant
variation that exists in the level of agreement and amount of evidence for indicators, even within commonly
studied vulnerability dimensions, means analysis and decision‐makers cannot treat all indicators with equal levels
of trust.

6. Conclusion
We are not the first to review water insecurity research (refer to Romero‐Lankao et al. (2012) on temperature
related hazards and Gerlak et al. (2018) on global water security). The contribution of this study is to look across
water‐use sectors and thematic areas of water insecurity to provide a framework comparing otherwise disparate
research on the complex subject of water insecurity in the geographic area of the western United States. Understanding vulnerability comes back to context. “Vulnerability to what?”—in our case, distinct thematic areas of
water insecurity. “Vulnerability of what?”—agricultural and municipal water‐use sectors. “Vulnerability of
whom?”—populations with different needs and concerns and that are affected by different arrangements of
vulnerability producing conditions. Reductionist approaches focusing on a single thematic area create a myopic
picture of water insecurity. A holistic understanding of this problem would benefit from contributions from
multiple views of water insecurity.
What is measured matters for determining how vulnerability is understood (Chmutina et al., 2021; Gerlak
et al., 2018; Kappes et al., 2012; Machado & Ratick, 2018). Different conceptualizations of social vulnerability
and water insecurity lead to diverging emphasis on vulnerability dimensions. Which determinants and specific
indicators are used is therefore dependent on an author’s focus on water quality, quantity, or access. Our findings
affirm this bounding (and limiting) role of framing. This meta‐analysis illustrates the benefits of intentionally
assessing these divergent frames of water insecurity to ensure social vulnerability to water insecurity is
adequately understood. Consolidative approaches such as integrated watershed management may provide
practical ways of including these multiple frames in water‐related planning. A nested spatial and temporal scale
approach may help bind the socially driven decision‐making elements of political/administrative units with
watershed dependent physical elements. Socio‐hydrology is another promising approach proposed for weaving
together multiple framings of vulnerability and water insecurity (Bakker, 2012).
Several of the assessed studies recommend soft paths to redress conditions of water insecurity. Soft paths,
however, warrant a critical look at decision‐making, attention to who can participate in water management and
planning, and what type of participation they are allowed to have (Brooks & Brandes, 2011). Studies that utilized
the participatory process demonstrated success in understanding the interplay of vulnerability producing conditions, and therefore which indicators of vulnerability are relevant to a particular context. Participatory process
can build paths toward equitable provision of water resources for all stakeholders. Although this review identifies
social vulnerability indicators deemed important to water insecurity in the academic literature, validating these
findings with communities experiencing social vulnerability would provide additional insight toward understanding how decision‐makers might manage water resources to support all. Given the high levels of uncertainty
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associated with many indicators and the demonstrated role the framing of vulnerability and water insecurity plays
in determining what is measured in the literature, stakeholder engaged research may be beneficial to address
existing gaps left by limitations of the current literature. Participatory assessments can help determine how the
relative importance of interacting social vulnerability indicators changes across communities. Likewise, community driven studies would build understanding of how decision‐making processes intensify or attenuate the
influence social vulnerability determinants, and ultimately water‐insecurity outcomes.
Concepts of equity and justice remain poorly explored in the literature contributing to this meta‐analysis. Water
security is a highly contested topic in the western United States (Pahl‐Wostl et al., 2016; Sheikh et al., 2015; Stern
& Pervaze, 2023). Varady et al. (2016) note the water insecurity discourse remains fraught with resistance to
address these topics, difficulty with defining and implementing measures for them, and limited in exploring them
as potential paths toward achieving water security. Though recent studies have addressed these issues (see Arcaya
et al., 2020; Collins, 2010; Méndez‐Barrientos et al., 2023; Tippin, 2021; Workman & Shah, 2023), the lack of
explicit attention given to equity and justice related drivers of marginalization and vulnerability in studies
reviewed this meta‐analysis suggests a continued need for research in this area. However, the limited framing of
vulnerability as an underlying factor may also contribute to the infrequent exploration of equity and justice as root
causes of water insecurity in the meta‐analysis.
The amount of uncertainly associated with several dimensions of social vulnerability to water insecurity is large.
The limited evidence for land tenure, health, and risk perception stretches beyond individual indicators,
encompassing entire determinants and broader themes of social vulnerability. Given the importance of these
dimensions of vulnerability, there is a large gap in understanding, and empirical evidence for or against the effects
of these indicators would be beneficial to fully understand social vulnerability to water insecurity. The reviewed
literature shows stronger evidence for the role of demographic characteristics, living conditions, socioeconomic
status, and exposure in defining conditions of water insecurity. Uncertainty still fluctuates widely at the indicator
level even within these determinants. Until empirical evidence for or against the effects of these indicators can be
obtained, understanding of social vulnerability to water insecurity remains shrouded.

Data Availability Statement
Data for this research, including a full list of assessed articles, coded data entry tables, and analysis outputs, are
available in the ScienceBase catalogue as Hines et al. (2023). Literature Summary of Indicators of Water
Vulnerability in the Western US 2000–2022. U.S. Geological Survey data release, https://doi.org/10.5066/
P93IDTUZ.
Software Availability: Co‐occurrence matrices and hierarchical clusters were calculated using the corroplot R
package version 0.92 (Wei & Simko, 2021), available under the MIT License at https://cran.r‐project.org/
package=corrplot.
Acknowledgments
The authors would like to thank Emily
Wilkins, Jack Friedman, Jennifer Rapp,
Nicole Herman‐Mercer, and Katrina Alger
for providing valuable and constructive
feedback on our manuscripts. Any use of
trade, firm, or product names is for
descriptive purposes only and does not
imply endorsement by the U.S.
Government.

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