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Published in: BMC Public Health 1/2022

Open Access 01-12-2022 | Research article

Trends of and factors associated with access to residential toilets among the middle-aged and elderly in rural China from 2011 to 2018

Authors: Qun Wang, Huiyuan Cao, Shuo Zhang

Published in: BMC Public Health | Issue 1/2022

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Abstract

Background

At the global and country levels, several important sanitation improvement initiatives were launched in the last decade. This study aimed to explore the temporal trend of and factors associated with access to residential toilets among the middle-aged and elderly in rural China from 2011 to 2018.

Methods

This study used the 2011, 2013, 2015, and 2018 data of China Health and Retirement Longitudinal Study (CHARLS). CHARLS was conducted among adults aged ≥ 45 years in 28 provinces of China. We used descriptive statistics and logistic regressions for data analysis.

Results

We found that residential toilet coverage increased by about 6% among population aged ≥ 45 years in rural China from 2011 to 2018. The coverage of flushable toilets and toilets with seats among this sector of the population increased by more than 10% during this period. We also found that being female, higher levels of education, higher annual per capita household consumption, having running water in the residence, larger household size, and better health status were significantly associated with an increased likelihood of residential toilet ownership among population aged ≥ 45 years in rural China.

Conclusions

China made progress in sanitation improvement in rural areas from 2011 to 2018. However, considering the current coverage levels of residential toilets and the vulnerable subgroups who are more prone to toilet deprivation in rural areas, we suggest to the government to implement further targeted toilet improvement interventions to ensure universal coverage of sanitation facilities for the whole of the Chinese population.
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Literature
2.
go back to reference Weststrate J, Dijkstra G, Eshuis J, Gianoli A, Rusca M. The Sustainable Development Goal on Water and Sanitation: Learning from the Millennium Development Goals. Soc Indic Res. 2019;143:795–810.CrossRef Weststrate J, Dijkstra G, Eshuis J, Gianoli A, Rusca M. The Sustainable Development Goal on Water and Sanitation: Learning from the Millennium Development Goals. Soc Indic Res. 2019;143:795–810.CrossRef
3.
go back to reference World Health Organization. Guidelines on sanitation and health. Geneva: World Health Oragnization; 2018. World Health Organization. Guidelines on sanitation and health. Geneva: World Health Oragnization; 2018.
4.
go back to reference Cheng S, Li Z, Uddin SMN, Mang H-P, Zhou X, Zhang J, et al. Toilet revolution in China. J Environ Manage. 2018;216:347–56.CrossRef Cheng S, Li Z, Uddin SMN, Mang H-P, Zhou X, Zhang J, et al. Toilet revolution in China. J Environ Manage. 2018;216:347–56.CrossRef
6.
go back to reference Arku RE, Bennett JE, Castro MC, Agyeman-Duah K, Mintah SE, Ware JH, et al. Geographical Inequalities and Social and Environmental Risk Factors for Under-Five Mortality in Ghana in 2000 and 2010: Bayesian Spatial Analysis of Census Data. Plos Med. 2016;13:e1002038.CrossRef Arku RE, Bennett JE, Castro MC, Agyeman-Duah K, Mintah SE, Ware JH, et al. Geographical Inequalities and Social and Environmental Risk Factors for Under-Five Mortality in Ghana in 2000 and 2010: Bayesian Spatial Analysis of Census Data. Plos Med. 2016;13:e1002038.CrossRef
7.
go back to reference Ezeh OK, Agho KE, Dibley MJ, Hall J, Page AN. The Impact of Water and Sanitation on Childhood Mortality in Nigeria: Evidence from Demographic and Health Surveys, 2003–2013. Int J Environ Res Public Health. 2014;11:9256–72.CrossRef Ezeh OK, Agho KE, Dibley MJ, Hall J, Page AN. The Impact of Water and Sanitation on Childhood Mortality in Nigeria: Evidence from Demographic and Health Surveys, 2003–2013. Int J Environ Res Public Health. 2014;11:9256–72.CrossRef
8.
go back to reference Fink G, Günther I, Hill K. The effect of water and sanitation on child health: evidence from the demographic and health surveys 1986–2007. Int J Epidemiol. 2011;40:1196–204.CrossRef Fink G, Günther I, Hill K. The effect of water and sanitation on child health: evidence from the demographic and health surveys 1986–2007. Int J Epidemiol. 2011;40:1196–204.CrossRef
9.
go back to reference Baker KK, O’Reilly CE, Levine MM, Kotloff KL, Nataro JP, Ayers TL, et al. Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007–2011: Case-Control Study. Plos Med. 2016;13:e1002010.CrossRef Baker KK, O’Reilly CE, Levine MM, Kotloff KL, Nataro JP, Ayers TL, et al. Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007–2011: Case-Control Study. Plos Med. 2016;13:e1002010.CrossRef
10.
go back to reference Carlton EJ, Liang S, McDowell JZ, Li H, Luo W, Remais JV. Regional disparities in the burden of disease attributable to unsafe water and poor sanitation in China. Bull World Health Organ. 2012;90:578–87.CrossRef Carlton EJ, Liang S, McDowell JZ, Li H, Luo W, Remais JV. Regional disparities in the burden of disease attributable to unsafe water and poor sanitation in China. Bull World Health Organ. 2012;90:578–87.CrossRef
11.
go back to reference Prüss-Ustün A, Bartram J, Clasen T, Colford JM, Cumming O, Curtis V, et al. Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries. Trop Med Int Health TM IH. 2014;19:894–905.CrossRef Prüss-Ustün A, Bartram J, Clasen T, Colford JM, Cumming O, Curtis V, et al. Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries. Trop Med Int Health TM IH. 2014;19:894–905.CrossRef
12.
go back to reference Agol D, Harvey P. Gender differences related to WASH in schools and educational efficiency. Water Altern. 2018;11:284–96. Agol D, Harvey P. Gender differences related to WASH in schools and educational efficiency. Water Altern. 2018;11:284–96.
13.
go back to reference Winter SC, Barchi F. Access to sanitation and violence against women: evidence from Demographic Health Survey (DHS) data in Kenya. Int J Environ Health Res. 2016;26:291–305.CrossRef Winter SC, Barchi F. Access to sanitation and violence against women: evidence from Demographic Health Survey (DHS) data in Kenya. Int J Environ Health Res. 2016;26:291–305.CrossRef
14.
15.
go back to reference Abubakar IR. Access to Sanitation Facilities among Nigerian Households: Determinants and Sustainability Implications. Sustainability. 2017;9:547.CrossRef Abubakar IR. Access to Sanitation Facilities among Nigerian Households: Determinants and Sustainability Implications. Sustainability. 2017;9:547.CrossRef
16.
go back to reference Afifah T, Nuryetty MT, DA Cahyorini M, Schlotheuber A, Bergen N, Subnational regional inequality in access to improved drinking water and sanitation in Indonesia: results from the, et al. Indonesian National Socioeconomic Survey (SUSENAS). Glob Health Action. 2015;2018(11):31–40. Afifah T, Nuryetty MT, DA Cahyorini M, Schlotheuber A, Bergen N, Subnational regional inequality in access to improved drinking water and sanitation in Indonesia: results from the, et al. Indonesian National Socioeconomic Survey (SUSENAS). Glob Health Action. 2015;2018(11):31–40.
17.
go back to reference Angoua ELE, Dongo K, Templeton MR, Zinsstag J, Bonfoh B. Barriers to access improved water and sanitation in poor peri-urban settlements of Abidjan. Cote d’Ivoire Plos One. 2018;13:e0202928.CrossRef Angoua ELE, Dongo K, Templeton MR, Zinsstag J, Bonfoh B. Barriers to access improved water and sanitation in poor peri-urban settlements of Abidjan. Cote d’Ivoire Plos One. 2018;13:e0202928.CrossRef
18.
go back to reference Wang C, Pan J, Yaya S, Yadav RB, Yao D. Geographic Inequalities in Accessing Improved Water and Sanitation Facilities in Nepal. Int J Environ Res Public Health. 2019;16:1269.CrossRef Wang C, Pan J, Yaya S, Yadav RB, Yao D. Geographic Inequalities in Accessing Improved Water and Sanitation Facilities in Nepal. Int J Environ Res Public Health. 2019;16:1269.CrossRef
19.
go back to reference Asfaw B, Azage M, Gebregergs GB. Latrine access and utilization among people with limited mobility: A cross sectional study. Arch Public Health. 2016;74:9.CrossRef Asfaw B, Azage M, Gebregergs GB. Latrine access and utilization among people with limited mobility: A cross sectional study. Arch Public Health. 2016;74:9.CrossRef
20.
go back to reference He W-J, Lai Y-S, Karmacharya BM, Dai B-F, Hao Y-T, Xu DR. Geographical heterogeneity and inequality of access to improved drinking water supply and sanitation in Nepal. Int J Equity Health. 2018;17:40.CrossRef He W-J, Lai Y-S, Karmacharya BM, Dai B-F, Hao Y-T, Xu DR. Geographical heterogeneity and inequality of access to improved drinking water supply and sanitation in Nepal. Int J Equity Health. 2018;17:40.CrossRef
21.
go back to reference Sara S, Graham J. Ending Open Defecation in Rural Tanzania: Which Factors Facilitate Latrine Adoption? Int J Environ Res Public Health. 2014;11:9854–70.CrossRef Sara S, Graham J. Ending Open Defecation in Rural Tanzania: Which Factors Facilitate Latrine Adoption? Int J Environ Res Public Health. 2014;11:9854–70.CrossRef
22.
go back to reference Tumwine J, Thompson J, Katui-Katua M, Mujwahuzi M, Johnstone N, Porras I. Sanitation and hygiene in urban and rural households in East Africa. Int J Environ Health Res. 2003;13:107–15.CrossRef Tumwine J, Thompson J, Katui-Katua M, Mujwahuzi M, Johnstone N, Porras I. Sanitation and hygiene in urban and rural households in East Africa. Int J Environ Health Res. 2003;13:107–15.CrossRef
23.
go back to reference Hirai M, Kelsey A, Mattson K, Cronin AA, Mukerji S, Graham JP. Determinants of toilet ownership among rural households in six eastern districts of Indonesia. J Water Sanit Hyg Dev. 2018;8:533–45.CrossRef Hirai M, Kelsey A, Mattson K, Cronin AA, Mukerji S, Graham JP. Determinants of toilet ownership among rural households in six eastern districts of Indonesia. J Water Sanit Hyg Dev. 2018;8:533–45.CrossRef
24.
go back to reference Chen J, Li Z, Gao X, Du H, Yu L, Ren H, et al. Toilet retrofit in rural areas of China: impact factors and effect analysis. Chin Rural Health Serv Adm. 2013;33:181–3. Chen J, Li Z, Gao X, Du H, Yu L, Ren H, et al. Toilet retrofit in rural areas of China: impact factors and effect analysis. Chin Rural Health Serv Adm. 2013;33:181–3.
25.
go back to reference Coffey D, Spears D, Vyas S. Switching to sanitation: Understanding latrine adoption in a representative panel of rural Indian households. Soc Sci Med. 2017;188:41–50.CrossRef Coffey D, Spears D, Vyas S. Switching to sanitation: Understanding latrine adoption in a representative panel of rural Indian households. Soc Sci Med. 2017;188:41–50.CrossRef
26.
go back to reference Li X, Gao Y, Miao Y, Chen W. Understanding Determinants of Inequality in Sanitation Improvement in Rural China. Iran J Public Health. 2014;43:1148–9.PubMedPubMedCentral Li X, Gao Y, Miao Y, Chen W. Understanding Determinants of Inequality in Sanitation Improvement in Rural China. Iran J Public Health. 2014;43:1148–9.PubMedPubMedCentral
27.
go back to reference Li X, Miao Y, Chen W. China’s three-year health reform program and equity in sanitation improvement: a panel analysis. BMC Public Health. 2015;15:38.CrossRef Li X, Miao Y, Chen W. China’s three-year health reform program and equity in sanitation improvement: a panel analysis. BMC Public Health. 2015;15:38.CrossRef
28.
go back to reference Tuyet-Hanh TT, Lee J-K, Oh J, Minh HV, Lee CO, Hoan LT, et al. Household trends in access to improved water sources and sanitation facilities in Vietnam and associated factors: findings from the Multiple Indicator Cluster Surveys, 2000–2011. Glob Health Action. 2016;9:93–100.CrossRef Tuyet-Hanh TT, Lee J-K, Oh J, Minh HV, Lee CO, Hoan LT, et al. Household trends in access to improved water sources and sanitation facilities in Vietnam and associated factors: findings from the Multiple Indicator Cluster Surveys, 2000–2011. Glob Health Action. 2016;9:93–100.CrossRef
29.
go back to reference Lin L, Liu D. Study on distribution equity of rural sanitary latrines. Chin J Public Health Manag. 2016;32:285–9. Lin L, Liu D. Study on distribution equity of rural sanitary latrines. Chin J Public Health Manag. 2016;32:285–9.
31.
go back to reference Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. the index of adl: a standardized measure of biological and psychosocial function. JAMA. 1963;185(2):914–9.CrossRef Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. the index of adl: a standardized measure of biological and psychosocial function. JAMA. 1963;185(2):914–9.CrossRef
32.
go back to reference Canta C, Cremer H, Gahvari F. “Honor thy father and thy mother” or not: uncertain family aid and the design of social long term care insurance. Soc Choice Welf. 2020;55:687–734.CrossRef Canta C, Cremer H, Gahvari F. “Honor thy father and thy mother” or not: uncertain family aid and the design of social long term care insurance. Soc Choice Welf. 2020;55:687–734.CrossRef
34.
go back to reference National Bureau of Statistics, Ministry of Environmental Protection. China Environmental Statistics Yearbook. Beijing: China Statistics Press; 2012. p. 2013. National Bureau of Statistics, Ministry of Environmental Protection. China Environmental Statistics Yearbook. Beijing: China Statistics Press; 2012. p. 2013.
35.
go back to reference National Bureau of Statistics, Ministry of Ecology and Environment. China Environmental Statistics Yearbook. Beijing: China Statistics Press; 2020. p. 2021. National Bureau of Statistics, Ministry of Ecology and Environment. China Environmental Statistics Yearbook. Beijing: China Statistics Press; 2020. p. 2021.
36.
go back to reference Eriksson T, Pan J, Qin X. The Intergenerational Inequality of Health in China. China Econ Rev. 2014;31:392–409.CrossRef Eriksson T, Pan J, Qin X. The Intergenerational Inequality of Health in China. China Econ Rev. 2014;31:392–409.CrossRef
37.
go back to reference Chiwandire N, Zungu N, Mabaso M, Chasela C. Trends, prevalence and factors associated with hypertension and diabetes among South African adults living with HIV, 2005–2017. BMC Public Health. 2021;21:462.CrossRef Chiwandire N, Zungu N, Mabaso M, Chasela C. Trends, prevalence and factors associated with hypertension and diabetes among South African adults living with HIV, 2005–2017. BMC Public Health. 2021;21:462.CrossRef
Metadata
Title
Trends of and factors associated with access to residential toilets among the middle-aged and elderly in rural China from 2011 to 2018
Authors
Qun Wang
Huiyuan Cao
Shuo Zhang
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2022
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-022-12739-3

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