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BMC Public Health
Published in: BMC Public Health 1/2023

Open Access 01-12-2023 | Flush | Research

Effect of household toilet accessibility on physical health of ethnic minority adolescents: a longitudinal study from the China Education Panel Survey 2013 and 2014

Authors: Yao Jiang, Fan Yang

Published in: BMC Public Health | Issue 1/2023

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Abstract

Background

Accessing household toilets is vital for adolescent health during crucial stages of growth and development; however, some ethnic minority families in China lack toilets. The relationship between household toilet accessibility and the physical health of adolescents in China’s ethnic minority areas has been underexamined.

Methods

Using two waves of data from the China Education Panel Survey (2013 and 2014), this study explored the effect of household toilet accessibility on Chinese ethnic minority adolescents’ physical health. The sample consisted of 576 ethnic minority adolescents with an average age of approximately 13 years. To test the health effect of household toilet accessibility on ethnic minority adolescents, a fixed effects ordinary least squares model and difference-in-differences combined with propensity score matching method were used.

Results

The results of the fixed effects model and difference-in-differences combined with propensity score matching showed a significant and positive effect of household toilet accessibility on adolescents’ physical health. The heterogeneity analysis indicated that among the toilet types of soil cesspits, cement cesspits, squat toilets, and flush toilets, the flush toilets were proven to be the most efficient in improving adolescents’ physical health. Moreover, the family living arrangement was proven to play a moderating role in the effect of household toilet accessibility on the physical health of ethnic minority adolescents. The average marginal effects of household toilet accessibility on the physical health of ethnic minority adolescents who lived without parents were more evident and significant than those who lived with their parents.

Conclusion

Promoting household toilet accessibility in China’s ethnic minority areas is essential for improving adolescents’ health. Moreover, having a household toilet is not sufficient, the quality and dignity of household toilets are also important.
Literature
1.
Stanwell-Smith R. Public toilets down the drain? Why privies are a public health concern. Public Health. 2010;124(11):613–6.CrossRefPubMed
2.
Wilson N, Thomson G. Deficient handwashing amenities in public toilets in the time of the COVID-19 pandemic: a multi-regional survey. N Z Med J. 2021;134(1538):18–27.PubMed
3.
4.
Zhou X. Toilet revolution in contemporary China. Beijing: Commercial Press; 2020.
5.
Nallari A. “All we want are toilets inside our homes!” The critical role of sanitation in the lives of urban poor adolescent girls in Bengaluru. India Environ Urban. 2015;27(1):73–88.CrossRef
6.
Ramani SV, Frühauf T, Dutta A. On diarrhea in adolescents and school toilets: insights from an Indian village school study. J Dev Stud. 2017;53(11):1899–914.CrossRef
7.
Soeiro RE, Rocha L, Surita FG, Bahamondes L, Costa ML. Period poverty: menstrual health hygiene issues among adolescent and young Venezuelan migrant women at the northwestern border of Brazil. Reprod Health. 2021;18:238.CrossRefPubMedPubMedCentral
8.
Camenga DR, Brady SS, Hardacker CT, Williams BR, Hebert-Beirne J, James AS, et al. The prevention of lower urinary tract symptoms research consortium. U.S. adolescent and adult women’s experiences accessing and using toilets in schools, workplaces, and public spaces: a multi-site focus group study to inform future research in bladder health. Int J Environ Res Public Health. 2019;16:3338.CrossRefPubMedPubMedCentral
9.
Coswosk ED, Neves-Silva P, Modena CM, Heller L. Having a toilet is not enough: the limitations in fulfilling the human rights to water and sanitation in a municipal school in Bahia. Br BMC Public Health. 2019;19:137.CrossRefPubMed
10.
Jørgensen CS, Breinbjerg AS, Rittig S, Kamperis K. Dissatisfaction with school toilets is associated with bladder and bowel dysfunction. Eur J Pediatr. 2021;180:3317–24.CrossRefPubMed
11.
12.
Zhou ML, Gu YW, Wang XL. Access to sanitary toilets and health outcomes: a panel data analysis using two-way fixed effects model. Math Biosci Eng. 2021;18(6):8815–30.CrossRefPubMed
13.
Commission CNH. China health statistical yearbook 2018. Beijing: Peking Union Medical College Press; 2018.
14.
Zang X. Market reforms and Han-Muslim variation in employment in the Chinese state sector in a Chinese city. World Dev. 2008;36(11):2341–52.CrossRef
15.
Cao H. Urban–rural income disparity and urbanization: what is the role of spatial distribution of ethnic groups? A case study of Xinjiang Uyghur autonomous region in western China. Region Studies. 2010;44(8):965–82.CrossRef
16.
17.
Liu ZY. Choice and reconstruction of local Tibetan cultural tradition. Beijing: Ethnic Publishing House; 2006.
18.
Zhou X. Change of the ideas of purity and impurity and the toilet revolution in China. J Yunnan Normal Univ (Humanit Soc Sci Ed). 2019;51:85–97.
19.
Sun LX, Shafiq MN, McClure M, Guo SS. Are there educational and psychological benefits from private supplementary tutoring in mainland China? Evidence from the China Education Panel Survey, 2013–15. Int J Educ Dev. 2020;72: 102144.CrossRef
20.
Guo YH, Chen QH, Zhai SY, Pei CC. Does private tutoring improve student learning in China? Evidence from the China Education Panel Survey. Asia Pac Policy Stud. 2020;27(3):322–43.CrossRef
21.
Burton R. The sitting-height index of build, (body mass)/(sitting height), as an improvement on the body mass index for children, adolescents and young adults. Children-Basel. 2018;5(2):30.CrossRefPubMedPubMedCentral
22.
Schwartz SM. Life without father: what happens to the children? Contexts. 2002;1:35–44.CrossRef
23.
Qi M, Zhou SJ, Guo ZC, Zhang LG, Min HJ, Li XM, Chen JX. The effect of social support on mental health in Chinese adolescents during the outbreak of COVID-19. J Adolesc Health. 2020;67(4):514–8.CrossRefPubMedPubMedCentral
24.
Fellmeth G, Rose-Clarke K, Zhao CY, Busert LK, Zheng YT, Massazza A, et al. Health impacts of parental migration on left-behind children and adolescents: a systematic review and meta-analysis. Lancet. 2018;392(10164):2567–82.CrossRefPubMedPubMedCentral
25.
Zhang N, Fan FM, Huang SY, Rodriguez MA. Mindfulness training for loneliness among Chinese College students: a pilot randomized controlled trial. Int J Psychol. 2018;53(5):373–8.CrossRefPubMed
26.
Mao Z, Zhao X. The effects of social connections on self-rated physical and mental health among internal migrant and local adolescents in Shanghai China. BMC Public Health. 2012;12:97.CrossRefPubMedPubMedCentral
27.
Zhou Q, Fan LB, Yin ZC. Association between family socioeconomic status and depressive symptoms among Chinese adolescents: evidence from a National Household Survey. Psychiatry Res. 2018;259:81–8.CrossRefPubMed
28.
Li M, Dibley MJ, Sibbritt DW, Zhou XY, Yan H. Physical activity and sedentary behavior in adolescents in Xi’an City China. J Adolescent Health. 2007;41(1):99–101.CrossRef
29.
Lanier P, Maguire-Jack K, Lombardi B, Frey J, Rose RA. Adverse childhood experiences and child health outcomes: comparing cumulative risk and latent class approaches. Matern Child Health J. 2018;22(3):288–97.CrossRefPubMed
30.
Borjigen A, Huang C, Liu MX, Lu J, Peng HT, Sapkota C, Sheng JM. Status and factors of menstrual knowledge, attitudes, behaviors and their correlation with psychological stress in adolescent girls. J Pediatr Adolesc Gynecol. 2019;32(6):584–9.CrossRefPubMed
31.
Guan J, Tena JD. Estimating the effect of physical exercise on juveniles’ health status and subjective well-being in China. Appl Econ. 2021;53(46):5385–96.CrossRef
32.
Christian H, Zubrick SR, Foster S, Giles-Corti B, Bull F, Wood L, et al. The influence of the neighborhood physical environment on early child health and development: a review and call for research. Health Place. 2015;33:25–36.CrossRefPubMed
33.
Clennin MN, Elliott M, Kelly C. The effects of neighborhood enhancements on children’s physical activity. Health Behav Policy Rev. 2015;2(6):421–8.CrossRef
34.
D’Haese S, De Meester F, Cardon G, De Bourdeaudhuij I, Deforche B, Van Dyck D. Changes in the perceived neighborhood environment in relation to changes in physical activity: a longitudinal study from childhood into adolescence. Health Place. 2015;33:132–41.CrossRefPubMed
35.
Wang MQ, Fitzhugh EC, Westerfield RC, Eddy JM. Family and peer influences on smoking behavior among American adolescents: an age trend. J Adolesc Health. 1995;16(3):200–3.CrossRefPubMed
36.
Ali MM, Dwyer DS. Social network effects in alcohol consumption among adolescents. Addict Behav. 2010;35(4):337–42.CrossRefPubMed
37.
Yu WH, Hara Y. Motherhood penalties and fatherhood premiums: effects of parenthood on earnings growth within and across firms. Demography. 2021;58(1):247–72.CrossRefPubMed
38.
Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometrika. 1983;70:41–55.CrossRef
39.
Duong PB, Thanh PT. Adoption and effects of modern rice varieties in Vietnam: micro-econometric analysis of household surveys. Economic Analysis Policy. 2020;64:282–92.CrossRef
40.
George R. The big necessity: the unmentionable world of human waste and why it matters. New York: Holt Paperbacks; 2009.
41.
42.
43.
44.
45.
Jiang Y, Yang F. Motherhood health penalty: impact of fertility on physical and mental health of Chinese women of childbearing age. Front Public Health. 2022;10: 787844.CrossRefPubMedPubMedCentral
Metadata
Title
Effect of household toilet accessibility on physical health of ethnic minority adolescents: a longitudinal study from the China Education Panel Survey 2013 and 2014
Authors
Yao Jiang
Fan Yang
Publication date
01-12-2023
Publisher
BioMed Central
Keyword
Flush
Published in
BMC Public Health / Issue 1/2023
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-023-15547-5

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