data
This study uses data from the CFPS, a national Comprehensive Social Survey project. The Social Science Survey Center of Peking University is responsible for questionnaire implementation and data cleaning. CFPS conducted a baseline survey in 2010, and subsequently conducted five rounds of full-sample follow-up surveys in 2012, 2014, 2016, 2018, and 2020. The samples covered 95% of China’s population, covering 25 provinces, Municipalities and autonomous regions. China. The survey content includes population, economy, education, family dynamics, physical and mental health, etc., and is divided into three levels: individual, family, and village (community). The data obtained from the survey can meet the needs of this study for indicators such as the penetration rate of sanitary toilets and the health status of family members.
As of 2016, the dataset no longer provides information on household toilet types, and this study uses survey data from 2012 to 2014. To compare the impact of hygienic toilet penetration on the health of adults and children, we divided the sample into adults and children. Children’s sample. In this study, the child sample was children aged 16 and under, and the adult sample was people over 16 years old. After data screening, 39,671 adult respondents and 7,263 child respondents were interviewed simultaneously in 2012 and 2014.
variable
dependent variable
This study selected self-rated health status at the time of the survey (2012 and 2014), discomfort in the past two weeks, and diarrhea in the past two weeks as indicators to measure adult health status, as well as parents’ evaluation of their children’s health status, whether it has been in the past The number of illnesses in a month and the number of illnesses in the past month were used as indicators of children’s health status. The Adult Health Self-Rating Questionnaire item specifically asks “How do you think your health is?” Possible responses are “5 = excellent,” “4 = very good,” “3 = good,” “2 = fair,” and “1 = Difference”. In this study, “excellent”, “very good” and “good” are defined as healthy, with a value of 1, and “average” and “poor” are defined as unhealthy, with a value of 0.
Malaise in the past two weeks and diarrhea in the past two weeks are binary variables, with 1 indicating yes and 0 indicating no. Young children’s self-assessed health was assessed by parents. The value range is 1~7, where 1 represents the worst health status and 7 represents the best health status. Illness in the past month is a binary variable: 1 represents illness, 0 represents no illness. If the child has been sick in the past month, parents report the specific number of times.
Explanatory variables
The core explanatory variable of this study is the penetration rate of sanitary toilets in the village; that is, the proportion of the total number of toilets that meet sanitary standards to the total number of households in the villagefootnote 1.We refer to Mangyo’s research [28] and Ramichaan and Mangio. [29] And based on the question of “whether a sanitary toilet is used at home”, we calculated the total number of households using independent sanitary toilets in the same village (community) as the numerator. We used the total number of households in the same village as the denominator to calculate the village sanitary toilet penetration rate.
control variables
The control variables in this study cover three aspects: (1) Personal characteristics, including age, marital status, and education level; (2) Family characteristics, including family per capita income, family size, household crowding, etc.; (3) Village Characteristics, including type of water used for cooking and the presence of public waste facilities and services. For the adult sample, we use age, marital status, education level, number of family members, household per capita income, household housing crowding in the past year, water used for cooking, and whether there is public garbage as control variables. The sample of children includes, among other variables, the variable of whether the child is enrolled in school. The description, type, and possible values of the variables are shown in Table 1.
statistical model
This study focuses on the impact of the popularization of sanitary toilets on the health of rural residents and the external benefits of the popularization of sanitary toilets. Considering that the ordinary least squares estimation method is used, unobservable or easily missed differences between individuals can be excluded, which may be related to the explanatory variables, thus leading to estimation bias. This study chooses the two-way fixed effects model (TW-FE). The TW-FE model can simultaneously solve the problem of omitted variables that do not change with time but change with individuals and omitted variables that do not change with individuals but change with time.
The Hausman test results show that the fixed effects model is better than the random effects model, and the joint significance test shows that the TW-FE model is better than the individual fixed effects model. Therefore, this study uses the TW-FE model to explore the impact of sanitary toilet penetration on the health of rural residents. The model settings are as follows:
$${Health}_{it}={\beta }_{1}+{\beta }_{2}{ST}_{it}+{\beta }_{3}{Z}_{it} +{\mu }_{i}+{T}_{t}{+\epsilon }_{it}$$
(1)
\({Health}_{It}\) It refers to self-evaluation of health status, discomfort in the past two weeks, diarrhea in the past two weeks, parents’ evaluation of the child’s health, whether the child is sick, and the number of illnesses in the past month, etc. \({ST}_{it}\) Represents the popularity of sanitary toilets, \({Z}_{it}\) represents the control variable, \({\mu}_{i}\) refers to province fixed effects that do not change over time, \({T}_{t}\) refers to the time fixed effect, which captures the impact of unobservable variables on the dependent variable that changes over time but does not vary across provinces, and \({\epsilon}_{it}\) Represents random distractors that vary over time. \({\beta}_{1}\) represents the constant term, and \({\beta}_{2}\) and \({\beta}_{3}\) are the coefficients of the explanatory variables and the control variables respectively.
We first use this model to evaluate the impact of rural sanitary toilet penetration on residents’ health (regardless of whether sanitary toilets are used at home). Secondly, we separately evaluated the impact of sanitary toilet popularization on the health of residents who use sanitary toilets and those who do not use sanitary toilets at home. Finally, we examined whether there are regional and gender differences in the impact of sanitary toilet access on the health of residents who do not use sanitary toilets at home.