Skip to main content

Advertisement

SpringerLink
Log in

The Association Between the WASH and Clean Cooking Fuel Access and the Nutritional Well-Being of Adolescents in China

  • Published:
Global Social Welfare Aims and scope Submit manuscript

Abstract

Background

Safe water, sanitation, and hygiene facilities (WASH) interventions and access to clean cooking fuels are widely recognized as important public health interventions to reduce environmental risk factors of undernutrition. However, limited evidence has been found associating access to WASH and clean cooking fuels with improved nutritional well-being and elucidating the mechanism behind the impact of those interventions. This paper aims to examine the relationship between WASH and clean fuel access and adolescence nutritional well-being and further to explore time spent on household chores, a socioeconomic mechanism that mediates the relationship between access to WASH and clean cooking fuels and the nutritional well-being of adolescents.

Methods

This study uses nationally representative data of the 2010 Chinese Family Panel Study, with a subsample of 3044 complete cases of adolescents aged from 10 to 16 from 2641 families in 589 communities. Multilevel logistic regressions were used to test the association between the count of WASH and clean fuel access and whether an adolescent is underweight or stunted. We further tested the mediation effects of time spent on the doing household chores.

Results

Access to a single type of facilities is not significantly associated with the probability of stunting or underweight of adolescents. However, access to more than two types of access facilities significantly reduced the odds of stunting. We also found a partial mediation effects between the count of WASH and clean fuel access and the probability of being stunted.

Conclusion

WASH and clean fuel access has significant associations with the probability of being stunted and disproportionally affects adolescent girls. Improving access to single type of facilities is not sufficient to prevent stunting. Improved water, improved sanitation, improved waste management, and access to clean fuels and electricity interplayed with each other and collectively reduced the environmental risk factors and improved the well-being of people in the community.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Alkire, S., & Shen, Y. (2017). Exploring multidimensional poverty in China: 2010 to 2014. Research on Economic Inequality, 25, 161–228. https://doi.org/10.1108/S1049-258520170000025006.

    Article  Google Scholar 

  • Bartram, J., & Cairncross, S. (2010). Hygiene, sanitation, and water: forgotten foundations of health. PLoS Medicine, 7(11), e1000367. https://doi.org/10.1371/journal.pmed.1000367.

    Article  Google Scholar 

  • Bentham, J., Di Cesare, M., Bilano, V., Bixby, H., Zhou, B., Stevens, G. A., et al. (2017). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. The Lancet, 390(10113), 2627–2642. https://doi.org/10.1016/S0140-6736(17)32129-3.

    Article  Google Scholar 

  • Bhutta, Z. A., Ahmed, T., Black, R. E., Cousens, S., Dewey, K., Giugliani, E., … Maternal and Child Undernutrition Study Group. (2008). What works? Interventions for maternal and child undernutrition and survival. The Lancet, 371(9610), 417–440. https://doi.org/10.1016/S0140-6736(07)61693-6.

    Article  Google Scholar 

  • Bhutta, Z. A., Das, J. K., Rizvi, A., Gaffey, M. F., Walker, N., Horton, S., et al. (2013). Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? The Lancet, 382(9890), 452–477. https://doi.org/10.1016/S0140-6736(13)60996-4.

    Article  Google Scholar 

  • Bruce, N. G., Dherani, M. K., Das, J. K., Balakrishnan, K., Adair-Rohani, H., Bhutta, Z. A., & Pope, D. (2013). Control of household air pollution for child survival: estimates for intervention impacts. BMC public health, 13(Suppl 3), S8. https://doi.org/10.1186/1471-2458-13-S3-S8.

  • Bryan, J., Osendarp, S., Hughes, D., Calvaresi, E., Baghurst, K., & Klinken, J.-W. (2004). Nutrients for cognitive development in school-aged children. Nutrition Reviews, 62(8), 295–306. https://doi.org/10.1111/j.1753-4887.2004.tb00055.x.

    Article  Google Scholar 

  • Carlton, E. J., Liang, S., McDowell, J. Z., Li, H., Luo, W., & Remais, J. V. (2012). Regional disparities in the burden of disease attributable to unsafe water and poor sanitation in China. Bulletin of the World Health Organization, 90(8), 578–587.

    Article  Google Scholar 

  • Chang, H., Dong, X., & MacPhail, F. (2011). Labor migration and time use patterns of the left-behind children and elderly in rural China. World Development, 39(12), 2199–2210. https://doi.org/10.1016/J.WORLDDEV.2011.05.021.

    Article  Google Scholar 

  • Clean Cooking Alliance (2018). China. Retrieved from https://www.cleancookingalliance.org/country-profiles/focus-countries/7-china.html

  • Crane, R. J., Jones, K. D. J., & Berkley, J. A. (2015). Environmental enteric dysfunction: an overview. Food and Nutrition Bulletin, 36(Suppl), S76–S87. https://doi.org/10.1177/15648265150361S113.

    Article  Google Scholar 

  • Crookston, B. B. T., Penny, M. M. E., Alder, S. S. C., Dickerson, T. T. T., Merrill, R. M., Stanford, J. B., et al. (2010). Children who recover from early stunting and children who are not stunted demonstrate similar levels of cognition nutrition. The Journal of Nutrition, 140(11), 1996–2001. https://doi.org/10.3945/jn.109.118927.

    Article  Google Scholar 

  • Cumming, O., & Cairncross, S. (2016, May). Can water, sanitation and hygiene help eliminate stunting? Current evidence and policy implications. Maternal and Child Nutrition. https://doi.org/10.1111/mcn.12258.

    Article  Google Scholar 

  • Danaei, G., Andrews, K. G., Sudfeld, C. R., Fink, G., McCoy, D. C., Peet, E., et al. (2016). Risk factors for childhood stunting in 137 developing countries: a comparative risk assessment analysis at global, regional, and country levels. PLoS Medicine, 13(11), e1002164. https://doi.org/10.1371/journal.pmed.1002164.

    Article  Google Scholar 

  • Fink, G., & Rockers, P. C. (2014). Childhood growth, schooling, and cognitive development: further evidence from the Young Lives study. American Journal of Clinical Nutrition, 100(1), 182–188. https://doi.org/10.3945/ajcn.113.080960.

    Article  Google Scholar 

  • Geere, J.-A. L., Cortobius, M., Geere, J. H., Hammer, C. C., & Hunter, P. R. (2018). Is water carriage associated with the water carrier’s health? A systematic review of quantitative and qualitative evidence. BMJ Global Health, 3(3), e000764. https://doi.org/10.1136/bmjgh-2018-000764.

    Article  Google Scholar 

  • Haghighi, P., Wolf, P. L., & Durie, P. (1997). Tropical sprue and subclinical enteropathy: a vision for the nineties. Critical Reviews in Clinical Laboratory Sciences, 34(4), 313–341. https://doi.org/10.3109/10408369708998096.

    Article  Google Scholar 

  • Hall, A., Hewitt, G., Tuffrey, V., & de Silva, N. (2008). A review and meta-analysis of the impact of intestinal worms on child growth and nutrition. Maternal & Child Nutrition, 4(s1), 118–236. https://doi.org/10.1111/j.1740-8709.2007.00127.x.

    Article  Google Scholar 

  • Humphrey, J. H. (2009). Child undernutrition, tropical enteropathy, toilets, and handwashing. The Lancet, 374(9694), 1032–1035. https://doi.org/10.1016/s0140-6736(09)60950-8.

    Article  Google Scholar 

  • Institute of Health Metrics and Evaluation (IHME) (2017) Global Burden of Disease (GBDx) Data Tool. Number of deaths and death rates from household air pollution. Retrieved from https://vizhub.healthdata.org/sdg/

  • Keusch, G. T., Rosenberg, I. H., Denno, D. M., Duggan, C., Guerrant, R. L., Lavery, J. V., Tarr, P. I., Ward, H. D., Black, R. E., Nataro, J. P., Ryan, E. T., Bhutta, Z. A., Coovadia, H., Lima, A., Ramakrishna, B., Zaidi, A. K., Burgess, D. C., & Brewer, T. (2013). Implications of acquired environmental enteric dysfunction for growth and stunting in infants and children living in low- and middle-income countries. Food and Nutrition Bulletin, 34(3), 357–364. https://doi.org/10.1177/156482651303400308.

    Article  Google Scholar 

  • Kurmi, O. P., Arya, P. H., Lam, K. B., Sorahan, T., & Ayres, J. G. (2012). Lung cancer risk and solid fuel smoke exposure: a systematic review and meta-analysis. The European Respiratory Journal, 40(5), 1228–1237. https://doi.org/10.1183/09031936.00099511.

    Article  Google Scholar 

  • Li, C., & Ma, H. L. (2010). Risk factors of non-occupational carbon monoxide poisoning during the 2008 ice storm in Guiyang county, Hunan Province, China. Public Health Rep., 125, 605–610.

    Article  Google Scholar 

  • Liu, S., Zhou, Y., Wang, X., Wang, D., Lu, J., Zheng, J., Zhong, N., & Ran, P. (2007). Biomass fuels are the probable risk factor for chronic obstructive pulmonary disease in rural South China. Thorax., 62(10), 889–897. https://doi.org/10.1136/thx.2006.061457.

    Article  Google Scholar 

  • Ministry of Foreign Affairs People’s Republic of China, & United Nations System in China. (2015). Report on China’s implementation of the Millennium Development Goals (2000–2015). Retrieved from http://www.cn.undp.org/content/china/en/home/library/mdg/mdgs-report-2015-.html

  • Ministry of Health (2009) China health year book: a comprehensive collection of 1983–2009. China Health Science and Technology Publishing House, Beijing, China.

  • Ministry of Health (2010-2015) China Health Year Book. China Xie-he Medical University, Beijing, China.

  • Mu, R., & de Brauw, A. (2013). Migration and young child nutrition: evidence from rural China (IZA Discussion Paper No. 7466). Retrieved from https://hdl.handle.net/10419/80640

  • Nie, P., Sousa-Poza, A., & Xue, J. (2016). Fuel for life: domestic cooking fuels and women’s health in rural China. International Journal of Environmental Research and Public Health, 13(8). https://doi.org/10.3390/ijerph13080810.

    Article  Google Scholar 

  • Oktaria, V., Lee, K.J., Bines, J. E. et al. (2017). Nutritional status, exclusive breastfeeding and management of acute respiratory illness and diarrhea in the first 6 months of life in infants from two regions of Indonesia. BMC Pediatr, 17, 211. https://doi.org/10.1186/s12887-017-0966-x.

  • O’Lorcain, P., & Holland, C. V. (2000). The public health importance of Ascaris lumbricoides. Parasitology, 121(Suppl), S51–S71. https://doi.org/10.1017/S0031182000006442.

    Article  Google Scholar 

  • Pan X.C., Dong Z., Wang L., Yue W (2002). An evaluation of the indoor/outdoor air pollution and respiratory health of farmers living in rural areas of Anhui Province, China; Proceedings of the Indoor Air 2002; Monterey, CA, USA. 30 June–5 July 2002; Monterey, CA, USA: International Academy of Indoor Air Sciences.

  • Peabody, J. W., Riddell, T. J., Smith, K. R., Liu, Y., Zhao, Y., Gong, J., Milet, M., & Sinton, J. E. (2005). Indoor air pollution in rural China: cooking fuels, stoves, and health status. Archives of Environmental & Occupational Health, 60(2), 86–95. https://doi.org/10.3200/AEOH.60.2.86-95.

    Article  Google Scholar 

  • Pollack, C., Egerter, S., Sadegh-Mobari, T., Dekker, M., & Bbraveman, P. (2008). Where we live matters for our health: the links between housing and health. In Issue Brief 2: Housing and Health. Princeton, NJ: Robert Wood Jonson Foundation.

    Google Scholar 

  • Prüss-Üstün, A. & Corvalán, C. (2006). Preventing disease through healthy environments – Towards an estimate of the environmental burden of disease. Geneva: World Health Organization.

  • Quinn, A. K., Bruce, N., Puzzolo, E., Dickinson, K., Sturke, R., Jack, D. W., … Rosenthal, J. P. (2018). An analysis of efforts to scale up clean household energy for cooking around the world. Energy for Sustainable Development, 46, 1–10. https://doi.org/10.1016/j.esd.2018.06.011.

    Article  Google Scholar 

  • Rehfuess, Eva & World Health Organization. (2006). Fuel for life: household energy and health. Geneva: World Health Organization.

    Google Scholar 

  • Shraim, A., Cui, X., Li, S., Ng, J. C., Wang, J., Jin, Y., Liu, Y., Guo, L., Li, D., Wang, S., Zhang, R., & Hirano, S. (2003). Arsenic speciation in the urine and hair of individuals exposed to airborne arsenic through coal-burning in Guizhou, PR China. Toxicology Letters, 137(1-2), 35–48. https://doi.org/10.1016/S0378-4274(02)00379-X.

    Article  Google Scholar 

  • Smith, K. R., Mehta, S., & Maeusezahl-Feuz, M. (2004). Indoor air pollution from household use of solid fuels. In M. Ezzati, A. D. Lopez, A. Rodgers, & C. J. L. Murray (Eds.), Comparative quantification of health risks (pp. 1435–1493). Geneva: World Health Organization.

    Google Scholar 

  • Song, Y., Agardh, A., Ma, J., Li, L., Lei, Y., Stafford, R. S., & Prochaska, J. J. (2019). National trends in stunting, thinness and overweight among Chinese school-aged children, 1985–2014. International Journal of Obesity, 43(2), 402–411. https://doi.org/10.1038/s41366-018-0129-7.

    Article  Google Scholar 

  • StataCorp. 2017. Stata structural equation modeling reference manual: release 15. Statistical software. College Station, TX: StataCorp LLC.

  • UNDP. (2017). UNDP support to the implementation of the 2030 Agenda for Sustainable Development. Retrieved from https://www.undp.org/content/dam/undp/library/Climate%20and%20Disaster%20Resilience/7%20Clean%20Energy-Feb%202017.pdf.

  • UNICEF. (2013). Improving child nutrition: the achievable imperative for global progress. Division of Communication, UNICEF, 1–132. https://doi.org/978-92-806-4686-3

  • World Bank. (2019). Tracking SDG7: the energy progress report. Retrieved from https://trackingsdg7.esmap.org/about-us.

  • Wu, J., Hou, B., Ke, R. Y., Du, Y. F., Wang, C., Li, X., et al. (2017). Residential fuel choice in rural areas: field research of two counties of North China. Sustainability (Switzerland), 9(4). https://doi.org/10.3390/su9040609.

    Article  Google Scholar 

  • Yu, X., Qiu, Z., & Lu, P. (2012). “Sampling Design.” CFPS-1. Institute of Social Science Survey (in Chinese). Available at www.isss.edu.cn/cfps/d/file/wd/jsbg/2010jsbg/c70c703752f7f6f24e27b5a8a85c1cba.pdf.

  • Zhao, Y., Wang, S., Aunan, K., Seip, H. M., & Hao, J. (2006). Air pollution and lung cancer risks in China—a meta-analysis. Science of Total Environment, 366(2-3), 500–513. https://doi.org/10.1016/j.scitotenv.2005.10.010.

    Article  Google Scholar 

  • Ziegelbauer, K., Speich, B., Mäusezahl, D., Bos, R., Keiser, J., Utzinger, J., & Hales, S. (2012). Effect of sanitation on soil-transmitted helminth infection: systematic review and meta-analysis. PLoS Medicine, 9(1), e1001162.

Download references

Author information

Authors and Affiliations

  1. Brown School at Washington University in St. Louis, One Brookings Dr., CB 1196, St. Louis, MO, USA

    Yiqi Zhu

  2. School of Social Work, Arizona State University, 411 N. Central Avenue, Suite 800, Phoenix, AZ, 85004-0689, USA

    Shiyou Wu

Authors
  1. Yiqi Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shiyou Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yiqi Zhu.

Ethics declarations

Conflict of Interest

Neither of the authors allowed personal interests to influence the research reported, and the authors declare that they have no conflicts of interests.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors. The data used in this article are from the China Family Panel Studies (CFPS) funded by 985 Program of Peking University and carried out by the Institute of Social Science Survey of Peking University. The data collection process was in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. We thank the funders and CFPS team members for providing the data which makes this study possible.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhu, Y., Wu, S. The Association Between the WASH and Clean Cooking Fuel Access and the Nutritional Well-Being of Adolescents in China. Glob Soc Welf 7, 97–107 (2020). https://doi.org/10.1007/s40609-019-00168-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40609-019-00168-x

Keywords

Search

Navigation