Aging Population and Lacking Sanitation Governance: Global Challenges in Alleviating Deaths from Unsafe Rural...

Area of Science:

• Environmental Health
• Public Health
• Demography

Background:

• Global urbanization often overlooks rural health risks, particularly Deaths Attributable to Unsafe Sanitation in Rural areas (DAUSRs).
• Existing studies on DAUSRs lack comprehensive global evaluation frameworks and scale.
• Demographic factors, disease mortality, and sanitation conditions significantly influence DAUSRs.

Purpose of the Study:

• To estimate global DAUSRs from 2000 to 2030.
• To analyze the influencing factors of DAUSRs, including population dynamics, sanitation, age structure, and disease mortality.
• To provide evidence-based recommendations for global rural environmental and public health policies.

Main Methods:

• Utilized data from the Global Burden of Disease (GBD) and the World Health Organization (WHO).
• Employed comparable risk assessment, Bayesian age (period) models, and AutoRegressive Integrated Moving Average (ARIMA) models.
• Applied a decomposition method to evaluate changes in DAUSRs and their drivers.

Main Results:

• Despite improvements, 12.2% of the rural population will lack sanitary toilets by 2030.
• An estimated 243,000 deaths (CI: 147,000-441,000) are projected due to unsafe rural sanitation.
• Aging and declining fertility rates are identified as key drivers of DAUSRs, with Africa and Southeast Asia at higher risk.

Conclusions:

• Enhanced rural sanitation governance is essential to address demographic shifts and reduce DAUSRs.
• Comprehensive measures, including improved medical facilities and sanitation infrastructure, are recommended.
• Focusing on vulnerable groups like the elderly and children is critical for effective public health interventions.