ArticleFrontiers in public health2026
Impact of Rural Sanitary Toilet Interventions on pesticide reduction: health literacy as a mediating effect.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: China's Rural Sanitary Toilet Interventions (2015-present) is a government-led initiative aimed at replacing unhygienic rural toilets with sanitary facilities. This study explores the impact of this policy on pesticide reduction and analyzes the mediating role of health literacy. Methods: Based on survey data from 4,277 rural households in 10 provinces, this study employed a three-step method and bootstrap resampling for mediation analysis, used alternative models for robustness checks, and conducted heterogeneity analysis. Results: The significant reduction in pesticide use due to the Rural Sanitary Toilet Interventions project remained robust across different model specifications. Heterogeneity analysis revealed that the policy had a particularly pronounced effect on reducing pesticide use in the lower-middle-income group, while no significant differences were observed in other income groups. The effect was significant in non-plain areas but not statistically significant in plain areas. Mediation analysis confirmed that health literacy played a crucial mediating role in the relationship between policy implementation and the reduction in pesticide use. Discussion: These findings emphasize the importance of tailoring policies to different income levels and geographical conditions for targeted interventions, as well as the necessity of integrating health education with agricultural practices to promote sustainable agricultural behaviors. This study contributes to the literature by bridging the gap between public health and agricultural sustainability, offering valuable insights for policymakers seeking to promote eco-friendly agricultural transitions.
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