Mental and physical health impacts of water/sanitation infrastructure in First Nations communities in Canada: An analysis of the Regional Health Survey

Abstract

• This study provides the first empirical analysis of the association between health and water/sanitation in First Nations in Canada. • I find that access to an indoor water supply and in-home sanitation are associated with large mental health benefits. • Water delivered by truck into a cistern is associated with mixed health outcomes relative to a piped system. • Large health benefits can be achieved through greater investment in new housing/indoor plumbing retrofits in First Nations. In this paper I estimate the magnitude of association between water/sanitation infrastructure and health/well-being for First Nations individuals living on reserve in Canada in 2002/3, 2008/10 and 2015/6. I find that access to an indoor water supply is associated with an 80% reduction in the odds of reporting depression. In-home sanitation is associated with a reduction in depression, gastrointestinal illness and kidney problems. These results suggest that large health benefits can be achieved through increased infrastructure investment in First Nations across Canada. Existing houses should also be retrofitted to ensure all homes have access to running water/sanitation.