Socio-economic Determinants and Spatial Analysis of Access to Sanitation among Older Adults in Ghana

Abstract

Access to sanitation is a fundamental human right essential for health and dignity, yet inadequate access remains a significant challenge globally�particularly for vulnerable populations like older adults. This study assesses the spatial distribution and socioeconomic determinants of sanitation access among older adults in Ghana. Using data from the 2021 Population and Housing Census, we applied Moran�s I, Hotspot, and Cluster & Outlier spatial analyses to identify geographic patterns of sanitation access. We then used logistic regression to examine individual-level factors. Results revealed regional and district-level disparities in sanitation access. Key determinants included sex, age, marital status, education, rural residence, religion, ownership of household assets, and disability status. Specifically, females and adults aged 80+ had higher odds of access, whereas rural residence, certain religious affiliations, and hearing disabilities were linked to lower odds. The findings highlight the need for integrated, spatially informed policies and interventions tailored to older adults� needs.