Health, income and poverty: evidence from China’s rural household survey

Abstract

Background: Understanding the health status of the poor households and the influence of unhealthy on their income can provide some vital insights into the effectiveness and appropriateness of poverty reduction solutions.Methods: Based on a nationwide cross-sectional survey of 29,712 rural poor households, this study systematically investigated the causes of poverty and health status of Chinese rural poor households, and revealed the relationship between health, income and poverty. Results:The health status of the rural poor in China is not optimistic, with 51.63% attributing their poverty to the illness of household members. NCDs are the biggest health threat to the rural poor in China. Over 60% of all the households have at least one patient and more than a quarter of the households with patients cannot afford expensive medical expenses. Although 98% of all the households participate in China's a rural health insurance system -the New Rural Cooperative Medical Scheme -16% are still unable to bear their medical expenses after reimbursement from the scheme. Further, high altitude, ill-health and low-income are interlinked and mutually reinforcing. The per capita net income of poor households was inversely proportional to the altitude of their places of residence, family aging and unhealthy status, but was positively correlated with the number of workforces in their families.Conclusions: Poverty due to illness is one of the root causes of rural poverty in China. With the backward medical infrastructure in high altitude areas, people are more prone to fall into the vicious circle of poverty-unhealthy-low income-poverty. The establishment of effective long-term mechanism of disease prevention and intervention is an important prerequisite to enhance the endogenous development power of the poor and reduce poverty.

Public Medical Insurance and Healthcare Utilization and Expenditures of Older with Chronic Diseases in Rural China: Evidence from NRCMS

“…Some studies have pointed the rural elderly population even commit suicide in order to end their suffering [ 6 , 7 , 8 , 9 , 10 , 11 ]. Illness is one of the root causes of poverty in rural China [ 12 ]. If health intervention is not carried out in time, therefore, it will not only aggravate the burden on their families, increasing the risk of poverty caused by ageing and illness, but also cause other social problems, making it more difficult to alleviate poverty precisely, and hindering the sharing of social development achievements with the rural elderly.…”

The Impact of Public Health Insurance on Household Credit Availability in Rural China: Evidence from NRCMS

“…Two questions need to be addressed: first, why does NRCMS increase the medical burden of rural households? On the one hand, although NRCMS can reduce the price of medical services and can reduce the medical expenditure under the conditions of the same medical service demand, the decline in the price of medical services can increase the demand for medical services by participators, resulting in actual medical care expenditure not falling but rising [ 9 , 10 , 11 , 12 , 13 ]. In fact, many rural individuals or households have no money for treatment when they fall ill; thus, medical expenditure is relatively small.…”

“…On the other hand, as a kind of medical insurance, the NRCMS also faces the moral hazard problem of medical institutions. The NRMCS sometimes causes he medical institutions to over-prescribe or over-diagnose, thereby increasing the cost of medical treatment of insured persons [ 13 , 36 ]. Second, why does medical burden cause rural households’ formal credit availability to increase significantly?…”

“…Past studies investigated the impact of NRCMS on access to care [ 9 , 10 , 11 , 12 ] and on health medical cost [ 13 ], as well as emphasized the role of nutrition or consumption [ 14 ], labor supply, or mobility [ 15 , 16 , 17 , 18 ]. For example, on the basis of 8273 people aged 45 or above from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011 and 2013, Liu et al found that NRCMS significantly reduced the elderly’s nonfarm labor force participation willingness and labor time [ 15 ].…”

The Moderating Effect of Community-Level Deprivation on the Association between Individual Characteristics and Smoking Behavior among Chinese Adults: A Cross-Level Study

“…In China, uneven economic reforms and decentralization have created inequalities among different social sectors, especially in the regional gap between rural urban and inland coastal areas [ 26 , 27 ]. Deprived communities mostly located in rural and inland areas may have difficulty effectively implementing smoking regulations due to environmental factors that facilitate smoking and inadequate health facilities, knowledge, and regional monitoring [ 28 , 29 , 30 ]. Previous studies found that tobacco control policies lowered smoking prevalence among females and in urban areas, whereas smoking prevalence in rural areas and among male heavy smokers (≥20 cigarettes daily) did not decrease [ 31 , 32 ].…”