umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Does "the injury poverty trap" exist? A longitudinal study in Bavi, Vietnam.
Show others and affiliations
2006 (English)In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 78, no 2-3, 249-257 p.Article in journal (Refereed) Published
Abstract [en]

In this study we concentrate on injuries and affected households' capacities to earn incomes. A longitudinal study was performed in Bavi district, Vietnam, with the specific objectives to investigate: (1) the affects of injuries on incomes by comparing income changes in injured and non-injured individuals; (2) the affect of injuries on social mobility by estimating households' relative risk of dropping into poverty for households with and without injuries and estimating the relative risk of escaping from poverty for households without and with injuries. The propensity score matching method using a logit model was used for data analysis. The results show that on average, the loss per household is estimated at VND 1,084,000 (USD 72) for poor and VND 2,598,000 (USD 173) for non-poor, equivalent to 11 (9) and 15 (13) working months of an average person in the poor and non-poor group, respectively, during 1999 (2001). The relative risk of dropping into poverty for non-poor households with and without injuries equal to 1.21 (p=0.08) and the relative risk of escaping from poverty between poor households without and with injuries equal to 0.96 (p=0.39). In conclusion, it has been argued that the introduction of user fees created a poverty trap and thus their removal may be a solution. However, user fees are only a part of the burden on households. Loss of income during the illness period is likely to be a problem of the same magnitude. A successful solution must thus follow two tracks: prepayment of health care and some insurance based compensation of income losses during the illness period. Both reforms, if they are persistent, must be done within the resource limits of the local society. If the risk of catastrophic illness is more evenly spread across the society, it would increase the general welfare even if no more resources are provided.

Place, publisher, year, edition, pages
2006. Vol. 78, no 2-3, 249-257 p.
Keyword [en]
Data Collection, Female, Humans, Income, Longitudinal Studies, Male, Poverty, Vietnam, Wounds and Injuries/*economics
Identifiers
URN: urn:nbn:se:umu:diva-16191DOI: 10.1016/j.healthpol.2005.10.003PubMedID: 16290127OAI: oai:DiVA.org:umu-16191DiVA: diva2:155864
Available from: 2008-10-07 Created: 2008-10-07 Last updated: 2017-12-14Bibliographically approved
In thesis
1. The injury poverty trap in rural Vietnam: causes, consequences and possible solutions
Open this publication in new window or tab >>The injury poverty trap in rural Vietnam: causes, consequences and possible solutions
2005 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The focus of this study is the vicious circle of poverty and ill-health. The case is injuries but it could have been any lasting and severe disease. Poverty and health have very close links to economic development and to how health care is financed. Out-of-pocket payment seems to increase the risk of poverty while prepaid health care reduces it. The overall objective is to investigate the “injury poverty trap” and suggest possible solutions for it. A cohort of 23,807 people living in 5,801 households in Bavi district of Vietnam was followed from 1999 to 2003 to investigate income losses caused by non-fatal unintentional injuries in 2000 as well as the relationships between social position in 1999 and those injuries. For the possible solutions, a survey in 2064 household was performed to elicit people’s preferences and willingness to pay for different health care financing options. The results showed that unintentional injuries imposed a large economic burden on society, especially on the victims. By two pathways – treatment costs and income losses – unintentional injury increased the risk of being poor. The losses for non-poor and poor injured households were about 15 and 11 months of income of an average person in the non-poor and poor group, respectively. Furthermore, poverty was shown to be a probable cause of non-fatal unintentional injuries. Specifically, poverty led to home injuries among children and the elderly, and adults 15 – 49 years of age were particularly at risk in the workplace. The middle-income group was at greatest risk for traffic injuries, probably due to the unsafe use of bicycles or motorbikes. About half of the population preferred to keep an out-of-pocket system and the other half preferred health insurance. People’s willingness to pay suggested that a community-based health insurance scheme would be feasible. However, improvements in the existing health insurance systems are imperative to attract people to participate in these or any alternative health insurance schemes, since the limitations of the existing systems were generalized to health insurance as a whole. A successful solution should follow two tracks: prepayment of health care and some insurance based compensation of income losses during the illness period. If the risk of catastrophic illness is more evenly spread across the society, it would increase the general welfare even if no more resources are provided.

Place, publisher, year, edition, pages
Umeå: Folkhälsa och klinisk medicin, 2005. 182 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 990
Keyword
unintentional injury, poverty, out-of-pocket payment, health insurance, Vietnam
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-627 (URN)91-7305-958-7 (ISBN)
Public defence
2005-12-09, 09:00 (English)
Supervisors
Available from: 2005-11-16 Created: 2005-11-16 Last updated: 2010-01-29Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMedhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=16290127&dopt=Citation

Search in DiVA

By author/editor
Emmelin, AndersLindholm, Lars
By organisation
Epidemiology and Public Health Sciences
In the same journal
Health Policy

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 71 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf