Household Budget Survey Research Articles

Geospatial analysis: a new frontier in humanitarian health research?

Geospatial analysis: a new frontier in humanitarian health research?

Households Health Expenditure in Interannual Correlation With Public Health Expenditure in Greece.

The aim of this article is to investigate the relationship between the public and the private health expenditure (macroeconomic and microeconomic approach) over time and within the recession and austerity period in Greece, in order to find out whether the strict Memorandum health policies pass, influence, or go along with the health expenditure to the final consumer, i.e., the health services user. In this context, by using econometric tools, such as multiple regression and cointegration analysis on the raw microdata of Household Budget Surveys from 1987/88 up to 2018, as well as by using data of public expenditure of Organization for Economic Co-operation and Development–Health Statistics 2019 in the Stata version 13, the study compares the variation of household and public health expenditures before and after the financial crisis in Greece and also examines the correlation between the two variables. The analysis demonstrated that the Greek household health expenditure (HHE) was rapidly increasing during the period 1988–2008, and afterward, it started decreasing. Moreover, the total private and the total public health expenditures seem to have a bidirectional long-run relationship and significant cointegration. The same was observed regarding the public expenditure and household medical services expenditure, as well as pharmaceuticals. Furthermore, the results indicate that over the years of recession, the monthly HHE decreases, due to the confiscation of middle-class income, which led to consumerism restrictions. However, as households are now spending a bigger portion of their shrunken income for health (as health is an inelastic commodity), HHE, as a proportion of total private expenditure, has eventually risen.

Rebound effects may jeopardize the resource savings of circular consumption: evidence from household material footprints

The circular economy model aims to reduce the consumption of virgin materials by increasing the time materials remain in use while transitioning economic activities to sectors with lower material intensities. Circular economy concepts have largely been focussed on the role of businesses and institutions, yet consumer changes can have a large impact. In a more circular economy consumers often become users—they purchase access to goods and services rather than physical products. Other consumer engagement includes purchasing renewable energy, recycling and using repair and maintenance services etc. However, there are few studies on whether consumers actually make these sorts of consumption choices at large scale, and what impacts arise from these choices on life-cycle material consumption. Here we examine what types of households exhibit circular consumption habits, and whether such habits are reflected in their material footprints. We link the Eurostat Household Budget Survey 2010 with a global input-output model and assess the material footprints of 189 800 households across 24 European countries, making the results highly generalizable in the European context. Our results reveal that different types of households (young, seniors, families etc) adopt different circular features in their consumption behaviour. Furthermore, we show that due to rebound effects, the circular consumption habits investigated have a weak connection to total material footprint. Our findings highlight the limitations of circular consumption in today’s economic systems, and the need for stronger policy incentives, such as shifting taxation from renewable resources and labour to non-renewable resources.

Modelling unbalanced catastrophic health expenditure data by using machine‐learning methods

SummaryThis study aims to compare the performances of logistic regression and random forest classifiers in a balanced oversampling procedure for the prediction of households that will face catastrophic out‐of‐pocket (OOP) health expenditure. Data were derived from the nationally representative household budget survey collected by the Turkish Statistical Institute for the year 2012. A total of 9,987 households returned valid surveys. The data set was highly imbalanced, and the percentage of households facing catastrophic OOP health expenditure was 0.14. Balanced oversampling was performed, and 30 artificial data sets were generated with sizes of 5% and 98% of the original data size. The balanced oversampled data set provided accurate predictions, and random forest exhibited superior performance in identifying households facing catastrophic OOP health expenditure (area under the receiver operating characteristic curve, AUC = 0.8765; classification accuracy, CA = 0.7936; sensitivity = 0.7765; specificity = 0.8552; F1 = 0.7797).

Electricity consumption analysis based on Turkish Household Budget Surveys

Electricity consumption analysis based on Turkish Household Budget Surveys

Quality of Match for Statistical Matches Used in the Development of the Levy Institute Measure of Time and Consumption Poverty (LIMTCP) for Ghana and Tanzania

This document presents a description of the quality of match of the statistical matches used in the LIMTCP estimates prepared for Ghana and Tanzania. For Ghana, the statistical match combines the Living Standards Survey Round 6 (GLSS6) with the Ghana Time Use Survey (GTUS) 2009, and for Tanzania it combines the Household Budget Survey (THBS) 2012 with the time-use data obtained from the Integrated Labor Survey Module (ILFS) 2006. In both cases, the alignment of the two datasets is examined, after which various aspects of the match quality are described. Despite the differences in the survey years, the quality of match is high and the synthetic dataset appropriate for the time poverty analysis.

An Analysis of out of Pocket Education Expenditures in Turkey: Logit and Tobit Models

This study used data acquired from the 2017 Household Budget Survey from the Turkish Statistical Institute and used Logit and Tobit models and researched the risk of out-of-pocket education expenditures creating catastrophic expenditures. The study also researched the interactions of the out-of-pocket education expenditures by 20% income quintile based on the socioeconomic properties of the household. As a result of the analysis, it was seen that the catastrophic and out-of-pocket education expenditures increase in situations in which the household annual income, income quintiles, head of household age and education level increased and in which the household owns the house in which it resides. In case of difficult access to education services and increasing household size per equivalent individual, it was seen that out-of-pocket education expenditures decreased. It was concluded that an increase in the number of preschool children and the number of children studying in primary school and university reduced both expenditures but that an increase in the number of children studying in high school increased these expenditures.

Availability of ultra-processed food associated with health outcomes: a systematic review

Abstract Background Ultra-processed food (UPF) consumption increases worldwide, which can be harm to population's health. To establish associations between UPF and health outcomes, food consumption can be assessed individually or by using availability data, such as purchase lists or household budget surveys. The aim of this review was to search for studies on the availability of UPF related with mortality and morbidity from noncommunicable diseases or their risk factors. Methods PRISMA guideline was used. Searches were performed on PubMED, EBSCO, Scopus and Web of Science on December 2019. Search strategy included terms related with exposure (UPF) and outcomes (mortality or morbidity from noncommunicable diseases and their risk factors). Studies were selected based on the title and abstracts. Full texts were screened for eligibility and the snowballing method was used to find other relevant studies. To be based on UPF availability data and its relation with health outcomes were the inclusion criteria. Studies that assessed only food consumption at an individual level and did not present health outcome were excluded. Selection was conducted by two reviewers and a third helped when disagreement occurred. Results After duplicates removal, 560 records were analyzed. From the 11 eligible studies, 55% were conducted in more than one country. Others were performed in Brazil (27%), Guatemala (9%) and Sweden (9%). Studies were ecological (64%), cross-sectional (27%) and longitudinal (9%). All had representative samples, 45.5% were national samples, and the others were from particular population subgroups. In all studies, the only health outcomes that showed positive association with UPF availability were overweight and obesity prevalence. Conclusions Studies relating ultra-processed food availability and health outcomes are mainly focused on overweight and obesity. It is thus necessary to further explore the relationship between UPF availability and other health outcomes. Key messages It is necessary to further research association between ultra-processed food availability and other health outcomes, such as morbidity and mortality from cardiovascular diseases, diabetes or cancer. Purchase lists or household budget surveys are an important source of food availability data and can be used to relate the consumption of ultra-processed foods to health outcomes.

The impact of ultra-processed food on carbon, water and ecological footprints of food in Brazil

Abstract Background Ultra-processed foods (UPF) have been associated with major diet-related public health issues that share underlying drivers with climate change. Both challenges require major changes to the food system and so the potential benefits to health and the environment present a double motivation for transformation. Our aim is to assess the impacts of UPF on total greenhouse gas emissions (GHGE), water and ecological footprints in Brazil food purchases. Methods We have used data from 4 Brazilian Household Budget Surveys (1987, 1996, 2003, 2009). Each food item was classified into NOVA food groups (unprocessed/minimally processed, culinary ingredients, processed and ultra-processed). The information was linked to nutrition and footprint data. Purchases were converted into grams per capita per day to estimate total energy (kcal), percentage of energy from UPF, as well as total GHGE, water and ecological footprints. We performed linear regression to calculate year-adjusted means of footprints per 1000 Kcal by year-specific quintiles of UPF participation in the total energy. The data were analysed in R v.3.6.1 and STATA SE 14.1. Results The mean UPF participation in total energy varied from 13% (SD 2.4) in the 1st UPF quintile to 29% (SD 5.1) in the 5th quintile. The footprints increased linearly across quintiles: the mean g CO2eq varied from 1312 in the 1st to 1721 in the 5th UPF quintile (p-trend<0.001); the mean litres of water varied from 1420 in the 1st to 1830 in the 5th quintile (p-trend<0.001); the mean m2 varied from 9.4 in the 1st to 12.3 in the 5th quintile (p < 0.001). Conclusions The environmental impacts were higher for Brazilian diets with a larger fraction of energy from UPF. Specifically, low UPF diets seem to have lower GHGE, water and ecological footprints. Our findings offer new motivators for dietary change to simultaneously healthier and more sustainable eating patterns and will be of relevance to consumers and policymakers. Key messages Diets high in UPF cause more climate impact than diets with lower levels of UPF. Healthy and sustainable dietary patterns should be low in ultra-processed foods.

Does education reduce gender differentials in labor market participation? A Kenyan perspective

AbstractThe paper examines the role of education in reducing gender differentials in the Kenyan labor market. Using 2015/16 Kenya Integrated Household Budget Survey, we estimate the logit and multinomial logit model. The paper employs instrumental variable technique to correct for potential endogeneity that arises when analyzing education and labor market outcomes. The results from both models show that being a woman reduces the chances of entering the labor market. We find that education yields positive effects in the labor market. On average, the difference between the marginal effect of education on employment probability between men and women is two percentage points, with the effect being higher for women. In the multinomial logit model, educated women are more likely to be employed in both the public sector and the informal sector, while in the private sector they are less likely to be employed. The implication of these findings is that policies should target education as a tool that can reduce gender differential in the labor market. This should be coupled with affirmative action that gives priority to women and minimizes preference for men in the labor market.

Financial protection against out-of-pocket health expenditure in Poland

Abstract Background Protecting people against financial hardship associated with using health care, is crucial for achieving universal health coverage. Despite the significant improvement happening in the last two decades, household out-of-pocket payments in Poland account for 23% of current spending on health, which is more than in many European Union countries. This implies an incased risk of financial hardship for Polish households. Methods The aim of this study was to assess the extent to which people in Poland experience financial hardship when they use health services. The analysis draws on household budget survey data collected annually by the Central Statistical Office of Poland between 2005 and 2014. It focuses on two indicators of financial protection: catastrophic health spending and impoverishing health spending. The study is a part of WHO country-based studies generating new evidence on financial protection in European health systems. Results In 2014, 8.6% of Polish households experienced catastrophic health spending, while 3.8% of households were impoverished or further impoverished due to health spending. Financial hardship is heavily concentrated among the poorest households for whom the incidence of catastrophic spending is 30%. Outpatient medicines are the largest single driver of catastrophic health spending across all consumption quintiles except the richest. For the richest households, payments for medical products and dental care are the main causes of financial hardship. Although financial protection improved between 2005 and 2014, the improvement among the poorest was marginal. Conclusions Policy attention should focus on protecting households against high spending on outpatient medicines, e.g. revising patient cost-sharing for prescribed medicines and strengthen regulation for over-the-counter medicines. The protection mechanisms should be targeted at low-income households (people living on social benefits, disability or survivor's pensioners). Key messages Financial protection is fairly weak in Poland compared to many European Union countries. Out-of-pocket payments for medicines (prescribed and over-the-counter) are the main cause of financial hardship for Polish households.

Tobacco price elasticity in Serbia: evidence from a middle-income country with high prevalence and low tobacco prices.

In this paper, we use Deaton's demand model and Household Budget Survey data from 2006 to 2017 to provide a first robust and reliable estimate of cigarettes price elasticity for Serbia. The case of Serbia is particularly interesting and important as it provides evidence for a country in which tobacco market is characterised by the high tobacco consumption, low prices and large perceived impact of multinational tobacco companies on public revenues, export and employment, given their considerable cigarette production in Serbia. The price elasticity of cigarettes is estimated at -0.639, in line with the previous estimates for the low-income and middle-income countries. Estimated negative cigarettes price elasticity for Serbia suggests that tobacco tax policy could be used effectively to reduce cigarette consumption in Serbia, which could lower the harmful health effects of cigarettes. Furthermore, a calculation based on the estimated elasticity suggests that increasing tobacco taxes could also have positive fiscal effects, as the expected revenue from the taxes would increase.

Price elasticity of demand for cigarettes in Bosnia and Herzegovina: microdata analysis

BackgroundBosnia and Herzegovina (B&H) is among the top 10 countries in the world in terms of number of smokers. The cigarette prices in B&H are under a direct impact of...

Accelerating progress on effective tobacco tax policies in Montenegro.

The objective of this study is to estimate the sensitivity of cigarette quantity demanded to price and income changes in Montenegro. The sensitivity of cigarette quantity demanded to price and income changes was estimated using micro and macro analysis. Micro analysis implied the use of Deaton's model on Household Budget Survey data (2006-2017). In macro analysis, conventional static demand model is applied using error correction and autoregressive distributed lag time series methodology on annual time series aggregated data (2001-2017). The same results were obtained using micro and macro analysis which contributes to the objectivity of the conducted research. Results derived from the Deaton's model indicate a negative price elasticity of cigarettes in the range between -0.62 and -0.80 (conditional and unconditional), while in macro model estimated price elasticity is in that range and equals -0.68. Simulation results confirm the efficiency of excise tax policy changes, having an evident decrease in consumption and increase of public revenues. Analysis of the tobacco market and regulatory environment suggests that the increase of excise and other taxes on tobacco have an important direct impact on the reduction of cigarettes and other tobacco products consumption. Our estimates of long and short-run price elasticity show that direct impact is strong and very much in accordance with the results obtained so far for other low-income and middle-income countries. This paper gives a contribution to the analysis of price elasticity of demand for cigarettes, which was for the first time conducted in Montenegro.

Small area estimation of expenditure means and ratios under a unit-level bivariate linear mixed model

Under a unit-level bivariate linear mixed model, this paper introduces small area predictors of expenditure means and ratios, and derives approximations and estimators of the corresponding mean squared errors. For the considered model, the REML estimation method is implemented. Several simulation experiments, designed to analyze the behavior of the introduced fitting algorithm, predictors and mean squared error estimators, are carried out. An application to real data from the Spanish household budget survey illustrates the behavior of the proposed statistical methodology. The target is the estimation of means of food and non-food household annual expenditures and of ratios of food household expenditures by Spanish provinces.

Impact of the economic crisis on household health expenditure in Greece: an interrupted time series analysis

Objectives and settingThe 2008 financial crisis had a particularly severe impact on Greece. To contain spending, the government capped public health expenditure and introduced increased cost-sharing. The Greek case is...

Mycotoxins in cereals and cereal-based products: Incidence and probabilistic dietary risk assessment for the Brazilian population

A probabilistic dietary risk assessment on mycotoxins was conducted using the Monte Carlo Risk Assessment software, with consumption data from the 2008/2009 Brazilian Household Budget Survey for individuals who were at least 10 years old and occurrence data for 646 samples of rice, maize, wheat, and their products, collected in the Federal District and in the state of Rio Grande do Sul, Brazil. Processing factors were estimated and applied to concentration data. Chronic exposure was estimated for fumonisins (free and bound/hidden), deoxynivalenol (DON) (including the acetylated forms) and zearalenone (ZON) (including alfa-zearalenol) and acute exposure was estimated for DON. For the general population, the chronic exposure exceeded the safe exposure levels at the 95P for DON and at the 99P for fumonisins. Additionally, safe level exceedance occurred at the 97.5P for fumonisins and at the 95P for DON for teenagers, as well as at the 99P for fumonisins for women of child-bearing-age. No exceedances were found for chronic exposure to ZON and acute exposure to DON. Maize couscous contributed most of the total fumonisins (91%) and ZON intakes (~40%) and bread to total intake of DON (~30%). Further studies should be conducted with updated Brazilian consumption data, which should include information for individuals aged less than 10 years old.

Empirical Analysis of Livelihood Strategies and Food Insecurity in Turkana County, Kenya

The pastoral communities of Turkana in northern Kenya have for ages satisfied their economic, social, and cultural needs through nomadic pastoralism. But due to increasing frequency of drought and market shocks, the ability of age-old strategies to shield these pastoralists from poverty and food insecurity has declined. With only livestock and social capital as the main assets in a communal property regime, it is not clear which of the various livelihood strategies that these pastoralists pursue can shield households from drought and market shocks. This study investigates livelihood strategies as pursued by pastoralists in Turkana County with a view to identify strategies that can effectively shield households from shocks. Data for the study is sourced from the Kenya Integrated Household Budget Survey (KIHBS) 2005/06. Available literature is used to identify livelihood strategies in Turkana, while the KIHBS data is used to establish the population of people pursuing each strategy. Anova and Bonferroni tests give evidence of the existence of four livelihood strategies using food expenditure ratio as the categorizing variable. Multinomial logit regression is used to analyse the determinants of livelihood strategies. Findings, though not conclusive, suggest correlation between food insecurity and livelihood strategy. Policies that target to influence livelihood strategies may have implications on food security in Turkana, even though further analysis is required to confirm the association.

The impact of the guaranteed minimum income on its beneficiaries

The means-tested social benefits provided in Romania are guaranteed minimum income, family support allowance, and heating aid. In this paper, we focus on the allocation of the guaranteed minimum income and their impact on the beneficiaries. Using data from Family Household Budget Survey 2016 we describe the profile of the beneficiaries, and we analyze the extent to which guaranteed minimum income beneficiaries continue to be in situations such as severe material deprivation, and relative poverty after social transfers. The results show that most beneficiaries are in severe material deprivation, with more than half of them deprived of food and new clothes. Also, the guaranteed minimum income manages to lift only 2% out of relative monetary poverty.

Kadınların İşgücüne Katılımında Gelir Etkisi: Türkiye Örneği

Bu çalışmada, TÜİK hane halkı bütçe anketlerinden yararlanılarak kadınların işgücüne katılımını belirleyen faktörler araştırılmaktadır. Bebek sahipliği, eğitim durumu, yaş ve hane geliri değişkenleri kullanılarak probit model tahmincileri elde edilmektedir. İktisat teorisinden bilindiği gibi, işgücüne katılım-boş zaman arasındaki bireysel tercihler gelir ve ikame etkisi üzerinden belirlenmektedir. Gelir etkisini tahmininde, “toplam hanenin geliri” değişkeninin kullanılması, ekonometrik açıdan içsellik problemine yol açmaktadır. Bu çerçevede çalışmada geleneksel probit modellerine ek olarak, araç değişken tekniği üzerinden kurulan probit modeli tahmincileri elde edilmektedir. Kadınların işgücüne katılımı üzerinde; bebek sahipliği, yaş ve hane gelirin etkisi negatif iken üniversite mezuniyetinin etkisi pozitiftir.