Burden For Households Research Articles

Costs and barriers faced by households seeking malaria treatment in the Upper River Region, The Gambia

BackgroundMalaria transmission in The Gambia decreased substantially over the last 20 years thanks to the scale-up of control interventions. However, malaria prevalence is still relatively high in eastern Gambia and represents both a health and a financial burden for households. This study aims to quantify the out-of-pocket costs and productivity losses of seeking malaria treatment at household level.MethodsA household survey was carried out through in-person interviews. Respondents were asked about malaria prevention methods, their treatment-seeking behaviour, and any costs incurred for transport, services, food, and/or overnight stays. A bottom-up costing approach was used to calculate the unit cost of treatment and a tobit regression approach to investigate cost drivers.ResultsThe survey included 864 respondents, mainly subsistence farmers. Most respondents (87%) considered malaria to be a problem affecting their ability to perform their regular duties. Respondents preferred going to a health facility for treatment. The primary reason for not going was related to costs; 70% of respondents incurred costs for seeking health care, with a median of £3.62 (IQR: £1.73 to £6.10). The primary driver of cost was living in one of the villages that are off the main road and/or far from health facilities. 66% reported productivity loss of 5 working days on average during a malaria episode of them or their child.ConclusionsAlthough malaria prevalence is decreasing and treatment is provided free of charge, households seeking treatment are confronted with out-of-pocket expenditures and lost working days; particularly in remote villages.

Financial burden of households on the treatment of malaria in Southern Nigeria

The number of deaths attributed to malaria is highest in Nigeria when compared with other countries of the world. This study estimated the monetary expenditure of households in Southern Nigeria in the treatment of malaria as well as the income forgone as a result of incapacitation due to the ailment. The study employed the cost-of-illness approach to estimate the financial burden of malaria treatment using the data contained in the Harmonized National Living Standard Survey (HNLSS) 2010. The results show that more cases of malaria were reported among children aged under-five while immunity increases with age up till age 45. Females, farming households and rural residents were also more vulnerable than their respective counterparts. The pattern of the distribution of direct and indirect cost was mixed across the three zones in the study area. Malaria poses both health and financial challenges to households. The financial burden of malaria is too high for a country like Nigeria whose majority of her citizens wallow in poverty. It is therefore recommended that the drug subsidy policy of government should be reviewed in order to increase the awareness of the public of its availability at subsidized rate. Massive public education on the importance of prevention as against treatment as well as the importance of seeking prompt treatment will also go a long way in ameliorating the indirect burden of malaria which forms a larger proportion of the total burden of malaria to households.

Estimating the effectiveness of national health insurance in covering catastrophic health expenditure: Evidence from South Korea.

The catastrophic health expenditure (CHE) indicator has been used to measure the medical cost burden of households. Many countries have institutionalized their health insurance systems to reduce out-of-pocket payments, the main contributor to the financial burden. However, there is no method to estimate how the insurance coverage reduces the CHE. This study proposes an approach to evaluate the effectiveness of insurance in reducing the CHE impacts in terms of incidence and gap, which are based on a modified calculation method of CHE. Additionally, we apply these methods to data from the Korea Health Panel Survey (2011-2016). The results are as follows. First, under the setting of a threshold of 10%, the CHE incidence rate was 19.26% when the Korean national health insurance benefits reduced the CHE's incidence for 15.17% of the population in 2017. Second, the results of the concentration index of CHE showed that the intensity approach of CHE is better than the incidence approach. Third, the new approach we applied revealed that health insurance reduces the burden of CHE to some degree, although it was not an efficient way to reduce CHE. In conclusion, this study provides new policy approaches to save the finances of national health insurance and reduce the intensity of CHE at the same time by raising the low-cost burden of medical services and lowering that of high cost. Moreover, we suggest that policymakers should focus on income level of the households rather than specific diseases.

Carbon pricing in Germany's road transport and housing sector: Options for reimbursing carbon revenues

In 2021, Germany launched a national emissions trading system (ETS) in its road transport and housing sectors that increases the cost burden of consumers of fossil fuels, the major source of carbon dioxide (CO2) emissions. A promising approach to secure public acceptance for such a carbon pricing would be to entirely reallocate the resulting “carbon” revenues to consumers. This article discusses three alternatives that were discussed in the political arena prior to the introduction of the national carbon pricing: a) a per-capita reallocation to private households, b) the reduction of electricity prices by, e.g., decreasing the electricity tax, as well as c) targeted financial aid for vulnerable consumers, such as increasing housing benefits. To estimate both the revenues originating from carbon pricing and the resulting emission savings, we employ a partial equilibrium approach that is based on price elasticity estimates on individual fossil fuel consumption from the empirical literature. Most effective with respect to alleviating the burden of poor households would be increasing housing benefits. While this measure would not require large monetary resources, we argue that the remaining revenues should be preferably employed to reduce Germany's electricity tax, which becomes more and more obsolete given the steadily increasing amount of electricity generated by renewable energy technologies.

Women’s Vulnerability and State Responsibility in China’s Family-planning Policy

Reproductive vulnerability is a pervasive social issue that requires efforts from multiple government departments and social groups to solve. However, China has traditionally focused on the reproduction function of the family and marginalized women's reproductive autonomy and related rights. Based on the overview of the existing literature, we have a better understanding of the fertility experience of Chinese women when facing the fertility policy, focusing on their continued harm, neglect and vulnerability during the process of changes in the fertility policy. Through research, we can not only analyze the work-family dilemma that women have been in for a long time but also an in-depth analysis of low fertility intentions of Chinese women under the pronatalism policy. The vulnerability of Chinese women to childbearing is caused by the following factors: women’s socio-economic status, the concept of marriage and childbirth in society, the control of the national fertility policy, and the availability of fertility support system arrangements. We suggest the amendment of the family-planning policy should be accompanied by a series of arrangements for family support, such as establishing a reproduction-friendly environment, promoting social gender consciousness in all aspects, reducing women's household burden, and actively eliminating gender discrimination in the workplace. Then, women's reproductive vulnerability can be mitigated, and the gender structure can be balanced.

Energy insecurity and community resilience: The experiences of Bedouins in Southern Israel

Energy insecurity has been recognized as a global social and public health challenge. Availability of and accessibility to energy infrastructure is a core element of community resilience—a concept that characterizes a community’s ability to promote health and well-being, and to cope with and recover from adversity. We conducted a quantitative survey in order to explore the interplay between these two experiences among residents of two types of Bedouin communities in Southern Israel: townships and informal settlements, which differ in their accessibility to energy infrastructure. We report a significant negative association between experiences of energy insecurity and perceived community resilience, especially with regard to trust in leadership and emergency preparedness. This indicates that energy insecurity is not only a personal or a household burden, but rather an issue that has broader communal and social aspects (and consequences) –one that should be tackled at the local and municipal levels. Our study deepens the current understanding of the processes and factors that may promote or impede community resilience and health by establishing a clear link between place-related physical and perceptual resources.

The household water insecurity nexus: Portraits of hardship and resilience in U.S-Mexico border colonias

This article contributes to the growing body of research examining the complex experiences of water insecurity in low-income households in the global north. I present a schematic, and evidence to support it, for a household water-insecurity nexus in U.S-Mexico border colonias, according to which water insecurity brings forth, influences, and interacts with a number of household burdens. Drawing from eight months of field research in communities that lack connections to piped water and sewerage, I rely on ethnographic portraiture to demonstrate how water insecurity at the household level exacerbates an array of hardships experienced by low-income families. These hardships relate to household budgets, health, time, and stress. In conversation with other qualitative case studies presented in the fields of geography, anthropology, and sociology, I argue that household water insecurity is both patterned, in that it influences many hardships beyond just quality and supply, and particular, in that each site experiences hardships that are unique to contexts such as culture, geography, and ecology. I contend that a comprehensive view of water insecurity’s many negative ramifications within low-income households strengthens arguments for the basic human right to water, making them more urgent, and bringing them into sharper relief.

THE IMPACT OF DEBT-SERVICING BURDEN ON HOUSEHOLD EXPENDITURE IN NIGERIA: A CASE OF EKITI STATE SENATORIAL DISTRICTS

This study employs binary logistic regression technique to explore the impact of household debt-servicing burden on expenditure patterns in South-West geo-political region of Nigeria, using Ekiti State as a case study. Questionnaires were randomly distributed to 2500 households, and the results unveil that households with high income, large family-size and heads within the age group (40 and above) were more susceptible to debtburden. In addition, the paper highlighted that indebtedness compromises the quality of nutrition and health status of household members. Based on the above findings, we conclude that high indebtedness and debt burden trajectories cause deleterious effects on household consumption patterns and overall economic well-being. Thus, household heads should inculcate fiscal discipline which promotes saving culture and averts future shocks that could emanate from precautionary demands. Second, debt providers should regulate loans in cognizance to household repayment capacity and other stipulated policies which break the vicious cycle arising from over-indebtedness, install stability and spur economic development.

Gender Differences in Work–Life Integration Among Medical Physicists

PurposeTo generate an understanding of the primary concerns facing medical physicists regarding integration of a demanding technical career with their personal lives. Methods and MaterialsIn 2019, we recruited 32 medical physics residents, faculty, and staff via emails to US medical physics residency program directors to participate in a 1-hour, semistructured interview that elicited their thoughts on several topics, including work–life integration. Standard techniques of qualitative thematic analysis were used to generate the research findings. ResultsOf the participants, 50% were women and 69% were non-Hispanic White individuals, with a mean (SD) age of 37.5 (7.4) years. They were evenly split between residents and faculty or staff. Participant responses centered around 5 primary themes: the gendered distribution of household responsibilities, the effect of career or work on home and family life, the effect of family on career or work, support and strategies for reconciling work–life conflicts, and the role of professional societies in addressing work–life integration. Participants expressed concern about the effect of heavy workloads on home life, with female respondents more likely to report carrying the majority of the household burden. ConclusionsMedical physicists experience challenges in managing work–life conflict amid a diverse array of personal and professional responsibilities. Further investigations are needed to quantitatively assess the division of work and household labor by gender in medical physics, particularly after the outbreak of the COVID-19 pandemic, but this study's qualitative findings suggest that the profession should consider ways to address root causes of work–life conflict to promote the future success and well-being of all medical physicists, and perhaps women in particular.

Changing the eligibility criteria for welfare payments at the end of life \u2013 a budget impact analysis for England and Wales

BackgroundTerminal illness can cause a financial burden for many households. In England and Wales, fast-track access to welfare payments is available through special rules for the terminally ill (SRTI). Individuals are eligible for SRTI if they are judged to have 6 months or less to live. This criterion has been criticised as lacking a clinical basis, and being unfair for people with conditions where life-expectancy is difficult to accurately assess.AimTo conduct a budget impact analysis on the possible increase in expenditure of personal independence payments (PIP) following a change in England and Wales to SRTI so that everyone with a terminal illness is eligible.MethodsThe fraction of individuals with a given long-term condition was estimated by combining data from the Health Survey for England, the Office for National Statistics (ONS) and the Department for Work and Pensions. Logistic growth modelling and ONS population projections were used to project PIP expenditure from 2020 to 2025. The increased expenditure was calculated for hypothetical scenarios which may occur following an SRTI regime change, specifically an increase of 1, 2 and 3 percentage points in the fraction of individuals claiming PIP under SRTI. Data from the literature on the projected prevalence of mild, moderate and severe dementia was used to calculate the cost if everyone with a given severity of dementia claimed PIP under SRTI.ResultsUnder the current SRTI regime, PIP expenditure under SRTI was projected to increase from £0.231bn in 2020 to £0.260bn in 2025, compared to equivalent figures of £11.1bn and £12.7bn under non-SRTI. Expenditure in 2025 following an increase in the fraction claiming of 1, 2 and 3 percentage points was projected to be £1.1bn, £1.9bn and £2.7bn respectively. In 2025, PIP expenditure was estimated to be £7.4bn if everyone with dementia claimed under SRTI, compared to £6.4bn if only individuals with moderate and severe dementia claimed, and £4.7bn if only individuals with severe dementia claimed.ConclusionChanges in SRTI are projected to lead to increases in PIP expenditure. However, the increased cost is small compared to expenditure under non-SRTI, especially as the highest costs were associated with extreme scenarios.

Fiscal Implications for Rural-Urban Income Inequality: The Case of Pakistan

Purpose: This study investigates the fiscal implications through taxes and total expenditures for rural-urban income inequality in Pakistan. Fiscal policy plays a significant role in stabilizing the macroeconomics variables and equal distribution of income among society. Pakistan is a good case study because there is a dual rural-urban sector that emerges with industrial development and other traditional rural agriculture-based regions. Design/Methodology/Approach: We use time series data (1985-2018) with autoregressive distributed lag models (ARDL) for long-run and error correction models (ECM) for short span dynamic co-integration. The above models try to capture the practical effect of fiscal progress on income distribution among modern urban and traditional rural regions. Findings: The findings show that tax side fiscal measures are more harmful to rural-urban income distribution. On the expenditure side, fiscal policy has a significant impact on all disburse income distribution. The most surprising results belong to trade liberalization, it has significantly improved income distribution in urban areas but not in the rurals. Financial development has also verified the accumulation of wealth among rural-urban areas because of the emergence of private profiteering groups in Pakistan. Practical Implications: For policy purposes the government of Pakistan should spend on improving the quality of life of the households by investing in social goods like health, education, and foundation inequality situation may be better off. The nature of public spending and who gains the benefits from this spending decide the nature of inequality. On the supply side, the government should reduce the tax burden for rural households. Originality/Value: The results of the study may improve the rural income distribution if they used properly.

Profiling household double and triple burden of malnutrition in sub-Saharan Africa: prevalence and influencing household factors.

Undernutrition and anaemia (the commonest micronutrient deficiency), continue to remain prevalent and persistent in sub-Saharan Africa (SSA) alongside a rising prevalence of overweight and obesity. However, there has been little research on the co-existence of all three conditions in the same household in recent years. The current study examines the co-existence and correlates of the different conditions of household burden of malnutrition in the same household across SSA. The study involved twenty-three countries across SSA who conducted Demographic and Health Surveys between 2008 and 2017. The analytical sample includes 145 020 households with valid data on the nutritional status of women and children pairs (i.e. women of reproductive age; 15-49 years and children under 5 years). Logistic regression analyses were used to determine household correlates of household burden of malnutrition. Anaemia was the most common form of household burden of malnutrition, affecting about seven out of ten households. Double and triple burden of malnutrition, though less common, was also found to be present in 8 and 5 % of the households, respectively. The age of the household head, location of the household, access to improved toilet facilities and household wealth status were found to be associated with various conditions of household burden of malnutrition. The findings of the current study reveal that both double and triple burden of malnutrition is of public health concern in SSA, thus nutrition and health interventions in SSA must not be skewed towards addressing undernutrition only but also address overweight/obesity and anaemia.

Household debt, automatic bill payments and inattention: Theory and evidence

• We analyze the impact of using automatic bill payments on household debt. • An intertemporal consumption model with inattention effect was developed. • Automatic payments would increase debt and could cause well-being loss due to inattention. • Empirical evidence is found for Chilean households. In this article we analyze the impact of automatic bill payment (ABP) on household debt. We present a theoretical intertemporal consumption model that shows an inattention effect when individuals subscribe an ABP for their debts. This effect causes a higher level of indebtedness (beyond optimal) and, therefore, well-being loss. Furthermore, we empirically test this theory for Chile, an emerging economy. We estimate a Tobit-Probit conditional mixed process (CMP) model, using data from the Central Bank of Chile’s Household Financial Survey (HFS). The results confirm the existence of a positive and significant effect of the use of ABP on the financial burden of households.

Estimation of Potential Economic Losses Due to Flooding Considering Variations of Spatial Distribution of Houses and Firms in a City

In Japan, flood disasters caused by record-breaking heavy rainfall frequently cause significant damages. It is also great concern that heavy rainfall may increase and occur more frequently due to global warming. In July 2013, a heavy rainfall event caused record-flooding of the Kakehashi River in Ishikawa Prefecture. In this study, pseudo global warming (PGW) experiments were implemented for the heavy rainfall in 1998 and 2013 around the Kakehashi River basin. Based on the results of PGW simulations, rainfall with different return periods were generated. Runoff analyses and inundation simulations were carried out by forcings with multiple return periods, and the results were used to estimate the economic losses due to flood inundation. Expected values of the economic losses were calculated using two methods for multiple return periods. Differences between the two expected values indicates the importance of the weighting method for the result of each return period. In addition, variations of spatial distribution of houses and firms in a city (i.e., urban structure) were simulated using a computable urban economics (CUE) model for the area of middle-lower reach of the Kakehashi River basin to examine its impact on economic loss due to flooding. In the simulation using the CUE model, a more severe flood inundation risk and an additional insurance burden for general households were added, and possible variations of urban structure were estimated around the lower part of the Kakehashi River basin. Under the more severe risk condition, relocation proceeded from higher risk areas to safer areas, and possible economic losses decreased in the target area. This result indicates that proper recognition of risk can reduce flood damages. On the other hand, there were small variations in economic losses under the condition with the additional flood insurance burden.

Will Women’s Careers in Medicine Be Another COVID-19 Casualty?

Many of the accommodations made in response to the COVID-19 pandemic have largely been born by women. Essential healthcare workers are no exception. We are asking women in the medical field to fight a pandemic, while also taking on more of the burden of household and child education duties than their male counterparts. It is likely that this will influence women's careers and could have major effects on our healthcare system. Now is the critical time to demonstrate that we believe women are essential to the field of medicine and our response to the pandemic should consider these realities.

Housing Cost Burden, Material Hardship, and Well-Being

ABSTRACT Millions of households face housing affordability problems as house prices and rents rise faster than incomes. Yet little is known about how high housing expenditures affect well-being. Using data from the Survey of Income and Program Participation, we examine the relationship between housing cost burden, material hardship, and residential satisfaction after the Great Recession. We find that households with higher housing cost burdens were more likely to experience some form of material hardship, controlling for other variables. The probability of material hardship increased with cost burden for households spending up to 50% of their income on housing. However, households that spend more than half of their income on housing are no more likely to experience material hardship than households who spend around 50%. We find some evidence that families with children trade high housing costs for improvements in housing conditions. The findings provide empirical support for using housing cost burden as a measure of affordability and suggest higher housing cost burdens may contribute to decreased well-being through multiple forms of material hardship but also may have threshold effects.

Does Ghana's National Health Insurance Scheme provide financial protection to tuberculosis patients and their households?

Financial barriers are a key limitation to accessing health services, such as tuberculosis (TB) care in resource-poor settings. In Ghana, the National Health Insurance Scheme (NHIS), established in 2003, officially offers free TB care to those enrolled. Using data from the first Ghana's national TB patient cost survey, we address two key questions 1) what are the key determinants of costs and affordability for TB-affected households, and 2) what would be the impact on costs for TB-affected households of expanding NHIS to all TB patients?We reported the level of direct and indirect costs, the proportion of TB-affected households experiencing catastrophic costs (defined as total TB-related costs, i.e., direct and indirect, exceeding 20% of their estimated pre-diagnosis annual household income), and potential determinants of costs, stratified by insurance status. Regression models were used to determine drivers of costs and affordability. The effect of enrolment into NHIS on costs was investigated through Inverse Probability of Treatment Weighting Analysis.Higher levels of education and income, a bigger household size and an multi-drug resistant TB diagnosis were associated with higher direct costs. Being in a low wealth quintile, living in an urban setting, losing one's job and having MDR-TB increased the odds of experiencing catastrophic costs. There was no evidence to suggest that enrolment in NHIS defrayed medical, non-medical, or total costs, nor mitigated income loss. Even if we expanded NHIS to all TB patients, the analyses suggest no evidence for any impact of insurance on medical cost, income loss, or total cost.An expansion of the NHIS programme will not relieve the financial burden for TB-affected households. Social protection schemes require enhancement if they are to protect TB patients from financial catastrophe.

The Burden of Social Connectedness: Do Escalating Gift Expenditures Make You Happy?

Gift expenses escalated in China in the last decades with rapid economic growth and account for a substantial share of household expenditures. Rising gift expenses signal good friendships and facilitate reciprocity, which may enhance one’s subjective wellbeing. However, increasing gift giving may also exacerbate the financial burden of households and thus has adverse welfare implications. This study examines how escalating gift expenses impact individuals’ subjective happiness by using data from the China Family Panel Studies. Findings suggest that an increase in the ratio of gift expenses to household income can significantly decrease one’s subjective happiness by crowding out other consumption items and harming psychological health. Overall, this study offers new insights into informal social networks maintained by gift giving, which may adversely affect household welfare.

Combustible costs! financial implications of flammable cladding for homeowners

More than 3400 residential apartment buildings around Australia have flammable cladding. The costs to rectify this defect fall onto homeowners. However, there is limited information about what the costs and implications are for homeowners. This paper identifies through interviews of 16 affected homeowners from Australia the different financial costs involved in rectifying flammable cladding. A range of financial implications were revealed including: increasing levies, body corporation fees, insurance rates, council rates, legal fees, material testing, inspections, other fire strategy defects and extra fire engines responding to alarms. Future costs included fines for non-compliance, loss of property value and the rectification work. The quoted costs of rectification work ranged from A$30,000 to A$12,000,000, depending on the scope of works required but this does not factor in those broader costs identified. The costs associated with cladding rectification have created significant financial burdens for households and influenced life decisions related to finances. The identification of the different types of costs could be used as a framework to quantify the costs to homeowners in further research. This would measure the costs as cladding rectification works are undertaken, in order to provide improved support to these households, not only in Australia but other impacted locations.

Mitigating poverty through solar panels adoption in developing economies

AbstractMotivated by a widely practiced strategy to combine the growth of the solar energy sector with poverty mitigation, we propose stylized models of households selling extra solar energy back to the grid, which generates a steady stream of income to overcome adoption barriers for solar panels, that is, high adoption cost and generation variability. By considering households' strategic consumption shifting behavior in response to varying intertemporal market electricity prices, we have presented the equilibrium adoption number and households' equilibrium profit. We have also demonstrated the government's optimal subsidy to reach a socially optimal adoption level. Furthermore, we investigate the popular Public Private Partnership (PPP) model in developing countries to promote the investment of solar panels. Under the PPP program, the private firms share both upfront cost and electricity revenue with households, while the government may provide subsidy to further encourage adoption. Despite the popularity of the PPP scheme, our model documents an unexpected negative implication by inducing a lower overall adoption level than the traditional scheme: As the PPP scheme relieves budgetary burden of households in adopting solar panels (infrastructure cost), anticipating the long‐term revenue loss, they are less likely to participate in the first place. However, combined with the government intervention via adoption subsidy, the PPP scheme can lead to a win‐win solution for all.