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Wang QS, Hua YF, Tao R, Moldovan NC. Can Health Human Capital Help the Sub-Saharan Africa Out of the Poverty Trap? An ARDL Model Approach. Front Public Health 2021; 9:697826. [PMID: 34178934 PMCID: PMC8222539 DOI: 10.3389/fpubh.2021.697826] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 04/30/2021] [Indexed: 11/24/2022] Open
Abstract
This article explores the impact of health human capital on the poverty trap in Sub-Saharan Africa by autoregressive distribution lag model. In the long run, there is no evidence that health human capital can help the Sahara out of the poverty trap. While health human capital has a significant effect on poverty reduction in the short term. There is a threshold effect in the poverty reduction model of healthy human capital. When the economic development level reaches the threshold, the effect of poverty reduction is more obvious and deeper. The extended Solow economic growth model also proved that if the external human capital breaks through the threshold, it can make developing countries get rid of the poverty trap. Therefore, the economic development brought about by health care expenditure must benefit the poor in Sub-Saharan Africa and allow them to enjoy the welfare of social security.
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Affiliation(s)
- Qiu-Su Wang
- School of Economics, Qingdao University, Qingdao, China
| | - Yu-Fei Hua
- School of Economics, Qingdao University, Qingdao, China
| | - Ran Tao
- Qingdao Municipal Center for Disease Control & Preventation, Qingdao, China
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Downward P, Rasciute S, Kumar H. Health, subjective financial situation and well-being: a longitudinal observational study. Health Qual Life Outcomes 2020; 18:203. [PMID: 32590985 PMCID: PMC7318449 DOI: 10.1186/s12955-020-01456-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 06/19/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND An individual's financial situation is a key contributor to their overall well-being. Existing research has examined the direct economic consequences of changes in health upon out-of-pocket healthcare expenditure, participation in the labour force and potential earnings. There is also research exploring an individual's concern about their subjective financial situation regardless of the level of their income or work status on their health. In contrast, this paper conducts a causal analysis of the effects of general and mental health on an individual's subjective evaluation of their financial situation controlling for their work status and income. This is of importance because current health policy in the United Kingdom (UK) stresses the role of health as an asset which can mediate the wider flourishing of individuals. Moreover, subjective financial situation comprises a key component of well-being now being measured and sought in social welfare policy. METHODS Fixed effects instrumental variable panel data regression analysis is applied to 25 years of longitudinal data, from 1991, drawn from the harmonised British Household Panel Survey (BHPS) and Understanding Society Survey (USS). RESULTS Improved general health and reduced mental illness both improve the subjective financial situation of males and females. However, these affects diminish across older cohorts of males and females. CONCLUSIONS Investing in and improving general and mental health can improve the subjective financial situation and hence well-being of individuals. The targeting of health also needs to take account of an individuals' life-stage.
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Affiliation(s)
- Paul Downward
- School of Sport, Exercise and Health Sciences, Loughborough University, Ashby Road, Loughborough, LE11 3TU, UK.
| | - Simona Rasciute
- School of Business and Economics, Loughborough University, Ashby Road, Loughborough, LE11 3TU, UK
| | - Harish Kumar
- School of Sport, Exercise and Health Sciences, Loughborough University, Ashby Road, Loughborough, LE11 3TU, UK
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The Association between Stressful Events and Food Insecurity: Cross-Sectional Evidence from Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112333. [PMID: 30360491 PMCID: PMC6266169 DOI: 10.3390/ijerph15112333] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/05/2018] [Accepted: 10/17/2018] [Indexed: 11/17/2022]
Abstract
A considerable body of empirical evidence exists on the demographic and socio-economic correlates of food insecurity in Australia. An important omission from recent studies, however, is an understanding of the role of stressful life events, or stressors in explaining exposure to food insecurity. Using nationally representative data from the 2014 General Social Survey and multivariable logistic regression, this paper reports on the association between 18 discrete stressors and the likelihood of reporting food insecurity in Australia. The results, adjusted for known correlates of food insecurity and complex survey design, show that exposure to stressors significantly increased the likelihood of experiencing food insecurity. Importantly, stressors related to employment and health approximately doubled the odds of experiencing food insecurity. The results underscore the complex correlates of food insecurity and indicates that conceptually it interacts with many important social and economic problems in contemporary Australia. There is no simple fix to food insecurity and solutions require co-ordination across a range of social and economic policies.
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Callander EJ, Schofield DJ. Psychological distress increases the risk of falling into poverty amongst older Australians: the overlooked costs-of-illness. BMC Psychol 2018; 6:16. [PMID: 29665851 PMCID: PMC5905185 DOI: 10.1186/s40359-018-0230-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 04/06/2018] [Indexed: 11/10/2022] Open
Abstract
Background This paper aimed to identify whether high psychological distress is associated with an increased risk of income and multidimensional poverty amongst older adults in Australia. Methods We undertook longitudinal analysis of the nationally representative Household Income and Labour Dynamics in Australian (HILDA) survey using modified Poisson regression models to estimate the relative risk of falling into income poverty and multidimensional poverty between 2010 and 2012 for males and females, adjusting for age, employment status, place of residence, marital status and housing tenure; and Population Attributable Risk methodology to estimate the proportion of poverty directly attributable to psychological distress, measured by the Kessler 10 scale. Results For males, having high psychological distress increased the risk of falling into income poverty by 1.68 (95% CI: 1.02 to 2.75) and the risk of falling into multidimensional poverty by 3.40 (95% CI: 1.91 to 6.04). For females, there was no significant difference in the risk of falling into income poverty between those with high and low psychological distress (p = 0.1008), however having high psychological distress increased the risk of falling into multidimensional poverty by 2.15 (95% CI: 1.30 to 3.55). Between 2009 and 2012, 8.0% of income poverty cases for people aged 65 and over (95% CI: 7.8% to 8.4%), and 19.5% of multidimensional poverty cases for people aged 65 and over (95% CI: 19.2% to 19.9%) can be attributed to high psychological distress. Conclusions The elevated risk of falling into income and multidimensional poverty has been an overlooked cost of poor mental health.
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Affiliation(s)
- Emily J Callander
- Australian Institute of Tropical Health and Medicine, James Cook University, Building 48, Douglas Campus, Townsville, QLD, 4811, Australia.
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Temple JB, Williams R. Financial well‐being of older Australians with multiple health conditions. Australas J Ageing 2018; 37:127-134. [DOI: 10.1111/ajag.12497] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jeromey B Temple
- Demography and Ageing Unit Melbourne School of Population and Global Health University of Melbourne Melbourne Victoria Australia
| | - Ruth Williams
- Hallmark Ageing Research Initiative Melbourne School of Population and Global Health University of Melbourne Melbourne Victoria Australia
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Callander EJ. Youth labour force absence and chronic health conditions in Australia. Occup Med (Lond) 2018; 68:135-142. [DOI: 10.1093/occmed/kqy011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E J Callander
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
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Callander EJ, Corscadden L, Levesque JF. Out-of-pocket healthcare expenditure and chronic disease - do Australians forgo care because of the cost? Aust J Prim Health 2017; 23:15-22. [PMID: 28442033 DOI: 10.1071/py16005] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 04/23/2016] [Indexed: 11/23/2022]
Abstract
Although we do know that out-of-pocket healthcare expenditure is relatively high in Australia, little is known about what health conditions are associated with the highest out-of-pocket expenditure, and whether the cost of healthcare acts as a barrier to care for people with different chronic conditions. Cross-sectional analysis using linear and logistic regression models applied to the Commonwealth Fund international health policy survey of adults aged 18 years and over was conducted in 2013. Adults with asthma, emphysema and chronic obstructive pulmonary disease (COPD) had 109% higher household out-of-pocket healthcare expenditure than did those with no health condition (95% CI: 50-193%); and adults with depression, anxiety and other mental health conditions had 95% higher household out-of-pocket expenditure (95% CI: 33-187%). People with a chronic condition were also more likely to forego care because of cost. People with depression, anxiety and other mental health conditions had 7.65 times higher odds of skipping healthcare (95% CI: 4.13-14.20), and people with asthma, emphysema and chronic obstructive pulmonary disease had 6.16 times higher odds of skipping healthcare (95% CI: 3.30-11.50) than did people with no health condition. People with chronic health conditions in Canada, the United Kingdom, Germany, France, Norway, Sweden and Switzerland were all significantly less likely to skip healthcare because of cost than were people with a condition in Australia. The out-of-pocket cost of healthcare in Australia acts as a barrier to accessing treatment for people with chronic health conditions, with people with mental health conditions being likely to skip care. Attention should be given to the accessibility and affordability of mental health services in Australia.
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Affiliation(s)
- Emily J Callander
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Qld 4811, Australia
| | - Lisa Corscadden
- Bureau of Health Information, Level 11, 67 Albert Avenue, Chatswood, NSW 2057, Australia
| | - Jean-Frederic Levesque
- Bureau of Health Information, Level 11, 67 Albert Avenue, Chatswood, NSW 2057, Australia
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Callander EJ, Schofield DJ. The risk of falling into poverty after developing heart disease: a survival analysis. BMC Public Health 2016; 16:570. [PMID: 27417645 PMCID: PMC4946172 DOI: 10.1186/s12889-016-3240-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 06/15/2016] [Indexed: 11/29/2022] Open
Abstract
Background Those with a low income are known to have a higher risk of developing heart disease. However, the inverse relationship – falling into income poverty after developing heart disease has not been explored with longitudinal data. This paper aims to determine if those with heart disease have an elevated risk of falling into poverty. Methods Survival analysis was conducted using the longitudinal Household Income and Labour Dynamics in Australia survey, between the years 2007 and 2012. The study focused on the Australian population aged 21 years and over in 2007 who were not already in poverty and did not already have heart disease, who were followed from 2007 to 2012. Cox regression models adjusting for age, sex and time-varying co-variates (marital status, home ownership and remoteness of area of residence) were constructed to assess the risk of falling into poverty. Results For those aged 20 who developed heart disease, the hazard ratio for falling into income poverty was 9.24 (95 % CI: 8.97–9.51) and for falling into multidimensional poverty the hazard ratio was 14.21 (95 % CI: 13.76–14.68); for those aged 40 the hazard ratio for falling into income poverty was 3.45 (95 % CI: 3.39–3.51) and for multidimensional poverty, 5.20 (95 % CI: 5.11–5.29); and for those aged 60 the hazard ratio for falling into income poverty was 1.29 (95 % CI: 1.28–1.30) and for multidimensional poverty, 1.52 (95 % CI: 1.51–1.54), relative those who never developed heart disease. The risk for both income and multidimensional poverty decreases with age up to the age of 70, over which, those who developed heart disease had a reduced risk of poverty. Conclusion For those under the age of 70, developing heart disease is associated with an increased risk of falling into both income poverty and multidimensional poverty.
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Affiliation(s)
- Emily J Callander
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Australia. .,Discipline of Public Health and Tropical Medicine, Building 41, Douglas Campus, Townsville, QLD, 4811, Australia.
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Callander EJ, Schofield DJ. Arthritis and the Risk of Falling Into Poverty: A Survival Analysis Using Australian Data. Arthritis Rheumatol 2016; 68:255-62. [PMID: 26384743 DOI: 10.1002/art.39277] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 07/07/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Low income is known to be associated with having arthritis. However, no longitudinal studies have documented the relationship between developing arthritis and falling into poverty. The purpose of this study was to evaluate Australians who developed arthritis to determine if they had an elevated risk of falling into poverty. METHODS Survival analysis using Cox regression models was applied to nationally representative, longitudinal survey data obtained between January 1, 2007 and December 31, 2012 from Australian adults who were ages 21 years and older in 2007. RESULTS The hazard ratio for falling into income poverty was 1.08 (95% confidence interval [95% CI] 1.06-1.09) in women who were diagnosed as having arthritis and 1.15 (95% CI 1.13-1.16) in men who were diagnosed as having arthritis, as compared to those who were never diagnosed as having arthritis. The hazard ratio for falling into multidimensional poverty was 1.15 (95% CI 1.14-1.17) in women who were diagnosed as having arthritis and 1.88 (95% CI 1.85-1.91) in men who were diagnosed as having arthritis. CONCLUSION Developing arthritis increases the risk of falling into income poverty and multidimensional poverty. The risk of multidimensional poverty is greater than the risk of income poverty. Given the high prevalence of arthritis, the condition is likely an overlooked driver of poverty.
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Callander EJ, Schofield DJ. Multidimensional Poverty and Health Status as a Predictor of Chronic Income Poverty. HEALTH ECONOMICS 2015; 24:1638-1643. [PMID: 25273394 DOI: 10.1002/hec.3112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 08/19/2014] [Accepted: 09/16/2014] [Indexed: 06/03/2023]
Abstract
Longitudinal analysis of Wave 5 to 10 of the nationally representative Household, Income and Labour Dynamics in Australia dataset was undertaken to assess whether multidimensional poverty status can predict chronic income poverty. Of those who were multidimensionally poor (low income plus poor health or poor health and insufficient education attainment) in 2007, and those who were in income poverty only (no other forms of disadvantage) in 2007, a greater proportion of those in multidimensional poverty continued to be in income poverty for the subsequent 5 years through to 2012. People who were multidimensionally poor in 2007 had 2.17 times the odds of being in income poverty each year through to 2012 than those who were in income poverty only in 2005 (95% CI: 1.23-3.83). Multidimensional poverty measures are a useful tool for policymakers to identify target populations for policies aiming to improve equity and reduce chronic disadvantage.
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Affiliation(s)
- Emily J Callander
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia
| | - Deborah J Schofield
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia
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Psychological distress and the increased risk of falling into poverty: a longitudinal study of Australian adults. Soc Psychiatry Psychiatr Epidemiol 2015; 50:1547-56. [PMID: 25994278 DOI: 10.1007/s00127-015-1074-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 05/13/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE To identify whether psychological distress is associated with an increased risk of falling into poverty, giving a more complete picture of how psychological distress affects living standards. METHODS Longitudinal analysis of the nationally representative Household Income and Labour Dynamics in Australian (HILDA) survey using Poisson regression models to estimate relative risk of falling into income poverty and multidimensional poverty between 2007 and 2012. The sample was limited to those who were not already in income poverty in 2007. Psychological distress was identified using the Kessler-10 (K10) scale. RESULTS After adjusting for confounding factors, having moderate psychological distress increased the risk of falling into income poverty by 1.62 (95% CI 1.31-2.01, p < 0.0001) and the risk of falling into multidimensional poverty by 1.85 (95% CI 1.37-2.48, p < 0.0001); having very high psychological distress increased the risk of falling into income poverty by 2.40 (95% CI 1.80-3.20, p < 0.0001) and the risk of falling into multidimensional poverty by 3.68 (95% CI 2.63-5.15, p < 0.0001), compared to those with low psychological distress. Those who did experience income poverty (RR: 1.29, 95% CI 1.04-1.61, p = 0.0210) and those who experienced multidimensional poverty (RR: 1.69, 95% CI 1.32-2.17, p < 0.0001) had an increased risk of having their level of psychological distress increase further compared to those who did not experience poverty. CONCLUSION To date, the increased risk of falling into poverty that is associated with elevated levels of psychological distress has been an overlooked burden of the condition.
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Stewart M, King M, Blood R, Letourneau N, Masuda JR, Anderson S, Bearskin LB. Health inequities experienced by Aboriginal children with respiratory conditions and their parents. Can J Nurs Res 2014; 45:6-27. [PMID: 24236369 DOI: 10.1177/084456211304500302] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Asthma and allergies are common conditions among Aboriginal children and adolescents. The purpose of this study was to assess the health and health-care inequities experienced by affected children and by their parents. Aboriginal research assistants conducted individual interviews with 46 Aboriginal children and adolescents who had asthma and/or allergies (26 First Nations, 19 Métis, 1 Inuit) and 51 parents or guardians of these children and adolescents. Followup group interviews were conducted with 16 adolescents and 25 parents/ guardians. Participants reported inadequate educational resources, environmental vulnerability, social and cultural pressures, exclusion, isolation, stigma, blame, and major support deficits. They also described barriers to health-service access, inadequate health care, disrespectful treatment and discrimination by health-care providers, and deficient health insurance. These children, adolescents, and parents recommended the establishment of culturally appropriate support and education programs delivered by Aboriginal peers and health professionals.
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Affiliation(s)
- Miriam Stewart
- Faculty of Nursing and Social Support Research Program, University of Alberta, Edmonton, Canada
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Callander EJ, Schofield DJ, Shrestha RN. Freedom poverty: a new tool to identify the multiple disadvantages affecting those with CVD. Int J Cardiol 2011; 166:321-6. [PMID: 22075411 DOI: 10.1016/j.ijcard.2011.10.088] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Revised: 10/06/2011] [Accepted: 10/18/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND It is recognised that CVD affects an individual's financial situation, placing them in income poverty. However, recent developments in poverty measurement practice recognises other forms of disadvantage other than low income, such as poor health and insufficient education also affect living standards. METHODS Using the Freedom Poverty Measure, the multiple forms of disadvantage experienced by those with no health condition, heart disease, other diseases of the circulatory system, and all other health conditions was assessed using data on the adult Australian population contained in the 2003 Survey of Disability, Ageing and Carers. RESULTS 24% of those with heart disease and 23% of those with other diseases of the circulatory system were in freedom poverty, suffering from multiple forms of disadvantage. Those with heart disease and those with other diseases of the circulatory system were around three times more likely to be in freedom poverty (OR 3.02, 95% CI: 2.29-3.99, p<.0001; OR 2.78, 95% CI: 1.94-3.98, p<.0001) than those with no health condition. CONCLUSIONS Recognising the multiple forms of disadvantage suffered by those with CVD provides a clearer picture of their living standards than just looking at their income alone and the high proportion of individuals with CVD that are suffering from multiple forms of disadvantage should make them a target for policy makers wishing to improve living standards.
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