Are Health Shocks Different? Evidence from a Multi-Shock Survey in Laos

Wagstaff, Adam ; Lindelow, Magnus

关键词: ADVERSE EFFECTS;    AGRICULTURAL SHOCKS;    AGRICULTURE;    ASSETS;    CLINICS;   

DOI  :  10.1596/1813-9450-5335
RP-ID  :  WPS5335

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

In Laos health shocks are more commonthan most other shocks and more concentrated among the poor.They tend to be more idiosyncratic than non-health shocks,and are more costly, partly because they lead to highmedical expenses, but also because they lead to incomelosses that are sizeable compared with the income lossesassociated with non-health shocks. Health shocks also standout from other shocks in the number of coping strategiesthey trigger: they are more likely than non-health shocks totrigger assistance from a nongovernmental organization andother households, dis-saving, borrowing, asset sales, anearly harvest, the pawning of possessions, and the delayingof plans; by contrast, they are less likely to triggerassistance from government. Consumption regressions point toonly limited evidence of households not being able to smoothconsumption in the face of any shock. However, these resultscontrast with households' own assessments of thewelfare impacts of shocks. The majority said they had to cutback consumption following a shock and that shocksconsiderably affected their welfare. Only health shocks areworse than a drought in terms of the likelihood of a familybeing forced to cut back consumption and in terms of theshock affecting a family's well-being "alot." The poor are especially disadvantaged in terms ofthe greater damage that health shocks inflict on householdwell-being. Health shocks stand out too in leading to a lossof human capital: household members experiencing a healthshock did not recover their former subjective healthfollowing the health shock, losing, on average, 0.6 pointson a 5-point scale. The wealthier and better educated arebetter able to limit the health impacts of a health shock;the data are consistent with this being due to their greaterproximity to a health facility.