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Poverty, wealth inequality and health among older adults in rural Cambodia

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  • Zimmer, Zachary

Abstract

Little research exists on health determinants among adults living in economically deprived regions despite the fact that these areas comprise a good part of the world. This paper examines the distribution of wealth then tests associations between wealth inequality and a variety of health outcomes, among older adults, in one of the world's poorest regions--rural Cambodia. Data from the 2004 Survey of the Elderly in Cambodia are employed. Using a disablement framework to conceptualize health, associations between four health components and a wealth inequality measure are tested. The wealth inequality measure is based on an index that operationalizes wealth as ownership of household assets and household structural components. Results confirm difficult economic conditions in rural Cambodia. The lowest wealth quintile lives in households that own nothing, while the next quintiles are only slightly better off. Nevertheless, logistic regressions that adjust for other covariates indicate heterogeneity in health across quintiles that appear qualitatively similar, with the bottom quintiles reporting the most health problems. An exception is disability, which presents a U-shaped association. It is difficult to determine mechanisms behind the relationship using cross-sectional data, but the paper speculates on possible causal directions, both from wealth to health and vice-versa. The analysis suggests the ability to generalize the relationship between wealth inequality and health to extremely poor populations as a very small difference in wealth makes a relatively large difference with respect to health associations among those in meager surroundings.

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  • Zimmer, Zachary, 2008. "Poverty, wealth inequality and health among older adults in rural Cambodia," Social Science & Medicine, Elsevier, vol. 66(1), pages 57-71, January.
    • Handle: RePEc:eee:socmed:v:66:y:2008:i:1:p:57-71
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    as
    1. Kristenson, M. & Eriksen, H. R. & Sluiter, J. K. & Starke, D. & Ursin, H., 2004. "Psychobiological mechanisms of socioeconomic differences in health," Social Science & Medicine, Elsevier, vol. 58(8), pages 1511-1522, April.
    2. David Evans & Edward Miguel, 2007. "Orphans and schooling in africa: a longitudinal analysis," Demography, Springer;Population Association of America (PAA), vol. 44(1), pages 35-57, February.
    3. Verbrugge, Lois M. & Jette, Alan M., 1994. "The disablement process," Social Science & Medicine, Elsevier, vol. 38(1), pages 1-14, January.
    4. repec:cai:popine:popu_p2001_13n1_0116 is not listed on IDEAS
    5. Bicego, George & Rutstein, Shea & Johnson, Kiersten, 2003. "Dimensions of the emerging orphan crisis in sub-Saharan Africa," Social Science & Medicine, Elsevier, vol. 56(6), pages 1235-1247, March.
    6. Ecob, Russell & Davey Smith, George, 1999. "Income and health: what is the nature of the relationship?," Social Science & Medicine, Elsevier, vol. 48(5), pages 693-705, March.
    7. Jersey Liang & John F. McCarthy & Arvind Jain & Neal Krause & Joan M. Bennett & Shengzu Gu, 2000. "Socioeconomic Gradient in Old Age Mortality in Wuhan, China," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 55(4), pages 222-233.
    8. Siegrist, Johannes & Marmot, Michael, 2004. "Health inequalities and the psychosocial environment--two scientific challenges," Social Science & Medicine, Elsevier, vol. 58(8), pages 1463-1473, April.
    9. Deon Filmer & Lant Pritchett, 2001. "Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India," Demography, Springer;Population Association of America (PAA), vol. 38(1), pages 115-132, February.
    10. Knesebeck, Olaf von dem & Lüschen, Günther & Cockerham, William C. & Siegrist, Johannes, 2003. "Socioeconomic status and health among the aged in the United States and Germany: A comparative cross-sectional study," Social Science & Medicine, Elsevier, vol. 57(9), pages 1643-1652, November.
    11. Wagstaff, Adam, 2003. "Child health on a dollar a day: some tentative cross-country comparisons," Social Science & Medicine, Elsevier, vol. 57(9), pages 1529-1538, November.
    12. Beydoun, May A. & Popkin, Barry M., 2005. "The impact of socio-economic factors on functional status decline among community-dwelling older adults in China," Social Science & Medicine, Elsevier, vol. 60(9), pages 2045-2057, May.
    13. Boyle, Michael H. & Racine, Yvonne & Georgiades, Katholiki & Snelling, Dana & Hong, Sungjin & Omariba, Walter & Hurley, Patricia & Rao-Melacini, Purnima, 2006. "The influence of economic development level, household wealth and maternal education on child health in the developing world," Social Science & Medicine, Elsevier, vol. 63(8), pages 2242-2254, October.
    14. Kunz-Ebrecht, Sabine R. & Kirschbaum, Clemens & Steptoe, Andrew, 2004. "Work stress, socioeconomic status and neuroendocrine activation over the working day," Social Science & Medicine, Elsevier, vol. 58(8), pages 1523-1530, April.
    15. James P. Smith, 1999. "Healthy Bodies and Thick Wallets: The Dual Relation between Health and Economic Status," Journal of Economic Perspectives, American Economic Association, vol. 13(2), pages 145-166, Spring.
    16. Zimmer, Zachary & Amornsirisomboon, Pattama, 2001. "Socioeconomic status and health among older adults in Thailand: an examination using multiple indicators," Social Science & Medicine, Elsevier, vol. 52(8), pages 1297-1311, April.
    17. Wang, Limin, 2003. "Determinants of child mortality in LDCs: Empirical findings from demographic and health surveys," Health Policy, Elsevier, vol. 65(3), pages 277-299, September.
    18. Marmot, Michael & Siegrist, Johannes, 2004. "Health inequalities and the psychosocial environment," Social Science & Medicine, Elsevier, vol. 58(8), pages 1461-1461, April.
    19. Matthews, Ruth J. & Jagger, Carol & Hancock, Ruth M., 2006. "Does socio-economic advantage lead to a longer, healthier old age?," Social Science & Medicine, Elsevier, vol. 62(10), pages 2489-2499, May.
    20. Huisman, Martijn & Kunst, Anton E. & Mackenbach, Johan P., 2003. "Socioeconomic inequalities in morbidity among the elderly; a European overview," Social Science & Medicine, Elsevier, vol. 57(5), pages 861-873, September.
    21. Sorlie, P.D. & Backlund, E. & Keller, J.B., 1995. "US mortality by economic, demographic, and social characteristics: The National Longitudinal Mortality Study," American Journal of Public Health, American Public Health Association, vol. 85(7), pages 949-956.
    22. McDonough, P. & Duncan, G.J. & Williams, D. & House, J., 1997. "Income dynamics and adult mortality in the United States, 1972 through 1989," American Journal of Public Health, American Public Health Association, vol. 87(9), pages 1476-1483.
    23. Freedman, V.A. & Martin, L.G., 1998. "Understanding trends in functional limitations among older Americans," American Journal of Public Health, American Public Health Association, vol. 88(10), pages 1457-1462.
    24. Pande, Rohini P. & Yazbeck, Abdo S., 2003. "What's in a country average? Wealth, gender, and regional inequalities in immunization in India," Social Science & Medicine, Elsevier, vol. 57(11), pages 2075-2088, December.
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    2. Barik, Debasis & Desai, Sonalde & Vanneman, Reeve, 2018. "Economic Status and Adult Mortality in India: Is the Relationship Sensitive to Choice of Indicators?," World Development, Elsevier, vol. 103(C), pages 176-187.
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    4. Zhifei He & Zhaohui Cheng & Ghose Bishwajit & Dongsheng Zou, 2018. "Wealth Inequality as a Predictor of Subjective Health, Happiness and Life Satisfaction among Nepalese Women," IJERPH, MDPI, vol. 15(12), pages 1-11, December.
    5. Sabina Lawreniuk & Laurie Parsons, 2017. "Mother, grandmother, migrant: Elder translocality and the renegotiation of household roles in Cambodia," Environment and Planning A, , vol. 49(7), pages 1664-1683, July.
    6. Eliana Jimenez-Soto & Jo Durham & Andrew Hodge, 2014. "Entrenched Geographical and Socioeconomic Disparities in Child Mortality: Trends in Absolute and Relative Inequalities in Cambodia," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-9, October.
    7. Lih-Shing Chan & Kee-Lee Chou, 2018. "A Survey of Asset Poverty Among Older Adults of Hong Kong," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 138(2), pages 605-622, July.
    8. Siu-Yau Lee & Kee-Lee Chou, 2016. "Trends in Elderly Poverty in Hong Kong: A Decomposition Analysis," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 129(2), pages 551-564, November.
    9. Maëlenn M Guerchet & Mariella Guerra & Yueqin Huang & Peter Lloyd-Sherlock & Ana Luisa Sosa & Richard Uwakwe & Isaac Acosta & Peter Ezeah & Sara Gallardo & Zhaorui Liu & Rosie Mayston & Veronica Monte, 2018. "A cohort study of the effects of older adult care dependence upon household economic functioning, in Peru, Mexico and China," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-19, April.
    10. Hend Gabr & Fiona Carmichael & Hui Li, 2019. "A Multilevel Simultaneous Equations Modelling Approach to Investigate the Relationship between Poverty and Labour-Force Participation among the Elderly in Egypt," International Journal of Environmental Sciences & Natural Resources, Juniper Publishers Inc., vol. 22(1), pages 01-12, October.
    11. Hannah Kuper & Sarah Polack & Wanjiku Mathenge & Cristina Eusebio & Zakia Wadud & Mamunur Rashid & Allen Foster, 2010. "Does Cataract Surgery Alleviate Poverty? Evidence from a Multi-Centre Intervention Study Conducted in Kenya, the Philippines and Bangladesh," PLOS ONE, Public Library of Science, vol. 5(11), pages 1-10, November.
    12. Gerda G Fillenbaum & Sergio L Blay & Carl F Pieper & Katherine E King & Sergio B Andreoli & Fábio L Gastal, 2013. "The Association of Health and Income in the Elderly: Experience from a Southern State of Brazil," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-1, September.
    13. Grace Lordan & Eliana Jimenez Soto & Richard P. C. Brown & Ignacio Correa‐Valez, 2012. "Socioeconomic status and health outcomes in a developing country," Health Economics, John Wiley & Sons, Ltd., vol. 21(2), pages 178-186, February.
    14. Md Ismail Tareque & Atsushi Koshio & Andrew D Tiedt & Toshihiko Hasegawa, 2015. "Are the Rates of Hypertension and Diabetes Higher in People from Lower Socioeconomic Status in Bangladesh? Results from a Nationally Representative Survey," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-17, May.
    15. Yang Cao & Feng Zhen & Hao Wu, 2019. "Public Transportation Environment and Medical Choice for Chronic Disease: A Case Study of Gaoyou, China," IJERPH, MDPI, vol. 16(9), pages 1-21, May.
    16. Md Ismail Tareque & Sharifa Begum & Yasuhiko Saito, 2014. "Inequality in Disability in Bangladesh," PLOS ONE, Public Library of Science, vol. 9(7), pages 1-10, July.
    17. Bakshi, Sanjeev & Pathak, Prasanta, 2010. "Social context and the burden of ill health among the older adults in India," MPRA Paper 40463, University Library of Munich, Germany.
    18. Treleaven, Emily & Ngin, Chanrith, 2021. "When parents are not present: Decision-making dynamics for young children's health and illness in migrant-sending households in rural Cambodia," Social Science & Medicine, Elsevier, vol. 287(C).

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