IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i17p10872-d903097.html
   My bibliography  Save this article

The Role of Microfinance in China’s Rural Public Health: Evidence from the Anti-Poverty Microcredit Program

Author

Listed:
  • Benjian Wu

    (School of Economics, Minzu University of China, Beijing 100081, China)

  • Yi Cui

    (School of Economics, Beijing Technology and Business University, Beijing 100048, China)

  • Yushuo Jiang

    (School of Economics, Minzu University of China, Beijing 100081, China)

Abstract

This study presents nonlinear evidence of the effects of a microcredit program implemented in poverty-stricken villages in China on rural public health using multivariate-ordered Probit and IV-ordered Probit models. The results, which were based on a unique set of data gathered from two rounds of official tracking statistics obtained through investigation (2015 and 2018) at a household level, suggest that rural residents’ health levels and health insurance demands are related to the formal credit amount that they receive from the microcredit program. Further, the amount of debt that remains to be paid is a negative mediator and the poverty reduction degree is a positive mediator for the health impact of credit. After dividing the sample into subgroups according to income, credit rating and social network, the results show heterogeneity: the health outcomes of groups with a low income, a high credit rating and a strong social network are more significantly improved by loans. The estimations are still robust after using network and village clan numbers as instrumental variables to address endogeneity. Although most of the existing literature demonstrates that credit and indebtedness have negative impacts on health, our results supplement previous findings of the positive causality between access to formal credit and rural public health by showing that the former can exert positive effects by relaxing individuals’ external constraints and increasing health spending.

Suggested Citation

  • Benjian Wu & Yi Cui & Yushuo Jiang, 2022. "The Role of Microfinance in China’s Rural Public Health: Evidence from the Anti-Poverty Microcredit Program," IJERPH, MDPI, vol. 19(17), pages 1-22, August.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:17:p:10872-:d:903097
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/17/10872/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/19/17/10872/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Gianni Betti & Neil Dourmashkin & Mariacristina Rossi & Ya Ping Yin, 2007. "Consumer over‐indebtedness in the EU: measurement and characteristics," Journal of Economic Studies, Emerald Group Publishing Limited, vol. 34(2), pages 136-156, May.
    2. Herman, P.M. & Rissi, J.J. & Walsh, M.E., 2011. "Health insurance status, medical debt, and their impact on access to care in arizona," American Journal of Public Health, American Public Health Association, vol. 101(8), pages 1437-1443.
    3. Richard Breen & Kristian Bernt Karlson & Anders Holm, 2013. "Total, Direct, and Indirect Effects in Logit and Probit Models," Sociological Methods & Research, , vol. 42(2), pages 164-191, May.
    4. Ronny Manos & Leonid Tsytrinbaum, 2014. "Determinants of Performance in the Microfinance Industry: The Role of Culture," Palgrave Studies in Impact Finance, in: Roy Mersland & R. Øystein Strøm (ed.), Microfinance Institutions, chapter 4, pages 53-78, Palgrave Macmillan.
    5. Alley, D.E. & Lloyd, J. & Pagán, J.A. & Pollack, C.E. & Shardell, M. & Cannuscio, C., 2011. "Mortgage delinquency and changes in access to health resources and depressive symptoms in a nationally representative cohort of Americans older than 50 years," American Journal of Public Health, American Public Health Association, vol. 101(12), pages 2293-2298.
    6. Titus J Galama & Hans van Kippersluis, 2019. "A Theory of Socio-economic Disparities in Health over the Life Cycle," The Economic Journal, Royal Economic Society, vol. 129(617), pages 338-374.
    7. Hudon, Marek & Traca, Daniel, 2011. "On the Efficiency Effects of Subsidies in Microfinance: An Empirical Inquiry," World Development, Elsevier, vol. 39(6), pages 966-973, June.
    8. Douglas Almond & Janet Currie & Valentina Duque, 2018. "Childhood Circumstances and Adult Outcomes: Act II," Journal of Economic Literature, American Economic Association, vol. 56(4), pages 1360-1446, December.
    9. Jalan, Jyotsna & Ravallion, Martin, 1999. "Are the poor less well insured? Evidence on vulnerability to income risk in rural China," Journal of Development Economics, Elsevier, vol. 58(1), pages 61-81, February.
    10. Janet Currie, 2009. "Healthy, Wealthy, and Wise: Socioeconomic Status, Poor Health in Childhood, and Human Capital Development," Journal of Economic Literature, American Economic Association, vol. 47(1), pages 87-122, March.
    11. Paul Gertler & Jonathan Gruber, 2002. "Insuring Consumption Against Illness," American Economic Review, American Economic Association, vol. 92(1), pages 51-70, March.
    12. DeanS. Karlan, 2007. "Social connections and group banking," Economic Journal, Royal Economic Society, vol. 117(517), pages 52-84, February.
    13. John Gathergood, 2012. "Debt and Depression: Causal Links and Social Norm Effects," Economic Journal, Royal Economic Society, vol. 122(563), pages 1094-1114, September.
    14. Islam, Asadul & Maitra, Pushkar, 2012. "Health shocks and consumption smoothing in rural households: Does microcredit have a role to play?," Journal of Development Economics, Elsevier, vol. 97(2), pages 232-243.
    15. Hoffmann, Rasmus & Kröger, Hannes & Pakpahan, Eduwin, 2018. "Pathways between socioeconomic status and health: Does health selection or social causation dominate in Europe?," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 36, pages 23-36.
    16. Anne-Fleur Roos & Maaike Diepstraten & Rudy Douven, 2021. "When financials get tough, life gets rough? Problematic debts and ill health," CPB Discussion Paper 428, CPB Netherlands Bureau for Economic Policy Analysis.
    17. Paul Gertler & David I. Levine & Enrico Moretti, 2009. "Do microfinance programs help families insure consumption against illness?," Health Economics, John Wiley & Sons, Ltd., vol. 18(3), pages 257-273, March.
    18. French, Declan & Vigne, Samuel, 2019. "The causes and consequences of household financial strain: A systematic review," International Review of Financial Analysis, Elsevier, vol. 62(C), pages 150-156.
    19. Korbinian Nagel & Dierk Herzer & Peter Nunnenkamp, 2015. "How Does FDI Affect Health?," International Economic Journal, Taylor & Francis Journals, vol. 29(4), pages 655-679, December.
    20. Shahidur R. Khandker, 2005. "Microfinance and Poverty: Evidence Using Panel Data from Bangladesh," The World Bank Economic Review, World Bank, vol. 19(2), pages 263-286.
    21. Kristina Czura & Anett John & Lisa Spantig, 2020. "Flexible Contract, Flexible Morale? Microcredit Design and Repayment Discipline," CESifo Working Paper Series 8322, CESifo.
    22. Anderson, C. Leigh & Locker, Laura & Nugent, Rachel, 2002. "Microcredit, Social Capital, and Common Pool Resources," World Development, Elsevier, vol. 30(1), pages 95-105, January.
    23. Cutler, David M. & Lleras-Muney, Adriana, 2010. "Understanding differences in health behaviors by education," Journal of Health Economics, Elsevier, vol. 29(1), pages 1-28, January.
    24. Drentea, Patricia & Lavrakas, Paul J., 2000. "Over the limit: the association among health, race and debt," Social Science & Medicine, Elsevier, vol. 50(4), pages 517-529, February.
    25. Cochrane, John H, 1991. "A Simple Test of Consumption Insurance," Journal of Political Economy, University of Chicago Press, vol. 99(5), pages 957-976, October.
    26. Kennelly, Brendan & O'Shea, Eamon & Garvey, Eoghan, 2003. "Social capital, life expectancy and mortality: a cross-national examination," Social Science & Medicine, Elsevier, vol. 56(12), pages 2367-2377, June.
    27. Johannes Stauder, 2019. "Unemployment, unemployment duration, and health: selection or causation?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 59-73, February.
    28. Frederick J. Zimmerman & Wayne Katon, 2005. "Socioeconomic status, depression disparities, and financial strain: what lies behind the income‐depression relationship?," Health Economics, John Wiley & Sons, Ltd., vol. 14(12), pages 1197-1215, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Anne-Fleur Roos & Maaike Diepstraten & Rudy Douven, 2021. "When financials get tough, life gets rough? Problematic debts and ill health," CPB Discussion Paper 428, CPB Netherlands Bureau for Economic Policy Analysis.
    2. Liu, Kai, 2016. "Insuring against health shocks: Health insurance and household choices," Journal of Health Economics, Elsevier, vol. 46(C), pages 16-32.
    3. Islam, Asadul & Maitra, Pushkar, 2012. "Health shocks and consumption smoothing in rural households: Does microcredit have a role to play?," Journal of Development Economics, Elsevier, vol. 97(2), pages 232-243.
    4. Gutiérrez-Nieto, Begoña & Serrano-Cinca, Carlos, 2019. "20 years of research in microfinance: An information management approach," International Journal of Information Management, Elsevier, vol. 47(C), pages 183-197.
    5. Haseeb Ahmed & Benjamin W. Cowan, 2019. "Mobile Money and Healthcare Use: Evidence from East Africa," NBER Working Papers 25669, National Bureau of Economic Research, Inc.
    6. Tianxin Pan & Michael Palmer & Ajay Mahal & Peter Annear & Barbara McPake, 2020. "The long‐run effects of noncommunicable disease shocks," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1549-1565, December.
    7. Owen (O.A.) O'Donnell, 2019. "Financial Protection Against Medical Expense," Tinbergen Institute Discussion Papers 19-010/V, Tinbergen Institute.
    8. Karlan, Dean & Morduch, Jonathan, 2010. "Access to Finance," Handbook of Development Economics, in: Dani Rodrik & Mark Rosenzweig (ed.), Handbook of Development Economics, edition 1, volume 5, chapter 0, pages 4703-4784, Elsevier.
    9. Gaurav, Sarthak, 2015. "Are Rainfed Agricultural Households Insured? Evidence from Five Villages in Vidarbha, India," World Development, Elsevier, vol. 66(C), pages 719-736.
    10. Chetty, Raj & Looney, Adam, 2006. "Consumption smoothing and the welfare consequences of social insurance in developing economies," Journal of Public Economics, Elsevier, vol. 90(12), pages 2351-2356, December.
    11. Abhishek Dureja & Digvijay S. Negi, 2022. "Coping with the consequences of short‐term illness shocks: The role of intra‐household labor substitution," Health Economics, John Wiley & Sons, Ltd., vol. 31(7), pages 1402-1422, July.
    12. Dalton, Michael & LaFave, Daniel, 2017. "Mitigating the consequences of a health condition: The role of intra- and interhousehold assistance," Journal of Health Economics, Elsevier, vol. 53(C), pages 38-52.
    13. Abhishek Dureja & Digvijay S. Negi, 2024. "Smoothing consumption in times of illness: Household recourse mechanisms," Health Economics, John Wiley & Sons, Ltd., vol. 33(7), pages 1584-1617, July.
    14. Kalyan Kolukuluri, 2023. "Adverse health shocks, social insurance and household consumption: evidence from Indonesia’s Askeskin program," International Journal of Health Economics and Management, Springer, vol. 23(2), pages 213-235, June.
    15. Kathleen Beegle & Rajeev Dehejia & Roberta Gatti, 2003. "Child Labor, Crop Shocks, and Credit Constraints," NBER Working Papers 10088, National Bureau of Economic Research, Inc.
    16. Islam, Asadul & Nguyen, Chau & Smyth, Russell, 2015. "Does microfinance change informal lending in village economies? Evidence from Bangladesh," Journal of Banking & Finance, Elsevier, vol. 50(C), pages 141-156.
    17. Sowmya Dhanaraj, 2014. "Health Shocks and Coping Strategies: State Health Insurance Scheme of Andhra Pradesh, India," WIDER Working Paper Series wp-2014-003, World Institute for Development Economic Research (UNU-WIDER).
    18. Neelsen, Sven & Limwattananon, Supon & O'Donnell, Owen & van Doorslaer, Eddy, 2019. "Universal health coverage: A (social insurance) job half done?," World Development, Elsevier, vol. 113(C), pages 246-258.
    19. Manoj K. Pandey, 2013. "Elderly's Health Shocks and Household's Ex-ante Poverty in India," ASARC Working Papers 2013-01, The Australian National University, Australia South Asia Research Centre.
    20. Paul Gertler & David I. Levine & Enrico Moretti, 2009. "Do microfinance programs help families insure consumption against illness?," Health Economics, John Wiley & Sons, Ltd., vol. 18(3), pages 257-273, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:17:p:10872-:d:903097. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.