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Poverty, Inequality and Health: А case study of Armenia

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  • Tamara Tonoyan

    (Armenian Medical Institute)

Abstract

The paper describes the issue of the impact of poverty and income inequality on the health of the population using Armenia as a case study. In the framework of this paper author provides an overview of research relating to inequalities in health to the disadvantage of the poor, and to changes in impoverishment and income inequality associated with payments for health care. After demonstrating the logic of the investigation, the paper recapitulates the information about results of reforms that do not appear to meet all the objectives of health care policy. The paper indicates that the gains in freedom have been accompanied by the losses of many basic economic and social services that the population had come to enjoy and expect. At the same time the success of reforms applied in Armenia is often evaluated against improvements in the health status of the population. Funding shortages often means that even vulnerable groups have to pay. Thus, the principle of equity with respect to financing and access is undermined. It is emphasized that reducing poverty and income inequality should be grounded in a pro-poor growth approach, i.e. for equality to be achieved economic growth in the development process should be deliberately adapted to the needs of the poor. The paper concludes that there is undoubtedly a large gap in our knowledge on how best to reach the poor in the health sector. In order to fill this gap, more work is needed along the lines of the above studies related to health sector inequalities and public policy. There is necessity to encourage the development of insurance companies, pension funds, and funds for public health care education, which have not yet been properly undertaken.

Suggested Citation

  • Tamara Tonoyan, 2005. "Poverty, Inequality and Health: А case study of Armenia," Departmental Discussion Papers 124, University of Goettingen, Department of Economics.
  • Handle: RePEc:got:vwldps:124
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    File URL: http://www2.vwl.wiso.uni-goettingen.de/departmentpaper/NO_124.pdf
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    References listed on IDEAS

    as
    1. Lavy, Victor & Strauss, John & Thomas, Duncan & de Vreyer, Philippe, 1996. "Quality of health care, survival and health outcomes in Ghana," Journal of Health Economics, Elsevier, vol. 15(3), pages 333-357, June.
    2. Ravallion, Martin & Chen, Shaohua, 1997. "What Can New Survey Data Tell Us about Recent Changes in Distribution and Poverty?," The World Bank Economic Review, World Bank, vol. 11(2), pages 357-382, May.
    3. Wong, Emelita L. & Popkin, Barry M. & Guilkey, David K. & Akin, John S., 1987. "Accessibility, quality of care and prenatal care use in the Philippines," Social Science & Medicine, Elsevier, vol. 24(11), pages 927-944, January.
    4. Thomas, Duncan & Lavy, Victor & Strauss, John, 1996. "Public policy and anthropometric outcomes in the Cote d'Ivoire," Journal of Public Economics, Elsevier, vol. 61(2), pages 155-192, August.
    5. Ulf‐ G. Gerdtham, 1997. "Equity in Health Care Utilization: Further Tests Based on Hurdle Models and Swedish Micro Data," Health Economics, John Wiley & Sons, Ltd., vol. 6(3), pages 303-319, May.
    6. David E. Bloom & Jeffrey D. Sachs, 1998. "Geography, Demography, and Economic Growth in Africa," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 29(2), pages 207-296.
    7. Rosenzweig, Mark R. & Wolpin, Kenneth I., 1982. "Governmental interventions and household behavior in a developing country : Anticipating the unanticipated consequences of social programs," Journal of Development Economics, Elsevier, vol. 10(2), pages 209-225, April.
    8. repec:pri:cheawb:deaton_inequalities.pdf is not listed on IDEAS
    9. Germano Mwabu & Martha Ainsworth & Andrew Nyamete, 1993. "Quality of Medical Care and Choice of Medical Treatment in Kenya: An Empirical Analysis," Journal of Human Resources, University of Wisconsin Press, vol. 28(4), pages 838-862.
    10. Angus Deaton, 1999. "Inequalities in Income and Inequalities in Health," NBER Working Papers 7141, National Bureau of Economic Research, Inc.
    11. van Doorslaer, Eddy & Wagstaff, Adam & Bleichrodt, Han & Calonge, Samuel & Gerdtham, Ulf-G. & Gerfin, Michael & Geurts, Jose & Gross, Lorna & Hakkinen, Unto & Leu, Robert E., 1997. "Income-related inequalities in health: some international comparisons," Journal of Health Economics, Elsevier, vol. 16(1), pages 93-112, February.
    12. Norman Weatherby & Charles Nam & Larry Isaac, 1983. "Development, inequality, health care, and mortality at the older ages: a cross-national analysis," Demography, Springer;Population Association of America (PAA), vol. 20(1), pages 27-43, February.
    13. Panis, Constantijn W. A. & Lillard, Lee A., 1994. "Health inputs and child mortality: Malaysia," Journal of Health Economics, Elsevier, vol. 13(4), pages 455-489.
    14. Lant Pritchett & Lawrence H. Summers, 1996. "Wealthier is Healthier," Journal of Human Resources, University of Wisconsin Press, vol. 31(4), pages 841-868.
    15. Gertler, Paul & Sturm, Roland, 1997. "Private health insurance and public expenditures in Jamaica," Journal of Econometrics, Elsevier, vol. 77(1), pages 237-257, March.
    16. Sen, Amartya, 1973. "On Economic Inequality," OUP Catalogue, Oxford University Press, number 9780198281931.
    17. Travers, Kim D., 1996. "The social organization of nutritional inequities," Social Science & Medicine, Elsevier, vol. 43(4), pages 543-553, August.
    18. A. C. Cameron & P. K. Trivedi & Frank Milne & J. Piggott, 1988. "A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 55(1), pages 85-106.
    19. van Doorslaer, Eddy & Wagstaff, Adam, 1992. "Equity in the delivery of health care: some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 389-411, December.
    20. Lynch, J.W. & Kaplan, G.A. & Pamuk, E.R. & Cohen, R.D. & Heck, K.E. & Balfour, J.L. & Yen, I.H., 1998. "Income inequality and mortality in metropolitan areas of the United States," American Journal of Public Health, American Public Health Association, vol. 88(7), pages 1074-1080.
    21. Robert Eastwood & Michael Lipton, 1999. "The impact of changes in human fertility on poverty," Journal of Development Studies, Taylor & Francis Journals, vol. 36(1), pages 1-30.
    22. Atkinson, Anthony B., 1970. "On the measurement of inequality," Journal of Economic Theory, Elsevier, vol. 2(3), pages 244-263, September.
    23. Wagstaff, Adam & van Doorslaer, Eddy, 1992. "Equity in the finance of health care: Some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 361-387, December.
    24. repec:bla:econom:v:45:y:1978:i:178:p:125-42 is not listed on IDEAS
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    Cited by:

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    3. Petra Enß & Robert Schwager, 2006. "Kommunaler Finanzausgleich und Gewerbesteuerhebesätze in Niedersachsen," Departmental Discussion Papers 127, University of Goettingen, Department of Economics.
    4. Renate Ohr, 2009. "European Monetary Union at Ten: Had the German Maastricht Critics Been Wrong?," Departmental Discussion Papers 141, University of Goettingen, Department of Economics.

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    More about this item

    Keywords

    poverty; inequality; health; income distribution;
    All these keywords.

    JEL classification:

    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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