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Health Shocks and Overindebtedness: A Panel Data Analysis from Rural Viet Nam

Author

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  • Chhay, Panharoth

    (Asian Development Bank Institute)

  • Rahut, Dil

    (Asian Development Bank Institute)

Abstract

Rural households in developing countries have limited capacity to cope with and manage shocks, thereby resulting in chronic poverty, indebtedness, and a decline in overall well-being. We analyze the effects of health shocks on overindebtedness in rural Viet Nam using four rounds of a balanced panel data set of about 1,750 households observed over a decade (2007, 2010, 2013, 2016). Employing the household-level fixed-effect model, we find that health shocks reduce household income and increase health expenditure among rural Vietnamese households. We also find that households cope with health shocks mainly by borrowing from more sources. Households experiencing health shocks are 2.2 to 3.1 percentage points more likely to be overindebted, which occurs primarily among households without health insurance, suggesting that social health insurance can reduce households’ vulnerability to the consequences of health shocks. These findings strongly support efforts to expand access to social health insurance in rural Viet Nam.

Suggested Citation

  • Chhay, Panharoth & Rahut, Dil, 2022. "Health Shocks and Overindebtedness: A Panel Data Analysis from Rural Viet Nam," ADBI Working Papers 1311, Asian Development Bank Institute.
    • Handle: RePEc:ris:adbiwp:1311
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    1. Chichaibelu, Bezawit Beyene & Waibel, Hermann, 2018. "Over-indebtedness and its persistence in rural households in Thailand and Vietnam," Journal of Asian Economics, Elsevier, vol. 56(C), pages 1-23.
    2. Milford Bateman & Ha-Joon Chang, 2012. "Microfinance and the Illusion of Development: From Hubris to Nemesis in Thirty Years," World Economic Review, World Economics Association, vol. 2012(1), pages 1-13, September.
    3. Keese, Matthias, 2012. "Who feels constrained by high debt burdens? Subjective vs. objective measures of household debt," Journal of Economic Psychology, Elsevier, vol. 33(1), pages 125-141.
    4. Ambrosius, Christian & Cuecuecha, Alfredo, 2013. "Are Remittances a Substitute for Credit? Carrying the Financial Burden of Health Shocks in National and Transnational Households," World Development, Elsevier, vol. 46(C), pages 143-152.
    5. Paul Gertler & Jonathan Gruber, 2002. "Insuring Consumption Against Illness," American Economic Review, American Economic Association, vol. 92(1), pages 51-70, March.
    6. Townsend, Robert M, 1994. "Risk and Insurance in Village India," Econometrica, Econometric Society, vol. 62(3), pages 539-591, May.
    7. Giovanni D’Alessio & Stefano Iezzi, 2013. "Household over-indebtedness - Definition and measurement with Italian data," IFC Bulletins chapters, in: Bank for International Settlements (ed.), Proceedings of the Sixth IFC Conference on "Statistical issues and activities in a changing environment", Basel, 28-29 August 2012., volume 36, pages 496-517, Bank for International Settlements.
    8. Manoj Mohanan, 2013. "Causal Effects of Health Shocks on Consumption and Debt: Quasi-Experimental Evidence from Bus Accident Injuries," The Review of Economics and Statistics, MIT Press, vol. 95(2), pages 673-681, May.
    9. 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.
    10. Khan, Farid & Bedi, Arjun S. & Sparrow, Robert, 2015. "Sickness and Death: Economic Consequences and Coping Strategies of the Urban Poor in Bangladesh," World Development, Elsevier, vol. 72(C), pages 255-266.
    11. Nguyen Thi Nhu Nguyet & Eiji Mangyo, 2010. "Vulnerability of households to health shocks: an Indonesian study," Bulletin of Indonesian Economic Studies, Taylor & Francis Journals, vol. 46(2), pages 213-235.
    12. 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.
    13. repec:wea:worler:v:2012:y:2012:i:1:p:2 is not listed on IDEAS
    14. Rasmus Heltberg & Niels Lund, 2009. "Shocks, Coping, and Outcomes for Pakistan's Poor: Health Risks Predominate," Journal of Development Studies, Taylor & Francis Journals, vol. 45(6), pages 889-910.
    15. Nguyen, Trung Thanh & Do, Truong Lam & Halkos, George & Wilson, Clevo, 2020. "Health shocks and natural resource extraction: A Cambodian case study," Ecological Economics, Elsevier, vol. 169(C).
    16. Schicks, Jessica, 2014. "Over-Indebtedness in Microfinance – An Empirical Analysis of Related Factors on the Borrower Level," World Development, Elsevier, vol. 54(C), pages 301-324.
    17. Maria Eugenia Genoni, 2012. "Health Shocks and Consumption Smoothing: Evidence from Indonesia," Economic Development and Cultural Change, University of Chicago Press, vol. 60(3), pages 475-506.
    18. Rinaldi, Laura & Sanchis-Arellano, Alicia, 2006. "Household debt sustainability: what explains household non-performing loans? An empirical analysis," Working Paper Series 570, European Central Bank.
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    More about this item

    Keywords

    health shocks; overindebtedness; social health insurance; household-level fixed effects; rural Viet Nam;
    All these keywords.

    JEL classification:

    • E21 - Macroeconomics and Monetary Economics - - Consumption, Saving, Production, Employment, and Investment - - - Consumption; Saving; Wealth
    • E24 - Macroeconomics and Monetary Economics - - Consumption, Saving, Production, Employment, and Investment - - - Employment; Unemployment; Wages; Intergenerational Income Distribution; Aggregate Human Capital; Aggregate Labor Productivity
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development

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