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Health screening for emerging non-communicable disease burdens among the global poor: Evidence from sub-Saharan Africa

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  • Ciancio, Alberto
  • Kämpfen, Fabrice
  • Kohler, Hans-Peter
  • Kohler, Iliana V.

Abstract

Evidence for the effectiveness of population health screenings to reduce the burden of non-communicable diseases in low-income countries remains very limited. We investigate the sustained effects of a health screening in Malawi where individuals received a referral letter if they had elevated blood pressure. Using a regression discontinuity design and a matching estimator, we find that receiving a referral letter reduced blood pressure and the probability of being hypertensive by about 22 percentage points four years later. These lasting effects are explained by a 20 percentage points increase in the probability of being diagnosed with hypertension. There is also evidence of an increase in the uptake of medication, while we do not identify improvements in hypertension-related knowledge or risk behaviors. On the contrary, we find an increase in sugar intake and a decrease in physical activity both of which are considered risky behaviors in Western contexts. The health screening had some positive effects on mental health. Overall, this study suggests that population-based hypertension screening interventions are an effective tool to improve health in low-income contexts.

Suggested Citation

  • Ciancio, Alberto & Kämpfen, Fabrice & Kohler, Hans-Peter & Kohler, Iliana V., 2021. "Health screening for emerging non-communicable disease burdens among the global poor: Evidence from sub-Saharan Africa," Journal of Health Economics, Elsevier, vol. 75(C).
  • Handle: RePEc:eee:jhecon:v:75:y:2021:i:c:s0167629620310341
    DOI: 10.1016/j.jhealeco.2020.102388
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    More about this item

    Keywords

    Health screening; Hypertension; Non-communicable diseases; Regression discontinuity design; Matching estimator; Low-income countries; Malawi;
    All these keywords.

    JEL classification:

    • C21 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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