Health vulnerability and health poverty of rice farmers: evidence from Hubei province in China

Purpose - The purpose of this study was threefold: (1) to measure farmers' health poverty, (2) to examine the effect of health vulnerability on health poverty and (3) to identify countermeasures that may alleviate health poverty in rural China. Design/methodology/approach - This study built a health poverty measurement model based on the multi-dimensional poverty framework to evaluate farmers' health vulnerability. Further, this paper used an econometric model to assess the impact of health vulnerability on health poverty. The sample for this study comprised 1,115 rice farmers from Hubei province, China. Findings - The medical affordability poverty ratio was 17.95%, where farmers in the low-income group faced severe medical affordability poverty (27.46%). Results from the multi-dimensional analysis showed that, the health poverty ratios were 17.95 and 30.50%, respectively. Our results indicated that climate change vulnerabilities, living habits, medical facilities and medical accessibility were positively related to health poverty, whereas the regular physical examinations reduced mental health poverty. Research limitations/implications - Based on this study's findings, we proposed that: (1) to address illness-induced poverty among members of the agricultural community, national and provincial strategies and programs grounded on a multi-dimensional health poverty framework ought to be formulated and implemented, (2) mechanisms of health knowledge exchange may facilitate the improvement of farmers' health status, (3) robust and comprehensive metrics should be employed to understand and improve farmers' ability to absorb and mitigate the negative health impacts and (4) the improvement in both quality and quantity for medical facilities and medical affordability in the rural areas should be key priorities in governmental-wide initiatives. Originality/value - Existing studies for alleviating poverty caused by disease mainly focus on medical service support to those economic vulnerabilities after a disease happens. However, few studies have focused on the root causes of poverty caused by disease, particularly from the preventive perspective of health vulnerability. To fill this gap, this study, therefore, proposes the health poverty index and analyzes the impact of health vulnerability on health poverty.