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The relationship between non-communicable disease occurrence and poverty—evidence from demographic surveillance in Matlab, Bangladesh

Mirelman, Andrew J, Rose, Sherri, Khan, Jahangir, Ahmed, Sayem ORCID: https://orcid.org/0000-0001-9499-1500, Peters, David H, Niessen, Louis ORCID: https://orcid.org/0000-0002-8639-5191 and Trujillo, Antonio J (2016) 'The relationship between non-communicable disease occurrence and poverty—evidence from demographic surveillance in Matlab, Bangladesh'. Health Policy and Planning, Vol 31, Issue 6, pp. 785-792.

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Abstract

In low-income countries, a growing proportion of the disease burden is attributable to non- communicable diseases (NCDs). There is little knowledge, however, of their impact on wealth, human capital, economic growth or household poverty. This article estimates the risk of being poor after an NCD death in the rural, low-income area of Matlab, Bangladesh. In a matched cohort study, we estimated the 2-year relative risk (RR) of being poor in Matlab households with an NCD death in 2010. Three separate measures of household economic status were used as outcomes: an asset-based index, self-rated household economic condition and total household landholding. Several estimation methods were used including contingency tables, log-binomial regression and regression standardization and machine learning. Households with an NCD death had a large and significant risk of being poor. The unadjusted RR of being poor after death was 1.19, 1.14 and 1.10 for the asset quintile, self-rated condition and landholding outcomes. Adjusting for household and individual level independent variables with log-binomial regression gave RRs of 1.19 [standard error (SE) 0.09], 1.16 (SE 0.07) and 1.14 (SE 0.06), which were found to be exactly the same using regression standardization (SE: 0.09, 0.05, 0.03). Machine learning-based standardization produced slightly smaller RRs though still in the same order of magnitude. The findings show that efforts to address the burden of NCD may also combat household poverty and provide a return beyond improved health. Future work should attempt to disentangle the mechanisms through which economic impacts from an NCD death occur.

Item Type: Article
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WA Public Health > Statistics. Surveys > WA 900 Public health statistics
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1093/heapol/czv134
Depositing User: Jessica Jones
Date Deposited: 16 Mar 2016 14:32
Last Modified: 04 Apr 2019 14:51
URI: http://archive.lstmed.ac.uk/id/eprint/5776

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