Morbidity Profiles of Kerala and All-India - An Economic Perspective

This study examines the economic profiles of morbidity by disease in Kerala and all- India by estimating Engel elasticities for diseases and classifying them as between those associated with affluence and deprivation. Morbidity rates, in general, are more for the rich than for the poor. There could be factors other than income, which influence the morbidity rates as revealed by horizontal pseudo-Lorenz curves for distribution of reported total morbidity across households. That morbidity rates are higher for the rich than for the poor households does not hold uniformly valid at the level of individual diseases. This is borne out by pseudo-Lorenz curves for diseasespecific morbidity. Pseudo-Lorenz curves lay above/below the Line of Equal Distribution depending upon the nature of diseases. The sub-set of undiagnosed diseases is a poor mans disease in both rural and urban all-India but only in urban Kerala. To avoid Type II errors in targeting medical facilities, it would be useful to identify those diseases, which afflict the rich proportionately more, that is, diseases with Engel elasticities more than one. Such diseases are virtually insignificant in Kerala. They account for 1.23 and 1.75 per cent of reported morbidity cases in rural and urban Kerala respectively. As regards all-India, they have significant presence. Their respective shares in total rural and urban morbidity cases are 7.83 and 6.83 per cent. Generally coronary heart diseases, diabetes and hypertension are considered as life style diseases. Among them, only diabetes mellitus has elasticity greater than one for rural and urban all-India; heart disease and hypertension too have elasticities greater than one only for rural all-India. As regards Kerala, none of them are luxury diseases. This could also be interpreted to represent a process whereby the diseases of affluence and deprivation converge in Kerala. In other words, this may represent a shift a in the epidemiology of diseases in Kerala.Affluence, Deprivation, Diseases, Engel elasticities

Morbidity and health vare in Kerala: A Distributional profile and implications

This paper takes up the issues pertaining to the health sector in Kerala in a larger comparative perspective in the Indian context. It would focus on the incidence of morbidity across socio-economic dimensions and their implications for economic policy. Its major findings are: The level of living of every decile group in Kerala is higher than that of the corresponding group at the all-India level. Extent of inequality in consumption distribution is higher in rural Kerala (North, South and combined) than in rural all-India and higher in urban Kerala (combined only) than in urban all-India. Within Kerala, the southern region is better off in terms of levels of living in both rural and urban sectors. The extent of inequality is also higher in South Kerala than in the North; still incidence of absolute poverty is higher in the North than in the South, reflecting the relatively lower level of standard of living in the former. As regards institutional facilities for health care, proportion of illness treated is higher in Kerala than in India as a whole. Extent of dependence on the public sector for health care is higher in Kerala than in all-India. Opportunity cost of illness is lower in Kerala than in India as a whole. Incidence of morbidity is higher in Kerala than in all-India. Within Kerala as a whole, it is (i) higher among women than men; (ii) higher in the rural than in the urban sector; and (iii) higher in the in the South than in the North. Incidence of morbidity is higher in rural than in urban Kerala and vice versa for all-India. As regards inequality in morbidity, the extent in general is lower in Kerala than in India though levels of morbidity are higher in the former than in the latter. Incidence of morbidity is uniformly higher among the poor than among the non-poor categories in South as well as North Kerala. In general, the poor rely relatively more on the public sector than on the private for treatment of illness as well as for hospitalization. Hence, the pursuit of privatization and public sector reform has to be carried out with due regard to the welfare costs associated with them.Socio-economic dimension, economic policy, inequality, opportunity cost

Poverty in India: Misspecified Policies and Estimates

Growth, Redistribution, Poverty, Specification error