Consumption displacement in households with noncommunicable diseases in Bangladesh

Abstract

The economic burden of noncommunicable diseases (NCDs), including treatment costs and income and productivity losses, is a growing concern in developing countries, where NCD medical expenditure may offset consumption of other essential commodities. This study examines the role of NCDs in household resource allocation in Bangladesh. We use the Bangladesh Household Income and Expenditure Survey (HIES) 2010 to obtain expenditure data on 11 household expenditure categories and 12 food expenditure sub-categories for 12,240 households. Household NCD status was determined through self-report of at least one of the six major NCDs within the household–heart disease, hypertension, diabetes, kidney diseases, asthma, and cancer. We estimated unadjusted and regression-adjusted differences in household expenditure shares between NCD and non-NCD households. We further investigated how consumption of different food sub-categories is related to NCD status, distinguishing between household economic levels. The medical expenditure share was estimated to be 59% higher for NCD households than non-NCD households, and NCD households had lower expenditure shares on food, clothing, hygiene, and energy. Regression results indicated that presence of NCDs was associated with lower relative expenditure on clothing and housing in all economic subgroups, and with lower expenditure on food among marginally poor households. Having an NCD was significantly associated with higher household spending on tobacco and higher-calorie foods such as sugar, beverages, meat, dairy, and fruit, and with lower spending on fish, vegetables, and legumes. The findings indicate a link between NCDs and the possibility of adverse economic effects on the household by highlighting the potential displacement effect on household consumption that might occur through higher medical expenditure and lower spending on essentials. The findings might also point to a need for raising awareness about the link between NCDs and diet in Bangladesh.

Beyond panic buying: consumption displacement and COVID-19

“…Disasters clearly influence consumption behaviours (Ballantine et al, 2014;Larson and Shin, 2018;Pantano et al, 2020;Sheu and Kuo, 2020). Consumption displacement, the shift in consumption that occurs when consumers experience a change in the availability of goods, services and amenities to which they are accustomed as the result of an external event, has been previously recognised in households with non-communicable diseases (Datta et al, 2018), and neighbourhood gentrification (Grier and Parry, 2018), but only to a limited extent in the context of disasters and crises. However, we argue that COVID-19 NPI measures, which restrict individual mobility and personal contact (physical or social distancing) (Anderson et al, 2020), and which include the closure of certain business functions and restrictions on social congregation and events, serve to displace consumption in several ways:…”

Introducing the PLOS special collection of economic cases for NCD prevention and control: A global perspective

“…Datta et al assessed the role of NCDs in household resource allocation in Bangladesh [12]. Household NCD status was based on a member of the household having at least one of the six major NCDs: heart disease, hypertension, diabetes, kidney diseases, asthma, and cancer.…”

Mapping the Multidimensionality of Medical Care related Catastrophe on Households: A Study of Four Blocks in Birbhum District, West Bengal

“…There also exists evidence that outpatient care expenses have the highest proportion in healthcare costs [28] and this can be attributed to the fact that social health insurance schemes in developing countries like India do not cover outpatient care [33]. There also exists enough empirical literature that suggests a positive relation between chronic illness and OOP health expenditure in LMICs [10,[34][35][36][37][38]. This is primarily because chronic care for NCDs is costly and place substantial burden on household budgets by increasing OOP payments and impoverishing households [39][40][41].…”