Illness and Wage Loss: Longitudinal Evidence from India (and Implications for the Universal Health Coverage Agenda)

Background: A key aim of Universal Health Coverage (UHC) is to protect individuals and households against the financial risk of illness. Large-scale health insurance expansions are therefore a central focus of the UHC agenda. Importantly, however, health insurance does not protect against a key dimension of financial risk associated with illness: forgone wage income (due to short-term disability). In this paper, we quantify the economic burden of illness in India attributable--separately--to wage loss and to medical care spending, as well as differences in them across the socio-economic distribution. Methods: We use data from two Indian longitudinal household surveys: (i) the Village Dynamics in South Asia (VDSA) survey (1,350 households surveyed every month for 60 months between 2010 and 2015) and (ii) the Indian Human Development Survey (IHDS) (more than 40,000 households surveyed in 2005 and again in 2011). The VDSA allows us to study the economic dynamics of illness using high-frequency observations, and the IHDS allows us to confirm our findings in a nationally-representative sample. Both contain individual- and household-level information about illness, wage income, and medical spending over time. We use longitudinal variation in illness to estimate regression models of economic burden separately for wage loss and medical care spending across the socio-economic distribution. Our regression models include a series of fixed effects that control for differences in time-invariant household (or individual) characteristics and time-varying factors common across households. Findings: 1,184 households (88%) in the VDSA sample reported an episode of illness over 60 months, and 15770 households (40%) in the IHDS reported an illness in the preceding year. In the VDSA sample, on average, a day of illness was associated with a reduction in monthly per capita wage income of Rs 77 [95% CI -99 to -57] and an increase in monthly per capita medical spending of Rs 126 [95% CI 110-142]. Variation across the socio-economic distribution was substantial. Among the poorest households, wage loss due to illness is roughly 15% of total household spending--nearly three times greater than medical spending. Alternatively, among the most affluent households, wage loss is less than 5% of total household spending--and only one-third of medical spending. Put differently, wage loss accounts for more than 80% of the total economic burden of illness among the poorest households, but only about 20% of the economic burden of illness among the most affluent. Estimates from the IHDS sample show that this socio-economic gradient is present in the Indian population generally. Interpretation: Wage loss accounts for a substantial share of the total economic burden of illness in India--and disproportionately so among the poorest households. If Universal Health Coverage truly aims to protect households against the financial risk of illness--particularly poor households, the inclusion of wage loss insurance or another illness-related income replacement benefit is needed.

People are more tolerant of inequality when it is expressed in terms of individuals rather than groups at the top

Despite the ever-growing economic gap between the very wealthy and the rest of the population, support for redistributive policies tends to be low. This research tested whether people’s tolerance of inequality differs when it is represented in terms of a successful individual versus a group of people at the top of the economic ladder. We propose that drawing people’s attention to wealthy individuals undermines support for redistribution by leading people to believe that the rich person’s wealth is well deserved. Across eight studies (n = 2,800), survey participants rated unequal distributions of resources as more fair when presented with an individual, rather than a group, at the top of the distribution. Participants also expressed lower support for redistributive policies after considering inequality represented by successful individuals compared to groups. This effect was driven by people’s different attributions for individual versus group success. Participants thought that individuals at the top were more deserving of their successes and, in turn, were less likely to support redistribution when inequality was represented by individual success. These findings suggest that support for inequality, and policies to reduce it, may depend on who people are led to consider when they think about the top of the economic distribution.

Religious Cycles of Government Responsiveness: Why Governments Distribute in Ramadan

In many Muslim societies, autocrats expand their distributive policies in the religious season of Ramadan. Why do autocrats distribute in Ramadan? And, who do they target? Focusing on Egypt (2014-2020), this paper argues that the regime distributes in Ramadan to contain political threats to its survival by co-opting areas where such threats are more credible. I test this argument using an original municipality-level dataset of government-reported provision of economic benefits. The findings show that the government reports more economic distribution in places where political threats are higher: more socioeconomically developed, more contentious, and more affected by unpopular austerity measures. Using survey data, I also find that distribution in Ramadan translates into reputational gains for the regime, particularly among its critics. The conclusions suggest that autocrats might adopt multiple targeting strategies to respond to different threats to their survival, sometimes rewarding threatening groups to buy their acquiescence.

MUSLIM YOUTH AND PHILANTROPHIC ACTIVISM

Since the last two decades, charity movements have been flourishing in Indonesian Islamic landscape. These organisations are involving not only state sponsored organizations, but also non-government associations and professional industries. This article exclusively discusses the youth-based charity movements in two important Islamic universities in Indonesia and tries to offer a new glance of youth charity movement as to which their movement relates to the issue of identity and social welfare. The article uses a qualitative method through a systematic literature review, in-depth interview, and observation to the activities of two youth-based charity movements at two state Islamic universities in Jambi and Surabaya. This paper further argues that the spirit of philanthropic movement does not only depend on economic wealth, but also on social solidarity, Islamic principle of economic distribution, and networks among the students that have been successfully translated into both social welfare activism and humanitarian activities.

(Im)mobility Subcontracted: Nesting Hierarchies, Uneven Distributions and the ‘Roma Inclusion’ Projects in Europe

This paper explores social mobilities and trajectories in relation to particular mechanisms of subcontracting and of unequal distribution of capitals in the emerging field of EU funded projects for poor and socially excluded populations in Europe. It discusses some of the struggles for possible mobilities and its limits amidst continuing production and reproduction of privileges, disadvantages and structural orders in these project-cum-policy worlds constraints. By examining a particular case of a large-scale and multi-sited project and other similar project schemes, described by some of its proponents as one of the most ‘participatory’ projects for Roma in Europe, the article illustrates particular mechanisms of power and knowledge reproduction that facilitates some kinds of mobilities while also reproducing certain constraints and limits on these possibilities (for some subjects and some social trajectories). It develops an ethnographic critique of situated and nesting hierarchies of management and brokerage leading to reproduction of particular setups, privileges, unequal economic distribution and (mis)recognitions of capitals, which allows for particular emergence of particular kinds of contested ‘expertise’ in the uneven field of so-called ‘Roma inclusion’.

Spending Level of Displaced Population Returned to La Palma, Cundinamarca (2018): A Machine Learning Application

This research aims to know the variables allowing to predict the spending level of the displacement victims that returned to La Palma, Cundinamarca. For this purpose, a measurement instrument was divided into four sections: characterisation of the population, restitution of economic rights, patterns of economic distribution and, finally, social innovation initiatives. We applied the instrument to 100 participants, and we use different Machine Learning algorithms to know the variables that allow predicting the level of expenses of the displacement victims that returned to La Palma, Cundinamarca. The findings permitted to observe that, at the aggregate level, the Random Forest and the SMV have a prediction capacity higher than 84%.

Nilai Ramadhan dan Pendidikan Kaum Tertindas (Mustadh’afin): Tinjauan Atas Ekonomi Islam

Ramadan teaches social care. Momentum that is present this month (fasting) includes the teaching of humans about education. The message of transformative Islam in education is the meaning of Ramadan on the education of the oppressed (mustadh'afin). Education on the grounds of equality of knowledge rights and also in obtaining economic distribution rights. Ramadan teaches economic equality and balance so that the practice of liberation from the economic downturn of the people can be overcome. Islam offers muamalah (economic activism) through Islamic economics. The aim is to open up confinement over economic oppression and also be aware of the obligations of fellow human beings to be economically just. The practice of Islamic economics tries to dismantle the deterioration of the lower class economy with the concept of financial inclusion.Keywords: Ramadan, Education of The Oppressed, Mustadh'afin, Islamic EconomicsAbstrak:Ramadhan mengajarkan kepedulian sosial. Momentum yang hadir pada bulan ini (puasa) diantaranya adalah pengajaran atas manusia tentang pendidikan. Pesan Islam transformatif dalam pendidikan yang dimaksud adalah pemaknaan Ramadhan atas pendidikan kaum tertindas (mustadh’afin). Pendidikan atas nalar kesamaan hak pengetahuan dan juga dalam memperoleh hak distribusi ekonomi. Ramadhan mengajarkan kesamaan dan keseimbangan ekonomi sehingga praktik pembebasan atas keterpurukan ekonomi umat dapat di atasi. Islam menawarkan muamalah (aktivisme ekonomi) melalui ekonomi syariah. Tujuannya adalah membuka keterkungkungan atas ketertindasan ekonomi dan juga menyadarkan akan kewajiban sesama manusia untuk dapat bersikap adil secara ekonomi. Praktik ekonomi Islam mencoba membongkar keterpurukan ekonomi kelas bawah dengan konsep keuangan insklusif. Kata Kunci: Ramadhan, Pendidikan Kaum Terindas, Mustadh’afin, Ekonomi Islam