© “UTKAL ECONOMIC PAPER”, Vol. XIII, 2007, pp. 17-23.
DETERMINANTS OF HOUSEHOLD HEALTH EXPENDITURE:
CASE OF URBAN ORISSA
Bhabesh Sen1
Himanshu Sekhar Rout2
I. RATIONALE OF THE STUDY
Poverty invites malnourishment. Malnutrition has been identified as the “biggest single
contributor to child mortality in developing countries” (FAO, 1970). The malnourished mother
gives birth to a low birth weight baby. Malnourishment after birth lowers the child’s resistance to
disease. A malnourished child may suffer mental impairment and thus benefit less from any
education that is provided. Malnutrition affects human growth and development by adversely
affecting the normal shape and size of the body, and early childhood it can result in serious
retardation in mental development. In India, where children are expected to help in agriculture
(as most of the people depend on it), the rates of school attendance is low, and poor health lowers
the still further. The child who is hungry while at school may gain little from education. Poverty
and ill health waste educational resources. Thus, ill health is the cause of poverty, but poverty is
also a cause of ill health. Lack of knowledge can be a direct cause of ill health, or it can cause it
indirectly by being one of the causes of poverty.
Different socioeconomic factors could affect health at different times in the life course
(Rahkonen, Lahelma and Huuhka, 1997; Smith, Hart, Blane and Hole, 1998), pertaining at
different levels (e.g., individual, household, neighbourhood) (Robert, 1999; Yen and Syme,
1999). Among researchers there is growing acceptance that health and its social distribution need
to be studied over the whole of the life course (Bartley, Blane and Montgomery; 1997). Diet
affects the health of socially disadvantaged people from the cradle to the grave (James, Nelson,
Ralph and Leather; 1997). Accumulating evidence suggests that an individual’s health can be
influenced by the socioeconomic characteristics of the neighbourhood in which she or he lives,
above and beyond her or his own individual level socioeconomic status (Robert, 1999; Yen and
Syme, 1999). Past socioeconomic factors could act independently or modify the effects of
1 Professor, Department of Analytical and Applied Economics, Utkal University, Bhubaneswar, Orissa
2 Lecturer, P.G. Department of Economics, Dr. SRK Government Arts College (Government of Puducherry),
YANAM - 533464, India