Conclusion and Recommendations

Breaking the vicious cycle of ill health and poverty is essential to economic development. Poor health can reduce productivity by reducing labor capacity, limiting productive investments, and depriving children of educational opportunities. The typical public policy response has been to make healthcare services available to the poor, an approach which is costly and generally not successful in reaching the most vulnerable groups. Organic agriculture, on the other hand, achieves health outcomes by promoting preventive health by improving the availability and nutritional quality of homegrown produce, improving the environment and sanitation conditions, and reducing exposure to toxic agrochemicals.

Despite abundant anecdotal evidence that organic agriculture leads to better health outcomes among farmers, there has so far been limited empirical evidence. Using household catastrophic medical expenditure as a proxy for health status, this study attempted to empirically examine whether the adoption of organic agriculture leads to lower medical expenditure, a proxy for improved health. The results of the empirical analysis support the assertion that organic households are in better health than conventional farming households.

The findings of the study revealed that organic households had lower OOP medical expenditure than conventional households, both in absolute terms and as a share of the household expenditure. The results show that organic households had lower incidences of catastrophic medical expenditure, as significantly more conventional farmers incurred healthcare payments in excess of a large fraction of the total household expenditure. In some cases, OOP healthcare payments absorbed more than one-quarter of total household expenditure and 40% of non-food expenditure in conventional households.

The findings also revealed that the impacts of catastrophic medical expenditure are greater in low-income households than higher-income households. The concentration curves and indices show that catastrophic healthcare payments are borne disproportionately by the poor, especially among conventional farmers. The highest medical expenditures are incurred by the poorest quintiles of conventional farming households. This result is not surprising as it is generally accepted that inappropriate pesticide use is most prevalent among the poorest farmers, who are often illiterate and do not receive training on the proper use of pesticides. This finding suggests that promoting organic agriculture among the poor, who are at high risk of pesticide abuse, would result in more significant health gains than promoting organic agriculture among higher-income farmers.

Households incurring catastrophic payments were forced to cut back expenditure on essential goods and services, such as clothing, fuel, transportation, communication, and food, thus investing less in their current production system. Poor households can only cover the high level medical expenditure by diverting resources from household consumption, accumulating debt, selling assets, or using savings, if they have any. Although we cannot draw a causal relationship between medical expenditure and consumption due to the limitations of cross-sectional data, our findings suggest that household consumption decreased with the incidence of catastrophic medical expenditure. Spending on all major categories of household consumption was lower among households with catastrophic expenditure than those without. Of great concern, education expenditure appears to be among the first expenditures sacrificed when a household member falls ill and requires medical care. These findings reveal that catastrophic expenditure on healthcare has a significant effect on household consumption and can have a negative impact on both the short- and long-term well-being of a household.

Our findings indirectly show that organic households experience less illness than conventional households. Although health outcomes are influenced by a variety of factors, it is likely that organic households are healthier due to a combination of reduced exposure to pesticides, improved food security, better nutrition, and better sanitation conditions in general. By reducing spending on healthcare, the adoption of organic agriculture enables poor households to invest in other areas, such as education, leading to long-term poverty reduction.

Health is so critical to development that three out of the eight United Nations Millennium Development Goals are health related. These findings suggest that promoting organic agriculture is an effective poverty reduction strategy leading to the achievement of the health-related Millennium Development Goals while saving public expenditure on healthcare for the poor. Organic agriculture also uniquely offers a comprehensive health improvement strategy which goes well beyond spending on healthcare to improve related areas such as food security, water, sanitation, and the environment.

Future research should further investigate the links between various health factors, such as nutritional intake, exposure (or lack of exposure) to pesticides, and sanitation conditions, and health outcomes in organic and conventional households through time-series data or a longterm household study. Beyond the health impacts on producers, the impacts on consumers should be further investigated. Since the trade of organic products is growing rapidly in international markets, future research should also investigate how international trade of organic products can have implications beyond national health programs as a global public good.

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Comment(s)

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1. Gabby
   (posted 21 January 2009 / 04:39:21 PM)
   
   this is a good contributon to understand the link between health outcomes and occupations...