Introduction

Health is one of the most important components of an effective poverty reduction strategy. Better health can increase productivity and household income, while poor health is likely to reduce output (Croppenstedt and Muller 2000; Antle and Pingali 1995). The conventional approach to addressing health problems among the poor has been to extend medical and health services. However, this approach can be a large burden on public expenditure and the outreach to poor in rural areas is often limited.

Among the rural poor, the majority of whom earn their living through agriculture, one of the main causes of health problems is exposure to agrochemicals, in particular pesticides. The World Health Organization (WHO) estimates that at least three to four million people in the developing world are severely poisoned each year from exposure to agrochemicals, a number that would likely be far higher if it included the many rural poor who do not seek treatment in hospitals. Recent attempts to quantify the health costs of pesticide use in Europe have estimated annual costs of 125 million euros in Germany and 190 million euros in the United Kingdom (IFAD 2005). In developing countries where safety standards are lower, the costs are likely to be considerably higher.

Surveys consistently show that one of the main reasons why organic producers choose to shift to organic methods of production is their concern about the health problems associated with the use of chemical inputs (International Fund for Agricultural Development [IFAD] 2003, 2005). When used in excess without proper care, pesticides and other agrochemicals can negatively affect the health of farmers, their families, and their communities. Incidences of serious illnesses such as cancer due to long-term exposure to pesticides are welldocumented, with evidence linking pesticide use to increased risks of birth malfunction, birth defects, and other reproductive problems (Kerdsuk 2004; Ransom 2002).

Organic agriculture can eliminate the health risks associated with pesticides and minimize the public health costs of conventional chemical farming. Although there has been little quantitative research on the health effects of shifting to organic agriculture, there is abundant anecdotal evidence. Farmers in India reported that symptoms of pesticide poisoning disappeared after they adopted organic farming (IFAD 2005), while an IFAD (2003) study in six Latin American countries found that organic farmers generally perceived themselves to be in better health after converting to organic agriculture.

Beyond reduced risk of exposure to agrochemicals, organic agriculture has indirect impacts on health through increased income and improved food security and dietary quality (Setboonsarng 2006). Rising incomes allow households to spend more on food and preventative healthcare, reducing the incidence of illness and lowering the long-term opportunity costs of poor health. Again, however, this conclusion is based on anecdotal evidence, as little quantitative data is available on the effects of organic production on health.

To fill this gap, this study attempts to empirically examine whether the adoption of organic farming practices leads to better health. As a proxy for health status, we compare the health expenditure patterns of organic and conventional rice-farming households in North and Northeast Thailand. Using data from a 2006 household survey covering 626 households in eight provinces, we calculate catastrophic health expenditures as out-of-pocket (OOP) medical expenditures exceeding a specified percentage of the household budget.

The structure of the paper is as follows: we first briefly provide background on OOP medical expenditures and our methodology for identifying the incidence of catastrophic health expenditure. We then define household expenditure and calculate the budget shares of OOP payments before presenting our findings on the incidence of catastrophic health expenditure for organic and conventional households. We next examine the differences in expenditure patterns of households with and without catastrophic health expenditure. A concluding section summarizes our main findings.

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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...