Part Two. The urgent need for action
Chapter Two. Chronic diseases and poverty
Indirect economic impact
Chronic diseases have an indirect impact on people's economic status and employment opportunities in the long term. Indirect costs include:
- reduction in income owing to lost productivity from illness or death;
- the cost of adult household members caring for those who are ill;
- reduction in future earnings by the selling of assets to cope with direct costs and unpredictable expenditures;
- lost opportunities for young members of the household who leave school in order to care for adults who are ill or to help the household economy.
Reduction in income
In most high income countries, people with chronic diseases and disabilities are protected by social security systems, yet they still experience adverse economic consequences. However, in low and middle income countries disability insurance systems are either underdeveloped or nonexistent. The illness of a main income earner in low and middle income countries significantly reduces overall household income. People who have chronic diseases are not fully able to compensate for income lost during periods of illness when they are in relatively good health.
Sale of household possessions
Chronic diseases affect household investment and consumption patterns. Households often sell their possessions to cover lost income and health-care costs. In the short term, this might help poor households to cope with urgent medical costs, but in the long term it has a negative effect: the selling of productive assets - property that produces income - increases the vulnerability of households and drives them into poverty. Such changes in the investment pattern of households are more likely to occur when chronic diseases require long-term, costly treatment.