Health screening for emerging non-communicable disease burdens among the global poor: Evidence from sub-Saharan Africa.
Health screening
Hypertension
Low-income countries
Malawi
Matching estimator
Non-communicable diseases
Regression discontinuity design
Journal
Journal of health economics
ISSN: 1879-1646
Titre abrégé: J Health Econ
Pays: Netherlands
ID NLM: 8410622
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
29
02
2020
revised:
19
07
2020
accepted:
14
09
2020
pubmed:
30
11
2020
medline:
25
11
2021
entrez:
29
11
2020
Statut:
ppublish
Résumé
Evidence for the effectiveness of population health screenings to reduce the burden of non-communicable diseases in low-income countries remains very limited. We investigate the sustained effects of a health screening in Malawi where individuals received a referral letter if they had elevated blood pressure. Using a regression discontinuity design and a matching estimator, we find that receiving a referral letter reduced blood pressure and the probability of being hypertensive by about 22 percentage points four years later. These lasting effects are explained by a 20 percentage points increase in the probability of being diagnosed with hypertension. There is also evidence of an increase in the uptake of medication, while we do not identify improvements in hypertension-related knowledge or risk behaviors. On the contrary, we find an increase in sugar intake and a decrease in physical activity both of which are considered risky behaviors in Western contexts. The health screening had some positive effects on mental health. Overall, this study suggests that population-based hypertension screening interventions are an effective tool to improve health in low-income contexts.
Identifiants
pubmed: 33249266
pii: S0167-6296(20)31034-1
doi: 10.1016/j.jhealeco.2020.102388
pmc: PMC7855787
mid: NIHMS1646755
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Pagination
102388Subventions
Organisme : NICHD NIH HHS
ID : R01 HD044228
Pays : United States
Organisme : NIA NIH HHS
ID : R21 AG053763
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG012836
Pays : United States
Organisme : NICHD NIH HHS
ID : R24 HD044964
Pays : United States
Organisme : NICHD NIH HHS
ID : P2C HD044964
Pays : United States
Organisme : NIA NIH HHS
ID : R03 AG069817
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD053781
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI045008
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD087391
Pays : United States
Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.
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