South-East Asia Regional Conference on Epidemiology

134 | <strong>South</strong>-<strong>East</strong> <strong>Asia</strong> <strong>Regional</strong> <strong>Conference</strong> on Epidemiology
Social
protection
(incl. health
insurance)
Nutrition
Health risky
behavior
Education
Unemployment &
inf ormalization
Household
real income
Catastrophic health
expenditure
Consumption on
other necessities
Fig. 8: Framework
Economic Recession
Currency
devaluation
Inflation
Health input price
(incl. drug &medical
supplies)
Deterioration of health outcome
Healthcare utilization
Informal
payment
Government
budget/expenditure
decrease
Public health
budget cut
Capacity/quality
of public
health service
and buy cheaper food, with an impact on their nutrition status, especially for children and women.
Instead of buying meat, they will buy only the staple food. Consumption and other necessities would
be reduced. Acute and chronic diseases increase. These factors will result in deterioration of the health
and nutrition status. In 1997-1998, there were problems of mental health in Japan, Korea and Hong
Kong SAR. There was an increase in the number of sex workers in Thailand because of poverty.
In order to assess the impact of current crisis, Professor Kwon and his team carried out a quick
survey in Bangladesh, China, Malaysia, Nepal and Viet Nam. The team selected small samples of the
populations that were probably directly affected by the crisis considering the structure of the economy.
In Bangladesh, for example, workers in garment factories were surveyed.
Let me make a parenthesis here: it is not easy to estimate the impact of the crisis on an industry.
Bangladesh, for example, has an important garment industry. Some economists contend that the crisis
will have a huge impact on Bangladesh because the garment industry is an important source of revenue
and the country relies heavily on exports. However, other economists believe that because Bangladesh
is producing cheap garments, it will increase exports and thus benefit actually from the crisis. As you
can understand, both hypotheses are reasonable.
Back to Professor Kwon’s quick survey, the results show that in the groups surveyed in Bangladesh,
China and Malaysia, workers who became recently unemployed were more stressed and depressed
than the ones employed. But other indicators of health utilization, at this time, show virtually no
change and no impact on health. (Data are not available for Nepal and Viet Nam).