Linking Women’s Incomes and Healthcare

UPSC Syllabus: Gs Paper 2- Issues relating to development and management of Social Sector/Services relating to Health

Introduction

India is experiencing both rising female labour force participation and an increasing burden of non-communicable diseases (NCDs). While healthcare policy has traditionally focused on expanding medical services, growing evidence shows that women’s economic empowerment can also influence household health decisions. Higher incomes earned by women encourage greater investment in nutrition, preventive care and healthier lifestyles, making economic empowerment an important factor in improving long-term public health.

India’s Twin Transformations

1. Rising Women’s Workforce Participation: Female labour force participation has increased sharply in recent years. Greater formalisation, digital payments and government initiatives have supported women’s entry into the workforce.
2. Changing Disease Burden: India is no longer dealing mainly with infectious diseases. Diabetes, hypertension, cardiovascular diseases, obesity and mental health disorders now account for most deaths and increase pressure on households and public finances.
3. A Hidden Link Between Two Changes: Economic and health transitions are often treated separately. New research shows that both developments may be closely connected through household decision-making.
4. Importance of Women’s Economic Role: Higher incomes for women can reshape household decision-making. This suggests that women’s economic participation is closely linked with better household health outcomes.

Beyond Healthcare Spending: Creating Better Health

1. Healthcare Is More Than Medical Treatment: Progress in healthcare is usually measured through hospitals, doctors, insurance and healthcare spending. These remain important for improving access and saving lives.
2. Role of Preventive Investments: Good health also depends on better nutrition, healthier lifestyles, preventive care, education, sanitation and informed household decisions. These factors reduce the chances of illness before treatment becomes necessary.
3. Ayushman Bharat and Primary Healthcare: Ayushman Bharat has expanded financial protection for millions of households. Improvements in primary healthcare infrastructure have also contributed to better health outcomes.
4. Lower Spending Can Mean Better Health: A fall in healthcare expenditure does not always indicate poor healthcare access. It may show that families are preventing diseases and therefore need less medical treatment.

Evidence Linking Women’s Income and Household Health Decisions

1. Natural Experiment Through EPF Reform: The 2018 Employees’ Provident Fund (EPF) reform reduced mandatory provident fund contributions for newly employed women in the formal sector from 12% to 8% during their first three years of employment. This increased women’s take-home salary without changing their gross wages.
2. Shift in Household Spending: Female-led households benefiting from the reform reduced overall healthcare expenditure by about 11.6%. Spending on medicines and doctors’ consultations declined, while spending on nutrition and physical fitness increased.
3. Medical Evidence Supports Preventive Spending: Electronic medical records from one of India’s largest eye hospital systems also showed lower healthcare expenditure among women receiving the income increase. This reflected greater investment in prevention and healthier living rather than lower value placed on healthcare.
4. Women’s Income Changes Household Priorities: Earlier studies show that income received by women increases household investment in education, nutrition and children’s wellbeing. The new findings show a similar pattern in healthcare, where women invest early to reduce future health risks instead of waiting for illness.

Policy Implications for India’s Development

1. Women’s Employment Supports Better Health: India’s demographic dividend depends on creating jobs for women and improving family health together. Higher female incomes can increase spending on nutrition, preventive care and healthier lifestyles.
2. Employment Policy Becomes Health Policy: Policies that strengthen women’s economic agency can improve public health along with labour market outcomes. Their benefits go beyond employment alone.
3. Reducing Pressure on Healthcare Financing: Better preventive health practices can reduce future illness and lower dependence on healthcare services. This can also reduce pressure on India’s healthcare system, where out-of-pocket expenditure remains a significant source of healthcare financing.
4. Creating Health Instead of Buying Healthcare: Households can improve health by investing in nutrition, healthier lifestyles and preventive care instead of depending mainly on medical treatment.
5. Healthcare Spending Is Not a Complete Measure: Lower expenditure on healthcare should not always be seen as neglect. It may reflect fewer illnesses because households have invested more in prevention.

Conclusion

India’s focus on preventive healthcare and healthier lifestyles should also promote women’s economic empowerment. Higher women’s incomes encourage greater investment in long-term health instead of only medical treatment. These different household spending decisions can improve family wellbeing, reduce pressure on the healthcare system and become an important investment in India’s public health.

Question for practice:

Evaluate the role of women’s economic empowerment in improving household health outcomes and promoting preventive healthcare in India.

Source: The Hindu