Health shocks, village elections, and household income: Evidence from rural China

Using a sample of 1185 households in 48 Chinese villages for the period 1987–2002, we study the effects of major health shocks on household income and the role played by village elections in mitigating these effects. Major health shocks are defined by abnormal increases in a householdʹs medical expenditure. Our results show that a major health shock reduces householdsʹ net income significantly and that village elections alleviate such adverse impacts by almost half. The main mechanism behind this effect is increased coverage of health care insurance, which helps households smooth their consumption when major health shocks happen.