Abstract
This study examined wealth trends in a rural Kenyan community between 2011 and 2018. Understanding wealth trends is important for understanding health outcomes and overall well-being of vulnerable communities, and for informing economic and health policy that can improve specific wealth challenges. Information regarding household materials, assets, education, and mortality from 20,370 households in the Kombewa Health and Demographic Surveillance System was used. Three indices were developed and compared to quantify wealth: a principal component analysis of assets, a multiple correspondence analysis of assets, and the multidimensional poverty index. Wealth quintiles and levels of deprivation relating to socioeconomic status were then created and analyzed over time. Wealth measured by the asset-based indices, suggested an increase in wealth during the assessment period with the percentage of households in the wealthiest quintile increasing from 19 to 23%. The multidimensional poverty index, however, suggests no change in socioeconomic status over time. Among other factors, a lack of access to sanitation and improved water seems to be the main justification. Our results indicate that households are accumulating assets, but their increased accumulation is not translating to changes in living conditions known to improve health. Hence, while houses may be getting wealthier, they may not necessarily be getting healthier.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Availability of Data and Materials
Household characteristic data is included. Figure 1 was generated in-house using the ArcGIS Version 10.3.1 (Environmental Systems Research Institute, Red-lands, CA, USA) software.
Code Availability
Data analyses scripts are included. All analyses were conducted using R Version 3.5.2
References
Akinboade, O. A., & Adeyefa, S. A. (2018). An analysis of variance of food security by its main determinants among the urban poor in the city of Tshwane, South Africa. Social Indicators Research, 137(1), 61–82. https://doi.org/10.1007/s11205-017-1589-1.
Alkire, S., & Santos, M. E. (2010). Acute multidimensional poverty: A new index for developing countries (No. 38). Retrieved from https://www.ophi.org.uk/wp-content/uploads/OPHI-wp38_with_note.pdf.
Alkire, S., Jindra, C., Robles Aguilar, G., & Vaz, A. (2017). Multidimensional poverty reduction among countries in Sub-Saharan Africa. Forum for Social Economics, 46(2), 178–191. https://doi.org/10.1080/07360932.2017.1310123.
AMCOW Country Status Overview. (2011). Water Supply and Sanitation in Kenya: Turning Finance into Services for 2015 and Beyond. An African Minister’s Council on Water Country Status Overview, 1–15. Retrieved from https://www.amcow.net.
Amek, N., Vounatsou, P., Obonyo, B., Hamel, M., Odhiambo, F., Slutsker, L., & Laserson, K. (2015). Using health and demographic surveillance system (HDSS) data to analyze geographical distribution of socio-economic status; an experience from KEMRI/CDC HDSS. Acta Tropica, 144, 24–30. https://doi.org/10.1016/j.actatropica.2015.01.006.
Anand, S., & Sen, A. (1997). Concepts of human development and poverty: A multidimensional perspective. (pp. 1–20). Human Development Papers.
Asselin, L.-M., & Anh, V. T. (2008). Multidimensional poverty measurement with multiple correspondence analysis. Quantitative Approaches to Multidimensional Poverty Measurement. https://doi.org/10.1057/9780230582354_5.
Association, A. P. (2007). Socioeconomic status. Retrieved March 26, 2020, from https://www.apa.org/topics/socioeconomic-status/.
Baum, F. (2005). Wealth and health: The need for more strategic public health research. Journal of Epidemiology and Community Health, 59, 542–545. https://doi.org/10.1136/jech.2004.021147.
Booysen, F., van der Berg, S., Burger, R., von Maltitz, M., & DU Rand, G. (2008). Using an asset index to assess trends in poverty in seven Sub-Saharan African countries. World Development, 36(6), 1113–1130. https://doi.org/10.1016/j.worlddev.2007.10.008.
Bruder, P. (2002). In context: Healthcare and public policy: Patterns of health and illness: The effects of poverty on health. Hospital Topics, 80(1), 34–36. https://doi.org/10.1080/00185860209597925.
Census Bureau United States. (2019). Income & Poverty. Retrieved March 26, 2020, from https://www.census.gov/topics/income-poverty.html.
Chowa, G. A., Masa, R. D., & Sherraden, M. (2012). Wealth effects of an asset-building intervention among rural households in Sub-Saharan Africa. Journal of the Society for Social Work and Research, 3(4), 329–345. https://doi.org/10.5243/jsswr.2012.20.
Coates, M. M., Kamanda, M., Kintu, A., Arikpo, I., Chauque, A., Mengesha, M. M., Price, A. J., Sifuna, P., Wamukoya, M., Sacoor, C. N., Ogwang, S., & Bukhman, G. (2019). A comparison of all-cause and cause-specific mortality by household socioeconomic status across seven INDEPTH network health and demographic surveillance systems in sub-Saharan Africa. Global Health Action, 12(1), 1–12. https://doi.org/10.1080/16549716.2019.1608013.
Córdova, A. (2008). Methodological note: Measuring relative wealth using household asset indicators. In Americas Barometer Insights (No. 6). Retrieved from http://vanderbilt.edu/lapop/insights/I0806en.pdf.
de la O Campos, A. P., Villani, C., Davis, B., & Takagi, M. . (2018). Ending extreme poverty in rural areas—Sustaining livelihoods to leave no one behind. . FAO.
Deaton, A., & Zaidi, S. (2002). Guidelines for constructing consumption aggregates for welfare analysis. . World Bank.
Engels, T., Baglione, Q., Audibert, M., Viallefont, A., Mourji, F., Faris, M. E. A., Aidi, S., & GRAVCM Study Group. (2014). Socioeconomic status and stroke prevalence in morocco:results from the rabat-casablanca study. PLoS ONE, 9(2), e89271. https://doi.org/10.1371/journal.pone.0089271.
Ezzrari, A., & Verme, P. (2012). A multiple correspondence analysis approach to the measurement of multidimensional poverty in Morocco 2001–2007. In Economic policy, poverty and gender, Middle East and North Africa region (Vol. 9). https://doi.org/10.1007/978-1-4614-5263-8_7
Feinstein, J. S. (1993). The relationship between socioeconomic status and health: A review of the literature. In The Milbank Quarterly (Vol. 71). Retrieved from https://about.jstor.org/terms
Ferguson, H. B., Bovaird Mph, S., & Mueller, M. P. (2007). The impact of poverty on educational outcomes for children. In Paediatr Child Health (Vol. 12).
Friedman, M. (1957). A Theory of the Consumption Function. National Bureau of Economic Research, Inc.
Haacker, M., & Birungi, C. (2018). Poverty as a barrier to antiretroviral therapy access for people living with HIV/AIDS in Kenya. African Journal of AIDS Research, 17(2), 145–151. https://doi.org/10.2989/16085906.2018.1475401.
Hargreaves, J. R., Morison, L. A., Gear, J. S. S., Kim, J. C., Makhubele, M. B., Porter, J. D. H., Watts, C., & Pronyk, P. M. (2007). Assessing household wealth in health studies in developing countries: A comparison of participatory wealth ranking and survey techniques from rural South Africa. Emerging Themes in Epidemiology. https://doi.org/10.1186/1742-7622-4-4.
Harttgen, K., & Vollmer, S. (2013). Using an asset index to simulate household income. Economics Letters, 121(2), 257–262. https://doi.org/10.1016/j.econlet.2013.08.014.
Howe, L. D., Hargreaves, J. R., & Huttly, S. R. A. (2008). Issues in the construction of wealth indices for the measurement of socio-economic position in low-income countries. Emerging Themes in Epidemiology, 5(3), 1–4. https://doi.org/10.1186/1742-7622-5-3.
Hruschka, D. J., Hadley, C., & Hackman, J. (2017). Material wealth in 3D: Mapping multiple paths to prosperity in low- and middle- income countries. PLoS ONE, 12(9), e0184616. https://doi.org/10.1371/journal.pone.0184616.
Kabudula, C. W., Houle, B., Collinson, M. A., Kahn, K., Tollman, S., & Clark, S. (2017). Assessing changes in household socioeconomic status in Rural South Africa, 2001–2013: A distributional analysis using household asset indicators. Social Indicators Research, 133(3), 1047–1073. https://doi.org/10.1007/s11205-016-1397-z.
Karan Charles, B., Nyonje, R., Leonard Ogweno, K., & Peter Anyang Nyongo. (2019). Determinants of implementation of county water and sanitation programme in Maseno Division of Kisumu West sub-county, Kisumu County. Invention Journal of Research Technology in Engineering & Management (IJRTEM), 3(2), 32–46. Retrieved from http://www.ijrtem.com.
Kenya Institute for Public Policy Research and Analysis (KIPPRA). (2020). Kenya Economic Report 2020: Creating an Enabling Environment for Inclusive Growth in Kenya. Retrieved from http://www.kippra.org
Lange, G.-M., Wodon, Q., & Carey, K. (2018). The changing wealth of nations 2018: Building a sustainable future. World Bank Group. https://doi.org/10.1596/978-1-4648-1046-6.
Lee, K., Miguel, E., & Wolfram, C. (2020). Experimental evidence on the economics of rural electrification. Journal of Political Economy, 128(4), 1523–1565. https://doi.org/10.1086/705417.
Morakinyo, O. M., Balogun, F. M., & Fagbamigbe, A. F. (2018). Housing type and risk of malaria among under-five children in Nigeria: Evidence from the malaria indicator survey. Malaria Journal, 17(1), 311. https://doi.org/10.1186/s12936-018-2463-6.
Nundy, S., Gilman, R. H., Xiao, L., Cabrera, L., Cama, R., Ortega, Y. R., Kahn, G., & Cama, V. A. (2011). Wealth and its associations with enteric parasitic infections in a low-income community in Peru: Use of principal component analysis. American Journal of Tropical Medicine and Hygiene, 84(1), 38–42. https://doi.org/10.4269/ajtmh.2011.10-0442.
Peña, M., & Bacallao, J. (2002). Malnutrition and poverty. Annual Review of Nutrition, 22(1), 241–253. https://doi.org/10.1146/annurev.nutr.22.120701.141104.
Peters, D. H., Garg, A., Bloom, G., Walker, D. G., Brieger, W. R., & Hafizur Rahman, M. (2008). Poverty and access to health care in developing countries. Annals of the New York Academy of Sciences, 1136, 161–171. https://doi.org/10.1196/annals.1425.011.
Phelan, J. C., Link, B. G., & Tehranifar, P. (2010). Social conditions as fundamental causes of health inequalities: Theory, evidence and policy implications. Journal of Health and Social Behavior, 51, S28–S40. https://doi.org/10.1177/0022146510383498.
R Core Team. (2018). R: a languange and environment for statistical computing. Retrieved from http://www.r-project.org
Rural Electriciation Authority. (2017). Strategic plan from 2017 to 2021. Nairobi, Kenya.
Rutstein, S. O., & Johnson, K. (2004). The DHS wealth index. Calverton, MD, USA.
Sahn, D. E., & Stifel, D. C. (2004). Urban-rural inequality in living standards in Africa. Journal of African Economies, 13(1), 564–597. https://doi.org/10.1093/jae/12.4.564.
Salecker, L., Ahmadov, A. K., & Karimli, L. (2020). Contrasting monetary and multidimensional poverty measures in a low-income sub-Saharan African country. Social Indicators Research, 151(2), 547–574. https://doi.org/10.1007/s11205-020-02382-z.
Sen, A. (1999). Development as freedom. Anchor Books.
Sifuna, P., Oyugi, M., Ogutu, B., Andagalu, B., Otieno, A., Owira, V., Otsyula, N., Oyieko, J., Cowden, J., Otieno, L., & Otieno, W. (2014). Health and demographic surveillance system profile: The Kombewa health and demographic surveillance system (Kombewa HDSS). International Journal of Epidemiology, 43(4), 1097–1104. https://doi.org/10.1093/ije/dyu139.
Mugoya, T., & G. C., & Mutua, K. N. . (2015). Childhood disability risk factors in Kenya: Impact of poverty and other socio-demographics. International Journal of Disability, Development and Education, 62(5), 501–517. https://doi.org/10.1080/1034912X.2015.1048670.
Taylor-Robinson, D., Lai, E. T. C., Wickham, S., Rose, T., Norman, P., Bambra, C., Whitehead, M., & Barr, B. (2019). Assessing the impact of rising child poverty on the unprecedented rise in infant mortality in England, 2000–2017: time trend analysis. British Medical Journal Open, 9(10), e029424. https://doi.org/10.1136/bmjopen-2019-029424.
The World Bank. (2019). GDP, PPP (constant international $)—Kenya. Retrieved April 15, 2020, from World Development Indicators website: https://data.worldbank.org/indicator/NY.GDP.PCAP.PP.KD?end=2018&locations=KE&start=2011&view=chart.
Tusting, L. S., Bisanzio, D., Alabaster, G., Cameron, E., Cibulskis, R., Davies, M., Flaxman, S., Gibson, H. S., Knudsen, J., Mbogo, C., & Bhatt, S. (2019). Mapping changes in housing in sub-Saharan Africa from 2000 to 2015. Nature, 568(7752), 391–394. https://doi.org/10.1038/s41586-019-1050-5.
Tusting, L. S., Gething, P. W., Gibson, H. S., Greenwood, B., Knudsen, J., Lindsay, S. W., & Bhatt, S. (2020). Housing and child health in sub-Saharan Africa: A cross-sectional analysis. PLoS Medicine, 17(3), e1003055. https://doi.org/10.1371/journal.pmed.1003055.
United Nations. (2019). Ending Poverty|United Nations. Retrieved March 26, 2020, from United Nations website: https://www.un.org/en/sections/issues-depth/poverty/.
Vyas, S., & Kumaranayake, L. (2006). Constructing socio-economic status indices: How to use principal components analysis. Health Policy and Planning, 21(6), 459–468. https://doi.org/10.1093/heapol/czl029.
WHO, & UNICEF. (2017). Progress on drinking water, sanitation and hygiene. In Update and SDG Baselines. Retrieved from http://apps.who.int/bookorders.
Wittenberg, M., & Leibbrandt, M. (2017). Measuring inequality by asset indices: A general approach with application to South Africa. Review of Income and Wealth, 63(4), 706–730. https://doi.org/10.1111/roiw.12286.
World Bank. (n.d.). Global Consumption Database. Retrieved March 26, 2020, from http://datatopics.worldbank.org/consumption/.
World Bank. (2000). World Development Report: Attacking Poverty. Retrieved from http://www.worldbank.org.
World Bank. (2019). Poverty Overview. World Bank. https://doi.org/10.1080/1364436012010051.
Yoshikawa, H., Aber, J. L., & Beardslee, W. R. (2012). The effects of poverty on the mental, emotional, and behavioral health of children and youth. American Psychologist, 67(4), 272–284. https://doi.org/10.1037/a0028015.
Acknowledgements
We would like to thank the Kombewa HDSS team, including the community health workers, who collected this data and made this analysis possible.
Funding
Alizée McLorg was funded through a fellowship from the Crown Wise Research Fund. David Larsen was funded by an internal grant from SUNY Upstate Medical University Institute for Global Health and Translational Science.
Author information
Authors and Affiliations
Contributions
Conceptualization: DL, AS, PS, AM. Data Curation: KO, PS. Formal Analysis: AM. Methodology: AM, DL, BW. Supervision: DL, AS. Visualization: AM. Writing: AM.
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Disclaimer
Material has been reviewed by the Walter Reed Army Institute of Research, Silver Spring, MD, USA. There is no objection to its presentation and/or publication. The opinions or assertions contained herein are the private views of the authors, and are not to be construed as official or as reflecting the true views of the Department of the Army or the Department of Defense.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
McLorg, A., Omolo, K., Sifuna, P. et al. Examining Wealth Trends in Kombewa, Kenya. Soc Indic Res 157, 631–651 (2021). https://doi.org/10.1007/s11205-021-02677-9
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11205-021-02677-9