The Hidden Costs of Care: Chronic Illness, Poverty, and the Healthcare Burden in India

• ISBN13: 9789372260229
• Binding: Hardcover
• Subject: Sociology and Anthropology
• Publisher: Atlantic Publishers & Distributors (P) Ltd
• Publisher Imprint: Atlantic
• Publication Date: July 18, 2026
• Pages: 248
• Original Price: INR 1195.0
• Language: English
• Edition: N/A
• Item Weight: 470 grams
• BISAC Subject(s): Public Health, Health Policy, and Sociology / General

The Hidden Costs of Care: Chronic Illness, Poverty, and the Healthcare Burden in India explores how out-of-pocket healthcare expenses for chronic illness contribute to economic hardship and social distress in India. It highlights that chronic illness is not just a health issue, but a social and structural problem that exacerbates poverty, inequality, and vulnerability. Drawing on primary research conducted in Aligarh District, Uttar Pradesh, with evidence from both public and private hospitals, the book examines how families manage the long-term socio-financial demands of treatment. It focuses on vulnerable sections of society, including women, daily wage earners, agricultural laborers, and marginalized groups affected by regional, income, and educational disparities. By linking healthcare spending to debt, asset loss, educational disruption, strained family relations, and weakened social support systems, the book offers a sociological perspective on the hidden consequences of chronic illness. It argues for more equitable, inclusive, and responsive health policies, and contributes significantly to the study of health inequality and healthcare access in contemporary India.

Dr. Aijaz Ahmed is an ICSSR Postdoctoral Fellow at the Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, whose journey blends rigorous research, teaching, and social engagement. He holds a Ph.D. in Sociology, a Postgraduate Diploma in Higher Education, and a B.Ed. An expert in Medical Sociology, the Sociology of Chronic Diseases, and Research Methodology, he has authored numerous books on these subjects as well as research papers in Scopus- and UGC-CARE-listed journals. With four years of teaching experience and active engagement in social initiatives, he combines scholarship with a commitment to real-world impact, inspiring students, researchers, and professionals alike.

Rahat Jabeen is currently pursuing a Ph.D. in Computer Science and Applications at SKD University, Hanumangarh, Rajasthan. Holding a Master's degree in Computer Applications (MCA) from BGSBU, Rajouri, she also qualified the UGC-NET, which has facilitated her doctoral endeavors. She has actively contributed to academia by co-authoring undergraduate-level textbooks, presenting research papers at national conferences, and participating in various workshops. With teaching experience from government degree colleges affiliated with the University of Jammu, she demonstrates a strong commitment to education and research.

• Preface............. xix
• Acknowledgments.............xxi
• Chapter 1: Foundations of Health Expenditure ............1
• 1.1 Introduction............1
• 1.2 Defining Health Expenditure: An Operational Perspective.............4
• 1.3 Catastrophic and Out-of-Pocket Expenditure: Key Concepts............5
• 1.4 Cost of Illness: Understanding the Economic Impact.............6
• 1.5 Breaking Down Medical Expenditure: Direct vs. Indirect.............7
• Chapter 2: Global Insights into Health Spending............9
• 2.1 Introduction............9
• 2.2 Global Health Expenditure: Analyzing Key Trends ....9
• 2.3 The Role of Public Spending in Global Health .........18
• 2.4 Global Public Health Spending during the COVID-19 Pandemic............23
• Chapter 3: Out-of-Pocket Health Expenditure: A Global Analysis............27
• 3.1 Introduction............27
• 3.2 Linking Out-of-Pocket Spending to Catastrophic Health Expenditure (SDG 3.8.2) ............29
• 3.3 Insights from Previous Studies............31
• 3.4 The Burden of Chronic Diseases and Related OOP Health Spending.............34
• Chapter 4: Health Spending in India: A National Overview.............39
• 4.1 Introduction............39
• 4.2 Understanding the Key Drivers of HealthExpenditure in India............39
• 4.3 Trends in Total Health Spending across India ..........40
• 4.4 The Role of Public Spending in Indian Healthcare ...45
• 4.5 Evolving Trends in Public Health Spending .............45
• 4.6 Socio-Economic Impact.............49
• 4.7 Health Spending and the Union Budget in India (2015–16 to 2025–26).............52
• Chapter 5: Out-of-Pocket and Catastrophic Health Spending in India.............57
• 5.1 Introduction............57
• 5.2 Insights from Previous Studies on Healthcare Costs.............65
• 5.3 Analyzing Catastrophic Spending on Health in India............69
• Chapter 6: Chronic Diseases in India: The Financial Impact............71
• 6.1 Introduction............71
• 6.2 Socio-Economic Impact of Non-Communicable Diseases (NCDs).............76
• Chapter 7: Health Spending in Uttar Pradesh: Public vs. Private............. 79
• 7.1 Introduction............79
• 7.2 The Impact of Out-of-Pocket Spending on Poverty...88
• 7.3 Critical Insights on Out-of-Pocket Spending and Healthcare.............92
• Chapter 8: Out-of-Pocket Spending on Chronic Diseases in Aligarh: Empirical Evidence of Public vs. Private............. 97
• 8.1 Introduction............97
• 8.2 Understanding Catastrophic and Out-of-Pocket Expenditure.............98
• 8.3 Global Summary: Health Spending and Chronic Disease Burden............99
• 8.4 India: Health Expenditure and Chronic Disease Overview............100
• 8.5 Uttar Pradesh: Healthcare Utilization and Disease Burden.............105
• 8.6 Comparative Analysis of Medical vs. Non-Medical Out-of-Pocket Spending: Empirical Evidence of Public vs. Private .............108
• 8.7 Socio-Economic Factors and Medical Spending: A Detailed Breakdown............108
• 8.8 Comparing Non-Medical Spending: Public vs. Private............127
• 8.9 Total Medical vs. Non-Medical Out-of-Pocket Spending.............143
• 8.9 Conclusion............149
• Chapter 9: Out-of-Pocket Spending on NCDs vs. Family Income.............151
• 9.1 Introduction............. 151
• 9.2 Examining the Total OOP Expenditure and Family Income............151
• 9.3 Conclusion............160
• Chapter 10: The Cost of Chronic Diseases: Public vs. Private Hospitals .............161
• 10.1 Introduction............. 161
• 10.2 Family Health Expenditure Over a Year: A Detailed Analysis.............164
• 10.3 Comparing Findings with Past Studies and Reports............166
• 10.4 The Social Impact of Healthcare Costs and Funding Sources............168
• 10.5 Financing Out-of-Pocket Spending: Sources and Strategies.............172
• 10.6 Conclusion............177
• Chapter 11: Key Findings and Analysis ............179
• 11.1 Introduction............. 179
• 11.2 Out-of-Pocket Spending by Disease Type .............179
• 11.3 Expenditure Trends across Rural and Urban Areas............. 180
• 11.4 Medical vs. Non-Medical Spending............180
• 11.5 Disparities by Caste and Income ............180
• 11.6 Total OOP Spending and Income Impact .............181
• 11.7 Borrowing and Asset Liquidation.............181
• 11.8 Comparison with National Data ............182
• 11.9 Socio-Cultural Impact of OOP Spending .............182
• 11.10 Conclusion............183
• References............185
• Appendix............211
• Index............215
• About the Authors.............225