Health Screening for Emerging and Non-Communicable Disease Burdens
Among the Global Poor
Health screenings are an important tool to improve population health. In high and
middle-income countries, blood pressure (BP) screening can reduce the risk of
cardiovascular diseases, the leading cause of death and disability for adults 50 and
older. However, evidence for the effectiveness of BP screening in low-income
countries (LICs) remains very limited.
In this study, I investigate the sustained impact of BP screening for adults in rural
Malawi, a LIC in sub-Saharan Africa. Each participant had three BP measurements
taken. Those with high BP received a letter referring them to a health care provider
for further medical assessment.
Using a regression discontinuity design and a matching estimator, I find that
individuals who received a letter at baseline had a 22-percentage point lower
probability of being hypertensive four years later. Compared to similarly at-risk
people who did not receive a letter, those who received a letter were 20-percentage
points more likely to be diagnosed with hypertension and 13-percentage points more
likely to be taking BP medication.
Among adults at risk of hypertension in rural Malawi, providing a simple referral letter
effectively reduced BP and hypertension over four years. This is one of the first
studies to document long-term health effects of a simple screening for non-
communicable disease in sub-Saharan Africa.
This paper was published in the Journal of Health Economics earlier this year: