Beban Ekonomi Rumah Tangga Akibat Penyakit Berbasis Lingkungan di Bantaran Sungai Batang Kumu

Abstract

Communities living along the Batang Kumu Riverbank in Pujud District, Rokan Hilir Regency, face persistent environmental health challenges arising from water quality degradation caused by domestic pollution and agricultural activities within the watershed. This study aims to identify and analyze the economic burden of environment-related diseases borne by households in this area through the lens of social accounting, and to examine its implications for local environmental health conditions. A qualitative approach with a phenomenological method was employed. Twelve household heads residing along the riverbank were selected purposively as primary informants, complemented by key informants comprising village officials, community health volunteers, and staff from Pujud Primary Health Center. Data were gathered through in-depth interviews, participatory observation, and documentary review of household health expenditure records. The findings reveal that the economic burden of environment-related diseases consists of direct medical costs, indirect costs in the form of lost productivity, and hidden costs that have never been accounted for in any public reporting system. Average environment-related health expenditure per household reached IDR 2,340,000 per year, with significant variation based on proximity to the riverbank. The social accounting perspective reveals a burden transfer from the public sector to households, reflecting accountability failures in local environmental management. These findings carry important policy implications for strengthening village sanitation programs and community-based environmental cost reporting systems.