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 household's medical expenditure. Our results show that a major health shock reduces households' net income significantly and that village elections alleviate such adverse impacts by almost half. The main mechanism behind thi