IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v267y2020ics0277953619303636.html
   My bibliography  Save this article

Educational inequalities in disability linked to social security coverage among older individuals in five Latin American countries

Author

Listed:
  • Hessel, Philipp
  • Sayer, Pieter
  • Riumallo-Herl, Carlos

Abstract

Although Latin American populations are ageing rapidly, many countries have important shortcomings in terms of access to social security coverage. Despite significant improvements regarding access to healthcare, the coverage gap in terms of pensions represents a major challenge for public health and equity in the region. The principal aim of this study was to systematically assess the association between social security coverage and disability among older individuals in five Latin American countries, as well as the extent of existing inequalities and its determinants. To do so we use cross-sectional and comparative data for individuals aged 60 and older in Chile, Colombia, El Salvador, Paraguay and Uruguay from the Longitudinal Social Protection Survey (ELPS). We used multivariate regression to assess the association between disability and healthcare as well as pension coverage. Concentration indices (CI) and an Oaxaca-Blinder decomposition approach were used to assess overall inequalities in disability according to education as well as their components. With the exception of El Salvador, we find significant inequalities in disability disfavoring lower educated individuals. With regards to healthcare, we find no significant association of healthcare coverage with disability in any of the five countries, nor does it explain educational inequalities in disability. However, pension access was associated with lower risks of disability in Chile, Colombia, Paraguay and Uruguay, and explains a substantial share of educational inequality in Chile, Colombia and Paraguay. Whereas significant changes have already been made regarding universal healthcare coverage, the results suggest that expanding access to pensions may not only lead to improvements in health among older individuals in the region, but also substantially reduce socio-economic inequalities in health and successful ageing.

Suggested Citation

  • Hessel, Philipp & Sayer, Pieter & Riumallo-Herl, Carlos, 2020. "Educational inequalities in disability linked to social security coverage among older individuals in five Latin American countries," Social Science & Medicine, Elsevier, vol. 267(C).
    • Handle: RePEc:eee:socmed:v:267:y:2020:i:c:s0277953619303636
    DOI: 10.1016/j.socscimed.2019.112378
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953619303636
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2019.112378?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Nora Lustig & Luis F. Lopez-Calva & Eduardo Ortiz-Juarez & Célestin Monga, 2016. "Deconstructing the Decline in Inequality in Latin America," International Economic Association Series, in: Kaushik Basu & Joseph E. Stiglitz (ed.), Inequality and Growth: Patterns and Policy, chapter 7, pages 212-247, Palgrave Macmillan.
    2. Jonathan Gruber, 2008. "Covering the Uninsured in the United States," Journal of Economic Literature, American Economic Association, vol. 46(3), pages 571-606, September.
    3. Galiani, Sebastian & Gertler, Paul & Bando, Rosangela, 2016. "Non-contributory pensions," Labour Economics, Elsevier, vol. 38(C), pages 47-58.
    4. Erreygers, Guido, 2009. "Correcting the Concentration Index: A reply to Wagstaff," Journal of Health Economics, Elsevier, vol. 28(2), pages 521-524, March.
    5. Nora Lustig & Carola Pessino, 2014. "Social Spending and Income Redistribution in Argentina during the 2000s: The Increasing Role of Noncontributory Pensions," Public Finance Review, , vol. 42(3), pages 304-325, May.
    6. Smith, Kimberly V. & Goldman, Noreen, 2007. "Socioeconomic differences in health among older adults in Mexico," Social Science & Medicine, Elsevier, vol. 65(7), pages 1372-1385, October.
    7. repec:idb:brikps:79303 is not listed on IDEAS
    8. Macinko, J. & De Oliveira, V.B. & Turci, M.A. & Guanais, F.C. & Bonolo, P.F. & Lima-Costa, M.F., 2011. "The influence of primary care and hospital supply on ambulatory care-sensitive hospitalizations among adults in Brazil, 1999-2007," American Journal of Public Health, American Public Health Association, vol. 101(10), pages 1963-1970.
    9. Robert Holzmann, 2013. "Global pension systems and their reform: Worldwide drivers, trends and challenges," International Social Security Review, John Wiley & Sons, vol. 66(2), pages 1-29, April.
    10. Oaxaca, Ronald, 1973. "Male-Female Wage Differentials in Urban Labor Markets," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 14(3), pages 693-709, October.
    11. OECD & Inter-American Development Bank & World Bank Group, 2014. "Pensions at a Glance : Latin America and the Caribbean," World Bank Publications - Books, The World Bank Group, number 21426.
    12. Kimberly V. Smith & Noreen Goldman, 2007. "Socioeconomic differences in health among older adults in Mexico," Working Papers 283, Princeton University, Woodrow Wilson School of Public and International Affairs, Office of Population Research..
    13. Arroyave, I. & Cardona, D. & Burdorf, A. & Avendano, M., 2013. "The impact of increasing health insurance coverage on disparities in mortality: Health care reform in Colombia, 1998-2007," American Journal of Public Health, American Public Health Association, vol. 103(3), pages 100-106.
    14. Ariel Fiszbein & Norbert Schady & Francisco H.G. Ferreira & Margaret Grosh & Niall Keleher & Pedro Olinto & Emmanuel Skoufias, 2009. "Conditional Cash Transfers : Reducing Present and Future Poverty," World Bank Publications - Books, The World Bank Group, number 2597.
    15. Santiago Levy & Norbert Schady, 2013. "Latin America's Social Policy Challenge: Education, Social Insurance, Redistribution," Journal of Economic Perspectives, American Economic Association, vol. 27(2), pages 193-218, Spring.
    16. Rafael Cortez & Isabella Bablumian & Danilo Fernandez, 2009. "Extension of Health Services Coverage in El Salvador : The RHESSA Project Experience," World Bank Publications - Reports 10217, The World Bank Group.
    17. Rosemary Thorp, 1998. "Progress, Poverty and Exclusion: An Economic History of Latin America in the 20th Century," IDB Publications (Books), Inter-American Development Bank, number 79303, February.
    18. Kaushik Basu & Joseph E. Stiglitz (ed.), 2016. "Inequality and Growth: Patterns and Policy," International Economic Association Series, Palgrave Macmillan, number 978-1-137-55459-8, June.
    19. Kjellsson, Gustav & Gerdtham, Ulf-G., 2013. "On correcting the concentration index for binary variables," Journal of Health Economics, Elsevier, vol. 32(3), pages 659-670.
    20. Álvarez-Gálvez, Javier & Jaime-Castillo, Antonio M., 2018. "The impact of social expenditure on health inequalities in Europe," Social Science & Medicine, Elsevier, vol. 200(C), pages 9-18.
    21. Erreygers, Guido, 2009. "Correcting the Concentration Index," Journal of Health Economics, Elsevier, vol. 28(2), pages 504-515, March.
    22. Zunzunegui, Maria-Victoria & Alvarado, Beatriz-Eugenia & Béland, François & Vissandjee, Bilkis, 2009. "Explaining health differences between men and women in later life: A cross-city comparison in Latin America and the Caribbean," Social Science & Medicine, Elsevier, vol. 68(2), pages 235-242, January.
    23. Peter Lloyd‐Sherlock & Nadia Minicuci & John Beard & Somnath Chatterji, 2012. "Social protection and preventing illness in developing countries: Establishing the health effects of pensions and health insurance," International Social Security Review, John Wiley & Sons, vol. 65(4), pages 51-68, October.
    24. Beckfield, Jason & Bambra, Clare, 2016. "Shorter lives in stingier states: Social policy shortcomings help explain the US mortality disadvantage," Social Science & Medicine, Elsevier, vol. 171(C), pages 30-38.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Rocha de Jesus Fernandes, Anderson & Lanza Queiroz, Bernardo, 2024. "Aging, education and some other implications for the silver dividend in developing countries: Evidence from Brazil," The Journal of the Economics of Ageing, Elsevier, vol. 27(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Guido Erreygers & Roselinde Kessels & Linkun Chen & Philip Clarke, 2016. "Decomposing Socioeconomic Inequality of Health," EcoMod2016 9574, EcoMod.
    2. Pulok, Mohammad Habibullah & van Gool, Kees & Hall, Jane, 2020. "Horizontal inequity in the utilisation of healthcare services in Australia," Health Policy, Elsevier, vol. 124(11), pages 1263-1271.
    3. Gerdtham, Ulf-G & Lundborg, Petter & Lyttkens, Carl Hampus & Nystedt, Paul, 2012. "Do Socioeconomic Factors Really Explain Income-Related Inequalities in Health? Applying a Twin Design to Standard Decomposition Analysis," Working Papers 2012:21, Lund University, Department of Economics.
    4. Conrad Murendo & Gamuchirai Murenje & Pepukai Prince Chivenge & Rumbidzai Mtetwa, 2021. "Financial Inclusion, Nutrition and Socio‐Economic Status Among Rural Households in Guruve and Mount Darwin Districts, Zimbabwe," Journal of International Development, John Wiley & Sons, Ltd., vol. 33(1), pages 86-108, January.
    5. Inés Berniell & Dolores de la Mata & Matilde Pinto Machado, 2020. "The Impact of a Permanent Income Shock on the Situation of Women in the Household: The Case of a Pension Reform in Argentina," Economic Development and Cultural Change, University of Chicago Press, vol. 68(4), pages 1295-1343.
    6. Erreygers, Guido & Van Ourti, Tom, 2011. "Measuring socioeconomic inequality in health, health care and health financing by means of rank-dependent indices: A recipe for good practice," Journal of Health Economics, Elsevier, vol. 30(4), pages 685-694, July.
    7. Aristides dos Santos, Anderson Moreira & Perelman, Julian & Jacinto, Paulo de Andrade & Tejada, Cesar Augusto Oviedo & Barros, Aluísio J.D. & Bertoldi, Andréa D. & Matijasevich, Alicia & Santos, Iná S, 2019. "Income-related inequality and inequity in children’s health care: A longitudinal analysis using data from Brazil," Social Science & Medicine, Elsevier, vol. 224(C), pages 127-137.
    8. Cruz-Martinez, Gibran, 2019. "Comparative social policy in contemporary Latin America: Concepts, theories and a research agenda," SocArXiv ygh8d, Center for Open Science.
    9. Guido Erreygers & Roselinde Kessels, 2017. "Socioeconomic Status and Health: A New Approach to the Measurement of Bivariate Inequality," IJERPH, MDPI, vol. 14(7), pages 1-23, June.
    10. Olufunke Alaba & Lumbwe Chola, 2014. "Socioeconomic Inequalities in Adult Obesity Prevalence in South Africa: A Decomposition Analysis," IJERPH, MDPI, vol. 11(3), pages 1-20, March.
    11. Kristof Bosmans, 2016. "Consistent Comparisons of Attainment and Shortfall Inequality: A Critical Examination," Health Economics, John Wiley & Sons, Ltd., vol. 25(11), pages 1425-1432, November.
    12. Yuejen ZHAO, 2013. "Decomposition of Concentration Index using Generalised Linear Model: Analysis of Socio-Economic Determinants of Health Inequality in the Northern Territory of Australia," Regional and Sectoral Economic Studies, Euro-American Association of Economic Development, vol. 13(1), pages 145-154.
    13. Carrieri, Vincenzo & Wuebker, Ansgar, 2013. "Assessing inequalities in preventive care use in Europe," Health Policy, Elsevier, vol. 113(3), pages 247-257.
    14. Martin Siegel & Andreas Mielck & Werner Maier, 2015. "Individual Income, Area Deprivation, and Health: Do Income‐Related Health Inequalities Vary by Small Area Deprivation?," Health Economics, John Wiley & Sons, Ltd., vol. 24(11), pages 1523-1530, November.
    15. Hansen, Fredrik & Anell, Anders & Gerdtham, Ulf-G & Lyttkens, Carl Hampus, 2013. "The Future of Health Economics: The Potential of Behavioral and Experimental Economics," Working Papers 2013:20, Lund University, Department of Economics.
    16. Paul Allanson & Dennis Petrie, 2013. "On The Choice Of Health Inequality Measure For The Longitudinal Analysis Of Income‐Related Health Inequalities," Health Economics, John Wiley & Sons, Ltd., vol. 22(3), pages 353-365, March.
    17. Gustav Kjellsson & Ulf-G. Gerdtham, 2013. "Lost in Translation: Rethinking the Inequality Equivalence Criteria for Bounded Health Variables," Research on Economic Inequality, in: Health and Inequality, volume 21, pages 3-32, Emerald Group Publishing Limited.
    18. Thomas Leoni, 2015. "Soziale Unterschiede in Gesundheit und Inanspruchnahme der Gesundheitsversorgung," WIFO Monatsberichte (monthly reports), WIFO, vol. 88(8), pages 649-662, August.
    19. Merino Ventosa, María & Urbanos-Garrido, Rosa M.maria.merino.ven@gmail.com, 2016. "Disentangling effects of socioeconomic status on obesity: A cross-sectional study of the Spanish adult population," Economics & Human Biology, Elsevier, vol. 22(C), pages 216-224.
    20. Peng Nie & Andrew E. Clarck & Conchita D'Ambrosio & Lanlin Ding, 2020. "Income-related health inequality in urban China (1991-2015): The role of homeownership and housing conditions," Working Papers 524, ECINEQ, Society for the Study of Economic Inequality.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:267:y:2020:i:c:s0277953619303636. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.