Do conditional cash transfers reduce hypertension?

Progresa, an anti-poverty conditional cash transfer program, has been a model for similar programs in more than 60 countries. Numerous studies have found positive impacts on schooling, the nutritional and health status of children and adolescents, and household consumption. However, the effects on the health of older adult beneficiaries have been particularly understudied. In this paper we analyze the effects of Progresa on middle-aged and older adult health, focusing on a high prevalence chronic condition: hypertension. Our results show that Progresa had significant benefits in terms of improved hypertension diagnosis and use of treatment drugs. However, we did not find significant changes in uncontrolled hypertension as measured by systolic and diastolic blood pressure biomarkers in household survey data. Thus, while cash transfer programs may facilitate financial access to healthcare visits and the ability to buy prescribed medicines, by itself the program might not improve hypertension outcomes without complementary healthcare system follow-up to ensure dosage titration and medication adherence.

Health Shocks and Economic Well-being of the Aging Population: Evidence from Mexico.

We exploit the longitudinal Mexican Health and Aging Study to estimate the effects of health shocks in the short-run on the subsequent economic well-being of the aging population in Mexico. While there is substantial evidence indicating negative economic effects of such changes in industrialized countries, little is known about health impacts on the future economic position of older adults in low- and middle-income countries. This paper takes an important step towards filling this gap in knowledge. Our results are widely relevant, with a large percentage of the world's population residing in developing countries such as Mexico that are experiencing rapid aging. We find evidence of negative impacts of health shocks on subsequent economic well-being of older adults in Mexico, but the effect varies according to several dimensions. First, the impact is clearly on income, not wealth. Second, responses are heterogenous across sources of income, with evidence of an impact mainly on labor income. Third, we find clear differences by gender in the impact of a health shock, with a larger negative impact on men. Fourth, we conclude that the population groups most negatively affected are those with the greatest degree of vulnerability prior to the shock, as measured by education and access to health insurance. Even though Mexico has made important gains with anti-poverty programs such as the Programa 70+ pension and a move towards universal health insurance, additional interventions targeted at the most vulnerable subsets of the aging population might be warranted.

Time Use of Youth during a Pandemic: Evidence from Mexico.

Studying how the pandemic affects the education and work of adolescents is a critical question with long lasting implications for well-being of the next generation, particularly in the developing world. The Covid-19 pandemic by mid-March 2020 had led to the closing of most educational institutions in Latin America and the Caribbean, and the region has been one of the worst hit by the pandemic (Sanmarchi et al. 2021). This paper uses the Mexican National Occupation and Employment Survey (ENOE) to provide initial evidence on the pandemic's effects on school and work of youth. We measure changes in the time use of adolescents comparing patterns just before the pandemic (January to March 2020) with those at the beginning of the following school year (September 2020), controlling for pre pandemic trends and potential seasonality. Our study finds a sharp reduction in the probability of being engaged in studies during the previous week for youth age 12 to 18 during the pandemic, as well as a reduction of about 30 percent in total hours spent on studies for those who report spending at least one hour on studies in the previous week. Time in work in general shows fewer changes than in time dedicated to studies, with some reductions in the probability of working outside the home for older youth, and a small increase in the number of hours dedicated to work inside the household. Our results overall are suggestive of an important decrease in youth who are engaged with school, who may be at particular risk for abandoning school permanently. It also suggests that even for those who remain engaged, there is a reduction on time spent studying likely to lead to a decrease in learning. Policies to combat potential dropout and negative effects on learning of the pandemic are urgently needed.

Health Insurance and the Aging: Evidence From the Seguro Popular Program in Mexico.

Aimed at covering the large fraction of workers in the informal sector without access to a social security program, the Mexican public health insurance program Seguro Popular began in 2002 and now reaches more than 50 million individuals. We estimate impacts of Seguro Popular for the population aged 50 and older on a set of indicators related to health care including utilization, diagnostic/preventive tests, and treatment conditional on being ill. Using the longitudinal Mexican Health and Aging Study over the period 2001-2012, we conduct before and after difference-in-difference matching impact estimators. Our results suggest large and important effects of the Program on utilization and diagnostic tests. We find overall smaller effects on the probability of being in treatment for individuals with chronic diseases, but these effects are concentrated in rural areas with relatively more health services versus rural areas with lower levels of health services. These results suggest that, to the extent that health services become more available in rural areas lacking services, effects of health insurance may increase.

Two Decades of Negative Educational Selectivity of Mexican Migrants to the United States.

Immigration is commonly considered to be selective of more able individuals. Studies comparing the educational attainment of Mexican immigrants in the United States to that of the Mexican resident population support this characterization. Upward educational-attainment biases in both coverage and measurement, however, may be substantial in U.S. DATA SOURCES: Moreover, differences in educational attainment by place size are very large within Mexico, and U.S. data sources provide no information on immigrants' places of origin within Mexico. To address these problems, we use multiple sources of nationally-representative Mexican survey data to re-evaluate the educational selectivity of working-age Mexican migrants to the United States over the 1990s and 2000s. We document disproportionately rural and small-urban-area origins of Mexican migrants and a steep positive gradient of educational attainment by place size. We show that together these conditions induced strongly negative educational selection of Mexican migrants throughout the 1990s and 2000s. We interpret this finding as consistent with low returns to the education of unauthorized migrants and few opportunities for authorized migration.

Is health of the aging improved by conditional cash transfer programs? Evidence from Mexico.

Conditional cash transfer (CCT) programs link public transfers to human capital investment in the hopes of alleviating current poverty and reducing its intergenerational transmission. Whereas nearly all studies of their effects have focused on youth, CCT programs may also have an impact on aging adults by increasing household resources or inducing changes in allocations of time of household members, which may be of substantial interest, particularly given the rapid aging of most populations. This article contributes to this underresearched area by examining health and work impacts on the aging for the best-known and most influential of these programs, the Mexican PROGRESA/Oportunidades program. For a number of health indicators, the program appears to significantly improve health, with larger effects for recipients with a greater time receiving benefits from the program. Most of these health effects are concentrated on women.

Are Conditional Cash Transfers Effective in Urban Areas? Evidence from Mexico.

Conditional cash transfer (CCT) programs have spread worldwide as a new form of social assistance for the poor. Previous evaluations of CCT programs focus mainly on rural settings, and little is known about their effects in urban areas. This paper studies the short-term (one- and two-year) effects of the Mexican Oportunidades CCT program on urban children/youth. The program provides financial incentives for children/youth to attend school and for family members to visit health clinics. To participate, families had to sign up for the program and be deemed eligible. Difference-in-difference propensity score matching estimates indicate that the program is successful in increasing school enrollment, schooling attainment and time devoted to homework for girls and boys and in decreasing working rates of boys.

Schooling Impacts of Conditional Cash Transfers on Young Children: Evidence from Mexico.

This paper evaluates impacts of Oportunidades, a Mexican conditional cash transfer program, on educational outcomes 5.5 years after program initiation for a group of children who were age 0 to 8 years pre-program. The oldest children within this age range received educational scholarships. The youngest children did not receive the scholarships because they had not yet started the third grade of school (the initial grade for scholarships), but were beneficiaries of the program's health components that included nutritional supplements for children 24 months of age or younger. All of these children also may have benefitted more generally from increased household income resulting from the program. This paper investigates how the program differentially affected younger and older children within this age range and examines whether the early nutritional intervention led to improvements in subsequent educational performance. The program impact estimates are derived from a randomly assigned treatment and control group, which participated for different lengths of time in the program, and from a matched comparison group that had not participated prior to the collection of data in 2003. The empirical findings show positive program impacts on reducing ages at entering school for the younger children as well as on accumulated grades of schooling after 5.5 years of benefits for older children, with estimates implying a 1 percent reduction in the age of entry to primary and an increase in grades of schooling completed to date of about 8 to 9 percent.

The discrimination of facial expressions by typically developing infants and toddlers and those experiencing early institutional care.

Early experience likely plays an important role in the development of the ability to discriminate facial expressions of emotion. We posited that compared to children reared with their biological families (n=72), abandoned children being reared in institutions (n=39) should demonstrate impairments in this ability. The visual paired comparison procedure was utilized to assess the abilities of 13- to 30-month-old children to discriminate among multiple pairs of photographs of facial expressions. Both groups exhibited a normative profile of discrimination, with no group differences evident. Such findings suggest that early institutionalization does not affect the ability of 1- to 3-year-olds to discriminate facial expressions of emotion, at least as inferred by the Visual Paired Comparison Procedure.

An event-related potential study of the impact of institutional rearing on face recognition.

Event-related potentials (ERPs) were recorded to brief images of caregivers' and strangers' faces for 72 institutionalized children (IG), ages 7-32 months, and compared with ERPs from 33 children, ages 8-32 months, who had never been institutionalized. All children resided in Bucharest, Romania. Prominent differences in four ERP components were observed: early negative (N170), early positive (P250), midlatency negative (Nc), and positive slow wave (PSW). For all but the P250, the amplitude of these components was larger in the never institutionalized group than the institutionalized group; this pattern was reversed for the P250. Typical effects of the Nc (amplitude greater to stranger vs. caregiver) were observed in both groups; in contrast, the IG group showed an atypical pattern in the PSW. These findings are discussed in the context of the role of experience in influencing the neural circuitry putatively involved in recognizing familiar and novel faces.

Sequential classification of endocrine stages during reproductive aging in women: the FREEDOM study.

OBJECTIVE: Reproductive aging involves complex endocrine changes affecting women's fertility, health, and well-being; however, understanding of the specific changes involved is limited by the lack of detailed quantitative studies. We undertook a thorough study with the aim of characterizing the different endocrine stages involved in female reproductive aging. DESIGN: FREEDOM is a cohort study designed to determine the endocrine changes during reproductive aging in women. Here, we ascertained the different endocrine patterns in a representative population and developed a staging system. In this study, 112 women aged 30 to 58 years collected daily urine samples over a 6- to 18-month period and recorded their menstrual periods. A total of 36,786 samples were analyzed for follicle-stimulating hormone (FSH), luteinizing hormone, estrone 3-glucuronide, and pregnanediol 3-glucuronide. RESULTS: A classification of five sequential endocrine stages of reproductive aging was developed: stage 1, regular menstrual cycles with mean initial (day 1-5) FSH less than 5 IU/L; stage 2, regular cycles with FSH greater than 5 IU/L; stage 3, menstrual irregularity (with the appearance of "delayed-response cycles"); stage 4, acyclical ovarian activity with no evidence of ovulation and luteinization; and stage 5, ovarian quiescence and persistently raised gonadotropins. Distinct hormonal characteristics during the follicular and luteal phase were noted at each stage. CONCLUSION: This classification provides a detailed insight into the endocrinology of reproductive aging in women that could be useful for both clinical guidance and personal health care.

The impact of early institutional rearing on the ability to discriminate facial expressions of emotion: an event-related potential study.

Event-related potentials (ERPs), in response to 4 facial expressions of fear, angry, happy, and sad, were collected from 72 institutionalized children (IG), ages 7 to 32 months, in Bucharest, Romania, and compared with ERPs from 33 children, ages 8 to 32 months, who had never been institutionalized (NIG). The NIG and IG exhibited different patterns of responding in early latency components. Moreover, group differences in amplitude were evident across all components. Such differences may point to the role of early deprivation in disrupting the development of the neural circuitry involved in the recognition of facial expressions.

Designing research to study the effects of institutionalization on brain and behavioral development: the Bucharest Early Intervention Project.

This paper provides an overview of the largest longitudinal investigation of institutionalized children less than 2 years old ever conducted. The Bucharest Early Intervention Project is an ongoing randomized controlled trial of foster placement as an alternative to institutionalization in abandoned infants and toddlers being conducted in Bucharest, Romania. In addition to describing the contexts in which this study is imbedded, we also provide an overview of the sample, the measures, and the intervention. We hope that the natural experiment of institutionalization will allow us to examine directly the effects of intervention on early deprivation. We hope it will provide answers to many of the critical questions that developmentalists have asked about the effects of early experience, the timing of deprivation, and the ameliorating effects of early intervention and provide clues to which underlying neurobiological processes are compromised by, and resilient to, dramatic changes in early experience.