Social Security Coverage Research Articles

Situation of Occupational and Environmental Health in Mexico.

Background:Mexico has a great diversity and richness of natural resources, but evaluations of the quality of life of Mexicans show the deep inequalities and the gap between rich and poor. While 5% of families concentrate 58% of the wealth, the health spending in environment and health is 0.2 and 2.7 of the GDP respectively. This has repercussions both on the gradual deterioration of the environment and on the insufficient health and social security coverage of the working population.Objective:To describe the current situation of occupational and environmental health in Mexico.Methods:A bibliographic review was performed on the socioeconomic, demographic, environmental, legal and health status of the Economically Active Population (EAP).Findings:There is a constant deterioration of terrestrial and marine ecosystems, accompanied by an increase in environmental pollution in large cities. The unemployment rate of the EAP has decreased in one year to 3.4%, but the informal labor rate reached 57.3%, which translates into population without social security. Compliance with legislation for the protection of workers’ health is insufficient. The recent amendments to the law have meant a setback in these respects. The reported information on accidents and occupational diseases corresponds to only 34% of workers. There has been a decrease in the rate of work accidents in the last six years, but an increase in diseases and permanent disabilities. During 2016, the first cause of occupational illness was hearing loss, but the profile was dominated by musculoskeletal diseases, which together reached 36.5%.Conclusions:To improve the occupational and environmental health situation, it is necessary to implement general and particular measures against inequalities, increase the budget in health and environment, enforce legislation and expand social security coverage to the population. These measures should be part of public policies as well as actions of academics and researchers.

Does retirement improve health and life satisfaction?

We utilize panel data from the Health and Retirement Study to investigate the impact of retirement on physical and mental health, life satisfaction, and health care utilization. Because poor health can induce retirement, we instrument for retirement using eligibility for Social Security and employer-sponsored pensions and coverage by the Social Security earnings test. We find strong evidence that retirement improves reported health, mental health, and life satisfaction. In addition, we find evidence of improvements in functional limitations in the long run. Although the impact on life satisfaction occurs within the first 4years of retirement, many of the improvements in health show up four or more years later, consistent with the view that health is a stock that evolves slowly. We find no evidence that the health improvements are driven by increased health care utilization. In fact, results suggest decreased utilization in some categories.

Living Conditions, Access to Healthcare Services, and Occupational Health and Safety Conditions of Migrant Seasonal Agricultural Workers in the Çukurova Region

ABSTRACTObjective: Migrant seasonal agricultural workers who are employed in one of the most hazardous occupations in Turkey experience difficulties in accessing health-care services. The aim of this study is to investigate the living conditions, access to health-care services, and occupational health and safety conditions of migrant seasonal agricultural workers in the Çukurova region.Methods: Four hundred migrant seasonal agricultural workers were contacted in the county of Karataş located in the province of Adana, Turkey. A four-section questionnaire was administered using face-to-face interview techniques.Results: The mean age of the participants was 32.8 ± 12.4 years. One-fourth of the participants did not have any social security coverage. Almost all had a monthly income below minimum wage, and 98% were living in tents. One-fifth experienced health problems in the last year, and 63% of them visited a health-care facility for diagnosis and treatment. About 3.3% of the participants sustained injuries at work, and only 23% of them visited a health-care facility.Conclusion: The findings of the study show that migrant seasonal agricultural workers in Turkey have insufficient working conditions, wages, accommodation facilities, nutrition opportunities, health conditions, and occupational health and safety conditions. This insufficiency negatively affects life qualities of the workers, utilization of health-care services, and their occupational health status and safety.

Convergences and dissonances within the Bismarckian welfare paradigm: a critical assessment of the impacts of Hartz-IV on the German unemployment insurance system

The paper deals with the repercussions of Hartz-IV on the German welfare system, implemented in 2005 in order to stimulate the labour market structure and to meet contemporary socio-economic and demographic challenges. Focussing on the convergences and dissonances between the historically contingent Bismarckian welfare paradigm and the Hartz-IV reform on the basis of Esping-Andersen’s typology of welfare regimes, it critically examines the modifications introduced into the system of unemployment insurance. Despite the overall reduction of the unemployment rate, the dualization between either the income-based unemployment benefit I (ALG-1), which guarantees the protection of the socio-occupational status, or the means-tested unemployment benefit II (ALG-2), providing for the strict minimum assistance to the jobless, has widened socio-economic inequalities. Evidence can be found for the introduction of recommodifying mechanisms, with regards to the tightening of eligibility criteria affecting the access to the ALG-1 and with regards to the implementation of the ALG-2 with a strong responsabilization of the recipients. Furthermore, an erosion of the principle of subsidiarity can be noticed, coupled with a formalweakening of the male breadwinner’s responsibility as the main income provider. Finally, the reforms have reaffirmed the rigidity of the social classes in Germany, thus creating structural obstacles to the economic upward mobility of the working poor. While the flexibility and greater absorbability of the employment market considerably increased German’s economic competitivity, the future yet has to prove whether the growing segment of working poor will be able to upgrade to full employment and social security coverage.
 Keywords: German Welfare System; Unemployment Insurance; Hartz-IV; Labour Market.
 
 
 Recebido em: março/2017
 Aprovado: maio/2018.

Social Security Coverage for Workers in Selected EU Countries

A worker is someone who does specific work for another person and is paid for it. In 2014, the employment rate in the EU member states was 64.9%. This means that a large percentage of people are exposed to the so‑called social risks, such as death, old age, accidents (including at work) or sickness (including occupational diseases). These risks are not only a concern for workers, who might lose their ability to work, partially or completely, but also affect other household members, such as spouses, children or parents, who might lose their breadwinner. There is no common mechanism in the EU member states to protect workers from any of those risks materialising. The purpose of this article is to identify the funding sources of social security coverage for workers, the kinds of risks covered, and the benefits offered. To do that, a comparison was drawn of various social security schemes in selected EU member states, based on the available literature and materials. The comparison shows that there is no common mechanism in the EU member states to protect workers should any of the social risks materialise, and that social security contributions are a common source of funding benefit payments.

Children’s education and parental old age survival – Quasi-experimental evidence on the intergenerational effects of human capital investment

While a large literature has investigated the role of parental human capital on children’s well-being, relatively little is known regarding the effects of human capital investment in children on long run outcomes of parents. In this study we explore the human capital variations created by the 1974 Tanzania education reform to estimate the effect of children’s primary schooling attainment on parental survival. Using 5,026,315 census records from 1988, 2002, and 2012, we show that the 1974 reform resulted in an additional 1.1 years (31%) of educational attainment among exposed cohorts. Using the reform as instrument for child education we find that each additional year of primary schooling in children resulted in a 3.7 percentage point reduction (p < .001) in the probability of maternal death, and a 0.8 percentage point reduction (p = .011) in the probability of paternal death by the time exposed child cohorts reach age 50. The results suggest that—at least in a setting where social security coverage is largely absent—a substantial fraction of human capital gains generated by reforms are shared with the parental generation.

Social Security, Retirement and Economic Growth

Population aging alters decisions of retirement and intergenerational transfers simultaneously. With the consideration of both decisions, this paper investigates the economic impacts of population aging in an Overlapping-Generation (OLG) model under social security coverage. Results show that the economy grows slower with voluntarily increased elderly labor supply than otherwise. Ignoring the interactions between these decisions may lead to a serious mis-estimation. Results also show that mandatory postponing retirement creates disincentive to saving and hinders the economy. To prevent the economy from slowing down and fertility from falling, mandatory postponing retirement must be accompanied by a lower replacement ratio.

Investigation of the Satisfaction and Affecting Factors of the Parents Attending to the General Pediatrics Outpatient Clinic

Objection: Patients satisfaction with the healthcare services they receive has been one of the important criteria for evaluating the quality of the services provided. In our study, it was aimed to determine the satisfaction level of the parents and the factors affecting the parents’ satisfaction in accordance with the information obtained from the parents of the patients who applied to the General Pediatric Outpatient Clinic. Material and Methods: This prospective and descriptive study was carried out on 500 parents who applied to the General Pediatric Outpatient Clinic, who had no communication and language problems, and approved the informed consent form. The demographic characteristics of the parents, social security coverage, number and reasons of referral, termination status, effects of waiting for doctor examination and total duration of hospital stay on general satisfaction were examined. Results: The study participants were mothers (51%), fathers (30.4%), and other relatives (18.6%) of the patients with a mean age of 34.1±8.9 years. Pediatric patients were less than 1 year (30.2%), 1-5 years (27%), and more than 5 years of age (42.8%). The parents were primary school (43.6%), middle school (36.6%), and high school graduates (15%). Overall satisfaction rate of the parents was as 72.4 percent. The effect of medical personnel behavior, information, cleanliness and comfort on overall satisfaction was statistically significant. Conclusion: With such studies, it can be ensured that hospitals effectively increase service quality and respond to community expectations.&nbsp;

Situación laboral y social de los empleados en hatos lecheros en pastoreo: El caso Donmatías y La Unión (Antioquia-Colombia)

Debido al grado de manualidad presente en el proceso productivo en hatos lecheros en pastoreo en Colombia, la calidad de vida laboral, las condiciones salariales y de seguridad social en el puesto de trabajo, entre otras, son factores a considerar si se busca mejorar los parámetros zootécnicos y la calidad del producto procesado. Considerando lo anterior, se seleccionaron 170 individuos (102 en La Unión y 68 en Don Matías) para identificar algunas condiciones laborales como salarios, antigüedad, escolaridad, jornada, cobertura en seguridad social, entre otras, de la población vinculada, y se relacionó con la productividad zootécnica de los hatos lecheros estudiados. Los resultados obtenidos indican difíciles condiciones laborales y los riesgos para la producción lechera, el relevo generacional y la continuidad de esta labor en la zona de estudio.

La tutela previdenziale della tubercolosi extra-lavorativa: sorpassati concetti medico-legali a fondamenta delle indennità per una malattia ancora in auge

The Author briefly summaries the legislative history of Italian social security cover for extra-occupational tuberculosis, and lists the economic benefits that the National Institute of Social Security (INPS) reserves for the individuals who are insured with it and suffer from this disease, describing both the administrative and health requirements. Thus, the publication attempts to place the purely conceptual medical-legal aspects on which social security for extra-occupational tuberculosis is based under the microscope of rational criticism; in this way, the medical and legal foundations for the prevalence of morbidity are examined, to reveal the anachronistic principles of a protection that, with current changes in social, geopolitical and labour dynamics, remains based on laws from the 1930s and 1970s, and the principles they expressed.

Introduction: Reflecting on the human right to social security

AbstractThe United Nations Universal Declaration of Human Rights of 1948 asserts that social security is an inalienable human right. Realizing this human right is often considered, simply, as a matter of political will and of administrative aptitude. In these terms, the progressive realization of the human right to social security may be viewed as the outcome of an appropriately‐resourced political and bureaucratic process. Such a perspective, however, is clearly inadequate. Characteristically, bureaucracies are designed to cater to the needs of all, based on common procedures and common deliverables designed for the “typical” case. Yet such approaches often lack the necessary flexibility and resources to make a distinction between individuals, which acknowledge their respective differences and needs. To meet the international commitment to progressively realize universal social security coverage, social security administrations are key actors. However imperative this role may be, if the pursuit of this commitment fails to respect people's differences this will put at risk the meeting in full of what is envisioned by the human right to social security. To this end, this special issue aims to foster an understanding that the goal of universal coverage must necessarily also respect and respond to the individual needs of each and every person.

Baseline characteristics, survival and direct costs associated to treatment of gastric cancer patients at the National Oncology Institute of Panama from 2012 to 2015: a hospital-based observational study

ObjectivesComprehensive epidemiological and economic studies of gastric cancer (GC) in Panama are limited. This study aims to evaluate the association between socioeconomic and clinical variables with survival, describe the survival...

Social security and firm performance: The case of Vietnamese SMEs

AbstractThis article investigates how social security provision – a key determinant of formality – impacts on small and medium‐sized firm performance in Viet Nam. Based on enterprise census data covering all registered firms from 2006 to 2011, the authors find that firms which increase their social security coverage by 10 per cent experience a revenue gain of 1.4–2.0 per cent per worker and a profit gain of up to 1.8 per cent, depending on the survival time of the firm. However, given the time lag between “investment” (in social security contributions) and returns (enhanced firm performance), specific policy measures such as initial social insurance subsidies for small firms could increase participation in mandatory schemes.

How to identify poor immigrants? - An empirical study of the Three Gorges Reservoir in China

This paper aims to study on the precise identification and targeting of immigrant poverty in the TGRR, with a multi-dimensional poverty line as a standard, which has transcended the traditional income poverty line. Then, we figured out the changing trend and the causes of immigrant poverty under the perspective of multidimensional poverty. Based on the dual cutoff method and regression analysis, the study results show that the discrepancy of poverty before and after immigration is significant, but the poverty problem of immigrants in the TGRR is still serious. The current multi-poverty incidence of immigrants is 30.15%, which means that there are still 2.3097 million people under poverty. The major causes of poverty in this region are poverty in assets, poverty in education and poverty in health. The poverty contribution rate of land scarcity has increased from 12.16% to 29.52% with the deterioration of land loss, which has a negative effect on immigrants' livelihood. The results reveal several outstanding poverty problems in this region: the coverage of social security of immigrants is far from ideal; There are still 12.75% of the impoverished immigrants without medical insurance and 11.36% without pension insurance; the percentage of female laborers, the education level of laborers, the percentage of agricultural expenditure and the percentage of medical expenditure have significant correlations with immigrants' poverty in this region. The paper argues that the precise identification and targeting of poverty reduction in China should be undertaken from a multidimensional perspective.

Relying on weak governments: Austrian trade unions and the politics of smoothed dualization

Austrian political actors have improved the protection of outsiders by expanding the coverage of labour rights, social security, and active labour market policy spending in the past two decades. The article attributes these ‘solidaristic’ traits of Austrian labour market policy change to the persistent reliance of weak governments on trade union support in the mobilisation of a durable consensus. When governments are internally divided and prone to reform deadlocks, they face a powerful incentive to share policy-making authority with the social partners. Despite a significant decline in power resources, the Austrian trade union confederation has therefore remained influential enough to compensate outsiders for growing economic uncertainty on a volatile labour market. To substantiate this claim empirically, the article draws on primary and secondary sources as well as interview evidence with policy-making elites.

Reverse mortgage in India: The way ahead

Reverse mortgage after its launch in February 2007 has not been able to do well. This is despite the fact that the product was seen as a cushion for the elderly & would provide them with much needed financial support during their last days. Another reason that should work out in favor of reverse mortgage is the unavailability of social security cover which is available in developed countries. Thus, an absence of social security, no age old pension except for government employees, the ever increasing health care expenses & the rising costs due to inflation has played its part in eroding the savings of the people. Other social issues like migration of children, being childless, and nuclear families have also contributed significantly to the economic struggle of the senior citizens. All these reasons are enough for this financial product to be a success. But ironically, the banks & financial institutions are left wondering, why the product even after 5 years of its launch has not taken off. This paper throws light on reverse mortgage as a financial product. The paper also identifies the intricacies involved, the issues & challenges for the sustainability of such a product in India. This article identifies the reasons, due to which reverse mortgage has not been successful as a financial product in India. The reasons are many, right from the lack of awareness about the product to cultural differences that exist among elderly folks of India, European & Western countries of the world. Also, the current financial products in the India like Public Provident Fund (PPF), Pension Plans & Senior Citizen savings Schemes are seen to satisfy the needs of the elderly post retirement. The data regarding reverse mortgage in India has been collected by various sources such as books, websites, research journals, magazines & newspapers.

Migration and health: a review of policies and initiatives in low and middle income countries

BackgroundThe migration of people within national borders is nearly four times higher than international migration. Internal labour migration is an important livelihood strategy for many poor groups worldwide, but this population faces exclusion from existing mainstream health programmes. We aimed to conduct a literature review to understand factors in low and middle income countries affecting the health of migrants, and policies and initiatives to address health issues. MethodsPubmed, The Lancet, Google Scholar, Advanced Google, Popline by K4 Health, reports of international agencies, country official websites, government publications and conference proceedings (restricted to the English language) were searched. Keywords were “low- and middle-income countries”, “urbanization”, “internal labour migration”, “rural-urban”, “migration”, “migrant workers”, “internal migrants”, “health problems/issues” “health”, “migrant women/children”, “social determinant”, “health services”, “social inclusion”, “health policies”. Empirical, non-empirical papers, reports from agencies, regional forums, and international conferences from 1970 to 2015 were retrieved. A narrative synthesis of literature was undertaken. Findings209 articles were retrieved; after screening for duplication and relevance, 136 were included in the review. Factors affecting migrants' health included political and social marginalisation, lack of socioeconomic and societal resources, inadequate nutrition, poor housing, hazardous occupational conditions, lack of access to health-care services, discrimination, and financial burden. Access to health and social benefits were usually linked to identity, and migrant families often did not have location-specific identity documents. Migrant women had less antenatal care than non-migrant women. Migrant women were more likely to experience violence, and their children were six times more at a risk of physical abuse. Policies related to migration included security, labour, trade, enforcement, and international aid laws; they rarely included health policy for migrants which was traditionally viewed in terms of a threat to public health resulting in screening, monitoring, quarantine, and communicable disease control. InterpretationLessons drawn from our review suggest three key strategies to improve the health of internal migrants—namely, formation of a nodal agency for the welfare of internal migrants, formation of a database on internal migrants and development of a tracking system to accommodate their mobility, and universal coverage of health and social security. FundingWellcome Trust Capacity Strengthening Strategic Award to the Public Health Foundation of India and a consortium of UK universities, WHO South-East Asia Regional Office.

Risk Factors for the Development of multidrug-resistant tuberculosis in Colombia 2008 A 2011

Determining the risk factors associated with developing multidrug-resistant tuberculosis in people aged over 18 years affiliated to 3 Colombian health insurance companies between 2008 and 2011. The study involved a matched case-control design (1 case to 4 controls). Patients were identified from 3 health insurance companies' tuberculosis program database; this gave 45 cases and 180 controls. Demographic, socioeconomic and clinical variables were evaluated. The median age for cases was 43 years (39.5 years for controls); males predominated in cases (73.3 %) while women predominated in controls (51.1 %). A statistically significant association was found between multidrug-resistant tuberculosis and being male (4.47 adjusted OR; 1.01-19.75 95 %CI), having subsidized social security cover (57.6 adjusted OR; 4.6-71.28 95 %CI) and having had prior treatment for tuberculosis (56.2 adjusted OR; 10.03-314.79 95 % CI]. Prior treatment for tuberculosis and being male were risk factors for developing multidrug resistance. Further studies are needed with the Colombian health system to clarify the findings with respect to being affiliated to a subsidized health system and the development of multidrug resistant tuberculosis.

Informal employment, unpaid care work, and health status in Spanish-speaking Central American countries: a gender-based approach.

To assess the relationship between paid work, family characteristics and health status in Central American workers; and to examine whether patterns of association differ by gender and informal or formal employment. Cross-sectional study of 8680 non-agricultural workers, based on the First Central American Survey of Working Conditions and Health (2011). Main explicative variables were paid working hours, marital status, caring for children, and caring for people with functional diversity or ill. Using Poisson regression models, adjusted prevalence ratios of poor self-perceived and mental health were calculated by sex and social security coverage (proxy of informal employment). A clear pattern of association was observed for women in informal employment who were previously married, had care responsibilities, long working hours, or part-time work for both self-perceived and mental health. No other patterns were found. Our results show health inequalities related to unpaid care work and paid work that depend on the interaction between gender and informal employment. To reduce these inequalities suitable policies should consider both the labor (increasing social security coverage) and domestic spheres (co-responsibility of care).

Social capital and healthy ageing in Indonesia.

BackgroundA large international literature has found a positive association between social capital and measures of physical and mental health. However, there is a paucity of research on the links between social capital and healthy ageing in a developing country environment, where universal social security coverage is absent and health infrastructure is poor.MethodIn this paper, we develop and empirically test a model of the linkages between social capital and the health outcomes for older adults in Indonesia, using data from the Indonesian Family Life Survey-East (IFLS-East), conducted in 2012. Using multivariate regression analysis, we examine whether social capital plays a role in mitigating poor health among older individuals aged 50 years and above in Indonesia’s most vulnerable provinces. We test the robustness of these social capital variables across different health measures (self-assessed health, Activities of Daily Living (ADL), measures of chronic illness and mental health measures), as well as across different demographic groups, after controlling for an array of socio-economic, demographic and geographic characteristics.ResultsOur findings show that access to better social capital (using measures of neighbourhood trust and community participation) is associated with a higher degree of physical mobility, independence, and mental well-being among older individuals but has no influence on chronic illnesses. These results are consistent when we estimate samples disaggregated by gender, rural/urban residence, and by age categories.ConclusionFrom a policy perspective these results point to the importance of social capital measures in moderating the influence of poor health, particularly in the Activities of Daily Living.