Adriana Camacho

Public health and international drug policy.

The Johns Hopkins–Lancet Commission on Drug Policy and Health has sought to examine the emerging scientific evidence on public health issues arising from drug-control policy and to inform and encourage a central focus on public health evidence and outcomes in drug-policy debates, such as the important deliberations of the 2016 UNGASS on drugs. The Commission is concerned that drug policies are often coloured by ideas about drug use and dependence that are not scientifically grounded. The 1998 UNGASS declaration, for example, like the UN drug conventions and many national drug laws, does not distinguish between drug use and drug misuse. A 2015 report by the UN High Commissioner for Human Rights, by contrast, emphasised that drug use “is neither a medical condition, nor does it necessarily lead to drug dependence”. The idea that all drug use is dangerous and evil has led to enforcement-heavy policies and has made it difficult to see potentially dangerous drugs in the same light as potentially dangerous foods, tobacco, and alcohol, for which the goal of social policy is to reduce potential harms.

Assessing the long-term effects of conditional cash transfers on human capital : evidence from Colombia

Conditional cash transfers are programs under which poor families get a stipend provided they keep their children in school and take them for health checks. Although there is significant evidence showing that they have positive impacts on school participation, little is known about the long-term impacts of the programs on human capital. This paper investigates whether cohorts of children from poor households that benefited up to nine years from Familias en Accion, a conditional cash transfer program in Colombia, attained more school and performed better on academic tests at the end of high school. Identification of program impacts is derived from two different strategies using matching techniques with household surveys, and regression discontinuity design using a census of the poor and administrative records of the program. The authors show that, on average, participant children are 4 to 8 percentage points more likely than nonparticipant children to finish high school, particularly girls and beneficiaries in rural areas. Regarding long-term impact on tests scores, the analysis shows that program recipients who graduate from high school seem to perform at the same level as equally poor non-recipient graduates, even after correcting for possible selection bias when low-performing students enter school in the treatment group. Although the positive impacts on high school graduation may improve the employment and earning prospects of participants, the lack of positive effects on test scores raises the need to further explore policy actions to couple the programs objective of increasing human capital with enhanced learning.

Effects of Subsidized Health Insurance on Newborn Health in a Developing Country

Colombia’s rapid and considerable expansion of health insurance coverage in the 1990s provides an opportunity to evaluate in a developing country whether health insurance improves health outcomes. Using administrative data and a regression discontinuity design, we find that babies born from mothers with health insurance have a lower incidence of low birth weight. We also find some indication that mothers with health insurance had better access to health facilities. These results are robust to different specifications and sample restrictions.

Conditional Cash Transfers, Political Participation, and Voting Behavior

This paper estimates the effect of enrollment in a large scale anti-poverty program in Colombia, Familias en Accion, on intent to vote, turnout and electoral choice. For identification the analysis uses discontinuities in program eligibility and variation in program enrollment across voting booths. It finds that Familias en Accion had a positive effect on political participation in the 2010 presidential elections by increasing the probability that program beneficiaries registered to vote and cast a ballot, particularly among women. Regarding voters choice, the authors find that program participants expressed a stronger preference for the official party that implemented and expanded the program. Overall, the findings show that voters respond to targeted transfers and that these transfers can foster support for incumbents, thus making the case for designing political and legislative mechanisms, as the laws recently passed by the Colombian government, that avoid successful anti-poverty schemes from being captured by political patronage.

Manipulation of Social Program Eligibility: Detection, Explanations and Consequences for Empirical Research

We document manipulation of a targeting system which used a poverty index score to determine eligibility for social welfare programs in Colombia, including health insurance. We show strategic behavior in the timing of the household interviews around local elections, and direct manipulation when some households had their eligibility scores lowered. Initially the number of interviews increased around local elections. After the algorithm was made public to local officials, the score density exhibited a sharp discontinuity exactly at the eligibility threshold. The discontinuity at the threshold is larger where mayoral elections are more competitive; and smaller in municipalities with less competitive elections, more community organizations and higher newspaper circulation.

Misallocation and Productivity in Colombia's Manufacturing Industries

Following Hsieh and Klenow (2009), this paper studies productivity dispersions in Colombian industrial establishments using the Colombian Annual Manufacturing Survey (AMS) from 1982 to 1998. The United States is used as a benchmark to estimate the reallocation of capital and labor to equalize marginal products across plants in Colombia. Gains are found in manufacturing Total Factor Productivity (TFP) of approximately 3-8 percent and TPF is positively correlated with exporting status, age, size, and location in the central region of the country. There is also suggestive evidence that opening the economy in 1991 is associated with an increase in plant productivity levels for firms that export goods. The 1990 reform that reduced dismissal costs is associated with an increase in productivity, while the reform that increased labor costs in 1993 is associated with a decrease in plants’ productivity. Further work is needed to establish a causal relation between productivity and policy changes.

The Health Consequences of Aerial Spraying of Illicit Crops: The Case of Colombia

This paper exploits the variation in aerial spraying across time and space in Colombia and employs a panel of individual health records in order to study the causal effects of aerial spraying of herbicides (Glyphosate) on short term health-related outcomes. The results show that exposure to the herbicide used in aerial spraying campaigns increases the number of medical consultations related to dermatological and respiratory related illnesses and the number of miscarriages. This finding is robust to the inclusion of individual fixed effects, which compares the prevalence of these medical conditions for the same person under different levels of exposure to the herbicide used in the aerial spraying program over a period of 5 years. Also, the results are robust to controlling for the extent of coca cultivation of illicit crops in the municipality of residence.

The Expansion of Higher Education in Colombia: Bad Students or Bad Programs?

A rapid expansion in the demand for post-secondary education triggered an unprecedented boom of higher education programs in Colombia, possibly deteriorating quality. This paper uses rich administrative data matching school admission information, socio-economic characteristics of the young graduates, standardized test scores pre- and post-tertiary education and entry wages, to assess the heterogeneity in the value added generated by new higher education programs. Our findings show that once we account for self-selection the penalty of attending a recently created program, which initially appeared to be quite large, becomes close to zero.

Effects of Subsidized Health Insurance on Newborn Health in Colombia

Colombias rapid expansion of health insurance coverage in the 1990s provides an opportunity to evaluate whether health insurance coverage positively affects health care usage and outcomes. We use the discontinuity in eligibility for the Subsidized Regime (SR), the subsidized health insurance for the poor, to see if the Subsidized Regime increased the incidence of doctor assisted births, prenatal care, and hospital deliveries; and if it improved newborn health measured by birth weight, gestation period, Apgar score and incidence of low (lbw) and very low birth weight (vlbw). We find that the Subsidized Regime had positive effects on newborn birth weight, but although positive, not consistently significant effects on other health measures or access to medical personnel and facilities.

Drug Consumption in Colombia

This paper examines the evolution of drug use in Colombia over the past years. Our analysis, based on surveys from the Direccion Nacional de Estupefacientes, shows that drug consumption grew substantially between 1996 and 2013. The growth occurred for both genders, all ages, socioeconomic strata and types of occupation. The results also suggest that men of high socioeconomic strata who regularly consume alcohol and cigarettes and who are between 18 and 24 years of age are more likely to use drugs. Finally, the paper presents some indirect evidence that contradicts the alleged effects of the judgment of the Constitutional Court (Sentencia C-221 of May 1994) that decriminalized the personal dose on the consumption of drugs in Colombia.