Ernesto F. L. Amaral

The Impact of Payment Source and Hospital Type on Rising Cesarean Section Rates in Brazil, 1998 to 2008

BACKGROUND High cesarean section rates in Brazilian public hospitals and higher rates in private hospitals are well established. Less is known about the relationship between payment source and cesarean section rates within public and private hospitals. METHODS We analyzed the 1998, 2003, and 2008 rounds of a nationally representative household survey (PNAD), which includes type of delivery, where it took place, and who paid for it. We construct cesarean section rates for various categories, and perform logistic regression to determine the relative importance of independent variables on cesarean section rates for all births and first births only. RESULTS Brazilian cesarean section rates were 42 percent in 1998 and 53 percent in 2008. Women who delivered publicly funded births in either public or private hospitals had lower cesarean section rates than those who delivered privately financed deliveries in public or private hospitals. Multivariate models suggest that older age, higher education, and living outside the Northeast region all positively affect the odds of delivering by cesarean section; effects are attenuated by the payment source-hospital type variable for all women and even more so among first births. CONCLUSIONS Cesarean section rates have risen substantially in Brazil. It is important to distinguish payment source for the delivery to have a better understanding of those rates.

Chain Migration and Residential Segregation of Internal Migrants in the Metropolitan Area of São Paulo, Brazil

This paper focuses on the geography of internal migration to and settlement within the metropolitan area of São Paulo. Specifically, the research objectives are to: (1) document the major flows of internal migration into the São Paulo metropolitan area; (2) map both short- and long-term migrant patterns of settlement within the São Paulo metropolitan area; and (3) approximate to what extent particular migrants from specific sending areas spatially concentrate in certain neighborhoods within the metropolitan area using both non-spatial and spatial measures of segregation. The key feature of our theoretical argument is that migrant networks evolve, accumulate, and generate higher than expected levels of internal migration to particular neighborhoods. As internal migrants become increasingly concentrated and a dynamic feedback process emerges between origin and destination, the metropolis becomes both segmented and segregated.

Deliberação online em consultas públicas? O caso da assembleia legislativa de Minas Gerais

Este artigo busca analisar uma consulta publica online sobre reforma politica promovida em 2011 pela Assembleia Legislativa de Minas Gerais. Embasado pela teoria deliberacionista, o estudo de 752 posts guiou-se pela discussao de seis topicos: (1) inclusividade; (2) provimento de razoes; (3) reciprocidade; (4) respeito mutuo; (5) orientacao para o bem comum; e (6) articulacao entre arenas. Os resultados indicam: (1) uma sobrerepresentacao de participantes masculinos e oriundos da Regiao Metropolitana de Belo Horizonte, embora nao tenha havido concentracao de posts em alguns comentadores; (2) o predominio de posts on topic e que apresentam justificativas para as posicoes advogadas; (3) indices muito baixos de reciprocidade entre posts e de uso de marcadores de interatividade; (4) graus muito elevados de respeito; (5) diferentes formas de ligacao das justificativas a ideias de bem comum; (6) o baixo impacto decisorio e a conexao com outras arenas da esfera publica, destacando-se a relacao com uma materia publicada em jornal de grande circulacao. Os achados sao ambivalentes para os defensores da deliberacao, indicando baixa probabilidade de deliberacao interna ao forum, mas algum potencial deliberativo quando se adotam lentes mais amplas. Os cruzamentos entre variaveis sugerem que as pessoas tendem a prover mais justificativas em discussoes mais controversas, embora tendam a dialogar menos nesses casos. Assim, a hipotese da preferencia por conversas entre like-minded encontra respaldo nos dados analisados.

A política de segurança pública no Brasil: uma análise dos gastos estaduais (1999-2010)

Resumo: Este artigo analisa os gastos estaduais em seguranca publica no periodo de 1999 a 2010, observando principalmente suas relacoes com as perspectivas ideologicas dos partidos eleitos para o Poder Executivo (governador). Testou-se, sobretudo, a hipotese de que o gasto com a politica de seguranca publica seria maior em estados governados por partidos de direita, uma vez que parte da literatura nacional aponta para a existencia de maior preocupacao desse espectro politico-ideologico com a funcao de controle social. Foram utilizados modelos de regressao multivariada que indicaram os seguintes achados: a) variacao positiva dos gastos quando os partidos sao de esquerda e centro, comparados aos partidos de direita; e b) relativa aproximacao dos percentuais de arrecadacao investidos em seguranca nos estados, independentemente dos partidos nos governos. Palavras-chave: seguranca publica; instituicoes subnacionais; gastos estaduais

Avaliação de Impacto das condicionalidades de educação do Programa Bolsa Família (2005 e 2009)

This paper analyzes the impact of the educational conditions of Brazils Bolsa Familia Program on the dropout rates of children benefiting from the program. The main hypothesis is that children living in a household that receives the benefit have a lower chance of dropping out of school. Data are from the 2005 and 2009 Impact Evaluation of the Bolsa Familia Program (AIBF), collected by the Ministry of Social Development and Combating Famine (MDS), Brazil. Logistic models estimated the chance that children would drop out of school in 2005 and 2009, for three different household income thresholds, taking into account characteristics related to the household, mother, and child. Children who lived in households benefiting from Bolsa Familia had a significantly lower chance of dropping out in 2005. Data for 2009 were not statistically significant, although results pointed to a decrease in dropout rates, due to the impact of Bolsa Familia.

The Decomposition of Economic Outcomes as a Result of Changes in Brazil’s Male Age–Education Structure

In Brazil, the age and education compositions of the male labor force is changing with great regional variation. Based on Demographic Census microdata, results indicate that cohort size has a negative impact on earnings, but this effect is decreasing over time. In this study we consider the impact on earnings by age and education, as well as estimated income inequality reduction and racial differentials. Fertility decline and improve regarding educational attainment had a significant influence on the decline of income inequality in the country. Moreover, the non-white population has been experiencing less success in relation to educational achievement, compared to the white population.

Seguro-desemprego e formalidade no mercado de trabalho brasileiro

The authors analyze the relationship between unemployment benefits and formal employment in the Brazilian labor market. The central hypothesis is that the receipt of such benefits has a negative impact on levels of formal employment, after benefits have been received. The data were extracted from the Brazilian Household Surveys between 1999 and 2009. Logistic regression models were estimated in order to evaluate the effect of unemployment benefits on the Brazilian labor market. The dependent variable is the occurrence of formal employment for workers. In addition to a set of independent variables (survey year, region of residence, census area, gender, race, age and education), the models include a public policy evaluation variable (unemployment benefits), as well as variables to analyze the trend of this public policy over time. After having received unemployment benefits, the occurrence of formal employment among workers falls by 42%. The analysis of interactive terms indicates that increases in the real values of the benefits, applied since 1999, have not caused significant effects on the dependent variable.

A meta-regression analysis on the association between income inequality and intergenerational transmission of income

Our aim is to provide an overview of associations between income inequality and intergenerational mobility in the United States, Canada, and eight European countries (Denmark, Finland, France, Germany, Italy, Norway, Sweden, and the United Kingdom). We analyze whether this correlation is observed across and within countries over time. Developed countries have been experiencing increases in inequality in recent decades, mostly due to a steep concentration of income at the top of the distribution. We investigate Great Gatsby curves and perform meta-regression analyses based upon several papers on this topic. Results suggest that countries with high levels of inequality tend to have lower levels of mobility. Intergenerational income elasticities have stronger associations with the Gini coefficient, compared to associations with the top one percent income share. Once models are controlled for methodological variables, country indicators, and paper indicators, correlations of mobility with the Gini coefficient lose significance, but not with the top one percent income share. This result is an indication that recent increases in inequality at the top of the distribution (captured by the top one percent income share) might be negatively affecting mobility on a greater magnitude, compared to variations across the income distribution (captured by the Gini coefficient).

Characterization of Fertility Levels in Brazil, 1970-2010

We analyze the 1970, 1980, 1991, 2000, and 2010 Brazilian Demographic Censuses, in order to investigate the associated factors with a woman having had a live birth during the year prior to each census. We estimated logistic regression models for women aged 10-49 years. As independent variables, we selected region of residence, rural/urban location, presence of electricity, color/race, religion, marital status, labor market participation, time of residence in the municipality, information about whether they had a stillbirth, age, education, and parity. Our findings confirm that the probability a woman had a child is higher in the North and Northeast regions, as well as in households without electricity. Women that have a greater chance of having had a child are black/brown, Catholic, married, non-labor market participants, short-term migrants, experienced a stillbirth, between 20-29 years of age, have less education, and have higher parity. Patterns have been changing throughout time, thus posing questions for further analyses.

The Influence of Internal Migration on Male Earnings in Brazil, 1970-2000

This paper deals with the impact of internal migration flows on the earnings of male workers. The availability of jobs and income levels in sending and receiving areas also influence internal population flows. Thus, migration is an endogenous variable that cannot be simply introduced as an exogenous variable when estimating labor outcomes. A methodological approach is developed to introduce migration into our models, dealing with the issue of reverse causality between migration and earnings. We implement this strategy using the 1970–2000 Brazilian Demographic Censuses. Our findings reflect our initial hypothesis, indicating that migration flows have a negative impact on male earnings, when considering cohort size as a factor. A ten percent increase in migration rates would have reduced the wages of competing workers by up to three percent in 2000. These methodological strategies can be applied to other countries that have similar available migration data.