Luis Tejerina

Education, Family Background and Racial Earnings Inequality in Brazil

This study investigates the role of race, family background and education in earnings inequality between whites and the African descendent population in Brazil. It uses quantile Mincer earnings regressions to go beyond the usual decomposition of average earnings gaps. Differences in human capital, including parental education and education quality, and in its returns, account for most but not all of the racial earnings gaps. There appears to be greater pay discrimination at the higher salary jobs for any skill level. Returns to education vary with the gradient of skin color. While returns are similar for white and mixed race workers at the top of the adjusted wage scale, mixed race workers at the bottom are rewarded similar to blacks. Thus, while equalizing access to quality education is key to reduce racial earnings inequality in Brazil, specific policies are also needed to facilitate equal access of non‐whites to good quality jobs.

Understanding public perception of the need for major change in Latin American healthcare systems

The opinions and experiences of the public regarding health services are valuable insights into identifying opportunities to improve healthcare systems. We analyzed the 2012-2013 Public Opinion Health Policy Survey carried out in Brazil (n = 1486), Colombia (n = 1485), El Salvador (n = 1460), Jamaica (n = 1480), México (n = 1492) and Panama (n = 1475). In these countries between 82 and 96% of participants perceived that their health systems needed fundamental changes. The most frequent barrier to access to healthcare was lack of the primary medical home, difficulties in obtaining medical care during the weekends and financial barriers. Type of health insurance and challenges in obtaining medical care during the weekends were associated with an increased opinion for the need for fundamental changes in healthcare systems, whereas having a primary medical home showed a protective effect. Focusing on tackling organizational and financial barriers and ensuring access to a primary medical home should be placed on the agenda of Latin American countries.

Desde el paciente: Experiencias de la atención primaria de salud en América Latina y el Caribe

En la region de America Latina y Caribe (ALC), la mayoria de los paises buscan reformar sus sistemas de salud para lograr la cobertura universal y mejorar la eficiencia de sus gastos sanitarios, al tiempo que cumplen con las expectativas cada vez mayores de los ciudadanos acerca de la calidad de la atencion. El papel de la atencion primaria de salud (APS) destaca como clave para lograr esos objetivos de forma integrada. Por ello, el Banco Interamericano de Desarrollo llevo a cabo, entre 2012 y 2014, la Encuesta sobre Acceso, Experiencia y Coordinacion de la Atencion Primaria de Salud en America Latina y el Caribe, en poblaciones adultas de Colombia, Mexico, Brasil, El Salvador, Panama y Jamaica, buscando contribuir al diseno de politicas publicas de salud, y considerando especialmente el punto de vista de los pacientes. Los dos primeros capitulos del presente libro presentan el contexto y desafios de los sistemas de salud de la region y describen el marco conceptual y la metodologia del estudio. Los capitulos tres al ocho tratan, por separado, de cada uno de los seis paises estudiados, con resultados sobre las experiencias de los pacientes con la atencion primaria de salud y su integracion con los demas niveles de atencion. El capitulo nueve cierra el libro con un analisis comparativo entre los seis paises de ALC y extiende la comparacion a 11 paises de altos ingresos de la OCDE, donde se evidencian las brechas persistentes en los indicadores de acceso, experiencia y coordinacion en la APS entre los paises de ALC y los de la OCDE. Un analisis multivariado con los 17 paises demuestra que los principales atributos observados de la APS estan directamente vinculados a las percepciones de los pacientes acerca de la necesidad de cambios fundamentales en los sistemas de salud y de la calidad de los servicios utilizados.

Trading Places: A Decade of Earnings Mobility in Chile and Nicaragua

Abstract Using longitudinal datasets from Chile and Nicaragua, we compare intragenerational earnings mobility over a decade for two economies with similar inequality levels but divergent positions in equality of opportunities within the Latin American region. Our results suggest that earnings mobility, in terms of origin independence of individual ranking in the earnings distribution, is greater in Chile than in Nicaragua.