Financial Distress and Psychological Well-Being During the COVID-19 Pandemic.

Objective: We examine the impact of financial distress caused by the COVID-19 pandemic on mental health and psychological well-being. Methods: We analyze cross-sectional survey data (n = 2,545) from the Life during Pandemic study in Chile. We estimate linear probability models to analyze the relationship between economic fragility, financial distress, and psychological well-being. Results: Our findings show unemployment and income loss are highly predictive of experiencing a range of financial problems, such as a lack of savings, as well as difficulties paying bills, consumer debt, and mortgage loans. In turn, financial distress leads to a higher prevalence of poor well-being and mental health deterioration, and sleep problems. Conclusion: Expansion of mental health assistance services are needed, as new diagnosis of mental health conditions has increased, but treatment has not, pointing to a barrier in the access to some mental health care services during the pandemic. Policies designed with the objective of improving financial education are necessary to increase precautionary savings and financial resilience, and alleviate the psychological burden of debt in the future.

Early life environment and adult height: The case of Chile.

In this paper, we analyze the relationship between adult height and early-life disease environment, proxied by the infant mortality rate (IMR) in the first year of life, using cohort-region level data for Chile for 1960-1989. IMRs show a remarkable reduction of 100 points per thousand over this thirty-year period, declining from 119.4 to 21.0 per thousand. We also document a 0.96 cm increase in height per decade.We find that the drop in IMRs observed among our cohorts explains almost all of the long-term trend in rising adult heights, and that per capita GDP does not appear to have any predictive power in this context. Results are robust in a variety of specifications, which include area and cohort dummies, an adjustment for internal migration, and urbanization rates. Our results point to the long-term effect of a public health policy.

Height in eighteenth-century Chilean men: Evidence from military records, 1730-1800s.

This article provides the first height estimates for the adult population for any period of Chilean history. Based on military records, it gives an analysis of the average heights of male soldiers in the last eight decades of the colonial period, c.1730-1800s. The average height of Chilean men was around 167 centimetres, making them on average taller than men from Mexico, Italy, Portugal, Spain and Venezuela, but of a similar height to men from Sweden. However, Chilean men were clearly shorter than men in neighbouring Argentina, the USA and the UK. Chilean height remained stable during the 1740-1770s, but it declined by some 2-3 centimetres between the 1780 s and the 1800s, in line with a fall in real wages due to increasing food prices and population growth.

Sistemas de salud locales: Análisis de la relación entre aseguramiento y mecanismos de contratación y pago en Córdoba, Salta y Tucumán / Local health systems: analysis of the relationship between insurance and contract and payment mechanisms in Cordoba, Salta and Tucuman

INTRODUCCIÓN: Los mecanismos de contratación y pago en salud generan un impacto diverso en la cantidad y calidad de los servicios médicos, en la transferencia de riesgo entre actores y en la eficiencia de la utilización de los recursos. OBJETIVO: Analizar la estructura del mercado de servicios de salud en las provincias de Córdoba, Salta y Tucumán durante los últimos cinco años. MÉTODO: Se consideraron las condiciones socio-económico-sanitarias locales, el marco institucional, la historia de los actores más relevantes del sector y las conductas adquiridas como respuesta a la estructura. La metodología incluyó un mapeo de los actores claves del sector salud cada provincia así como la administración de un cuestionario a una muestra de establecimientos públicos y privados de cada jurisdicción. RESULTADOS: Los ministerios de salud provinciales son los principales financiadores del sistema público de salud y el Instituto Nacional de Servicios Sociales para Jubilados y Pensionados (PAMI) y las obras sociales provinciales lo son del sistema privado. CONCLUSIONES: PAMI tiene una política nacional que lo torna menos flexible para contemplar las particularidades locales, mientras que las obras sociales provinciales se presentan como los actores idiosincrásicos, siendo más permeables a las demandas locales. En la medida en que el PAMI coordine con los ministerios y la obra social provincial, se podría converger a modelos más homogéneos de atención y mecanismos de pago, generando incentivos para una mayor eficiencia en la asignación de recursos y una mayor equidad en salud

INTRODUCTION: The contracting and payment mechanisms in health generate different impact on the quantity and quality of medical services, the transfer of risk among actors and the efficient use of resources. OBJECTIVES: To analyze the market structure of health services in the provinces of Cordoba, Salta and Tucuman during the past five years. We considered the local socioeconomic and health conditions, institutional framework, the history of the most relevant actors, and their behaviour in response to the structure. The methodology included a mapping of key actors in the health sector in each province and the administration of a questionnaire to a sample of local public and private health institutions. RESULTS: The results show that the provincial ministries of health are the primary funders of the public services and the national insurance for retired people (PAMI) and the provincial social insurances are the primary funders of the private system. CONCLUSION: PAMI has a national policy which makes it self less flexible to consider the local particularities,while the provincial social insurances present themselves as idiosyncratic actors, being more receptive to local demands. If PAMI were coordinated with the structure of the local social insurance and the ministries of health, it could beachieved homogeneous models of health care and payment mechanisms, generating incentives for a more efficient resources allocation and equity in health