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Immigrants are ineligible for federally-funded Medicaid in the U.S. until at least 5 years after arrival. There is little information on where they receive care in light of this restriction. Using Blinder-Oaxaca decomposition, this study examines whether the setting in which older recent immigrants receive care (i.e., health clinic, emergency room or doctor's office) explains delays in care. Among older adults with a usual source of care, 13.5% of recent immigrants had not seen a health professional in the past year compared to 8.6% of non-recent immigrants and 6.3% of native-born. Approximately 23% of these differences is attributable to recent immigrants' tendency to receive care in clinics and community health centers. Even when older recent immigrants manage to find a usual source of care, it is of lower quality than that received by their non-recent immigrant and native-born counterparts.

Aging populations and the prevalence of poverty in old age have led to the introduction of noncontributory pensions in many countries. We consider a number of alternative targeting approaches and simulate their effects in an empirical application in the State of Yucatan, Mexico. We compare the approaches with respect to leakage, under-coverage, and their effects on government budgets. We are also able to compare the simulated effects of one alternative with the observed effect of a recently introduced demogrant and find that the simulation is a close approximation of the empirical outcomes. We discuss issues of implementation and political feasibility.

We analyze two noncontributory Mexican pension programs for the elderly. Both paid similar amounts, but one paid monthly while the other paid every two months. The Life Cycle Hypothesis suggests frequency of benefits payments should not affect consumption smoothing, but we find the monthly program was more effective in smoothing food expenditure. It also increased doctor visits and reduced the incidence of hunger spells. Under the bimonthly program, expenditures on food significantly decline between paychecks but ownership of durable goods increased. This suggests the importance of payment frequency in social programs.

Older adults make up an increasing share of new legal immigrants to the United States. These immigrants are often financially dependent on family since they are often barred from receiving several U.S. support programmes and are less likely to receive U.S. retirement benefits than natives. However, little information exists as to whether they receive retirement income from abroad. Using the New Immigrant Survey (N=2,150), we find that only 8.1 per cent of older recent immigrants report receiving foreign retirement income. In logistic modeling, older immigrants from Asia and Latin America were less likely to receive retirement income from abroad than those from Europe (Odds ratio = 0.50, p

For decades scholars have attempted to understand the effects of immigration on the U.S. Social Security system. To date, this research has been primarily limited to migrants in the U.S. and does not consider those who return to their countries of origin. Immigrants often pay OASDI taxes using illegitimate Social Security numbers and may return to their home countries without collecting U.S. Social Security benefits. In this study, we analyze the socioeconomic and labor characteristics, health, migration histories, and transitions to retirement of male Mexican return migrants who contributed to the U.S. Social Security system. Using the 2003 and 2012 Mexican Health and Aging Study (MHAS), we find that in 2012, 32 percent of male return migrants reported having contributed to the U.S. Social Security system but only five percent of those who contributed, received or expected to receive benefits. Those who reported having contributed were more likely to have completed college, spent more years in the U.S., and were more likely to be U.S. citizens or legal permanent residents than those who did not contribute. We also find that return migrants who spent one to nine years in the U.S. had a lower probability of transitioning to retirement between 2003 and 2012 than those had never been to the U.S. In contrast, those who spent 20 or more years in the U.S. had a higher probability of transitioning to retirement.

This paper uses data from the Health and Retirement Study (HRS) and the Mexican Health and Aging Study (MHAS) to study the cognitive function of Mexican-born older adults residing in the United States (Mexican immigrants). We find that, once differences in socioeconomic factors are accounted for, the cognitive function of male Mexican immigrants is statistically indistinguishable from that of male non-Hispanic (NH) whites, but the cognitive scores of female Mexican immigrants remain significantly below those of their NH white counterparts. We explore four potential hypotheses that may explain the cognition gap for female Mexican immigrants. Namely, we investigate whether the relative incidence of risk factors for dementia, when compared to NH whites, is higher for female than for male Mexican immigrants (the "risk factor hypothesis"); whether the mortality rate of male Mexican immigrants with low cognition is higher, relative to their white counterparts, than that of female Mexican immigrants (the "survival bias hypothesis"); whether female Mexican immigrants are less positively selected than their male counterparts in terms of predisposition to cognitive decline when compared with either the non-migrant Mexican population or the population of return migrants (the "differential selection hypothesis"); and whether male immigrants are better acculturated to life in the United States than female immigrants (the "acculturation hypothesis). We find no support for the risk-factor, survival, or acculturation hypotheses but we find evidence suggesting that the differential selection hypothesis may explain part of the female cognitive gap. Our results imply that older Mexican females currently residing in the U.S. may be at elevated risk for dementia and should be targeted by campaigns aimed at preventing or diagnosing the condition.

Background We documented results from a cluster-randomized controlled trial we designed to supplement incomes in poor towns among adults 70 or older. We analyzed effects on health by gender, persistence over time, and variation by payment frequency. Methods We compared supplemental income effects over an 18-month period for two towns in Yucatan, Mexico: Valladolid, where eligible individuals received a monthly income supplement over the entire analysis period, and Motul, a demographically matched control town, where eligible individuals received a bimonthly income supplement over the last 12 months of the analysis period. While differing in frequency of payment, supplements provided similar levels of income. We conducted three surveys of recipients: (1) at baseline, (2) six months after baseline, and (3) 18 months after baseline. Results The primary outcomes we examined were peak expiratory flow, hemoglobin level, and verbal recall. The secondary outcomes were health care use and food availability. We found health benefits persisted for at least eighteen months for the monthly income supplement, with both males and females benefiting. Bimonthly income supplements had smaller health benefits. Conclusions Older people in the developing world who lack social security benefits and health care may benefit most from monthly income programs. The greater payment frequency of monthly programs may influence how household resources are allocated. Supplemental income programs are common in low- and middle-income countries; hence, our results have implications for program design in many nations.

In this study, we analyze factors that determine the likelihood of an individual undertaking caregiving responsibilities as well as the time spent providing assistance. We utilize a large sample of older adults (N = 2821) from a survey with rich information at the child and household member level (N = 16,014) in the State of Yucatan, Mexico. We define caregivers as those that provide assistance with activities of daily living (ADLs) to an older adult—both those living inside and outside the household—and non-caregivers as any person living in the household as well as children living outside that do not provide care. The Heckman two-step procedure is employed to account for sample selection bias in the analysis. We find that 77.7% of caregivers were women and 22.3% were men. In addition, daughters were most likely to take on the role as caregiver. A larger proportion of men in comparison to women worked while providing care, and women provided more hours of care work per month on average than men. We find that caregivers have lower educational attainment, a lower proportion worked, and a higher proportion lived with the older adult in comparison to non-caregivers. Also, non-caregivers provide a higher amount of monetary and in-kind transfers to older adults on average. The oldest adults—80 years and older—and those with the worst health status are more likely to receive care and received higher amounts of caregiving time. Moreover, older women are more likely to receive care than older men. Taking up caregiving activities reflects a two-way decision-making process consisting of older adult needs and caregiver characteristics influenced by societal and economic structures. Taking into account the increasing needs for older adult caregiving in Mexico due to changes in life expectancy and family composition, this model of informal caregiving is unsustainable and requires intervention.

The observed racial/ethnic gap in bank account ownership among older adults is substantial. We investigate socioeconomic, cognitive, and cultural barriers underling it. As additional potential barriers are accounted for, the residual gaps in financial inclusion with respect to Whites are reduced by 19% for blacks and 46% for Hispanics. We find that citizenship and "taste for privacy" play a limited role for both minority groups, while real asset ownership, health, cognitive ability, and cultural hurdles contribute substantially to the gap. For Hispanics, language barriers explain most of the gap, while neighborhood-level socioeconomic characteristics are more salient for blacks. We also examine how the racial/ethnic composition of couples influences financial decisions. We estimate a significantly smaller residual gap between "mixed" and white couples than between minority and white couples. We provide empirical evidence suggesting that, other things equal, mixed couples are less concerned with the cultural/psychological barriers facing minority couples.

Non-contributory pension programs in the developing world seek to provide older adults with an income that may improve their health and wellbeing in old age by enabling access to health care and better nutrition. There is no previous evidence of the effects of non-contributory pensions on frailty, a comprehensive measure of health and well-being of the oldest old. We aimed to estimate the effects of non-contributory pension programs on frailty of older adults in the state of Yucatan, Mexico. We use rich panel data, including objective markers and self-reported assessments of health and well-being, for 944 adults at least 70 years of age in two communities of Yucatan, Mexico. The first wave was collected in 2008; the second wave was collected in 2010, 18 months after implementation of a monthly state pension in one community and 12 months after a federal pension paid every two months in the other. We found the state pension led to a statistically significant decrease in the severity of frailty for women, but the federal pension was associated with an increase. We found no statistically significant change in the frailty index for men in either community. Among explanations for these findings are monthly payments being more likely to be spent on health care, medicines, and more regular food expenditures, enabling women who previously lacked independent means of support to increase their longer-term health. The federal program paid every two months led to irregular patterns of food expenditure and increased ownership of durable goods but had no effects on health care utilization, subsequently leading to deterioration in longer-term health for women.

We conducted a qualitative study on retirement preparedness among middle-aged and older low-income Hispanics in Los Angeles. Data were derived from four focus groups conducted in the greater Los Angeles area. Findings demonstrate how behavioral and cultural factors-family experiences, religiosity, and denial of retirement-explain the lack of savings and preparedness for retirement. Findings also indicate that the majority of participants want to be economically independent and to keep working until they are unable to do so. Participants helped their parents financially but did not feel comfortable asking their own children for help. Instead, participants placed their survival in retirement "in God's hands."

Objectives: Investigate the “salmon-bias” hypothesis, which posits that Mexicans in the U.S. return to Mexico due to poor health, as an explanation for the Hispanic health paradox in which Hispanics in the United States are healthier than might be expected from their socioeconomic status. Method: Sample includes Mexicans age 50 years or above living in the United States and Mexico from the 2003 Mexican Health and Aging Study and the 2004 Health and Retirement Study. Logistic regressions examine whether nonmigrants or return migrants have different odds than immigrants of reporting a health outcome. Results: The salmon-bias hypothesis holds for select health outcomes. However, nonmigrants and return migrants have better health outcomes than immigrants on a variety of indicators. Discussion: Overall, the results of this study do not support the salmon-bias hypothesis; other explanations for the paradox could be explored.

For decades scholars have attempted to understand the effects of immigration on the U.S. Social Security system. To date, this research has been primarily limited to migrants in the U.S. and does not consider those who return to their countries of origin. Immigrants often pay OASDI taxes using illegitimate Social Security numbers and may return to their home countries without collecting U.S. Social Security benefits. In this study, we analyze the socioeconomic and labor characteristics, health, migration histories, and transitions to retirement of male Mexican return migrants who contributed to the U.S. Social Security system. Using the 2003 and 2012 Mexican Health and Aging Study (MHAS), we find that in 2012, 32 percent of male return migrants reported having contributed to the U.S. Social Security system but only five percent of those who contributed, received or expected to receive benefits. Those who reported having contributed were more likely to have completed college, spent more years in the U.S., and were more likely to be U.S. citizens or legal permanent residents than those who did not contribute. We also find that return migrants who spent one to nine years in the U.S. had a lower probability of transitioning to retirement between 2003 and 2012 than those had never been to the U.S. In contrast, those who spent 20 or more years in the U.S. had a higher probability of transitioning to retirement.

The goal of this study is to deepen the understanding of how middle age and older Hispanics plan for retirement, where we conducted four focus groups in the Los Angeles area with a total of 38 participants. Our study provides interesting findings, specifically for women since 84 percent of the participants were female. We find that that most participants, whether they were already retired or not, are not well prepared for retirement since they have been unable to save for retirement and have not made specific retirement plans, such as determining desired retirement age, estimating retirement budget, and collecting information about expected retirement benefits. In relation to saving on a regular basis, results were mixed. Some participants are able to save on a regular basis, but others cannot save because they live day to day. Our study contributes to the literature by showing how family experiences and religion play a significant role in retirement planning among this population. We found that the majority of the participants had parents who did not plan for retirement, and very few had parents who were able to save. We also found that many participants do now worry about retirement because they believe “God will provide.” We also found an interesting shift in relation to intergenerational transfers and family networks. While many participants help their parents, most of them do not want to ask children for help and do not expect getting help from them.

The informed-consent process seeks to provide complete information to participants about a research project and to protect personal information they may disclose. In this article, we present an informed-consent process that we piloted and improved to obtain consent from older adults in Yucatan, Mexico. Respondents had limited fluency in Spanish, spoke the local Mayan language, and had some physical limitations due to their age. We describe how we adapted the informed-consent process to comply with U.S. and Mexican regulations, while simplifying the forms and providing them in Spanish and Mayan. We present the challenges and lessons learned when dealing with low-literacy older populations, some with diminished autonomy, in a bilingual context and a binational approach to the legal framework.

Targeting based on individuals or households needs instead of applying universal programs helps distribute scarce resources to those who need it most, avoiding “leakage” of the poverty budget to non-poor households. In this paper, the authors explore the use of different household and individual characteristics for targeting needy households. They estimate a Heckman selection model to explain household income and use the estimated model to simulate the effects of different means testing schemes. Their analysis focuses on the evaluation of cash transfer programs for older populations. Using data from the Survey of Household Socioeconomic Characteristics in the State of Yucatan, Mexico, they evaluate the feasibility and target efficiency of different possible means-tested programs. Their analysis shows that a means-tested “flat rate” option would be more effective in alleviating poverty than the less costly option of a sliding scale. The tradeoff between raising welfare for the poor, thereby prioritizing low under coverage rates; and allocating limited resources, thus prioritizing low overall costs of a program, remains however a political challenge for all administrations designing poverty alleviation programs.

Designs and evaluates a new non-contributory social security program in the State of Yucatan, Mexico.

Analyzes the retirement behavior of Mexican return migrants from the United States and non-migrants.