Esteban Calvo

Highlights
• China has rapidly enrolled most of its rural population in a voluntary pension system.

• Working age adults signed up in part due to a clever family-binding policy.

• China's rural pension scheme needs more adequate social pension benefits.

• Benefit levels in Latin America suggest that China could afford more generous pensions.

Este proyecto dirigido por el Centro de Investigación Social
de Un techo para Chile desde octubre de 2002, consistió en
la recolección de historias personales y comunitarias en 30
asentamientos precarios del país ubicados en regiones de la I a
la X. La metodología utilizada para recolectar estas historias fue
de corte cualitativo y los encargados de hacer las entrevistas
particulares y colectivas fueron voluntarios de Un techo para
Chile de todo el país, quienes fueron capacitados con este
propósito. El resultado de este proyecto es la formación del
primer archivo de historia oral de personas de campamentos
de Chile.

In spite of the high prevalence of mental health disorders in Chile, there is a significant financing deficit in this area when compared to the world’s average. The financing for mental health has not increased in accordance with the objectives proposed in the 2000 Chilean National Mental Health and Psychiatry Plan, and only three of the six mental health priorities proposed by this plan have secure financial coverage. The National Health Strategy for the Fulfilment of Health Objectives for the decade 2011-2020 acknowledges that mental disorders worsen the quality of life, increase the risk of physical illness, and have a substantial economic cost for the country. Thus, this article focuses on the importance of investing in mental health, the cost of not doing so, and the need for local mental health research. The article discusses how the United States is trying to eliminate the financial discrimination suffered by patients with mental health disorders, and concludes with public policy recommendations for Chile.

Objectives. This study examined the relationship between patients' object relations and interpersonal process in psychotherapy. Namely, we tested the hypothesis that the quality of patients' object relations is positively associated with both patient- and therapist-rated alliance quality.

Design. Psychotherapy was administered naturalistically, with quantitative data collection before and during treatment.

Methods. Participants included 73 adult outpatients and 23 therapists at two mental health clinics. Using the Bell Object Relations and Reality Testing Inventory, we measured four dimensions of patients' object relations at baseline—alienation, insecure attachment, egocentricity, and social incompetence. Using the Working Alliance Inventory, we measured alliance from patient and therapist perspectives. Control variables included time, patient demographics, symptom severity, and clinic. We employed hierarchical linear modelling to analyse data with a nested structure, with 138 sessions at Level 1, 73 patients at Level 2, and 23 therapists at Level 3.

Results. Patient alienation and insecure attachment were associated with lower patient-rated alliance, while egocentricity was associated with higher patient-rated alliance. Patients' object relations were not significantly associated with therapist-rated alliance. On average, patients perceived the alliance more positively than their therapists, with a weak positive correlation between the alliance perspectives.

Conclusions. The results suggest that object relation dimensions may be important patient characteristics for forecasting therapeutic relationship quality. They also call for more attention to differences between alliance rating perspectives.

Practitioner points.
    Treatment may benefit from more attention to the quality of patients' object relations.
    If patients present with high levels of alienation and insecure attachment, therapists may need to pay especially close attention to the therapeutic alliance, and prudently address any ruptures in its quality.
    When monitoring the alliance quality, it is important to consider that patients and therapists may have different perspectives. Therapists relying solely on their own perceptions are at risk of missing alliance difficulties, and patients' object relations may be uniquely predictive of their own sense of the alliance. Therefore, it may be helpful to ask patients in session and through standardized measures for feedback on how they perceive the goals and tasks of treatment and the emotional bond with their therapist. Again, any alliance tensions could then be addressed directly as a means to maintaining engagement in the service of better outcome.

Objective: To evaluate the effect of a smoking ban in high schools on smoking behaviour among Chilean students. Methods:  We  conducted  an  interrupted  time-series  analysis,  using  repeated  cross-sectional data  from  Chile’s  school  population  survey  (2000–2011)  for  high-school  students  aged  12–18  years  and  a  control  group  of  persons  aged  19–24  years.  Poisson  regression  models were used to assess trends in smoking behaviour before and after the policy changes. The outcome measures were self-reported smoking prevalence (any smoking in the past month) and high frequency of smoking (smoking 15 days or more per month). Findings: From 2005 to 2011, the prevalence of smoking declined among high-school students by 6.8% per year compared with 3.6% decline per year in the control group. The decline in the target group was 2.9% (95% confidence interval, CI: 0.18 to 5.00) greater. We estimated that 5–6 years after enforcing the law, smoking prevalence among high-school students was 13.7% lower as a result of the ban. The impact of the smoking ban was primarily driven by declines in smoking prevalence among students in grades 8 to 10. The smoking ban did not significantly alter the frequency of smoking. Conclusion: The 2005 school smoking ban reduced smoking prevalence among younger high-school students in Chile. Further interventions targeting older individuals and frequent smokers may be needed.

Objectives. This article explores the effects of the timing of retirement on subjective physical and emotional health. Using panel data from the Health and Retirement Study (HRS), we test 4 theory-based hypotheses about these effects— that retirements maximize health when they happen earlier, later, anytime, or on time.

Method. We employ fixed and random effects regression models with instrumental variables to estimate the short- and long-term causal effects of retirement timing on self-reported health and depressive symptoms. Results. Early retirements—those occurring prior to traditional and legal retirement age—dampen health.

Discussion. Workers who begin their retirement transition before cultural and institutional timetables experience the worst health outcomes; this finding offers partial support to the psychosocial-materialist approach that emphasizes the benefits of retiring later. Continued employment after traditionally expected retirement age, however, offers no health benefits. In combination, these findings offer some support for the cultural-institutional approach but suggest that we need to modify our understanding of how cultural-institutional forces operate. Retiring too early can be problematic but no disadvantages are associated with late retirements. Raising the retirement age, therefore, could potentially reduce subjective health of retirees by expanding the group of those whose retirements would be considered early.

This article reviews two rounds of pension reform in ten Latin American countries to determine whether they are moving away from individual retirement accounts (IRAs). Although the idea is provocative, we conclude that the notion of ‘moving away from IRAs’ is insufficient to characterise the new politics of pension reform. As opposed to the politics of enactment of IRAs of the late twentieth century, pension reform in Latin America in recent years has combined significant revival of public components in old-age income maintenance with improvement of IRAs. Clearly, the policy prescriptions that were most influential during the first round of reforms in Latin America have been re-evaluated. The World Bank and other organisations that promoted IRAs have recognised that pension reform should pay more attention to poverty reduction, coverage and equity, and to protect participants from market risks. The experience and challenges faced by countries that introduced IRAs, the changes in policies by international financing institutions, and the recent financial volatility and heavy losses experienced in financial markets may have tempered the enthusiasm of other countries from applying the same type of reforms. Scholars and policy-makers around the globe could benefit from looking closely at these changes in pension policy.

This study explores the factors that affect an individual's happiness while transitioning into retirement. Recent studies find that workers often view the idea of gradual retirement as a more attractive alternative than a "cold turkey" or abrupt retirement. However, there is very little evidence as to whether phasing or cold turkey makes for a happier retirement. Using longitudinal data from the Health and Retirement Study, this study explores what shapes the change in happiness between the last wave of full employment and the first wave of full retirement. Results suggest that what matters is not the type of transition (gradual retirement or cold turkey), but whether people perceive the transition as chosen or forced.

While numerous Western countries first experienced cultural rationalization, next economic modernization, and then faced the challenges of population aging and pension policy reform, both Latin America and China, in contrast, are dealing with these challenges in the context of much less developed economies and stronger traditional cultures. In this article we analyze old-age pension reform efforts in eight Latin American countries that have introduced funded defined contribution schemes with individual accounts. We are searching for insights about the potential success of similar reforms being implemented in China. All of these societies are organized primarily around the principles of family, reciprocity, loyalty and poverty. Our analysis suggests that these distinctive characteristics have important implications for the likely success of the reforms currently being implemented in China, particularly in four interrelated areas: coverage, compliance, transparency, and fiscal stability.

Desde la llamada Revolución de los Pingüinos en 2006 a las reformas educativas de mediados de la década del 2010, la educación se ha convertido en uno de los temas más candentes y arduamente debatidos en Chile. Los que abogan por reformas profundas, en la senda de la gratuidad y equidad de acceso, se enfrentan duramente a aquellos que salen en defensa de un modelo educativo que ha imperado desde inicios de los años 80. Así, en la actualidad hablar de educación es hablar de política. Y este libro aborda justamente las políticas que explican el modelo y las reformas, así como los aspectos técnicos para reformar el sistema educacional chileno.

Este libro es el resultado de un importante trabajo de análisis y el aporte de destacados investigadores y académicos de la Universidad Diego Portales y otras instituciones chilenas, convocados por el Instituto de Políticas Públicas, dependiente de la Facultad de Economía y Empresa. Representa una colección de distintas Claves de Políticas Públicas, un conjunto de publicaciones cuya autoría pertenece a académicos de esta casa de estudios y de otros centros de estudio nacional. Tal como lo ha hecho en otras ocasiones frente a temas de relevancia nacional, el Instituto de Políticas Públicas quiso en esta instancia aportar diversas miradas y propuestas para abordar lo que se presentó desde comienzos de 2014 como un proyecto de gobierno que buscaba hacer una importante reforma a la educación del país.

Esta vez se pidió a muy destacados expertos en el tema educativo de distintas disciplinas que abordaran todo el ciclo educativo –desde preescolar, a escolar y educación superior– y respondieran, con fundamentos empíricos, una serie de interrogantes. Por ejemplo: ¿Cómo se podría financiar una educación superior que sea gratuita para todos? ¿Cómo evitar de manera efectiva que, en el actual sistema, las universidades privadas lucren? ¿Cómo reducir el financiamiento compartido en los colegios de manera tal de asegurar una mayor equidad en el acceso? ¿El lucro genera mejor calidad, equidad, diversidad e innovación en el sistema escolar? ¿Cómo funciona y cuán bueno es el modelo preescolar chileno? ¿Qué necesitamos para dar el salto y tener una enseñanza de primera infancia que logre tempranamente que todos los niños y niñas desarrollen su potencial? Estas y muchas otras preguntas encuentran respuestas en las siguientes páginas. Este libro está pensado para que sea de interés amplio y tenga un impacto tanto dentro como fuera de la academia.

Para facilitar su uso académico con fines docentes en nuestro Magíster de Políticas Públicas y otros programas similares, cada sección cuenta con una página de inicio donde se resumen los principales conceptos y se plantean una serie de preguntas que permiten ahondar en la reflexión. Confiamos también en que este libro sea del interés de los encargados de políticas públicas, legisladores y periodistas, entre otros, con el fin de comprender el contexto de una ambiciosa reforma de la educación chilena, acaso la más transformadora de las últimas décadas. Las ideas aquí planteadas contribuyeron al debate sobre reforma educacional, y en algunos casos, fueron recogidas en la Ley de Inclusión que fue promulgada a fines de 2014 y también en otros proyectos de ley en educación bajo discusión en 2015. Esperamos que este libro también contribuya a un debate informado sobre el futuro de la educación en Chile.

La posibilidad de incorporar la búsqueda de la felicidad como un objetivo del desarrollo está hoy cada vez más presente en la discusión pública internacional. Diversos países y líderes están comenzando a valorar como un fin políticamente relevante las consideraciones asociadas
a la satisfacción que las personas experimentan con sus vidas. Aunque de manera incipiente, la conversación está también instalada en la sociedad chilena.

Este capítulo discute consideraciones no pecuniarias en torno a la reforma del sistema de pensiones chileno. El diseño del sistema de pensiones ha sido poco sensible al contexto, lo cual ha resultado en recursos insuficientes para financiar periodos de jubilación más extensos. Au-mentar la edad de jubilación puede tener un efecto perjudicial en la salud y bienestar sicológico si se sobrepasan las capacidades físicas que las personas tienen para trabajar o si están obligadas a trabajar pero no pueden encontrar empleo. Sin embargo, fortalecer los mecanismos solidarios de redistribución de recursos tiene un impacto emocional positivo sin requerir de un gasto público excesivo. El gran desafío que tienen los sistemas de pensiones para contribuir a la satisfacción de las personas mayores no es administrar el riesgo, sino mantener y fortalecer las redes de protección social. Tomando en cuenta este diagnóstico, se proponen propuestas para reformar el sistema de pensiones.

This study assesses the influence of the Chilean old-age pension model on the life satisfaction of older adults across the world. Numerous countries have implemented similar old-age pension reforms, combining
individualization of risk through pension privatization and redistribution of resources through mechanisms such as non-contributory pensions.
Using data for 126,560 adults age 45 and over living in 91 countries over the period 1981-2008, and employing three-level hierarchical linear regressions, this study finds that on average redistribution increases life satisfaction, while individualization has no significant effect. However, the relationship between pension policy and life satisfaction varies in
complex ways across countries.

Los chilenos de hoy esperan vivir más y también vivir mejor. Según el informe de “Estadísticas Sanitarias Mundiales 2012” de la Organización Mundial de la Salud (OMS), los chilenos que nacen hoy esperan vivir 79 años. Esto es siete años más que los que nacieron en 1990 y 25 años más que los que nacieron en 1950. Este aumento radical en la expectativa de vida es un buen indicador del progreso de Chile, pero solo toma en cuenta el largo de la vida, y no su calidad.

Los chilenos de hoy esperan vivir más y mejor. Según el informe de “Estadísticas Sanitarias Mundiales 2012” de la Organización Mundial de la Salud (OMS), los chilenos que nacen hoy esperan vivir 79 años. Esto es siete años más que los que nacieron en 1990 y 25 años más que los que nacieron en 1950. Este aumento radical en la expectativa de vida es un buen indicador del progreso de Chile, pero solo toma en cuenta el largo de la vida y no su calidad.
La vejez es una experiencia ambivalente, que encierra pensamientos y emociones contrapuestas. Esta etapa combina elementos positivos, como la sabiduría acumulada a lo largo de la vida y el tiempo libre ganado con la jubilación y elementos negativos, como los problemas de salud y el riesgo de no generar suficientes ingresos y depender económicamente de otros.

Históricamente, el debate sobre el envejecimiento ha estado excesivamente centrado en sus elementos negativos. Aunque las políticas previsionales y de salud son fundamentales, el énfasis en los jubilados y enfermos ha llevado a pensar en las personas mayores como consumidores o cargas y no como productores o recursos valiosos para la sociedad.

En el presente capítulo se revisan algunos antecedentes y desarrollos recientes del sistema de salud chileno. En primer término, se lleva a cabo un repaso de los principales períodos e hitos históricos de las políticas de salud en Chile. Posteriormente, se revisa el contexto epidemiológico y demográfico en Chile y se compara con el caso de Colombia, en relación a indicadores relevantes como la esperanza de vida, el envejecimiento de la población y los gastos en salud. En tercer lugar, se profundizará en la realidad actual de las políticas de salud chilenas. Por último, se analizará cómo es posible priorizar el sistema de salud de una forma justa, legítima y sustentable.

En este estudio nos preguntamos quiénes son los responsables de la salud del adulto mayor. Para responder esta pregunta, primero identificamos los principales determinantes de la salud del adulto mayor y luego exploramos actores sociales relevantes a los cuales es posible atribuir una responsabilidad.  Nuestro análisis se basa en datos longitudinales de la Encuesta de Protección Social en Chile y sugiere que, si bien un estilo de vida saludable puede hacer una gran diferencia, la salud también es afectada por factores que no están bajo el control directo de las personas. Dado que muchas personas entran a la tercera edad habiendo trabajado por más de 30 o 40 años, las características de su empleo pueden tener un impacto duradero en su salud. Yendo todavía un paso más atrás en el tiempo, también es importante considerar que existen grupos de ancianos que partieron su vida en una situación desaventajada y acumularon desventajas desigualmente durante el curso de su vida. Particular atención requieren las personas que crecieron en un hogar de nivel socio-económico bajo y las mujeres. En síntesis, nuestros resultados sugieren que la salud del adulto mayor es influenciada significativamente por tres factores interrelacionados: estilo de vida saludable, empleo saludable y factores estructurales. Tomando esto en cuenta, proponemos que la salud del adulto mayor es una responsabilidad compartida por las personas, las empresas y el estado.

In this article we debate who are responsible for the health of older adults in Chile. In order to answer this, we first use data to identify the determinants of the health of older adults: life styles, employment attributes, and structural advantages/disadvantages. Next, we connect these determinants to three relevant social actors: individuals, companies, and the State. These three actors influence the health of older adults through different mechanisms, such as: actions and decisions, organizational politics, and public policies. This analytical model includes determinants, responsible actors, and mechanisms that influence health, at three different levels of social reality: micro, meso, and macro. We conclude that the health of older adults is a responsibility shared by individuals, companies, and the State.

Este  artículo  utiliza  los  enfoques  de  bienestar  subjetivo  y desarrollo  humano  para contribuir al debate sobre calidad del empleo en Latinoamérica y criticar las evaluaciones exclusivamente  centradas  en  la  satisfacción  laboral.  Se  define  calidad  del  empleo como características  relacionadas  al  trabajo  que  aumentan  la  libertad  de  las  personas  para alcanzar  funcionamientos  deseados  como  el  bienestar  subjetivo.  Se  propone  evaluar  la calidad del empleo incluyendo indicadores de satisfacción vital y capabilities. Esto permite considerar  áreas  de  la  vida  distintas  al  trabajo,  comparar  empleos  de  mala  calidad  con otras  alternativas  al  empleo  y  balancear  las  ventajas  y  desventajas  de  distintos  métodos evaluativos.

El  cáncer  es  una  enfermedad  devastadora. Una  de  cada  cuatro  muertes  en  Chile  es  por  cáncer. Esto equivale  22.000  muertes  anuales,  cifra  que  fácilmente podría empeorar si se toma en cuenta que la población está  envejeciendo.  Desafortunadamente,  el  costo  del  tratamiento  del  cáncer  es  alto  y  el  sistema  de  salud público  chileno  carece  actualmente  de  los  recursos necesarios  para  universalizar  la  terapia  de  radiación  o  tratamientos similares. En este contexto es fundamental complementar  las  alternativas  de  tratamiento  con esfuerzos para prevenir y detectar el cáncer antes de que sea necesario un tratamiento excesivamente costoso. Los  programas  de  prevención  del  cáncer  que  buscan anticipar  y  evitar  el  desarrollo  de  la  enfermedad  son particularmente  útiles  cuando  existe  una  exposición cancerígena conocida y evitable, como por ejemplo los rayos solares y ultravioleta. Los programas de detección utilizan  una  prueba  o  examen,  como  las  mamografías, para  descubrir  el  cáncer  en  una  etapa  temprana  y  más tratable. En esta Clave de Políticas Públicas discutimos los  avances  y  desafíos  que  Chile  enfrenta  en  la prevención del cáncer de piel y detección del cáncer de mama, destacando el rol del Foro Nacional del Cáncer y de una eventual estrategia y plan nacional para enfrentar el cáncer.

This study reviews developments in national aging policies in four Latin American countries: Argentina, Chile, Costa Rica and Mexico. Using case studies and a comparative-historical analysis, we focus on social policy reforms aiming to promote the well-being of older adults. We aim to determine whether a common profile of characteristics making up a particular aging policy could be identified across countries, and whether systematic differences between national aging policies could be uncovered. We find that similarities outweight differences. Although the timing and magnitude of the changes differ, historical trends are largely similar in substance: The initial charity-based approach to poverty and illness has been gradually replaced by a rights-based approach to broader notions of well-being, which have been formally promoted by
newly created national aging offices. Current reforms are at different levels of development and emphasize diverse themes, but they advance in largely similardirections across the countries analyzed: Heavily influenced by the 2002 Madrid Plan, current reforms emphasize the need of intersectoral policies of national scope, with active participants of older adults, including specific efforts to train specialized professional on
aging, and implementing the first steps toward building evidence-based policy. Results from this project have implications for understanding aging policy in Latin America and informing the reforms currently being
implemented in developing countries worldwide.

Corresponde a una metodología compuesta por una encuesta construida por un set de preguntas y un gráfico radial donde se dibujan las respuestas, complementada con una tecnología que automatiza el procesamiento y facilita la visualización de la información recogida sobre el bienestar de las personas. Además, cuenta con una plataforma interactiva online desde la cual personas y organizaciones pueden acceder gratuitamente a los materiales necesarios para realizar una encuesta, subir de forma sencilla sus respuestas y explorar los resultados obtenidos e una interfaz amigable. Está pensada para que un
público no especializado participe activamente en el proceso de obtención y manejo de datos.

1
Reforma
al
Sistema de Pensiones Chileno
:
Consideraciones No Pecuniarias
Esteban Calvo, PhD, MSPH
*
Este
documento
discute
consideraciones
no pecuniarias
en torno a
l
a reforma
del
sistema de pensiones chileno. El diseño del sistema de pensiones ha sido poco sensible  al  contexto,  lo  cual  ha  resultado en  recursos  insuficientes  para financiar periodos de jubilación más extensos. Aumentar la edad de jubilación puede tener un efecto perjudicial en la salud y bienestar sicológico si se sobrepasan las capacidades físicas que las personas tienen para trabajar o si están obligadas a trabajar pero no pueden  encontrar  empleo.  Sin  embargo,  fortalecer  los  mecanismos  solidarios  de redistribución de recursos tiene un impacto emocional positivo sin requerir de un gasto  público  excesivo.  El  gran  desafío  que  tienen  los  sistemas  de  pensiones  para contribuir a la satisfacción de las personas mayores no es administrar el riesgo, sino mantener  y  fortalecer  las  redes  de  protección  social. Tomando  en  cuenta  este diagnóstico, se propuestas para reformar el sistema de pensiones.

This article provides a critical review of the Chinese New Rural Pension System (NRPS), which combines a voluntary funded defined contribution (FDC) pillar with contingent social pensions (SP). NRPS successfully expanded rural coverage and thus emerged as a potential model for other developing countries. However, NRPS is also facing challenges with respect to future incentives for participation among younger workers, benefit adequacy, and financial sustainability. We discuss the strengths, weaknesses, and feasibility of expanding the number of participants and generosity of the SP pillar, switching to a matching definedcontribution scheme, and exploring a novel notional matching defined contribution scheme.

Este artículo utiliza los enfoques de bienestar subjetivo y desarrollo humano para contribuir al debate sobre calidad del empleo en Latinoamérica y criticar las evaluaciones
exclusivamente centradas en la satisfacción laboral. Se define calidad del empleo como características relacionadas al trabajo que aumentan la libertad de las personas para
alcanzar funcionamientos deseados como el bienestar subjetivo. Se propone evaluar la calidad del empleo incluyendo indicadores de satisfacción vital y capabilities. Esto permite considerar áreas de la vida distintas al trabajo, comparar empleos de mala calidad con otras alternativas al empleo y balancear las ventajas y desventajas de distintos métodos evaluativos.

La simpleza de los rankings mundiales de la felicidad ha facilitado su acogida en los debates sobre políticas públicas, que están ávidos por incorporar nuevas medidas del bienestar de las sociedades. Lamentablemente, éstos han sido interpretados de forma poco cuidadosa, tratando las diferencias entre países como si tuvieran una certeza que en la práctica no tienen. En la presente Clave de Política Pública mostramos que es posible reconocer la incertidumbre de estos rankings utilizando intervalos de confianza para los promedios nacionales de felicidad y definiendo puntos de referencia, sin por ello sacrificar la simpleza que hace tan atractivos a los rankings mundiales de felicidad. Tomando cuenta sólo las diferencias estadísticamente significativas respecto a Chile, observamos que las conclusiones obtenidas no exageran las diferencias entre países.

Much literature debates whether transitions to retirement lead to increased or reduced well-being. We attribute this controversy to the lack of theorizing on life course transitions and argue that the effects of such transitions depend on their characteristics such as speed (gradual/abrupt), perceived control (voluntary/forced), anticipation (expected/unexpected), timing (earlier/later), and synchronicity with other life changes (focal/overlapping). Using change models with Heckman correction on the panel data from the Health and Retirement Study, we examine the effects of retirement on four dimensions of well-being – psychological, physical, economic, and social. Retirement transitions can be both beneficial and detrimental to well-being, depending on their characteristics, dimensions of well-being, and the specific point in the trajectory of change. Compared to abrupt retirement, gradual retirement in beneficial for health and income but it dampens social ties; the effects on income
and social ties disappear once the transition is completed. Perceived control boosts well-being. Unexpected transitions dampen social ties, but only after the transition in completed. Retiring later is associated with better psychological and economic outcomes but worse health outcomes. Finally, the effects of synchronicity depend on the nature of contemporaneous changes. Our findings underscore the need for a more complex view of life course transitions.

OBJECTIVE: This article explores the relationship between the timing of retirement
and subjective well-being change following that transition. Using longitudinal data from the Health and Retirement Study (HRS), we test four theory-based hypotheses about this relationship– that retirements maximize subjective well-being when they happen earlier, later, anytime, or on-time. METHODS: We examine individuals before and after transitioning to retirement and employ probit models with instrumental variables to estimate the causal effects of retirement timing on subjective health and mood after retirement. RESULTS: The results support the hypothesis that retirements maximize subjective well-being when they happen “on-time”: Both very early and very late retirement transitions are associated with lower subjective well-being after retirement. DISCUSSION: Workers who begin their retirement transition around age 62–Social Security’s early eligibility retirement age–experience the best outcomes in terms of subjective health and mood. This finding offers empirical support for the cultural-institutional theory that emphasizes the role of norms, expectations, and institutional cues. It highlights a tension between the economic gains of working longer and the subjective well-being benefits of retiring at early eligibility age. Raising the retirement ages would probably reduce well-being in the short run, but over time, cultural expectations would likely adjust.

In 1981, Chile initiated old-age pension reforms that introduced mandatory funded individual retirement accounts (IRAs) and moved away from public systems. Beginning in the 1990s, ten other Latin American countries followed in Chile’s wake. In recent years, even before the onset of the financial crisis, a second round of pension reforms was initiated to strengthen the public component and address the problems created by individual accounts. The most extreme case of retrenching is Argentina, where IRAs were eliminated for mandatory contributions in late 2008. This country has gone back to a traditional defined-benefit pay-as-you-go scheme. This brief reviews the two rounds of pension reforms to determine whether Latin American countries are moving away from individual pensions. Even though this region is quite heterogeneous, its labor markets and social security systems share some common features, such as a large informal economy and a variety of uncoordinated institutions providing old-age income protection. The 2008-2009 financial crisis and economic recession is posing new challenges to systems that have introduced IRAs.

Moving is an important decision for any homeowner, requiring one to weigh the familiar comforts of a home and neighborhood against the uncertain potential of a new location. A move decision may be even more challenging for an older person. On the one hand, older people often have a decades-long attachment to their current residence. On the other hand, they may face new opportunities (ample leisure time) or challenges (the loss of a spouse) that affect their desire or ability to stay where they are.

This brief is the second of two examining moving decisions among older Americans. The first brief covered how often older households move, where they move, and their stated reasons for moving. An initial analysis of these reasons indicated two general types of movers: those who are able to affirmatively plan a move (“Planners”) and those who react to a change in their circumstances that may force them to relocate (“Reactors”). Given the different stated motivations of these movers, the determinants and consequences of their move decisions may vary. This brief tests these hypotheses, using the Health and Retirement Study.

The first section introduces the sample of households used in the analysis. The second section analyzes what characteristics influence a decision to move. The third section looks at the impact of moving on home equity, while the fourth section considers the impact on psychological well-being. The final section concludes.

The lore on whether older Americans move is mixed. While the familiar stereotype is that retirees flock to Florida or Arizona, prior studies have found that their home equity rises modestly over time, suggesting that they tend to stay put. This paper examines moving trends, determinants, and consequences using the original cohort of the Health and Retirement Study (HRS). We find that a full 30 percent of homeowners in the HRS cohort move over the 1992-2004 period, but most moves occur close to home. Overall, two types of movers emerge from the analysis – those who affirmatively plan to move and those who react to changing circumstances. As proxies for these two types, this study uses the presence or absence of a negative shock, such as death of a spouse or entry into a nursing home. Our results show that the factors that help determine a move are similar for both groups, while the consequences of a move vary. Homeowners with shocks are more likely to discontinue homeownership and reduce net equity, supporting the hypothesis that households may view housing wealth as insurance against catastrophic events. Finally, while movers in both groups of homeowners experience improvements in psychological well-being, movers with shocks are impacted most by the shocks themselves.

Un chileno que nace hoy espera vivir cerca de 80 años. Esta cifra es impactante si la comparamos con los 55 que esperaba vivir uno nacido en 1950. Si bien este aumento substancial en la esperanza de vida es un gran logro, también trae consigo nuevos desafíos, fundamentalmente, garantizar una buena salud para un número creciente de personas que viven más allá de los 65 años. Los adultos mayores de 65, que en 1950 correspondían al 4% de la población de Chile, hoy representan cerca del 15% de los habitantes. Dado que se espera que esta cifra siga creciendo
rápidamente durante las próximas décadas, el éxito o el fracaso en asegurarles niveles de salud adecuados tendrá implicancias de considerable magnitud para el país en su totalidad. Una pregunta clave al respecto es ¿quién es el responsable de la salud de los adultos mayores?

Financing retirement is one of the major challenges facing an aging U.S. population. If individuals continue to retire in their early 60s, many will be hard pressed to maintain an adequate standard of living throughout retirement due to the declining role of Social Security, the shift to 401(k) plans, and low personal saving rates. Combine the retirement income crunch with the dramatic increase in life expectancy, and continued employment in later life appears to be an attractive option.

While it is clear that working longer would benefit older Americans financially, less attention has focused on the non-monetary effects of work at older ages. This brief addresses the impact of late-life paid work on physical and psychological well-being. The first section reviews the literature on work at older ages and elderly well-being. The second section describes the analysis. The third and fourth sections present the results. The fifth section identifies vulnerable groups. A final section offers concluding thoughts.

This study assesses the influence of old-age pension policy on older adults' life satisfaction, and examines factors that shape this relationship. It theorizes that two distinct dimensions capture variation in the type of pension policy: individualization of risk (as opposed to ...

Work is an important environment shaping the aging processes during the adult years. Therefore, the cumulative and acute effects of work characteristics on late-life health deserve great attention. Given that population aging has become a global trend with ensuing changes in labor markets around the world, increased attention is paid to investigating the effects of the timing of retirement around the world and the macroeconomic benefits often associated with delaying retirement. It will be essential for societies with aging populations to maintain productivity given an aging workforce and for individuals it will be crucial to add healthy and meaningful years rather than just years to their lives. We first describe the available evidence about participation of older workers (65+) in the labor force in high, middle, and low-income countries. Second, we discuss the individual-level and societal influences that might govern labor-force participation of older adults. Thirdly, we review e...

In spite of the high prevalence of mental health disorders in Chile, there is a significant financing deficit in this area when compared to the world's average. The financing for mental health has not increased in accordance with the objectives proposed in the 2000 Chilean National Mental Health and Psychiatry Plan, and only three of the six mental health priorities proposed by this plan have secure financial coverage. The National Health Strategy for the Fulfilment of Health Objectives for the decade 2011-2020 acknowledges that mental disorders worsen the quality of life, increase the risk of physical illness, and have a substantial economic cost for the country. Thus, this article focuses on the importance of investing in mental health, the cost of not doing so, and the need for local mental health research. The article discusses how the United States is trying to eliminate the financial discrimination suffered by patients with mental health disorders, and concludes with public policy recommendations for Chile.

This study examined the relationship between patients' object relations and interpersonal process in psychotherapy. Namely, we tested the hypothesis that the quality of patients' object relations is positively associated with both patient- and therapist-rated alliance quality. Psychotherapy was administered naturalistically, with quantitative data collection before and during treatment. Participants included 73 adult outpatients and 23 therapists at two mental health clinics. Using the Bell Object Relations and Reality Testing Inventory, we measured four dimensions of patients' object relations at baseline-alienation, insecure attachment, egocentricity, and social incompetence. Using the Working Alliance Inventory, we measured alliance from patient and therapist perspectives. Control variables included time, patient demographics, symptom severity, and clinic. We employed hierarchical linear modelling to analyse data with a nested structure, with 138 sessions at Level 1, 73 patients at Level 2, and 23 therapists at Level 3. Patient alienation and insecure attachment were associated with lower patient-rated alliance, while egocentricity was associated with higher patient-rated alliance. Patients' object relations were not significantly associated with therapist-rated alliance. On average, patients perceived the alliance more positively than their therapists, with a weak positive correlation between the alliance perspectives. The results suggest that object relation dimensions may be important patient characteristics for forecasting therapeutic relationship quality. They also call for more attention to differences between alliance rating perspectives. Treatment may benefit from more attention to the quality of patients' object relations. If patients present with high levels of alienation and insecure attachment, therapists may need to pay especially close attention to the therapeutic alliance, and prudently address any ruptures in its quality. When monitoring the alliance quality, it is important to consider that patients and therapists may have different perspectives. Therapists relying solely on their own perceptions are at risk of missing alliance difficulties, and patients' object relations may be uniquely predictive of their own sense of the alliance. Therefore, it may be helpful to ask patients in session and through standardized measures for feedback on how they perceive the goals and tasks of treatment and the emotional bond with their therapist. Again, any alliance tensions could then be addressed directly as a means to maintaining engagement in the service of better outcome.