 Okay, we're ready to start again. Okay, now it is my distinct pleasure to introduce our president, Ricardo Romo. On his background, Ricardo became Romo, became the fifth president of the University of Texas at San Antonio. In May 1999, under his leadership, UTSA was named by the Texas Legislature as an Emerging Tier 1 Research University and a leading and providing access to excellence in teaching, research, and community outreach. During President Romo's tenure, UTSA's enrollment has grown 68%, now close to 29,000 students, and the university has added numerous programs and facilities to enhance student life. At the time that President Romo came, there were only three Ph.D. programs. Now we have 24 Ph.D. programs. A native of San Antonio's west side, we're in here the entrance into the west side. President Romo graduated from Fox Tech, which is just down the road here, Fox Tech High School and attended the University of Texas at Austin on a track scholarship. He was the first Texan to run the mile in less than four minutes, a record that stood for 41 years. He has earned numerous, he has been recognized for numerous achievements, including the prestigious Clark Care Award for Distinguished Leadership in Higher Education from the University of California. The Wheaton College Otis School Social Justice Award for Promoting Social Justice through Education and Public Service has served in so many prestigious positions, including on President Bush's and President Obama's White House Advisory Commission on Educational Excellence for Hispanics. He graduated with a Ph.D. in history from UCLA and is the author of the book East Los Angeles, A History of a Barrio that is now in its ninth printing, including one printing in Spanish. So help me welcome President Ricardo Romo. Thank you so much. Good to be here with all of you. I see some familiar faces over here. Néstor is a very old friend of mine, and we worked together on a couple of projects in Houston and also the Claremont Colleges. So Néstor and others are here. What a pleasure to be here. My book that appeared in Spanish has been sitting dormant there for the last few years until Graciela, the famous photographer from Mexico, Graciela, he told me that came and she said, what do you do? And I told her I was interested in Los Angeles and she said, I'm interested in reading your book. I have one for you. That's not moved in five years, so it's good to give it away. Okay, so I know why you're here because the census just noted that the poverty rate by age has improved and there's less poverty among the older. So according to my news from this morning, the good news is that the poverty rate for our elderly dropped significantly from approximately 35% in 1959 to only 8.8% in 2015. So the poverty rate also dropped for those under 18 from 27% to 19%, and then for those 18 and 64 dropped from 17 to 12%. So this is sort of good news, not necessarily that it's going to get a lot of coverage and it will not necessarily help the younger candidate in the presidential race, but I think it can in terms of the economy is better, the world is better. We have much better things to brag about. So officially I'm here to welcome you because when we get a chance to see individuals coming from other campuses and from other parts of the world, we just get excited. We want to brag on our campus and you're at the downtown campus, which has about 3,000 students, mostly architecture and public policy with criminal justice, social work, demography, the lead. But if you get a chance to see the rest of our campuses, we have the main campus. We have 11 acres here so we can't grow. We have 725 acres, 15 miles from here, which is the main campus, and that's where the majority of our students are, and it's true. We are in fact a growing and emerging tier one institution. One of the things, that was a lot of bio for you. You need to just say three things about somebody because they won't remember everything. But I think one of the things that we're really proud of is we just finished a campaign, raised money, so what do you raise money for? Why do you talk to all these donors? What do you tell the donors? And I said, well, we tell the donors, we're trying to kind of connect with donors and what is it that you're interested in and what do you want to do with us? And so we, a lot of scholarship money. But the thing I'm really proud of is there were this, when I got here, there were seven endowed professors and now we have 70 endowed professors. So by a factor of 10, that is the thing that I think has to be happening here if we're going to be a tier one institution. We've got to continue the momentum in increasing the number of endowed professors because some of the people that we are recruiting are heavily recruited as well and they have other places to go. And so we need these professors because we have a very important work to do. And I think what Rogelio was talking about and what my good colleague, Rene Centeno, was talking about, this work of, es el trabajo nos acaba. Vamos a estar aquí siempre para trabajarlo. So what you're doing in terms of immigration processes, immigration studies nos acaba. It's going to be here for a long time. And the reason I was being here a long time, because my family actually migrated a long time ago. They actually crossed the river in 1750. I did say 1750 before there was America, before there was Mexico, and they've been on the border. So it's been continuing for quite some time. At the same time, when you have migration, you have families, and then you begin to say, what makes it different? What makes it distinct? What are we doing here with another? We have 53 million Hispanics, especially I'm interested in that area. What can we say about it? And we need to say a lot because yesterday, day four yesterday, 110 scholars showed up at the Capitol to denounce a book that was supposedly told the history of Mex-Americans. And it was full of errors. Rogelio wrote a critique of it, which I thought was really impressive there. And how many errors did you find, Rogelio? 141 mistakes in the book. Now, think about this. They're about to adopt this book. If these scholars don't show up and say, no, no, no, no, they will adopt it because of the power in politics. If I had a student that made 11 errors in my history essay, I would say this is an F, you know? And if they wrote a thesis, master's thesis or doctoral thesis with 141 mistakes, say you're not going to get a degree from us. It's pathetic. So anyway, that's why we need scholarship because those books are going to be distributed to every single child in the school districts. We're talking in the hundreds of thousands, the hundreds of thousands. Every year, we actually have 85,000 more students in the schools. You can imagine that hundreds of thousands would be influenced with garbage. Not only by mistakes of garbage, but also by saying Cesar Chavez does not belong in this book. He wasn't a revolutionary. He doesn't belong in this book. Oh, my God, this is crazy. Okay, so now, all the stuff that you're going, I see a lot of work going on in Harlem, Generalist Cruces, San Diego, Chicago, worked in, I think you're bringing a lot of things that are exciting to you here. Because of Rene's good work with Mexico and Conacyt, we now will have a base here. UTSA will be the base. Rene will be the director of Contex, which is where we invite 50 Mexican scholars, graduate students to come study in the University of Texas system, UT Austin, MD Anderson, Southwestern, UT Dallas. And I hope many of them will end up at UTSA as well doing doctoral work and then postdocs. Mexico is investing $15 million in this project. We're investing $5 million to keep the operation going. So look for great things to happen in our relationships. These things are going to build. It may look like administrative stuff, but we're going to meet a lot of scholars. And it's going to build and build and build over time. And it'll make an impact in our community. The people and friendships that we make will go forever. The first thing I, when someone told me that they had been connected to Notre Dame, I said, oh yeah, I remember Notre Dame. Jorge Bustamante and I met in 1972 and we made the friendships for that whole time. Those friendships mean something to me. I know they mean something to you, but they're going to mean a lot to our students and our scholars who are going to benefit from that friendship and that connection. So I congratulate you on getting together on such an important topic. I wish I could be here at the end of the day when you get to vote for which of the two presidents get the highest votes, the young one or the old one. I might say Trump is 70 and older than Hillary. So, need I say more? Thank you so much. Adios. So we'll start the next session. Fernando Rios Menal is the chair of that. Welcome to UCLA. So come on over. While we're getting settled in, I'm Fernando. I'm Fernando Torres-Hil testing. Testing to the organizers for today. Do I assume we still have one hour? Jackie Rogelio, do I assume we have one hour? Yes, yes. Even though we're a little behind. And let's see what we have. I see Mariana, Veronica, and Hyra. We're all here. Anyways, good morning and we thank President Romo for welcoming us to this beautiful campus and this very successful and growing tier one institution. I'm Fernando and from UCLA. And I have the great honor of presiding over this panel on Mexico and the healthcare context and also a privilege to be one of the co-investigators of this project, which simply means that I work for Jackie and whatever she tells me to do, that's what we do. That's what you do as a co-PI with Jackie. And everything works out like magic. So thank you, Jackie, for your continued leadership. Before we begin, I'd like to just take the prerogative of the chair just to make two very quick comments. First to thank Dr. Peter Ward. Is he here? Peter, are you here? We went back to teach for his just impressive presentation yesterday on how place and space matter and bringing out vividly why the issues of housing, the built environment, land use, the topics of infrastructure that we normally don't think about in relation to aging issues. That in fact matters and is important in determining or influencing the quality of life of Latinos and Latinos as they age. An excellent presentation. I also want to thank Dr. Rene Santheno for his just really intriguing presentation on the collapse of Mexican immigration and without being political but being a little catty, I just wish the presidential candidates or senior advisors could be here to listen to this presentation. And that's one of the dilemmas in public policy in which I'm quite involved with is that the current public narrative is the void of the facts and the data and the contemporary trends about immigration, migration, undocumented persons. It's almost like living in parallel universes where the public dialogue is about the barbarians at the gate. The reality is that we've never faced a situation where we're close to zero migration. And the other part of that narrative is that, and I'm really appreciate Dr. Santheno for bringing out, it was a little kind of politically incorrect but he brought out the reality that law enforcement has made a difference and is making a difference. The only dilemma is that I know the president and his staff when they expanded law enforcement along the border, they did it largely to make the public more comfortable with accepting major immigration reform. Now the political narrative is quite the opposite of what the public is concerned about, constant flow of undocumented immigration. So we have this kind of irony about where we're at in terms of Mexico immigration but bringing it to our experts. The reality is that we are aging and Latinos matter and Latinos across the America and in Mexico and the United States will always be with us at the great demographic good fortune of having a relatively high longevity and a relatively high fertility rate. So we're going to be around for a long time and so therefore these issues are important and with that it's my privilege to have three superb scholars who will give us the actual facts and data and analysis about what is really occurring and I'm going to introduce them in turn and you each have 15 minutes for your presentation. I hope that's what you understood. The first two, my right and your left, my right and your left is Mariana López Ortega from the Internationales de Salud de Mexico and in meeting her abstract and paper, I loved your introduction and I always tell my doctoral students when you do a thesis or a paper, always have a catchy headline, a catchy headline and hers is very straight to the point. In Mexico, getting old isn't nearly as bad as people think it will be, nor is it quite as good. It makes a real nice headline. So I'd like to introduce Dr. López Ortega, please. Presenters can choose to speak from here or of course at the podium. I want to start by thanking Jackie and Rogelio Sanz for giving us the opportunity to present this work here and also Michelle and everyone here at the university because I agree with Rogelio. Of course, that makes a difference and we all know what that means, all the work that gets done, that has to be done. Okay, so it's hard to slow down. What should we look at? So the title of our presentation is contextualizing health and aging in Mexico an opinion nation or a nationwide survey. This presentation was prepared by Ms. Miguel Montierras here from the Institute. You all know. And another colleague from the Institute, she's the researcher there too. So the objective in general is first to present some study results on perceptions of aging in Mexico. Also to present some results on perceptions around family, health and well-being by different age groups in the country. And also we want to talk about some challenges of what these results mean in terms of health and social care policies. And a bit of a reflection on some alternatives that we have to start thinking in terms of care and support for older adults and their families. So the data comes from three surveys that were included in the project called Mexicans viewed by themselves, the major national issues. So the main title in Spanish, los mexicanos vistos por sí mismos, los grandes temas nacionales. So this was a very big project carried out by the area of applied research and opinion at the National Autonomous University, UNAM. It included participation of 93 researchers, 48 research assistants from multiple institutions, research institutions, public institutions, of course UNAM and other universities. The main objective was to present a view of the country's main problems and to know their extension of their modalities, what within our society, the perceptions of society around these main issues. The project applied 25 surveys to try to paint a map of the country based on people's beliefs, their needs, expectations and wishes according to who was then the, what's the equivalent, like the provost or the president of the university, Dr. Naro. So it was really trying to know we have a lot of income surveys, health surveys. So we really, you know, it was to have some survey that told us what are people thinking, what are they, you know, about these main issues. It's all about perceptions, opinion surveys. Some of the topics included are human rights, justice, public surveys, public safety, I'm sorry, adolescence, migration, indigenous populations, religion. So you can see it's a very diverse project. This is just to show you it's the webpage of the study. You can access the PDFs for each, you know, for each topic, for each survey, there was a book created and all the information is available there. So what I'm going to present to you is first results of perceptions on aging in the whole country. It was a project that was carried out with the national aging survey within the project. It was carried out at the National Institute of Georetics. Riz Miguel Gutierrez and our colleague Geyana Giraldo were the coordinators of that project within the institute. Other authors, we collaborated through that. And on family and national health issues concerning the whole population, we have results from the National Health Survey, we have the coordinator, and the National Family Survey. So it's three surveys. And the main one on aging was done at the institute. So first, talking about social perceptions on aging, the results from the National Aging Survey. We can see that among the sample interviews, there was a prevalence of like a vibrance in the attitudes towards aging and other older adults. On one hand, we have sort of people, you know, having this idea of deterioration and everything's sort of going down. And on the other side, you know, there's this idea of wisdom. So, you know, it's a great older adult. But there also I have, we could see negative stereotypes that seem to influence most fears of everyday life of older adults. Household arrangements, work, health, and how this impacts on their quality of life and overall well-being. So most of questions were, for example, please tell me how much you agree or disagree with this statement. And we can see, so this is how people have, you know, 73% of people think many older adults suffer from memory loss. Their health is bad, 60%. You know, they lose their independence half of the sample. You know, they don't have interest in sex anymore. They have less friends than, you know, the rest of the population. They lose their temper easily. So you can see older adults are like children. So you can see how, you know, in many ways, most, you know, at least half a bit more, half a percent of people interviewed have, you know, not a very good, as I was saying, you know, it's like, you know, things are going down. They're not as good as they were when you were young. And I'm sorry, I forgot to say, the samples in the interview are people 15 years and older. So it's, you know, from quite a young age. In terms of which places do people think that older adults get discriminated on? It's when they are looking for a job or when they are at work because they don't have access to financial products or services or access to healthcare or continuing education or in their own home. So like the household or family members. In terms of perception on their conditions, how their overall conditions are, when they were asked, you know, why do you think older adults work? And, you know, many surveys see this as a positive thing, you know, overall, but, you know, in countries like ours, most of them, you know, it's because more of an economic reason. But, sorry. So people say, you know, they don't have enough resources because they are poor or to feel useful and productive. So it's also a lot of, like, economic means more than others. Also, what we saw in terms of perception of sort of mistreatment or abuse, which is a very important topic, when people were asked, you know, in your family, has any older adults offered from any of the following? So if you say, like, 31% said, yes, some older adult has offered from psychological abuse from someone in the family or physical abuse or neglect. And that was a very, so our colleague here in the project, that's one of her main research topics and it was something that we really were thinking about as a very important topic. Why is this happening? Is there pressure in the families or something that has to be looked at? So in terms of caring for these people, they are asked, you know, when older adults lose their independence, who should take care of them? And most people still think, you know, it's the families that have to be in charge or the family with some participation of the state. So, you know, there's still this idea that the family is the main provider and should be much less when they said, you know, the state has to be in charge. So it's still this idea that families are really important. And in terms of access, so that most people, you know, see that their neighborhood has really good access in terms of ramps or home health care, you know, areas for older adults to gather and, you know, do sidewalks or transportation that caters to their needs. So there's this perception that they really need access to infrastructure and things that are not letting them interact fully within society. And then according to the others, to service, we can see perceptions of older adults and older age groups regarding health and family issues. And for example, we can start to see this age gradient in a way in terms of first, you know, this was very interesting. The only one where we could see quite similar is when you ask people, you know, when people form a family, what do they aspire to? What type of family do you think it's the ideal? And, you know, the very young or the very old, almost everyone says, you know, families are a mother, a father and children. That was like the main thing. Instead of, you know, some saying multiple generations or other arrangements, but most still see a family as like the very traditional way of thinking. In terms of other things, you know, what do you think the main problem that families have currently? It's also very similar in terms of economic problems are, you know, very important. In terms of, even when you're like really young or older, in terms of sort of like of time to spend with the family, you also see that that's a very big issue and it's, you know, not very different between younger and older generations. So then you, when they were asked, you know, what does a person look when they decide to form a family? And that's when you start seeing some changes in terms of what young people towards older adults think. And here, for example, you see that sort of the older, you know, you start a family to have children. You know, that was their main idea as sort of younger ones say, you know, because you're in love. So it's sort of, you know, you start to see those changes. You know, to have company was also something that was different. And one of the main things that was sort of, it seems like 55 to 64 is sort of a cohort or a group that, you know, things start to sort of break there. So that's where, you know, they, even different from the older adults and also very different from the young ones. So it started, you know, some age difference in some of the perceptions on sort of family issues. And in terms of health, it's where we could see the most differences in terms of age groups. And for example, when people were asked, you know, how, in general, how would you rate your health? In order to what we, you know, had that self-reported question that we have in health surveys. And obviously, well, we have this difference in terms of, for example, those, let's say good, you know, or poor. Sort of we can see sort of the very good, sort of the younger versus, you know, the older. Although that, you know, 42% of the older adults, 43% versus 3%. So we can see that, you know, health and age difference. In general, how would you consider your quality of life is? And also we can see some, you know, you can start to see the differences. Those that say very good in terms of the difference between the young and the older. Those that say poor, you know, also very different. How satisfied are you with your life? I have very little time, so I'm going to go faster with this. Also, you can see, I mean, just the colors, you can see, like, the difference between the age groups. How much would you say you enjoy your life? You know, the same, you can see just by the colors, the differences. So, just some main challenges that were brought up that, you know, looking at these questions. First, we think like the need to fight racial and labor discrimination against older adults, as well as in service provision. People do feel sort of how older adults are getting left out in terms of even when they still are economically active or participating in work or employment or some type of job, there's discrimination. As I was saying, the topic about mistreatment and abuse is also very important. Within the families, is it you know, pressure, probably the right from pressure of caring. We can still see scarce interest in support of older adults in terms of big national policies. And then also, lack of inadequate infrastructure and resources towards older adults, physical, financial. In terms of health professionals, some insufficient in terms of health and social care professionals. And a very slow increasing training in aging, sort of the part of a big effort on training health professionals in aging and sort of aging issues, but you know, it still has to be grown. Most care is still done by the families with little or no support, formal support from the families. I'm sure family is going to talk about that. Also, one of the few exceptions is Mexico City, but you know, still nationwide, there's very little support in terms of formal strategies to care for them. Also, lack of priorities aimed at promoting well-being in old age and prevention strategies, sort of some more prevention strategies that sort of can allow the aging process to be a little bit less negative. So then just to finish, it's about thinking maybe to change some paradigms in the contract towards aging. So increase awareness and education and you know, the whole population, all agents in terms of the importance of achieving an active and healthy aging to prevent, to look to the future. So this is going to be you, so you should be increasing that awareness. Empowerment of older adults, so they demand their rights, take responsibility also of their care effectively in society. The term inclusion thinking of all older adults in society work, politics, education and training and try to eliminate discrimination and those negative stereotypes also to protect older adults human rights and then I don't know if it translates very well, but instead of seeing them as a group that has to be some attention at them there to being subject of their human rights, you know, they can fight for those rights and for them of the society to protect them and also to finally to plan programs and services to support older adults on their needs to the aging future generations and taking their expectations into account. We really need to know what their expectations are and this is why these type of surveys are so important, to know what they are expecting and what society is expecting about caring, policies for older adults. And finally to introduce an aging perspective a cross-cutting issue in terms of for all policies and strategies but some alternatives just thinking of how to tackle adverse economic conditions some intergenerational strategies to start to work what are the conditions in terms of very intergenerational strategies to support them sharing learning experiences establishing new roles that reflect exchanging changing expectations and have the state as a regulator coordinator of these strategies already in place within families and also civil society which are already doing a lot of the work. And I think that's it. Thank you. Thank you. Thank you Dr. Lopez Ortega for those important survey and I would just add that you may well have presented seminal data but also a roadmap for how Mexico will and should respond to its inevitable aging. So I commend you and your colleagues for providing the baseline for what may well be the strategies in the future. I will, we're going to go through each presentation and then we'll open it up to questions and comments and I'm going to pose my own each of you but I'll keep you in suspense. Our next presentation is Dr. Hiram Beltran Sanchez from UCLA. I introduced myself to him today because I was thinking I've been at UCLA forever and I've never met you and that's because he just joined us as an assistant professor but I think more relevant he's a product of our aging in the Americas conferences and a great example of an emerging scholar who if I can add Hiram benefited from your participation in our earlier projects so it's great to see you moving well into your career and he will be presenting on issues of occupational history and functional limitations. Hiram? Thank you. So yeah, thank you for inviting to present. That was one of the things that I was going to mention early on in my presentation. First I want to thank you to Jackie for organizing these meetings and UTSA for hosting the meeting but also trying to highlight one of the important things among the many important things of these meetings. The one on emerging scholars as was just mentioned I participated in the emerging scholars early on so I'm very excited to see that they continue this program and it's very, very important to have this program particularly in this particular conference and we have the opportunity to talk to our colleagues and other professors so thank you Jackie for organizing these type of meetings. So the movement I'm going to show you today I'm going to switch gears a little bit so I'm going to focus more on functional limitations among older adults in Mexico so I'm going to do a deal with our focus on what is the impact of occupational history on the mobility limitations of older people in the U.C. and with Doreen Godman at Princeton. So before I start I want to give you a brief background given the time constraint I'm not going to spend too much time on the background so very briefly just give you some idea on sort of the links that we think along the lines of work and health. The traditional work has been done along the lines of occupation meaning that occupation in itself defines some sort of status particularly professional say with food workers that there is some sort of differentiation between those occupations one of the areas of work relates to professional ranking and that has to do with some of the stress levels how much control the individual has the particular occupation and how that might have an impact on their health through the psychosocial stressors and the work which is more along the lines of the physical hazards the environmental hazards that people might experience in their work. My advice in tracing these along these lines of work where I will argue and we argue in this paper is that very little emphasis has been played on how the occupational histories have had an impact on mobility limitations. Most of the work along the lines of health tends to look on indicators of ACS whether that's education whether that's income whether that's network indicators along those lines but very little attention on the job occupation. So there are also not some mechanisms that we know are related to health. One of those is the link between health and job this is sort of the long discussion whether poor health leads to having a poor job or is the other way around having a poor job is what makes individuals get sicker because they don't have enough money to buy food and provide health care and so on. Another possibility is that we know that other adults have a higher risk of health and probably disability mobility limitations this is sort of along the lines of the accumulation like one perspective and we know some of that might be due to these trans-generational admission of health that in countries that will argue low and middle income countries is very characteristic to have this because there is very little social mobility people tend to sort of inherit the profession of their parents extremely low social mobility and we know that in Mexico there are some gradients in health what that means is people who have low levels of education who have low levels of income or low networks who have worse health outcomes so those who are at the bottom of the SES distribution tend to be more likely to be disabled or more likely to have some mobility limitations and this is particularly true in urban settings so what we are able to enable in this particular case is that we are going to move a little beyond just looking at SES gradients that tend to look at how this links with education and income and now as a question what would happen if we now include occupation as a possible mechanism through which individuals might get disabled or might get some functional limitations and the relevant work that is out there along the lines of occupation tends to look more at the occupational safety more of the environmental hazards along the lines of mobility limitations so what we are trying to do in this particular paper is to try to look at the degree to which these social gradients in mobility limitations which we know exist in Mexico there is a social gradient as I just mentioned those with low education or low networks tend to have worse health outcomes how these gradients are associated with work or with work among quadrados and we have two particular questions which are whether we see that occupational differences account for a significant portion of that social gradient in mobility limitations we know there is some SES differences in mobility limitations we account for occupational history are those gradients reduced that is kind of the question and the second which are the occupations that seem to be associated with the high rates of mobility limitations among these older adults so in the case of Mexico I just want to briefly mention it's quite interesting to study these cases because older adults in particular with the data that I'll be using which is the M-class in 2001 these are people who were born before 1951 so what we know from the urbanization and the industrialization in the country what that means is most of these adults spend their working lives working most likely in physical history occupations because even the ones who work in agriculture there was very little use of machinery back in the 60s and 70s so there is likely that most of that professional history might lead to mobility functional limitations by the time that they get to be older adults so the way we're going to measure these mobility limitations we're going to use these Mexican heads and they can study these are people like 50 and older in 2001 so the mobility limitations are all the ones that you see on the light sitting working stairs lifting some heavy weights up to 10 pounds and grasping like a coin from a table and then they're going to call depending on whether they have difficulties or they can do it or they cannot do it so every individual could have a range between zero meaning they don't have any mobility limitations up to 18 they have a lot of those issues with mobility limitations so that's going to be our outcome so what we're looking at and the basic idea is let's see we include the typical indicators of ACS which is like the use of education one of the markers or net worth, the net worth in this case was estimated by the valuable assets that the individuals own meaning land, vehicles or whatever other assets they may have minus whatever depths they may also at the end we have a single value for the family and the main occupation is estimated through this a question that is the most precise question to the historical and sort of occupational history of individuals but it's in some way the most we could do with this data and they ask them to think about the activities that they perform in their main job throughout their life so with the idea that hopefully they will pick up the one that they did the most in their working life and then they give us a name for that occupation and then there is a code for occupational categories that we use in Mexico, we didn't go into the details of trying to see how well does match with international classification, we just use the one that is typically used in the Mexican context by the INEI which is the sort of the Census Bureau office so once our methodology just a little trick in how this is traditionally done I'm not going to go too much into the methodology I just want to mention that this is what is actually called a hurdle model what that means is that when we are not model this process of getting a mobility function and mobility in two pieces one for the probability that the individual could potentially have any mobility limitation meaning moving from zero to any mobility limitation and the second part is when I model what is the likelihood of having any number of limitations so the first part would be think of as getting at the incidents and the second part would be think of the progression of the disability moving from one to two to three three to four and so on and so forth the reason why that is interesting to do is because when we ask individuals whether they have mobility limitations usually we tend to end up with a lot of individuals reporting zeros so we get with 30% of all the samples having zeros so there is statistically speaking there is an issue of how we model those zeros so this is a way to sort of get around that bunch of zeros because that we model the zeros in the first part of the model and then we model the second part in the ones who actually report some limitations so as a result I'm just going to focus on results for the common population for now and I'll give you some examples later so this is the idea, it is quite simple what we do is what would happen if in the first model we only include education and then this is what the gradient would look like the negative sign basically means the higher education they have the less likely is that they would have mobility limitations and then we say what if we now include an indicator for the occupation how much the impact of the coefficient reduces and there is a similar idea over here for network we have individuals with different levels of network once we are at the top of the of the best distribution of network are the less likely to have mobility limitations the ones who are getting the sixth and the ninth best are also less likely but not as likely as the ones who are within the first level of distribution are more likely to have mobility limitations and similar idea what if we were to include an indicator of occupation how much impact this will be reduced and the final model is let's put everything together and see how much is that impact so if we do that exercise this is how much occupation would account for the change in the magnitude of the most coefficient so it would be up to 10% in the gross model of up to 81% or 9% reduction of the impact of those ACS gradients in the case of network the impact is a little bit larger it would be up to a third or almost a half due to these occupational differences if we now look at the second part of the model which is now let's look at the progression of the functional mobilities and we repeat the exercise the impact is a little bit larger of occupation in other words what that basically means is occupations tend to have a larger impact on the progression of the mobility rather than on the incidence of the mobility so basically once an individual gets disabled depending on what occupations they could have had in their lifetime they make them more likely to move subsequently into more mobility limitations if we now look into which occupations are the ones that have the highest impact is probably not a surprise so we look at the predictor from this statistical model we predict what would the overall mean number of mobility limitations among these individuals the top five occupations with the highest average number of mobility limitations are the ones that I'm showing here so as I said it might not be a surprise that domestic workers tend to have the highest average number of mobility limitations followed by workers in the making of food, beverage and tobacco products not the ones who report on occupation the ones who report on occupation are mainly females who are basically stay at home who those are Agricultural workers are also part of the top occupations that tend to have the highest average number of mobility limitations and some of the artists and the workers and in the product of textiles, leather products and related goods so this is what the overall population if we now split this by six for less again probably not a surprise Agricultural workers are the ones who have the highest average number of mobility limitations followed by workers in the making of food products, tobacco products and so on also drivers and assistant drivers are also among the top occupations that have the highest average number of mobility limitations if we now look among females things work a little bit different now the top category are those who work in the food industry basically food services the second are the agricultural workers a little bit of domestic workers but also look at the scale on the y-axis let me just look at the scale in the case of females most of them are over three mobility limitations on average but we both men probably none of them get to three so on average although the occupations are somewhat similar between men and women in terms of the ones who have the highest average number of mobility limitations females in Mexico who have a higher number of mobility limitations than men so just to conclude so what we find is that it looks like these occupational differences account for a size of a portion of the social gradient in mobility limitations among older adults in Mexico the magnitude are about fifth percent reduction in the old ACS gradients that we observed in the case of education and up to a 10% reduction in the case of network occupational history seems to have an impact on whether individuals get mobility limitations and whether they transition further on having more of those mobility limitations more likely the physical demand of the occupations are the ones that we found to be the ones who have the highest rates of having these mobility limitations it's probably not surprising as I mentioned among men agricultural workers are the ones who have the higher average number of mobility limitations and among women are those in the food industry so those are basically the conclusions for today thank you for that important issue of mobility limitations and I will have a question for you later and our third and final paper from Dr. Veronica Monteseoka from the UNAM is an important issue related to civil society and the role of aging and how Mexico and I believe in this case Mexico City is responding to issues of aging thank you very much for the invitation Jackie and Angelio I'm really happy to know the beauty they say San Antonio and the other parts of Mexico is here in the city and with my friends I'm part of the highlights of the research who have different objectives but now I only present some reflections and some evidence for the field work in Mexico City and in some parts of Mexico for example I want to share the content of this paper but I want to emphasize and focus on the civil society organizations with other people because in the research everybody talk about the economic insecurity because in Mexico we don't have universal coverage of pensions and for example we have a lot of research about the health care and the medical coverage is not universal too and there are a lot of research about the house for example the support of the family for health care and for another kind of support social support in families another very important in the social networks because it is not only the family the response to the aging in Mexico the social networks are the family but another kind of social networks and then we have social civil organizations what happened with that it's impossible for the sociologists for the demography because it's very difficult to research this kind of analysis the category of analysis and the theoretical approach for this research is the active aging because it's very important and it's really consistent with the social participation and do you know the concept of the generosity did you know that generosity is a very important concept in gerontological issues because it's a mix of the productivity and generosity is the legacy for the older generations for the next generations and that is very important in the social participation in the literature of gerontological and now it's very important now look what is the power of the human rights perspective in the policy but in the actions of the social civil organization and for example it is in this moment in the last years in the last decade we have a process very important in Latin America because after the assembly the second assembly of the older people in Madrid we become in Latin America a lot of congress a lot of meetings a lot of discourse a lot of integrated with the government and then academic and the scientists everybody every year we make a difference for the social constructions of the human rights in the older people organizations sign the convention inter-americana for the human rights of the older people and this is a very important point now for America not only for Latin America for America too in this convention is a very important instrument in the legal issue for the human rights because some articles emphasize the community participation the social participation the political rights and the right of meeting and associations and other topics and this is in this sense in this great context for me we analyze what is the role of the civil society organizations with older people and what is the transition of the assistential point of view for the human rights perspective obviously it's very early for the historical issues, historical events but it's very important to look for a maybe for a first time what's happening with these organizations and really describe for example what kind of types of organizations are in Mexico City for example and it's a quality of research with a lot of nine focus groups and a lot of interview with different groups and different women and men in this participation in this service we have some background about this topic and the evidence is a very, very little the social participation in Mexico maybe higher than the Brazil and obviously is very less for the American for the Latin America and for example in the United States in Canada and it's very important for example in the New South in the Mexican health agency it's very consistent the tendency of the social participation for the elderly and for example the women participates higher than the men and this is very, very interesting because it's a voluntary work and it's without paid and this is very important because remember women in Mexico don't have pension but they have a higher participation well in the in 2002 we have in Mexico the federal law for the elderly persons and in this law in fact it's a human rights and in fact it's obviously the legal protection the integrity health education and social assistance and participation that is very important what kind of organization have in Mexico we have a different kind of organization for example neighborhood organizations, civil associations unions are very important private assistance institutions every community political organizations and religion organizations we find in this process to reflection about the role of this kind of organizations in Mexico we find at least this kind of types of kind of organization for example the groups for cues on quality of life and personal self development this group is mainly the problem that's in the Mexico city is for me that is promoting for the government in Mexico city and it's very important organizations that can value reference to the quality of life and human rights the organization in quality of life and sustainability economic basic and care and the focus another one is focus in human rights and the economy and the economy sustainability another one is the quality of life sustainability in the economic way and human rights and another very exciting group Mexico city in Oaxaca in another in another station in Mexico combines the face of the human rights and economic sustainability and the defense of the territory in Mexico the characteristics have each group for example and I say that La Cruzana is very very interesting group because it's mainly the new prevalent group in different countries in Mexico city and they are really very old without migrants, most with primary incomplete with an ancient income and dedicated to the household task the ancient experience that women can be described as a magic agent focus in the area in the new area abysses in recreational activities to save the body from similarity from disability and chronic disease this organization is characterized by the search of support government criminal response another one is Grupo Renueva that is very interesting for me because he is located in the center of the social and development social and cultural his name is Karen Alistegui Karen Alistegui is a journalist very very important from Mexico because he is a woman who denotes a lot of cases of corruption and other cases of pederast for example with the search and this is very very important and this centers the name for these women that look this is the sense of this kind of group we live in a building and high stories but there are mostly women who ever work but not all have knowledge most are married high degree of autonomy independence, personal mobility intellectual and physical development the active ageing is part of the daily life clear awareness on the ageing and the responsibility of the same and the exercise of the human rights are very very important they have a lot of workshops, schools to train permanently in different parts of this Mexico city another one is Granita de Arena it's an association it's going to find very obvious provide a system extended to people with high cognitive deterioration and liberal personal mobility the older person with functional or cognitive deterioration have a very living level of organization but the caregivers of the administrator of this kind of association are very active and they is the mediators for the government and they negotiate with the government different ventures for this group and for this kind of association another one is very very important for the political history of the organizations in Mexico because they are in extinction and this is very very interesting because they are the pensioners of the worker of the government in Mexico the only Mexican of electrician because in the past government was privatized the electricity and the co-director of the educational its workers its workers in the Mexico meets with many preponderance who meets the every retirement that is very very interesting organizations of character government with high degree of empowerment and engage with the social and political change characterized by strong political organization in high level studies and very very very very engaged with the organization the political organization there is not aging perspective because they said the aging is after the retirement no? the quality of life is very active these organizations leave the past benefits of the state that protected them as a strategic sector for the model of the development previous the neoliberalism this is for example some photographs in the newspapers who show what is the activism of this kind of groups another one for example the religious group they combine the money to fly sustainability economic and human rights and this this organization for example is a position for the national university they obviously have no great organization but high grade of citizenship that is very interesting high grade of schooling that effect the promotion and defense of this right basically women with degree and PhD and another and very high labor trajectory high grade of empowerment and the other very exciting groups because for us is very important because the characterization of aging in Mexico is a multicultural clinical and that and this kind of organization have a very very important activities for the elderly and for and with general activity for example the grandmothers this community in the community of electricity is very interesting because it's laboratory for the grandmothers who have a rival I don't know how to say a rival identity for the human for the rural community and they are very important actors for the transnational for example before a university before college and they became solar engineers and rectified their own communities in Cochimbo, Oaxaca another one for example in Sonora is the community organizing around the international festival the characteristic of this kind of community of organization is because the grandparents of the nation come have a very important in the transmission of the ancestral knowledge for the new generations and that's very very interesting the position for the for example in the artistic and cultural activities who make of the difference intergenerational activities and they combine the human rights and the ancestral knowledge for this kind of this kind of organization and the last one is very interesting because is the descendant of the testigos La Pelojera Liberación the best ecclesiastical communities and they work for example in different states with higher marginalizations like Chiapas, Oaxaca Veracruz and they don't have a worry about the aging they work about to the poverty they work about to the health and they have a very interesting point of view of the transmission in the different generations and have a very very interesting point because they recruit spirituality the activities with generality no? and with the activity that they don't conceptualize this kind of concept so what happen in Mexico with this kind of social organization now we have a difference a diversity of social civil organizations with older people but the young people too and you know with the change in the demographic change in Mexico and the of the human rights the change of the political public in Mexico and the change in the economic development that kind of organizations is very important because it's another another institution so the level of the public policy, society and the family are going to evolve to improve the activities and the point of view of the aging and the generality for the next generations and the difference of the human rights in the tomorrow we talk about the sense of the law and for example the sense the emphasis in Mexico the power of the family but the family is not enough we need to talk about the human rights in the worldwide sense in Mexico because we have a lot of kind a lot of change for the transnational companies for what happened with the water what happened with the land and we need to work with these kind of organizations because Mexico is a multi-cultural have a very important in ethnic culture in ethnic populations I think we need to see what happened with this thank you very much thank you Dr. Montes said that the important schematic overview of the diversity of civil society organizations with time remaining I'd like to ask each of the panelists a question if you can respond concisely and then we will open it up and since my background is in public policy and aging I'll raise I'd like to raise some of the policy implications for Dr. Lopez Ortega and the various surveys that you presented to what extent do you believe that the results should be either public dissemination or promoted in the media or is that already occurring where it can perhaps increase public awareness throughout Mexico that these are important issues to what extent should they be highlighted I think I think well it's very important that they should be highlighted but there was some work on it already as you said as you could see it has their page so they were very or they are because the web page is there they're interested in having it as a known to as much they did have a big media but they also organized a series of presentations I'm not sure how many they were I think every of the surveys because they have a book they all had a presentation at the senate so for example we were all there but they were presenting the results so they did do a very active work in terms of in this case joining with the senate so the results were known and there was an open presentation at that level the problem is Unam was very good but then what happens will the senate we have congress in general will they take it and go further so that's where the work has to be done thank you in this country we have a word that we use but I don't know how to translate it into Spanish where we are gerontologizing the American public I don't know how you would say that in Spanish too well I guess gerontologizing I don't know you can make up the word and for professor thank you for bringing out the important changes in both the economy and the workforce where issues of mobility limitations are certainly connected to various occupations and with increased longevity in Mexico we can expect that issues of physical mobility limitations will become more pronounced so my question to you is to what extent should Mexico or has Mexico embarked on a national legislation as we have in this country like the Americans with disability act which attempt to promote civil rights to those with physical mobility limitations is that occurring in Mexico? should it occur in Mexico? I'm not aware of that to those who live in Mexico are probably more experts on the law but I'm not familiar with those there is something on the workings but in terms of sort of legislation to define that no, I'm not familiar is there any legislation? is there any legislation? we have a very good well Mexico have a very good legislation law to the disability but maybe the very original point of view of IRAM is because they make work with the occupation on territory and because that's really important because with the flexibilization they adjust their time in the local market a lot of workers don't have any kind of security or prevention activity for a lot of kind of activity with risk it's very important because Mexico is playing a hypocrisy we have law but in the fact in the living market is in another sense although I look my family is in Mexico City and I appreciate that Mexico City now has parking for the disabled and handicapped placards which I take advantage of so there's real progress there lastly for Dr. Montes, the OCA one of my areas is in the politics of aging and it appears that there's growing empowerment on the basis of old age or being older to what extent might that eventually lead to a version of what we have here like AARP or a national AARP, the American Association of Retired Persons or a national coming together of these various civil society groups to form a political movement around issues of aging I don't know exactly for example for this kind of organization but for example we saw the Hispanic organization and I suppose they are in the first group with the quality of life and self-development but for example the pensioners of this organization are in the quality of life and economic sustainability but I don't know if they defend the human rights the concept of human rights we need to enforce for example in the North American culture because it's very important not to break the ethnic groups or class groups because for example for the white for the African descent and for his punk it's really important to defend the human rights here and now in Canada on Mexico and Latin America we have a great instrument very great our document for the American state organization and maybe we need to work in the social work with sociologists and topologists in these kind of groups Thank you very much and I think we have time for a few more questions from the audience comments, questions the audience otherwise you believe in everything you've heard and you answer we have education we have health services all combined into one and some of these people older people they have a lot of experience a lot of talent that they can still enjoy and they form almost like the therapy of their own and all interaction do they have anything like that in Mexico? Sorry We have a lot of the center of they but they really see the first group only for the development and quality of life but I think there is selfish kind of public policy and programs because it's only for the functionality it's only for the health or to improve the functionality for the body but another one take this kind of vision but another kind of activity with another generations and with a political sense in the human rights sense because the human rights is built in the perceptions the disorder is very very interesting because the viral medical sense is very very strong paradigm for the aging but another way is the reason and when I listen to your thoughts I think this because it's the patient in Mexico we have a very assistive point of view only in the sense for example the social development in my selfish health but another kind of organization have in the collective with other generations a great gene activity and that is very very important Thank you, good question and one last one if I see it and I'll take this last one over there so we can pick up so we can hear you Yeah, oh great Thanks, my question is for Veronica about the organizations that you were talking about I was wondering how are they funded for work my friend and we and for example we have anthropologists with a lot of social workers and there are a lot of work with this kind of organization but the scientific the social scientific don't see that because maybe it's in the family it's in the public policy and they exist in different parts maybe it's it's better for this organization where the government don't see that because when I see that they suffer violence for example the community in the church the very cyclical communities they have problems with the government no? I don't know it's very few work so very grassroots from the community not funded by the state at all I'll just thank you thank you thank you very much and let's give a round of applause to these excellent presentations thank you all very much if you like the snacks to the right over there some fresh snacks put out for everyone so see it's just pronounced like ts if you pronounce ts very very fast so it's basically phonetic it works but the last name actually it's actually rzh oops so it's like this yeah so normally when you see russian names they say that as z and h like general zhuko it's zh u k zh right right so normally people translate right yeah okay creation right? okay since we're getting ready sit down I can tell people I know how to sit down the sooner we start the sooner we get to lunch with breakfast tacos I'm not sure how hungry you might be how are you? pretty much so oh yeah it's working people are terrified they're running back to the seats because I was thinking if we just presented this situation it's really bleak it's dark that's good okay so it's my pleasure to to present the two speakers today unfortunately our third speaker had some problems at home and couldn't make it but welcome you to be a second panel presentation contextualizing human security in the Americas Mexico Brazil and the US we have two papers one on Brazil and Mexico and one on aging Latinas in the United States that continue the conversations actually from the prior panel so if you have questions that you were not quite sure how to ask as I sometimes have and they come up you know I'm sure we can take one of those questions as well but let me introduce our first speaker Flavia Andrade from the University of Illinois who's going to present a paper co-authored with Mariana Lopez Ortega and the yeah okay because the names are sorry in the title well you can see it there but it's the assessment of the impacts of socioeconomic disparities in health among retirement age adults in Brazil and Mexico thank you thank you everyone okay good so as most of you know I feel that I'm part of this group I have been so many years and I'm strong supported of the I call ICLA I don't know why but you know Jack also says ICA so I think it's something with the language in Portuguese what ICA means so hold with me but it's a pleasure to be here one more time and I really truly believe on the mentoring that I got from here and how it helped me in my career so thanks to everybody from the staff to the organizing of this event still like I don't like the height of this give you a little bit of background so Brazil and Mexico well I think we ever buy like in Brazil and Mariana is Mexican but like if anything else Brazil and Mexico have the largest population of older adults in Latin America so it's about 16.5 million people in Brazil and 8.2 in Mexico both countries have experienced like live gains in life expectancy in recent decades so if you're thinking Brazil life expectancy in 2010-2015 was 75 years 74 years in Brazil and 77.5 years in Mexico so we have like this growth in the proportion of older adults and like of course this has impacted the public health cost and also the patient assistance in two countries so one of the especially in Brazil because the Mexican case is likely different so we have this issue about extending working life right it's become like more and more visible so you see highlights for example the explosion of the potential crisis in Brazil and then in the Mexican case there's like there really like a Mexican patient system there's the real crisis right so it's part of like a more it's a larger process that's not only like Brazil and Mexico part of it so if you think about Brazil in Brazil it's a very interesting case because coverage is almost universal nowadays after the 1988 constitution almost everybody like it's a very very high coverage of course there's still some inequalities if you don't participate in the formal service but there are ways of getting patients at least for the current cohort so it's a very high coverage and I can show you the numbers if you have interest but in Brazil there's no minimum age at retirement so as a result if you work in the contribution system the average age of the retirement is 54 years for a man and 51 years for women okay I have known a lot of people I mean a lot of people that have retired in Brazil in their 40s okay so as a result there's a major crisis in Brazil because a man who has retired will receive a patient on average for 23 years and a woman for almost 30 years will take the math and it's really like a system that doesn't have a future if you think about current experience it was really using about 7% of our GDP just for retirement benefits okay the situation in Mexico is different so if you look at the data from 2013 only 26% of the adults 16% over 25% of women actually had retirement so in Brazil it's really like coverage is not as much as an issue as it really like probably retirement but in Mexico it's really like a problem of coverage right and because the coverage is so much lower in Mexico the GDP expenditure is about 2% so in Brazil we're thinking okay so how much we can push it back let's extend it to 60 65 because the system is absolutely broken right so even Tutankhamun would not be able to retire in the future but in Mexico it's like how long do we have to work to be able to get something right because the coverage is so lower so the objective is really like to first take a look on the health of the individuals that are around this age of retirement by then we were very flexible we said 50 to 74 so we're trying to look at national estimates for Brazil and Mexico and seeing how universal policy would affect people differently because their health status is different so initially we look at the data from Brazil the PINADI in the National Health Survey that was collected in 2013 and for Mexico we look at 2000 and then in 2012 so we're looking at basic descriptive statistics this time by age sex and we can feel like doing low-discret regression and having some graphical representations for you using lowest graphs so what we're looking at education it was very hard also to come with a way of getting Brazil and Mexico in this page so bear with us at no education, primary education meaning one to six years of completed foreign education and more than seven or more for the modern primary so these are the three categories we're going to be using for the rest of the graphs so just to give you like a sense of what has been going on in Brazil and Mexico in terms of diabetes there is a growth in both countries in terms of the prevalence of diabetes and not so much for hypertension it's kind of almost stabilized during this time the world gains in education over this time for the people that are 15 older but still just like point to the other you still have a, especially in Brazil a large number of people it's like no education there are 15 other Brazilians it was very low to start acting so there is a low education for older adults during Brazil when we do a simple regression to analyze some of these things we see the increase of diabetes over time time was here so there is like for both Mexico and Brazil and we don't see this change for hypertension when we look at education we have some interesting things in Brazil compulsive the people with no education the people that have actually primary education they are more likely to report having diabetes in both countries and in Brazil people that have higher education there are more than primaries there are more in the form of schooling they are less likely to report having diabetes but there are no differences in Mexico and remember the thing that we are working with is healthcare so these are the results for diabetes and then when we look at hypertension we have fewer patterns in which the ones with lower education are less likely to report having hypertension than ones with primary and in Brazil we have a gradient of that actually those with more education are also less likely to report having hypertension but not so much in Mexico again this is based on self-reported data so you can imagine that people with more education have more access to healthcare so they are more aware of their health conditions so when we graph this is what we see so the so the blue line will be all of the people with mild education and the green lines are the people with less education so if we just about the pulse of 65 years old right you see that at least for diabetes in both countries the people with less education have a much higher prevalence of worse health conditions in the people with more education right so if we think about the people they would have the same health status 10 years before so someone with more education would have seen the levels of diabetes if someone with 10 years passed with no education would be up here when we look at the situation for men it changes as men in both so here for both Brazil and Mexico we have a reverse that we saw for women in each man in both Brazil and Mexico with lower education report having less diabetes having lower diabetes there is a change in recent cohorts especially in Brazil but we again this is all based on self-reported age so just hold with me for yourself when we look at hypertension for women we see the clear gradient in which like women with more education have lower prevalence of hypertension women with higher with lower education have higher prevalence of hypertension and the reverse is seen in Mexico right but again this is based on self-report right and when we look at Mexico for men the situation is even not American it shows that at least at self-reported levels women with lower education are reporting have lower levels of hypertension than women with higher education so I said okay let me look at other variables so we look at other variables and so if you look at self-reported health like how you feel about your health and we just called okay we're feeling poor health then what we have seen for women in Brazil remains but look at the gradient here how perfect right women with lower education are less likely to report having poor health women that have primary needle and women with lower education are less likely to have poor health right very clearly gradient women for men in Brazil I jumped too much okay so when we look for men we see again the very nice gradient with men with lower education reporting having worse health which we would expect given what we know for health so the self-reported poor health rather than hypertension seems to give this gradient of like how people really feel about their health when it gets to this retirement age and it's worse for those with lower education and then when we look at Mexico well we didn't have the same data in Enfamut so when we switch it to the M-HAS 2015 that actually was just released this week and when we look at both disability based on ADL activity of the daily living and poor health we see the gradient that we would expect that in this case women women are in Mexico with higher education with poor health having better health both in terms of having lower disability but also being less likely to report poor health and the same thing happens for men so if you remember in the past that we have for diabetes and hypertension we would think that well poor men are doing better like less educated men are doing better but actually they are not like if you think that self-reported health and disability access is much higher among these groups but again these are like the data that we have in Enfamut and so the data bias is what we have for prevalence on self-reports so you see that a large number of older adults or adults including myself almost like the 50 so 9 of them so when you think about adults and older adults a lot of us don't know that we have hypertension and diabetes there is a lot of that going on so if we trust that if we are doing this comparison we can't really trust like self-reports so what we did so we look at the measured hypertension for example and the situation changes completely when we look at self-reports measured data when we look at measured data we see that actually there is almost no difference between the men with no education and higher education being worse in terms of hypertension and when the situation was for women actually sorry so for women there is no difference when you look at the measured data and when we look at women this situation is worse it's completely so if we based on self-reports we would come to the conclusion that lower education is associated with better levels of hypertension and in fact it's exactly the opposite there are many people that are unaware and this situation is worse for men so in doing this comparison women and me because the way they deal with the health care system they are more aware, they have conditions but the men, they are not so what we see that there are these important social gradient and in doing this international comparisons the challenge is that one is the availability that should be seen across the two countries so we can compare many times we are left with only self-reported data that we really can't use for chronic disease especially for diabetes and hypertension because of the levels of diabetes so ultimately we still have to rely on measures of self-reported general health and also measures of like disability so we can analyze better measures of these populations but the bottom line is if we look at data that is better collected we see this clear gradient that poor people are doing far worse than people with higher education so there is this social gradient and in those policies that use everybody at the same time we have like very different impact on how these people really time live at older ages so we have as I said the problem of the self-reported data what we want to do later is because there is a very big difference in urban and rural areas in these countries to explore more how it's going on and we want to point it out to this morning there are also important occupational differences and because occupation makes you a different assertion on the labor force but you're going to have a retirement from the government this will also impact how people will enjoy life at older age that's all we have for today thank you thank you Flavia thank you for showing how the effect of socioeconomic differences in health and in healthy aging can be quite large in both countries there are many health systems and even though Mexico has improved its coverage of health care that will hopefully improve the statistics in many ways or has begun to improve them I even would think it has already begun to improve them it shows subsuming that there is a story of poor control and management and very different quality of health care access as well across the country but related to the pension system issue now present results I think is going to present results of a larger project on trying to understand basically how ready are we Latinos for retirement I'm looking forward to it but I'm not ready for it anyway how further I do first of all I guess as all panelists I would like to thank the organizers Jackie in particular not only for this installment of ICA but all previous installments and I know that many of us have been coming to this conference for quite a few years now and I feel as if we are really becoming a part of one large family so in the interest of time I'll start especially knowing that I am apparently the last person standing between you and your lunch which is never a good position to be in don't worry that's me thank you no pressure okay so I'll talk about retirement security for aging Hispanics and this is what I'm going to talk about is part of a larger report that me and my colleagues are preparing for the department of labor and so I would like to recognize Rich Johnson and Claire Bank who are working with me on this project so I don't really have to sell you on the idea of the importance of this topic but since I have a couple of my slides I'll just show you that obviously Hispanic population is growing very fast and even though it's comparatively younger the size of older Hispanic population is also increasing and in fact by 2040 1 in 4 of all Americans about 1 in 7 almost 1 in 6 of older Americans as they'll be of Latino so research questions that we are addressing in this report or at least some of the questions are how financially secure are older Hispanics compared to non-Hispanic whites and blacks so we'll see here particularly paying attention to the distinction between US born and foreign born Hispanics also we are looking at the issue of how financial security for older Hispanics changed over time both looking at longer term, longer time horizon about 35 years and also time before and after the great recession finally how changing demographic and labor market experience is going to shape financial security for the next wave of Hispanic retirees we are also looking at some other questions that I won't address in the presentation such as the we've been modeling retirement decisions and transition to retirement and so if you have any questions about it please feel free to ask them during the Q&A also I would just like to mention at this point that our projections are really only preliminary so I'm just going to mention a couple of things but these are only first cuts and these are going to most likely change for the final report so we used for this report multiple data sources and the reason being that simply there is no one great source of data especially once when you get to Hispanic population and when you start distinguishing between US and foreign born and so I'll just mention without really telling you all the nitty-gritty of what we did we used American community survey current population survey survey of income and program participation, health and retirement study and finally our in-house micro simulation model that we like to call Dynasim so let's turn to financial security for aging or older Hispanics today first thing in terms of incomes when we look at median family incomes at ages 65 and older we see that Hispanics especially those who are born outside of the US do have substantially lower incomes than older non-Hispanic whites the way we did the adjustment just for reference is that we actually used a square root of family size so that basically at least to some extent accounts for economies of scale so it was not just pure division by number of family members this comes as no surprise that with our incomes less well poverty rates are nearly three times as high for older Hispanics than non-Hispanic whites especially for those who are foreign born but behind this trend there's something that is even more dramatic and that's when we focus on older unmarried women of color what we see and these are ages 75 and older that about 40% or more of never married women live in poverty one in three divorced or separated women of color live in poverty so those are quite striking things and much worse than when we just focus on the headline number in terms of wealth differences are huge Hispanics have on average about five times less compared to non-Hispanic whites for foreign born we are talking about magnitude of difference of about nine and what is probably or arguably even worse is that about one in four of all Hispanics including one in three or more Hispanics age 65 and older have zero or negative wealth now compare that just with non-Hispanic whites where you have only about four percent so obviously many of the differences in income and wealth are compositional differences but even when we did and this was just the very first cut of controlling for education, controlling for other compositional differences personal characteristics that did not eliminate racial and ethnic gap in income or in wealth and what I'm not showing you here is really that we repeated this for the data from late 70's 80's, 90's 2000's and obviously as I'm showing you here 2013 and this unexplained difference for the difference that we could not attribute to any other factors than race ethnicity actually increased over this period of time so all of these things show you that Hispanics have fewer resources in retirement but that's only part of the story the other part of the story is demand for resources or need for resources and an important factor there is health because many costs in old age are related to health and when we look at percentage of adults who are reporting two or more ADLs or a severe cognitive impairment we see that older Hispanics are pretty much twice as likely to report them and then twice as likely to need LTSS support compared to non-Hispanic whites and this is also consistent with self reports of health where older Hispanics are about twice as likely to report being in favor of poor health compared to non-Hispanic whites now this was basically a snapshot of the current situation so let's just for a moment on recent trends in income and wealth at older ages and while all the things that I presented so far have been well pretty bleak when we actually look at longer when we look at longer period of time not all news is bad so real median family incomes at older ages actually increased over the past 35 years for Hispanics and non-Hispanics alike somewhat less for a foreign born population but still now you should be aware that much of this increase is related if not all of it with increased labor force participation of women simply two incomes go further than one income so this is nothing to say about individual incomes but on average people do have families do have higher incomes related to this poverty rates actually decrease over the past 35 years and I think we actually heard that information this morning and this is consistent with what we find much less also for foreign born Hispanic population in the US in terms of wealth and we are looking here at the period leading up to great recession and after it the the findings are not that positive there was a substantial increase in wealth in the before the great recession but then decline during the recession and the wealth has not recovered completely now Hispanic started from a very low point so they really had very relatively in absolute terms actually little to lose but in relative terms their losses were on the same magnitude or similar magnitude as for non-Hispanic whites so let's turn to working ages and let's turn to what the future may hold for a future Latino retirees in the US so one interesting thing is that foreign born Hispanic men have higher employment rates than non-Hispanic whites and in fact that is true across all age groups US born Hispanics are laying behind and African Americans have by far the lowest employment rates again this is data for men when we turn to women the situation is actually quite the opposite foreign born Latinos in the US have by far the lowest employment rates of all groups and they do catch up at older ages age 55 and beyond another thing that distinguishes US and foreign born Latinos is basically what I could call occupational segregation of foreign born Latinos here we see that among men about 60% of them work in construction cleaning food preparation manufacturing which is here production or agriculture not so for US born Latinos among Latinos again we see that about 40% of foreign born Latinos in the US work in either cleaning food preparation or manufacturing among US born Latinos though we see that they are much more represented in office administrative support social services education and management occupations so originally very different populations in terms of the earnings we see both for men and women that US born Hispanics are less than non-Hispanic whites more than non-Hispanic blacks whereas foreign born earn less than both of these groups over time we see that for men real median earnings actually decreased across all racial and ethnic groups however among women they increased except for foreign born Latinos now we come to employment sponsored retirement plan coverage and here we see that among men and similar results are among women Hispanics are less likely to be covered by such a plan and this is particularly true of foreign born Hispanics in fact US born Hispanics look much more like non-Hispanic blacks in terms of coverage than like foreign born Hispanics again I said the same trends are observed for women so let's quickly turn to the future and what might the future hold for older Hispanics good news is that the educational gains have been substantial so over the past several decades all racial and ethnic groups had substantial educational gains because Latina started from the lowest point they actually made very substantial gains however still especially foreign born population lagging behind both US born and non-Hispanic black population our projections and the way they work is basically we take different cohorts in this case we take cohorts born at 49, 50, 59 and so on through 77 and then project what their incomes should be at age 70 given their current characteristics and this first cut especially because of educational gains gives us a pretty optimistic picture which we'll see we'll have to work on this and adjust it because there are some things that the models still cannot capture but in any case what we see is that Hispanics are going to continue to lag behind other groups but be catching up to some extent the main part or the backbone of income of older persons will be social security benefits when it comes to private pensions the results are more mixed our projections are that defined benefit pensions participation in defined benefit plans will continue to shrink and also that median amounts will continue to fall whereas on the other hand there will be more an increase in defined contribution plans and median DC built amounts now the gains in defined contribution plans are probably not going to be enough to offset all of the declines defined benefit plans so where are some policy options well this will come as no surprise we need to further promote education that's been a great leveler and workforce development initiatives that do promote and improve skills acquisition and speaking especially about foreign born population we have to keep in mind that many of these people come past age 18 so we cannot necessarily affect their education in the traditional sense but we are talking more about on-the-job training programs that would be really beneficial for that population social security reforms could go into the direction of increasing benefit progressivity or maybe even creating a minimum benefit that would really benefit in particular those with the lowest incomes and birth labor market prospects we need to do more to promote retirement savings private retirement savings and there are efforts in this direction people are exploring options like auto enrollment into IRAs or for those who are enrolled auto escalation of contributions so far there is not definitive evidence on whether these work but there is some at least tentatively promising promising evidence and finally I guess everybody agrees that we need to do more to support family caregivers and this is particularly important for older Latinos and their families given that they have almost always expressed a strong preference for staying in the community and staying for as long as possible with family and so with that I conclude my presentation. Thank you Thank you, Stipita and your presentation reminds us of and I'm eager to see what the simulation model does to show the effects of possible reforms to social security because the general discourse is that the system is broken and that correct me if I'm wrong but the dominant discourse is that benefits need to be curbed there is not that much discussion about increases in social security taxes or any other kinds of contributions so it will be interesting to see how this affects retirement for so many people given the projections that you showed at the beginning as well as by for instance linking to Yoram's paper which is in Mexico but I'm sure that there's a similar gradient that's one of the questions I have worked on that I mean people high retirement ages for people who have been working in manual occupations we'll have also many different kinds of help challenges for these people and disability challenges that I can keep working until I'm 70, I'm sitting here just talking but people that do real work I don't know if that's doable let's open it up for questions a few questions yes we are going to do it next yeah yeah yeah so the the diet and so for this diabetes hypertension might be different but then when we look at the disability and poor self rated health I believe that we're going to see things that different even with different levels of health conditions like because of the amount of accumulation of other types of stress in the work so we'll keep you posted we'll keep you posted so yeah a few models take into account a large number of undocumented adults among Hispanics and if you're projected raises or these levels of income are based on social security eligibility that might be really problematic if you're doing any adjustments for that so thank you for that question so dinosaur is a model that was started many decades ago I just came a year ago to the urban institute but I know that in recent years they've been trying with the department of labor and their support to improve some of the inputs into the model include undocumented better sense of tracking undocumented population so it does take undocumented so the short answer it does take undocumented population into account how good those numbers are that's more questionable because they effectively our researchers start from other surveys and then ultimately it's a residual so you know what amount of error is inherent to it I don't quite know but at least in theory that population should be somewhere in the projections so there was actually at the retirement research consortium conference in DC that happened just few weeks ago there was an interesting presentation on the incomes of undocumented persons in the US and now this is I guess these are still somewhat controversial findings but they've been increasing and converging to incomes of other of documented Latinas in the US now one of the explanations is that because there's less of the circular migration and these are people who now spend longer time in the United States that they have actually over time to remain undocumented they have become more established and so that over time their labor market position actually somewhat improved even though they're still lagging behind other groups again remains to be seen very hard to find data but that's what some of the recent studies show just following up on that just so even in forgetting about those who are about to retire and don't have documentation many especially I would say Mexican and maybe Central Americans in the United States have who have legal standing many of them have prior undocumented status so with the model basically assume okay they became documented in there's an age profile of becoming legalized after which you start accruing social security and FICA benefits because the prior ones accrued are not forgotten right so that's what the model would do and another thing you've seen those very high employment rates so another thing that's happening is because many foreign born atinas including those undocumented if they don't qualify for retirement benefits many of them just don't retire so you see very high employment participation at very old ages yes regarding the presentation I love your charts there's a wealth of information there the statement here is not just about income it's about the opportunity to participate in 401 plans and other pension plans your IRA do not have that opportunity sometimes when they have the opportunity they don't take advantage of it because they don't realize the value of them but anyway the idea is that it's more than just income another part is that there are some very enterprise in types of immigrants that are coming that are setting up their own companies because they don't have the opportunity for other jobs they say I set up my own construction company not at the upper level too much but anyway enterprise do you have anything to say on that yeah I mean it's a very important point and in terms of when you mentioned 401 case and participation that's where actually education comes into play because ultimately what happens is the type of job you have pretty much determines whether you're going to be offered a plan whether it comes with certain benefits like retirement plans and so that's a main driver of the difference in participation in 401K type plans between Latinos especially foreign born and non-Latinos but you're also correct that take-up rates are marginally lower for Latino population and obviously if you have private business then you're pretty much on your own and it's a matter of how much resources you have to invest in your IRA or to save on the side but that is something that is more of a problem because it is much harder to find that systematic solution as you can with larger employers where you can either mandate it or have this as I said out enrollments where basically an old research show if people have to opt to do it then if they have to opt in so yeah that is a major problem given that many immigrants for many immigrants their private business is their ticket to labor market thank you any other questions or points comments anything lingering from the prior three comments sorry need to check that I have a quick question for Dr. also Brazilian recently we saw a change in the presidency from the previous president being impeached and the new president taking place and one of his first proposal was to change the year of retirement to 65 for men and 64 women really eliminating that earlier years of time of service that you showed so I would like to know that based on your expertise do you think that this change is in the correct direction and do you think that is the key to resolve the deficit in the system that we are facing right now thank you so the issue is that we didn't have a minimum wage before in Brazil and now the idea is like to impose one with a difference for women this is the easiest thing that the government can do so when we talk about changing the age it's easier for the government to change and actually to change the benefits so it came to a point that because we have already 8% committed to that the government feels that it's easier to pressure that way to the aid instead of changing the benefits there are several sectors in Brazil that are much benefited if you work for the government you retire but it's so much more difficult to work with these groups because of their power that the government is going to deprive of the easiest in terms of like will there be less tension in them yet if it's going to go there I think some reform has to be done in Brazil if this is the best one I don't think that's the only thing that they could be doing there are a lot of other things that could be done before in terms of much more in terms of the political aspects will be much more harder to navigate so they are doing what probably is easier but there's no doubt that the patient system it's completely broke and needs a strong reform but we'll penalize if they do a one cut for everybody as you saw from the graphs will definitely affect different social groups very differently Fernando Torres-Hill with the last question just to build on your comment about Brazil my understanding is that the unfunded pension liabilities are unsustainable unsustainable and that even by raising the minimal age of requirements that only helps down the line so I guess I'd like you to pursue the current scenario we're facing that in this country and whether or not you can roll back existing retiree pension benefits there's a great debate about whether that can be done but what would be the potential scenarios for Brazil is there unfunded liability truly unsustainable or is that more media type so here I was looking at the health side but interested in the retirement age so from everything I read it's really unsustainable given especially the growth of the population the way the system works in Brazil there are several groups that actually have already won the the rights of retirement earlier age so even for the fact next even if it changes now it's only going to affect people that are getting their labor force now because the other groups have already secured their benefits right in their rights so it seems that it's really like the math is unsustainable the way as you saw the retirement age for women they retire for 30 years a lot of people will have benefits that are close to 100% but they have not contributed for 30 years so it's a simple math that it doesn't close there's no way to pay it the way it was working Brazil so what we are doing now is mixed systems when we have private companies entering the market try to cover some of the gaps but there's a big risk like it seems very clear in Brazil there's a big risk that something dramatic may happen because there's no funds there are no funds it seems that I had a beautiful graph but if we look at the proportion of older adults and the percentage of the GDP a lot of the countries now as you get more people older you're going to spend more a very linear association but it's just high up there it's the only outlier in the world on that note thank you for your attention and we'll break for lunch right until 1.30 1.30 so we'll restart promptly at 1.30pm and I don't know about lunch you guys want to give oh it's right there okay great thank you outside what a presentation thank you great work we are still in the step-by-step you did great do you have any reports on