Publication: Cash Component of Conditional Cash Transfer Program Is Associated with Higher Body Mass Index and Blood Pressure in Adults
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Published
2008
ISSN
0022-3166
Date
2012-03-30
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The cash component of Oportunidades, a large conditional cash transfer (CCT) program in Mexico, has previously been shown to be associated with better outcomes for child growth and development, The objective of this analysis was to determine whether the cash transfers were also associated with positive outcomes for adult health. Oportunidades was originally randomized across 506 rural (<2500 inhabitants) communities assigned to immediate incorporation into the program in 1997 or incorporation 18 mo later. Adults (n = 1649 early, (3 = 2039 late intervention) aged 18-65 y were then assessed in 2003. All of the households included in the analysis reported here complied with Oportunidades's requirements for the entire period, but some received higher cumulative cash transfers because they were living in communities randomized to begin receiving transfers earlier and/or they accumulated cash at a faster rate because they had more school-aged children at baseline. Our primary findings were that a doubling of cumulative cash transfers to the household was associated with higher BMI (beta = +0.83, 95% CI 0.46, 1.20, P < 0.0001), higher diastolic blood pressure (beta = +1.19, 95% CI 0.09, 2.29; P = 0.03), and higher prevalence of overweight [odds ratio (OR) = 1.41, 95% CI 1.18, 1.67; P < 0.0001), grade I obesity (OR = 1.41, 95% CI 1.14, 1.75, P = 0.002), and grade II obesity (OR = 1 57, 95% CI 1.05, 2.36; P = 0.03), while controlling for a wide range of covariates, including household composition at baseline. Oportunidades has been portrayed as a model for CCT programs worldwide, but the results reported here support the notion that the cash component of Oportunidades may be negatively associated with some adult health outcomes. J. Nutr. 138: 2250-2257, 2008.
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In this paper we examine whether the PROGRESA programme of Mexico affects adult participation in the labour market and overall adult leisure time, and we link these effects to the impact of the programme on poverty. Utilising the experimental design of PROGRESA's evaluation sample, we find that the programme does not have any significant effect on adult labour force participation and leisure time. Our findings on adult work incentives are reinforced further by the result that PROGRESA leads to a substantial reduction in poverty. The poverty reduction effects are stronger for the poverty gap and severity of poverty measures.Publication Overweight and poor? On the relationship between income and the body mass index(2011)Contrary to conventional wisdom, NHANES data indicate that the poor have never had a statistically significant higher prevalence of overweight status at any time in the last 35 years. Despite this empirical evidence, the view that the poor are less healthy in terms of excess accumulation of fat persists. This paper provides evidence that conventional wisdom is reflecting important differences in the relationship between income and the body mass index. The first finding is based on distribution-sensitive measures of overweight which indicates that the severity of overweight has been higher for the poor than the nonpoor throughout the last 35 years. The second finding is from a newly introduced estimator, unconditional quantile regression (UQR), which provides a measure of the income-gradient in BMI at different points on the unconditional BMI distribution. The UQR estimator indicates that the strongest relationship between income and BMI is observed at the tails of the distribution. There is a statistically significant negative income gradient in BMI at the obesity threshold and some evidence of a positive gradient at the underweight threshold. 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