Impact of the Non-Contributory Social Pension Program <i>70 y más</i> on Older Adults’ Mental Well-Being

<div><p>Background</p><p>In 2007, a non-contributory pension program was launched in rural areas of Mexico. The program consisted in a non-conditional cash transfer of US$40 monthly to all older adults (OA) aged 70 and over. We evaluate the effect of the program on mental well-being of its beneficiaries.</p><p>Methods and Findings</p><p>Quantitative and qualitative methods were used. For the quantitative component, we used the selection criteria established by the program (age and locality size) to form the Intervention (OA aged 70–74 residing in rural localities, <2500 inhabitants) and Control groups (OA aged 70–74, in localities with 2501–2700 inhabitants). Baseline data collection was conducted in 2007 where 5,465 OA were interviewed. The follow-up survey was conducted in 2008, and it was possible to interview 5,270 OA, with a response rate of 96%. A difference-in-difference linear probability model with individual fixed effect was used to estimate the impact of the program on mental well-being indicators. In 2009 a qualitative component was designed to explore possible causal pathways of such effect.</p><p>Results</p><p>After a year of exposure, the program had a significant effect on reduction of depressive symptoms (β = −0.06, CI_95% −0.12; −0.01) and an increase in empowerment indicators: OA participated in important household decisions (β = 0.09, CI_95% 0.03;0.15); and OA participated in household decisions pertaining to expenses (β = 0.11, CI_95% 0.05;0.18). Qualitative analysis found a strong trend showing a reduction of sadness, and feeling of increasing empowerment.</p><p>Conclusions</p><p>These results suggest that a non-conditional transfer in older ages have an impact beyond the economic sphere, impacting even the mental well-being. This effect could be explained because the pension produces feelings of safety and welfare. It is recommendable that governments should invest efforts towards universalizing the non-contributory pension programs in order to ensure a basic income for the elderly.</p></div

Overall effect on mental well-being indicators: Depressive symptoms and empowerment.

£<p>Moving older adults (aged 69) from control group at baseline to the intervention group.</p><p>GDS: Geriatric Depression Scale.</p><p>Linear probability models with fixed effect at individual level, adjusted for time-varying covariates in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0113085#pone-0113085-t001" target="_blank">Table 1</a>.</p><p>Standard errors in brackets.</p><p>*p<0.10; **p<0.05; *** p<0.01.</p><p>Overall effect on mental well-being indicators: Depressive symptoms and empowerment.</p

Overall effect on mental health indicators.

<p>Alternative strategies of estimation</p><p>GDS: Geriatric Depression Scale.</p>1<p>Caliper algorithm with a specified distance of 0.0005 and one-to-one merge (713 units in intervention and control groups).</p>2<p>Using epanechnikov kernel, and one-to-one matching (875 units in intervention and control groups).</p><p>Linear probability models with fixed effect at individual level, adjusted for time-varying covariates in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0113085#pone-0113085-t001" target="_blank">Table 1</a>.</p><p>Standard errors in brackets.</p><p>*p<0.10; **p<0.05; *** p<0.01.</p><p>Overall effect on mental health indicators.</p

Analytic sample definition.

<p>Analytic sample definition.</p

Baseline characteristics by study group.

<p>OA: Older adult.</p><p>Standard error in brackets.</p>1<p>p-value for a t-test or z-proportion test.</p>2<p>Hypertension, diabetes, dyslipidemia, myocardial infarction, angina pectoris, heart disease, stroke, chronic lung disease, osteoporosis, and cancer.</p><p>Baseline characteristics by study group.</p