Social Panorama of Latin America 2005

Includes bibliography

The 2005 edition of the Social Panorama of Latin America analyses recent poverty trends and the increase in migrant remittances, together with their impact on the well-being of the region's population. Short- and long-term trends in social spending, the distribution of such expenditures among the various socio-economic strata and their effects in terms of income deconcentration and increased well-being are also reviewed. The analysis seeks to explore the question as to whether the demographic transition taking place in the Latin American countries over the past 15 years has helped to narrow the long-standing gaps between different socio-economic groups' and areas' mortality and birth rates. Attention is also drawn to the magnitude of the HIV/AIDS epidemic in Caribbean countries and to the reversal of its skewed gender distribution, which has had a devastating impact on households and the community at large. Finally, this edition looks at major changes in the health sector, the policies and programmes being used to cope with them, and the various financial and management issues that the countries will have to address in this connection. The chapter on poverty presents projections of poverty and indigence levels for 2003-2005, together with recent estimates for some countries in the region. This information appears to indicate that poverty is on the decline, although not fast enough to enable the region to meet the first target set in relation to the Millennium Development Goals. In addition to examining the progress made by the region towards the satisfaction of basic needs, this chapter provides new data on remittances' impact on the population's living standards. The data indicate that remittances are helping to raise recipient households' living standards substantially and are enabling many of their members to escape from poverty. The impact that such remittances have on overall poverty and indigence rates and on income distribution is very limited, however. The chapter on social spending provides information on public social expenditure levels in the region, recent and longer-term trends in such expenditure, spending patterns and the impact on income distribution. A close look is taken, in particular, at how the Latin American and Caribbean countries have been allotting these funds among the various social sectors in recent years. This analysis includes a consideration of how the economic recessions experienced by some countries early in the decade have affected social expenditure and seeks to determine whether or not the traditional relationship between social spending levels and the business cycle has changed in any way. Spending patterns in the areas of education and health are reviewed, with attention being devoted to the proportion to public funds received by the different income strata and how progressive the resulting pattern is. This analysis closes with an examination of the impact of total social expenditure and its various components in terms of income deconcentration and increases in the level of well-being of the region's households. Microdata from the 1990 and 2000 census rounds were processed in an effort to answer the question as to whether the demographic transition that has occurred in Latin America over the past 15 years has helped to narrow the long-standing gaps between different socio-economic groups' and areas' mortality and birth rates. The analysis of these data points to the existence of differing trends across countries in terms of the link between social inequality and mortality and fertility rates. In most of the countries, infant mortality (especially in urban areas) fell more sharply among lower socio-economic strata, thereby reducing this extreme indicator of social inequality. There are still exceedingly sharp disparities in such rates, however, owing to the high number of preventable premature deaths in the poorer strata. Differentials in fertility rates declined only in a minority of the countries under review, however. Moreover, in almost all cases, fertility rates rose among adolescents in low and mid-level socioeconomic strata. This trend reflects both the intractability of fertility rates among these groups and a considerable increase in social inequality in terms of early reproduction. These findings validate measures targeting the proximate determinants of mortality and fertility —whose effect is felt in all socio-economic groups and even under macroeconomically adverse circumstances— and underscore the need to apply new policies and approaches to address emerging issues such as those posed by the existence of fertility schedule differentials. The chapter on HIV/AIDS briefly reviews how this epidemic is affecting the Caribbean and looks more closely at the trends observed within the female population. It also analyses how gender relationships influence Women's access to their sexual and reproductive rights and why women have become more vulnerable to HIV infection, which is having devastating consequences in terms of female morbidity and mortality rates, Women's health, and the well-being of their families and the community in general, as well as the implications in relation to perinatal disease transmission. It also highlights the importance of understanding what sorts of gender-related problems are contributing to this epidemic in the Caribbean in order to devise policies and programmes that will help to stem the advance of the disease. The chapter on the social agenda provides an overview of the health situation and health care programmes in Latin American countries. This analysis is based on the responses received from the health ministries of 17 countries to a survey conducted by ECLAC. This survey was designed to provide information on how existing health programmes are viewed from the institutional perspective of the countries' ministries of health and how national authorities are assessing the health situation and specific health problems affecting the population. The responses reflect the different sociodemographic situations of the countries and provide a mixed picture in terms of governments' response capacity to public health issues. Most of the countries cite financing and management difficulties that hinder their efforts to cover health needs. Inequality in health care stems not only from shortcoming in access associated with sociocultural and geographical circumstances but also from income inequality, which translates into living conditions that are insufficient to prevent health problems or satisfy the health needs of the population. As is customary, this discussion of the international social agenda also reviews the international meetings at which social issues have been addressed. In this instance, special attention is devoted to various regional meetings held within the United Nations system in order to launch the inter-agency document coordinated by ECLAC entitled The Millennium Development Goals: A Latin American and Caribbean Perspective. The main conclusions of this study are also summarized.