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With the exception of Sub-Saharan Africa, Latin America and the Caribbean has been one of the regions of the world with the greatest inequality. Inequality in Latin America and the Caribbean: Breaking with History? explores why the region suffers from such persistent inequality, identifies how it hampers development, and suggests ways to achieve greater equity in the distribution of wealth, incomes and opportunities. The study draws on data from 20 countries based on household surveys covering 3.6 million people, and reviews extensive economic, sociological and political science studies on inequality in Latin America. To address the deep historical roots of inequality in Latin America, and the powerful contemporary economic, political and social mechanisms that sustain it, Inequality in Latin America and the Caribbean outlines four broad areas for action by governments and civil society groups to break this destructive pattern:Build more open political and social institutions, that allow the poor and historically subordinate groups to gain a greater share of agency, voice and power in society. Ensure that economic institutions and policies seek greater equity, through sound macroeconomic management and equitable, efficient crisis resolution institutions, that avoid the large regressive redistributions that occur during crises, and that allow for saving in good times to enhance access by the poor to social safety nets in bad times. Increase access by the poor to high-quality public services, especially education, health, water and electricity, as well as access to farmland and the rural services. Protect and enforce the property rights of the urban poor. Reform income transfer programs so that they reach the poorest families.

Equality of opportunity is about leveling the playing field so that circumstances such as gender, ethnicity, place of birth, or family background do not influence a person's life chances. Success in life should depend on people's choices, effort and talents, not to their circumstances at birth. 'Measuring Inequality of Opportunities in Latin America and the Caribbean' introduces new methods for measuring inequality of opportunities and makes an assessment of its evolution in Latin America over a decade. An innovative Human Opportunity Index and other parametric and non-parametric techniques are presented for quantifying inequality based on circumstances exogenous to individual efforts. These methods are applied to gauge inequality of opportunities in access to basic services for children, learning achievement for youth, and income and consumption for adults.

Inequality of opportunity : what it is, how it can be measured, and why it matters -- A human opportunity index for children -- Uses and policy applications of the human opportunity index -- Inequality of economic opportunity in seven Latin American countries -- Inequality of opportunity in educational achievement in five Latin American countries.

Equality of opportunity is about leveling the playing field so that circumstances such as gender, ethnicity, place of birth, or family background do not influence a person's life chances. Success in life should depend on people's choices, effort and talents, not to their circumstances at birth. Measuring Inequality of Opportunities in Latin America and the Caribbean introduces new methods for measuring inequality of opportunities and makes an assessment of its evolution in Latin America over a decade.An innovative Human Opportunity Index and other parametric and non-parametric techniques are p

In this second volume we turn our attention to the Americas: North America, Latin America, and the Caribbean. During the past decade many American countries amended their constitutions and enacted laws protecting the rights of indigenous people.

This edited collection aims to contribute to the decolonial social and cultural analyses of global entangled inequalities by focusing on their local articulations. Drawing on empirical research conducted by scholars in Germany, Trinidad and Tobago, Australia and in Canada, the book engages with the conceptual framework of global inequalities and the methodological perspective on entanglement. It does so by approaching global inequalities and their local articulations: (a) global political economy, structural violence, entangled inequalities; (b) financial inequalities and state injustice; (c) inequality within and beyond race and ethnicity; (d) decolonial struggles against inequality; and (e) decolonial futurities. It is on these grounds that this edited volume aims to contribute to the analysis of entangled global inequalities by mobilizing a decolonial framework paying attention to the intersections of race, gender, labour, finances and the State.

Background Since the early 1990s, Colombia has made great strides in extending healthcare coverage to its population. In order to measure the impact of these efforts, it is important to assess whether the introduction of universal health coverage has translated into equitable access to healthcare in the country, particularly for the elderly. Thus, in this study we assessed the inequality in utilization of health services among elderly patients in Colombia. In addition, we identified the determinants of healthcare utilization. Methods We analyzed the 2015 Colombian health, well-being and aging study (SABE). To classify determinants of healthcare use into predisposing, enabling and need factors, we employed the Anderson framework of healthcare utilization. Use of outpatient, inpatient and preventive health services constituted the dependent variables. We performed multivariate logistic regressions, estimated concentration indexes (CI) and performed decomposition analyses of the CIs to determine the contribution of various determinants to inequality of healthcare utilization. Results The study sample included 23,694 adults over 60-years-old. Wealth quintile, urban dwelling, health insurance type and multimorbidity predicted the utilization of all types of healthcare services except for hospitalization. Aside from inpatient care, pro-rich inequality in utilization of healthcare services was present. Wealth quintile and type of health insurance were the largest contributors to pro-rich inequality in use of preventive services. Conclusions While there has been progress in health insurance coverage for the elderly in Colombia, there are still equality challenges in the delivery of healthcare, especially for preventive and outpatient care. These inequalities are driven by individual characteristics such as wealth, urban residence, type of health insurance carried, and presence of multimorbidity. To address this issue, the Colombian health system should extend health insurance coverage to uninsured populations, as well as reduce barriers of access to healthcare services among poorest and the rural population receiving subsidized insurance.

In the Caribbean colony of Grenada in 1797, Dorothy Thomas signed the manumission documents for her elderly slave Betty. Thomas owned dozens of slaves and was well on her way to amassing the fortune that would make her the richest black resident in the nearby colony of Demerara. What made the transaction notable was that Betty was Dorothy Thomas's mother and that fifteen years earlier Dorothy had purchased her own freedom and that of her children. Although she was just one remove from bondage, Dorothy Thomas managed to become so rich and powerful that she was known as the Queen of Demerara. Dorothy Thomas's story is but one of the remarkable acounts of pluck and courage recovered inEnterprising Women. As the microbiographies in this book reveal, free women of color in Britain's Caribbean colonies were not merely the dependent concubines of the white male elite, as is commonly assumed. In the capricious world of the slave colonies during the age of revolutions, some of them were able to rise to dizzying heights of success. These highly entrepreneurial women exercised remarkable mobility and developed extensive commercial and kinship connections in the metropolitan heart of empire while raising well-educated children who were able to penetrate deep into British life.

Background The ways of life in the Amazon are diverse and not widely known. In addition, social inequities, large geographic distances and inadequate health care network noticeably limit access to health services in rural areas. Over the last decades, Brazilian health authorities have implemented fluvial mobile units (FMU) as an alternative to increase access and healthcare coverage. The aim of the study was to identify the strategies of access and utilization of primary health care (PHC) services by assessing the strengths and limitations of the healthcare model offered by the FMU to reduce barriers to services and ensure the right to healthcare. Methods Qualitative and ethnographic research involving participant observation and semi-structured interviews. Data collection consisted of interviews with users and health professionals and the observation of service organization and healthcare delivered by the FMU, in addition to the therapeutic itineraries that determine demand, access and interaction of users with healthcare services. Results Primary care is offered by the monthly locomotion of the FMU that serves approximately 20 rural riverside communities. The effectiveness of the actions of the FMU proved to be adequate for conditions such as antenatal care for low-risk pregnancy, which require periodic consultations. However, conditions that require continued attention are not adequately met through the organization of care established in the FMU. The underutilization of the workforce of community health workers and disarrangement between their tasks and those of the rest of the multi-professional team are some of the reasons pointed out, making the healthcare continuity unfeasible within the intervals between the trips of the FMU. From the users’ perspective, although the presence of the FMU provides healthcare coverage, the financial burden generated by the pursuit for services persists, since the dispersed housing pattern requires the locomotion of users to reach the mobile unit services as well as for specialized care in the urban centers. Conclusions The implementation of the FMU represents an advance in terms of accessibility to PHC. However, the organization of their activity uncritically replicates the routines adopted in the daily routine of health services located in urban spaces, proving to be inadequate for providing healthcare strategies capable of mitigating social and health inequalities faced by the users.

Efforts to promote equity in healthcare involve implementing policies and programs that address the root causes of healthcare disparities and promote equal access to care. One such program is the public social healthcare protection schemes. However, like many other developing countries, Tanzania has low health insurance coverage, hindering its efforts to achieve universal health coverage. This study examines the role of equity in public social healthcare protection and its effects on household healthcare financing in Tanzania. The study used secondary data collected from the National Bureau of Statistics' National Panel Survey 2020/21 and stratified households based on their place of residence (rural vs. urban). Moreover, the logit regression model, ordered logit, and the endogenous switching regression model were used to provide counterfactual estimates without selection bias and endogeneity problems. The results showed greater variations in social health protection across rural and urban households, increasing disparities in health outcomes between these areas. Rural residents are the most vulnerable groups. Furthermore, education, income, and direct healthcare costs significantly influence equity in healthcare financing and the ability of households to benefit from public social healthcare protection schemes. To achieve equity in healthcare in rural and urban areas, developing countries need to increase investment in health sector by reducing the cost of healthcare, which will significantly reduce household healthcare financing. Furthermore, the study recommends that social health protection is an essential strategy for improving fair access to quality healthcare by removing differences across households and promoting equality in utilizing healthcare services.