First published in 1948, the International Social Security Review is the principal international quarterly publication in the field of social security.
This article assesses the effectiveness of pension provision and health insurance in preventing ill health among older people in developing countries. It argues that, until recently, social protection agendas devoted insufficient attention to health risk prevention, instead focusing on the reduction of income poverty through cash transfers. The article shows that there is little reliable evidence to indicate that providing older people with pension benefits enhances their health status and that these effects should not be taken for granted by policy‐makers. The article then focuses on the effect of inclusion in health insurance schemes on health outcomes for older people, with specific reference to outcomes related to hypertension. Drawing on newly‐available data from the World Health Organization for Ghana, Mexico and South Africa, it shows that older people with health insurance are marginally more likely to be aware of health conditions such as hypertension and more likely to have them under control. Nevertheless, the great majority of hypertensive older people, insured or uninsured, are not effectively treated. The chief barriers to treatment are shown to be mainly related to awareness and service provision, rather than financial ones. Consequently, the capacity of pensions or health insurance to enhance health outcomes for older people in such countries, including in rural areas, is heavily contingent upon health education, health screening and adequate health service provision. These interventions should be viewed as an integral element of mainstream social protection strategies, rather than adjuncts to them. Yet, in practice, social protection and health promotion continue to be treated as almost entirely separate spheres, thus presenting substantial institutional barriers to developing combined interventions.
There has been a marked development in the way that institutional investors address environmental, social and governance (ESG) issues in their investment practices. For public and private investors alike, these issues have now become part of mainstream investment practices, reflecting a greater understanding that they represent material risks and opportunities that must be addressed as part of fiduciary duty. Some ESG issues require an approach that goes far beyond the traditional simple screening approaches that the early niche funds employed. This is illustrated through a detailed discussion of investor practices on climate change, which must include an assessment of long‐term risks and opportunities and of the strategies that have been put in place to address these. It is also argued that as the role of policy and regulation is critical to shifting the economics in favour of low carbon investments, a structured dialogue between investors and policy‐makers is critical to ensuring that institutional capital is mobilized to support the policy goals of limiting climate change whilst still allowing investors to operate in line with their fiduciary responsibility.