The Impact of Social and Economic Indicators on Maternal and Child Health

As early as 1985, Rosenfield and Maine began to look at what is called the maternal child field (MCH). More than two decades later, maternal and infant mortality is still among the worst performing health indicator in resource-poor countries and regions, and it has barely changed since 1990. Although three of the eight United Nations Millennium Development Goals aim at reducing child mortality, maternal mortality, and promoting gender equality, most literature in the field is either clinical or exclusively deals with women’s health problems. In this study, I proposed an empirical model that tests the impact of gender equality, women’s human rights, and maternity care on MCH with economic and political development as background factors. The proposed model was tested by using structural equation analysis. Data were obtained from 137 developing countries. The proposed model is partially supported by the data. Empirical findings demonstrate that gender equality has a pivotal role to play in the promotion of MCH. The relationship between MCH and maternity care is found to be strong and statistically significant. This finding may permit a probable verification given the current social conditions in some developing countries, particularly the neglect of many of women’s health needs and the assignment of their primary responsibilities in childrearing. The women’s human rights hypothesis is not supported by the data. It is perhaps that human rights instruments provide a legal discourse for political functions and social welfare issues, but that the legal approach alone does not necessarily provide a moral and social foundation to ensure the implementation of social welfare and human well-being, particularly maternal and child health in developing countries. The findings also indicate the importance of economic development in predicting maternity care. Finally, a positive and statistically significant relationship is found between economic development and gender equality. Implications and limitations of the study are discussed.     

A tentative discussion on the reproduction of population in China]

Population reproduction is a physiological phenomenon necessary to continue the human race, replacing the older generation with a new one. Population reproduction is also closely related to material production. Both are mutually restricted and supportive of each other. Population reproduction can be divided into 2 types: 1) short life span and rapid generation replacement or high birth rate and high mortality rate, and 2) long life span and slow generation replacement or low birth rate and low mortality rate. Since 1949 China has significantly reduced the mortality rate because of the improvement of our health system and working conditions and the increased living standard. The birth rate, however, still remains high because we are a developing country and our levels of education, science, and technology are quite low. This intermediate stage of low mortality rate but high birth rate also existed in most developed countries for several decades. China's large population and high population growth rate severely inhibit the development of social production and the achievement of the "Four Modernizations." The only way to resolve this contradiction of population reproduction and development of productivity is to control the population growth. Family planning and advocation of 1 child per couple are important strategic tasks in realizing the "Four Modernizations."     

The relationships between population and economy, and between population and education]

The relationship between population and economy is regarded seriously by China and other countries. This problem can be analyzed and studied under 2 aspects: 1) the influence of economic development on changes in population, and 2) the influence of population increases on economic development. Under the 1st aspect, improved living conditions, hygiene, and health care generally result in lowered mortality rates. Improved economic conditions in China also increased the birthrate and at the same time increased birth control among the people; the increased birthrate was due to more marriages after liberation. In economically advanced countries, due to high expenses in raising children, people tend to limit family sizes to 2 children/family. Under the 2nd aspect, population increases place strains on the food supply and nutritional requirements, especially when increases are too rapid. They also demand more educational resources and influence quality of education. As there are currently 210 million students in China, the quality of education suffers, particularly at the college level, since most of Chinese manpower, physical and financial resources are spent on primary and secondary education. In terms of housing, transportation, health care, and natural resources, they are all intimately related to and influenced by increases in population. Consequently, the living standard would be difficult to raise if population increases are too rapid. Since 1971, population increases have been incorporated into 5-yearly and later yearly national economic plans in China. The large Chinese population is a major obstacle in raising the Chinese economic level, hence a well-planned population control program is essential.     

Women,Demography, and Politics: How Lower Fertility Rates Lead to Democracy

Where connections between demography and politics are examined in the literature, it is largely in the context of the effects of male aspects of demography on phenomena such as political violence. This project aims to place the study of demographic variables’ influence on politics, particularly on democracy, squarely within the scope of political and social sciences, and to focus on the effects of woman-related demographics—namely, fertility rate. I test the hypothesis that demographic variables—female-related predictors, in particular—have an independent effect on political structure. Comparing countries over time, this study finds a growth in democracy when fertility rates decline. In the theoretical framework developed, it is family structure as well as the economic and political status of women that account for this change at the macro and micro levels. Findings based on data for more than 140 countries over three decades are robust when controlling not only for alternative effects but also for reverse causality and data limitations.     

Inequality, Wealth and Health: Is Decreasing Income Inequality the Key to Create Healthier Societies?

The idea that the level of stratification of societies contributes to the well-being of their members is gaining popularity. We contribute to this debate by investigating whether reducing inequalities in the income distribution of societies is a strategy for improving population health, especially appropriate for those countries that have reached the limits of economic growth. We test this idea on a dataset covering 140 countries and 2360 country-year observation between 1987 and 2008 and formulate hypotheses separately for countries with different level of economic development. We indeed found that countries with higher levels of income inequality also have lower levels of life expectancy (our measure of population health), and this result was consistent both in cross-sectional and longitudinal analyses. However, the relationship was found only among low- and middle-developed countries. In the group of high-developed countries, the relationship between income inequality and life expectancy was non-significant, which contradicts the literature. Expectations on the relationship between a country’s wealth and health were confirmed: economic growth does contribute to improving population health, but this effect is weaker in more economically developed countries. These results imply that a decrease in a country’s income inequality parallel with an increase in its wealth can help to improve health in economically lesser-developed countries, but not in high-developed countries.     

Does Society Matter? Life Satisfaction in the Enlarged Europe

Life satisfaction is quite heterogeneously distributed across countries of the enlarged European Union. Previous research has shown how living conditions within individual countries, such as access to material and emotional resources, are important for personal well-being, but it has been less successful in explaining differences between countries. This article investigates whether it matters in which political and economic circumstances people live, as well as whether their particular perception of the quality of their societal environment plays a role. People are well aware that the institutional and cultural settings in which their lives are embedded create opportunities and limitations: within individual countries, perceptions of society influence life satisfaction outcomes irrespective of access to resources. However, their importance for well-being differs across Europe: perceptions of societies are highly decisive in countries that provide only a minimum of social security and in which the reliability of political institutions is poor. In rich and stable countries, the impact is weaker and private social support becomes more important. In addition to these country-specific weights of life satisfaction determinants, life satisfaction variations between countries can be explained to a large extent by taking into consideration the economic performance, the social security level, and the political culture in a country—all in all, general conditions that enable people to live a respectable life.     

Television and Postfeminist Housekeeping: No Time for Mother

This feminist, qualitative study sheds light on how young Arab women used cyberactivism to participate in the wave of political and social transformations widely known as the Arab Spring. It argues that these activists leveraged social media to enact new forms of leadership, agency, and empowerment, since these online platforms enabled them to express themselves freely and their voices to be heard by the rest of the world, particularly the global media. This resulted in a multidimensional personal, social, political, and communicative revolution. This study is based on in-depth, personal interviews with more than twenty young Arab women citizen journalists, bloggers, and activists from Arab countries that witnessed political upheaval.     

Why Is Fertility Lower in Wealthier Countries? The Role of Relaxed Fertility‐Selection

Lower fertility in wealthier countries can be explained in evolutionary terms by three key factors: (i) higher fertility in poorer countries—an evolutionary consequence of many generations of intense “fertility‐selection” favoring innate behaviors promoting high fertility, especially in males; (ii) the empowerment of women in wealthier countries that serves to reduce fertility directly—an evolutionary consequence of selection favoring an inherent preference for lower fertility in females, combined with release from the evolutionary effects of a long history of male control over female fertility; and (iii) offspring access in wealthy countries to public health care, welfare, and other social services, which combined with inherited wealth for offspring, virtually eliminates competition between families for the resource needs of offspring. The combined consequences of (ii) and (iii) mean that the fertility‐selection so prevalent in poor countries is relaxed in wealthy countries, thus allowing random genetic drift to produce an increased relative frequency of innate behaviors promoting low fertility and discontentment with high fertility.     

Comparing relative effects of education and economic resources on infant mortality in developing countries

Research on the social determinants of health has often considered education and economic resources as separate indicators of socioeconomic status. From a policy perspective, however, it is important to understand the relative strength of the effect of these social factors on health outcomes, particularly in developing countries. It is also important to examine not only the impact of education and economic resources of individuals, but also whether community and country levels of these factors affect health outcomes. This analysis uses multilevel regression models to assess the relative effects of education and economic resources on infant mortality at the family, community, and country level using data from demographic and Health Surveys in 43 low-and lower-middle-income countries. We find strong effects for both per capita gross national income and completed secondary education at the country level, but a greater impact of education within families and communities.     

Human capital,technological progress and the demographic transition*

We emphasize the importance to consider components of population growth — fertility and mortality ‐ separately, when modeling the mutual interaction between population and economic growth. Our model implies that two countries with the same population growth will not converge towards the same level of per capita income. The country with the lower level of birth and death rates will be better off in the long run. Introducing a spill over effect of average human capital on total productivity our model implies multiple equilibria as illustrated in Becker el al. (1990) and Strulik (1999). Besides the existence of a low and high level equilibrium ‐ as characterized by low and high levels of per capita output respectively ‐ we show the existence of multiple low level (Malthusian) equilibria. Initial conditions and parameters of technological progress and human capital investment determine whether an economy is capable to escape the low level equilibrium trap and to enjoy sustained economic growth.     

Population planning in Asia in the 1970s

Summary To what extent is family planning integrated with broader population planning in the countries of East Asia and South Asia? To what degree do these countries combine population planning with economic and social planning in their development plans? An attempt to answer these questions suggests that, despite variability from country to country in development goals and policy implementation, family planning has been largely separated from economic planning, and birth control programmes have often been substituted for intermediate and long-range population planning. Demographic factors have been treated as exogenous variables rather than as integral parts of social-economic-demographic plans. Such comprehensive planning is difficult for both technical and political reasons, but in any case is unlikely to be achieved so long as family planning and population planning continue to be confused.     

Determinants of mortality transition in developing countries before and after the Second World War: Some evidence from Cuba

Few studies provide an insight into what factors contributed to declines in the mortality rates of developing countries before the Second World War. In this paper, statistics on causes of death from Cuba, particularly Havana, are used to investigate what may have been some of the principal determinants of mortality decline in the developing world before the arrival of modern drugs and insecticides. Trends in cause-specific mortality are examined in the light of Cuba's social, economic, medical and public health history. The Cuban experience strongly suggests that in this country public health and sanitary reforms and nutritional improvements were largely responsible for initial declines in mortality throughout the first half of the twentieth century. One important finding is that the impact of these reforms and improved nutrition was greatly influenced by prevailing economic conditions. Periods of economic prosperity facilitated declines in mortality; but in times of adversity, the reverse occurred. It appears that during prosperous periods the maintenance and expansion of public health and sanitary facilities were made possible by increased public and private revenues, and that individuals had access to a more abundant diet. The severe economic crisis of the Great Depression had the opposite effect. With the appearance of sulphonamides in the late 1930s, antibiotics, and residual insecticides and other specific measures at the end of the Second World War, the relevance of economic conditions as a determinant of mortality decline diminished. Although this analysis points to the aforementioned trends, the Cuban experience also suggests that other factors enter into the process of declining mortality and that this phenomenon can only be explained as the result of the complex interplay of many forces.     

A quantitative study of the determinants of fertility behavior

Recent literature shows great interest in the quantitative study of the determinants of fertility. In a similar way, this study takes an across-country approach to specify independent variables, to separate economic from social and political variables, to make distinct comparisons of fertility responses in developed and underdeveloped countries, and to examine a wide range of hypotheses. The key is empirical analysis by separate regressions. This permits direct comparisons of countries at different levels of development, increases the probability of obtaining statistically significant regression coefficients, and standardizes the analysis for factors which vary with level of development.In this way, the authors determine positive and statistically significant relations between fertility and illiteracy, child mortality, proportion of agricultural population, proportion of nonfarm selfemployment, and overcrowded housing and show a negative significant relationship between fertility and communism. The study does not establish statistically significant relations, however, for population density, social mobility, substitutes for sexual intercourse, achievement motivation, protein in the diet, and religion.In general, the signs of the regression coefficients for the separate levels of development are the same as those for all countries combined. Any failure to attain statistical significance may be explained by small sample size and insufficient variation in the variables for separate levels of development.     

Social change,population policies,and fertility decline in Colombia and Venezuela

This paper takes a comparative case-study approach to examine the social and policy correlates of fertility decline. The analysis compares fertility behavior across a mature and young cohort of women in Colombia and Venezuela, two countries that experienced rapid demographic change under dissimilar socioeconomic and population policy conditions. Based on the distinction between birth-spacing and birth-stopping behavior the analysis tests several propositions derived from the adaptation and innovation explanations of fertility decline. Results show that fertility regulation at low parities was largely absent among mature women in both countries, representing an innovative behavior among younger women. The introduction of fertility control, however, was highly dependent on women's socioeconomic position, particularly their educational and occupational characteristics. The strong family planning programs in Colombia resulted in a more rapid extension of contraceptive use, particularly female sterilization, and stopping behavior after two children relative to Venezuela. Results highlight the diversity of conditions under which fertility can decline in developing countries and the importance of family planning and other policy initiatives to understanding the different pathways towards lower fertility.     

The Association between Health Workforce and Health Outcomes: A Cross-Country Econometric Study

This study investigates the strength and significance of the associations of health workforce with multiple health outcomes and COVID-19 excess deaths across countries, using the latest WHO dataset. Multiple log-linear regression analyses, counterfactual scenarios analyses, and Pearson correlation analyses were performed. The average density of health workforce and the average levels of health outcomes were strongly associated with country income level. A higher density of the health workforce, especially the aggregate density of skilled health workers and density of nursing and midwifery personnel, was significantly associated with better levels of several health outcomes, including maternal mortality ratio, under-five mortality rate, infant mortality rate, and neonatal mortality rate, and was significantly correlated with a lower level of COVID-19 excess deaths per 100 K people, though not robust to weighting by population. The low density of the health workforce, especially in relatively low-income countries, can be a major barrier to improving these health outcomes and achieving health-related SDGs; however, improving the density of the health workforce alone is far from enough to achieve these goals. Our study suggests that investment in health workforce should be an integral part of strategies to achieve health-related SDGs, and achieving non-health SDGs related to poverty alleviation and expansion of female education are complementary to achieving both sets of goals, especially for those low- and middle-income countries. In light of the strains on the health workforce during the current COVID-19 pandemic, more attention should be paid to health workforce to strengthen health system resilience and long-term improvement in health outcomes.

     

Diverging Trends in Female Old‐Age Mortality: The United States and the Netherlands versus France and Japan

In the most advanced countries, child mortality and adult mortality under age 65 years have fallen so low that further improvement in life expectancy relies almost completely on the decline of mortality at older ages. This phenomenon is particularly pronounced among women, who are far ahead of men in survival rates. Thus, to project the future of life expectancy, this study focuses on trends in female life expectancy at ages 65 and older. Four countries are selected for this analysis: the United States, Netherlands, France, and Japan. It is particularly interesting to understand why American and Dutch trends in female old‐age mortality have been diverging from those in France and Japan for two decades. It is shown here that most of the divergence derives from the fact that decline in cardiovascular mortality is more and more offset by increases in other causes of death in the United States and the Netherlands, while the other two countries are more successful in reducing mortality from all causes at increasingly older ages. This latter phenomenon could represent a new stage of the health transition.     

Globalization,Technology and Female Empowerment: Breaking Rights or Connecting Opportunities?

What are the main impacts of globalization and new information and communication technologies (ICTs) on female empowerment? The first part of this paper surveys two main disputing arguments concerning this issue through a review of the literature investigating the causal mechanisms that links both dimensions. One stream of academia highlights the negative impacts of globalization. It argues how market liberalization resulted in the weakening of welfare policies and the flexibilization of labor rights. Another stream of literature emphasizes the role played by international organizations, like the World Bank, as well as civil society movements, and highlights how globalization made it possible for women conquer an important place in their societies. This paper attempts to add to these analyses the assumption that ICTs provided differential opportunities to women. The second part of the paper verifies which arguments are most consistent with empirical data. In a panel analysis from 2000 to 2014 we focus on how globalization may have affected female economic empowerment (measured as women’s participation in the work force) and political representation (measured as women participation on the labor force and participation in national parliaments). We find evidence that access to ICTs may represent a crucial variable to enhance women’s empowerment.     

Multinational Corporations,Democracy and Child Mortality: A Quantitative,Cross-National Analysis of Developing Countries

This study presents quantitative, sociological models designed to account for cross-national variation in child mortality. We consider variables linked to five different theoretical perspectives that include the economic modernization, social modernization, political modernization, ecological-evolutionary, and dependency perspectives. The study is based on a cross-lagged effects regression analysis of a sample of 59 developing countries. Our preliminary analysis based on additive models replicates prior studies to the extent that we find that indicators linked to economic and social modernization have beneficial effects on child mortality. We also find support for hypotheses derived from the dependency perspective suggesting that multinational corporate penetration fosters higher levels of child mortality. Subsequent analysis incorporating interaction effects suggest that the level of political democracy conditions the effects of dependency relationships based upon multinational corporations. Transnational economic linkages associated with multinational corporations adversely affect child mortality more strongly at lower levels of democracy than at higher levels of democracy–that is intranational, political factors interact with the international, economic forces to affect child mortality. We conclude with some brief policy recommendations and suggestions for the direction of future research.