Birth delays skew developing world's fertility figures

This article explains that birth delays skew developing world's fertility figures. When successive groups of women who have delayed childbearing start having children, the rapid fertility decline stalls. Such change in the timing of childbearing skews the total fertility rate (TFR). Analysis of the tempo component of TFR trends in Taiwan suggests that tempo effects reduced its TFR by about 10% in the late 1970s and early 1990s and by about 19% in the late 1980s. In Colombia, on the basis of increasing mean maternal age at childbirth between the 1970s and the late 1980s, tempo distortions of the TFR during the most of the 1980s seem likely. Moreover, many developing countries are now experiencing rapid fertility declines that are in part attributable to tempo changes. These changes have accelerated past fertility transitions, but they also make these countries vulnerable to future stalls in fertility when the delays in childbearing end. Since fertility reductions caused by tempo effects lead to real declines in birth rates and hence in population growth, countries that wish to reduce birth rates can take actions that encourage women to delay marriage and the onset of childbearing.     

Birth and death in cities in the developing world

City dwellers in Sub-Saharan Africa have increased roughly 600% in the last 35 years. Throughout the developing world, cities have expanded at a rate that has far outpaced rural population growth. Extensive data document lower fertility and mortality rates in cities than in rural regions. But slums, shantytowns, and squatters' settlements proliferate in many large cities. Martin Brockerhoff studies the reproductive and health consequences of urban growth, with an emphasis on maternal and child health. Brockerhoff reports that child mortality rates in large cities are highest among children born to mothers who recently migrated from rural areas or who live in low-quality housing. Children born in large cities have about a 30% higher risk of dying before they reach the age of 5 than those born in smaller cities. Despite this, children born to migrant mothers who have lived in a city for about a year have much better survival chances than children born in rural areas to nonmigrant mothers and children born to migrant mothers before or shortly after migration. Migration in developing countries as a whole has saved millions of children's lives. The apparent benefits experienced in the 1980s may not occur in the future, as cities continue to grow and municipal governments confront an overwhelming need for housing, jobs, and services. Another benefit is that fertility rates in African cities fell by about 1 birth per woman as a result of female migration from villages to towns in the 1980s and early 1990s. There will be an increasing need for donors and governments to concentrate family planning, reproductive health, child survival, and social services in cities, particularly in Sub-Saharan Africa, because there child mortality decline has been unexpectedly slow, overall fertility decline is not yet apparent in most countries, and levels of migration to cities are anticipated to remain high.     

Urban Growth in Developing Countries: A Review of Projections and Predictions

Comparison of the United Nations' earliest and most recent projections to the year 2000 suggests that urban and city growth in developing regions has occurred much more slowly than was anticipated as recently as 1980. A modified “urban population explosion” in developing countries since the 1970s conforms to explanatory models of urban growth developed by economists around 1980. Trends in productivity and terms of trade, in particular, have been highly favorable to agriculture as compared to manufacturing, presumably slowing migration to urban centers. Increases in national population growth rates have produced less than commensurate increases in rates of city growth, further supporting an economic and migration-related explanation for unexpectedly slow recent urban growth. Despite the efforts of the United Nations to maintain reliable statistics on urban and city populations, urban population projections should be interpreted with caution because of inadequacies of the data on which they are based. Moreover, current projections that virtually all world population growth in the future will occur in urban areas of developing countries may be misconstrued, if the forces that have retarded urban growth in recent years persist.     

The World Fertility Survey: charting global childbearing

Interviewing some 350,000 women in 42 developing countries and 20 developed countries representing nearly 40% of the world's population, the World Fertility Survey (WFS) is in a unique position to document the historic 1970s slowdown in global population growth. This Bulletin describes efforts begun in 1972 to ensure high quality, internationally comparable, accessible data, the data's importance for policymakers, planners and researchers, and major findings available by early 1982 from directly assisted WFS surveys in 29 developing countries and contraceptive use data from WFS-type surveys in 16 developed countries. Marital fertility has declined in all developing regions except Africa but still averages from 4.6 children/woman in Latin America to 6.7 in Africa, while preferred family size ranges from 3.0 children in Turkey to 8.9 in Senegal--far above the average 2.2-2.5 children/woman needed to end developing countries' population growth in the long run. However, women ages 15-19 prefer nearly 2 children fewer than the oldest women ages 45-49; 3.8 vs. 5.7 on the average. Nearly 1/2 (48%) of married women surveyed in 27 countreis said they wanted no more children. Preventing all unwanted births would reduce birth rates up to 15 births/1000 population in these countries. Overall, 32% of married, fecund women in developing countries are using contraception compared to an average 72% in 16 developed countries. Education, literacy, and more available family planning services increase contraceptive use. Age at marriage is rising in Asia, but this factor alone has little effect on fertility. Infant mortality is higher in many developing countries than previously thought. Breastfeeding is an important restraint on fertility in most developing countries but is declining among more educated, employed, and urban women which could raise fertility if not compensated for by gains in contraceptive use.     

The environment as a determinant of child mortality among migrants in frontier areas of Pará and RondÔnia, Brazil, 1980

This article examines child mortality as an indicator of the quality of life among migrants living in Brazilian Amazonia in 1980. I focus on migrants in the frontier states of Pará and RondÔnia, which experienced rapid settlement during the 1970s. The key question here is the effect of settlement location on child mortality rates. While RondÔnia had lower ratios of population per public health establishments and personnel than Pará, RondÔnia nonetheless exhibited a higher malaria prevalence in 1980. I therefore attribute locational differences in child mortality to environmental factors important to malaria transmission rather than to health care infrastructure. The findings from multivariate regression analysis show that net of the effects of human capital, migration history and migrant living standards, settling in Pará rather than RondÔnia resulted in significantly lower rates of child mortality. These findings suggest that environmental factors coinciding with location of frontier settlement had important consequences for the living standards of migrants in the Brazilian Amazon.     

America's children: mixed prospects

The prospects of US children are uneven and uncertain. Today's youngsters are more apt to have fewer siblings, come from a broken home, have a working mother, and pass time as a "latchkey kid." More children are in child care than in the past and there has been a significant move toward center-based care. Increasingly, preschool-age children, particularly from relatively well-off families, are enrolled in prekindergarten educational settings. Declining family size and recent American prosperity have created material well-being for most of today's children. But the development of an underclass has also increased the number of children trapped in poverty. The stagnant wages of the "working poor" and the growing number of mother-only households have exacerbated income inequality among children from different family circumstances. The decline in educational achievement scores, which characterized the 1970s, has, for the moment at least, ended and the average school performance even improved slightly in the 1980s. In addition, more students, especially black students, completed high school in the 1980s. And the physical health of the average American child has improved dramatically since 1960. Most American children lead happy, healthy lives and several trends portend well for the future of most youngsters. But the picture is marred by the problematic future of the children of the underclass and the uncertain psychological impact of America's transformed family life.     

Neighbourhood Ethnic Density Effects on Behavioural and Cognitive Problems Among Young Racial/Ethnic Minority Children in the US and England: A Cross-National Comparison

Studies on adult racial/ethnic minority populations show that the increased concentration of racial/ethnic minorities in a neighbourhood—a so-called ethnic density effect—is associated with improved health of racial/ethnic minority residents when adjusting for area deprivation. However, this literature has focused mainly on adult populations, individual racial/ethnic groups, and single countries, with no studies focusing on children of different racial/ethnic groups or comparing across nations. This study aims to compare neighbourhood ethnic density effects on young children’s cognitive and behavioural outcomes in the US and in England. We used data from two nationally representative birth cohort studies, the US Early Childhood Longitudinal Study-Birth Cohort and the UK Millennium Cohort Study, to estimate the association between own ethnic density and behavioural and cognitive development at 5 years of age. Findings show substantial heterogeneity in ethnic density effects on child outcomes within and between the two countries, suggesting that ethnic density effects may reflect the wider social and economic context. We argue that researchers should take area deprivation into account when estimating ethnic density effects and when developing policy initiatives targeted at strengthening and improving the health and development of racial and ethnic minority children.     

Asian Americans: growth,change, and diversity

The 1980 US census counted 3.5 million Asian Americans, up from 1.4 million in 1970. Asian Americans made up just 1.5% of the total US population of 226.5 million as of April 1, 1980, but this was the 3rd largest racial or ethnic minority after blacks and Hispanics. Asians increased far more during the 1970s (141%) than blacks (17%) or Hispanics (39%). This Bulletin examines the characteristics of Asian Americans, how their numbers have grown, where they live, how different groups vary in age structure, childbearing, health, and longevity. It reports on the kinds of households Asian Americans form and how they fare with regard to education, occupation, and income. Asian Americans are now often perceived as the model minority. As a whole, they are better educated, occupy higher rungs on the occupational ladder, and earn more than the general US population and even white Americans. This Bulletin presents the 1st comprehensive look at many important facts about Asian Americans and how the groups differ. Special tabulations of data collected in the 1980 census are provided. The 1980 census data are the latest available to give a true picture at the national level of Asian Americans and the various groups among them. The Bulletin examines the current numbers of Asian Americans and how this population is defined. The major Asian American groups are Chinese (21%), Filipinos (20%), Japanese (15%), Vietnamese (21%), Koreans (11%), and Asian Indians (10%). Except for the latest-arrived Vietnamese, the fertility of the 6 groups is lower than the white average. The following areas are also discussed: mortality and health; families and households; education; Asian youth; employment; income and poverty; and future prospects.     

Book reviews

Fertility has declined to below replacement levels in many of the modern industrialized countries during the last three decades. This decline has been explained by various modern socio-economic characteristics, such as the change in women's status, their increased participation in non-familial activities, modern consumption patterns, and increasing costs of raising ‘quality’ children. The Jewish population of Israel is a modern society with such characteristics. Yet, total fertility in Israel during the 1980s was at least one child higher than in most European countries. It is shown that social heterogeneity makes this an over-simplified comparison. Indeed, it is the high fertility of the orthodox population among the two major ethnic groups, combined with the decline towards below-replacement fertility of the non-orthodox, which produces the high mean fertility of the entire population. While during the 1950s and 1960s the major explanations of fertility variation were concerned with ethnicity and socio-economic status, these were replaced by religiosity in the 1970s and the 1980s.     

The effects of child health on marital status and family structure

The purpose of this paper is to provide evidence on the effect of child health on marital stability and family structure in an economic framework. We use the 1988 National Health Interview Survey's Child Health Supplement, with a sample of about 9,000 families, to test whether having an unhealthy child decreases the mother's chance of being married and whether it increases her chance of living in an extended family. Using two different measures of child health, we find that having an unhealthy child decreases the mother's likelihood of being married. Our results imply that children in poor health are more likely to face obstacles beyond their illness because they also are more likely to suffer the consequences of poverty and the poor schooling outcomes that result from being raised in a female-headed household. The only mitigating factor is that unhealthy white children are more likely than their healthy counterparts to be living in an extended family.     

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.     

An exploration of China's mortality decline under Mao: A provincial analysis, 1950–80

Between 1950 and 1980, China experienced the most rapid sustained increase in life expectancy of any population in documented global history. We know of no study that has quantitatively assessed the relative importance of the various explanations proposed for this gain in survival. We have created and analysed a new, province-level panel data set spanning the decades between 1950 and 1980 by combining historical information from China's public health archives, official provincial yearbooks, and infant and child mortality records contained in the 1988 National Survey of Fertility and Contraception. Although exploratory, our results suggest that gains in school enrolment and public health campaigns together are associated with 55–70 per cent of China's dramatic reductions in infant and under-5 mortality during our study period. These results underscore the importance of non-medical determinants of population health, and suggest that, in some circumstances, general education of the population may amplify the effectiveness of public health interventions.

Supplementary material for this article (Babiarz et al. 2014, Suppl.) is available at: http://dx.doi.org/10.1080/00324728.2014.972432     

An analysis of the fertility transition in developing countries]

Most developing countries are in the demographic stage of early mortality, high birth rates and high rates of natural population increase. A characteristic of developing countries is that after World War ii, particularly since the 1960s fertility rates are on the decline, even though they still remain high. The fertility rate of developed countries fell from a 1950 rate of 22.9/1000 to 15/1000 in 1982, a decrease of 34.5%, whereas the fertility rate of developing countries hovered around 43/1000 between 1930-1950, 40.6/1000 during the 1960s and 33/1000 in 1982. Between 1950 and 1982 there was a decrease of 24.8%. But the main reason for this decrease is the decline in the last 20 years of the fertility rates of China and India, whose rates fell 34.9% from 1960-1980. Changes in fertility rates are influenced by the age structure of a country, as seen in the changing age structure of developing countries from 1960-80. For example, an increase in fertility rates was 1 consequence of an increase in the number of fertile women aged 15-45 from 42.6% in 1960 to 44.4% in 1980. Nevertheless, there exists some sort of birth control, whether conscious or subconscious, because the number of births per fertile woman is 3-4 fewer than the 14-15 children a woman can theoretically bear. The reason for changes in fertility rates in developing countries can be traced to marriage and family customs, and even more important, to social and economic factors. For example, Asian, African and Latin American cultures tend to support early marriages. When the fertility rates of developed and developing countries are looked at for a comparable period, then the rate of decrease for developing countries is slower than developed countries. But, if the comparison is made for a transitional period (i.e., industrialization), then the rate of decrease for developing countries is faster than for developed countries. Currently there are 25 developing countries that have attained a fertility rate of 25/1000 or lower, and 52 developing countries with a rate of 35/1000.     

Using survey data to assess neonatal tetanus mortality levels and trends in developing countries

Demographic and health surveys are a useful source of information on the levels and trends of neonatal mortality in developing countries. Such surveys provide data on mortality occurring at 4–14 days of life, which is a sensitive indicator of neonatal tetanus mortality. We analyze birth history data from 37 national surveys in developing countries to assess the quality of neonatal mortality data and to estimate levels and trends in mortality occurring at 4–14 days. It is shown that mortality at 4-14 days has declined considerably during the last decade in most developing countries, concomitant with development and expansion of programs to reduce neonatal tetanus. These declines show that reductions in neonatal tetanus mortality probably have been an important contributor to the decline of neonatal and infant mortality during the 1980s.     

Population studies of mortality

Population Studies has become the principal outlet for demographic research on mortality. Many of the advances in the measurement of mortality in data-poor countries were reported in its pages. It has also published most of the influential articles which attempted to make a broad-scale assessment of the sources of mortality change. These include special attention to developments in England and Wales and Sri Lanka. Capitalizing on the widespread availability of demographic surveys, articles in the 1980s featured careful analyses of the demographic correlates of child mortality. Such studies have passed the point of diminishing returns, and declines in child mortality have focused increased attention on conditions among adults. Unfortunately, demography has not developed the means for measuring and analysing adult mortality in underdeveloped countries that are equivalent in their power to methods for studying child mortality.     

World food resources and population: the narrowing margin

This bulletin examines the narrowing margin between global food production and population growth. Between 1950 and 1971, world grain production nearly doubled and per capita production increased 31%. During the 1970s, gains in output barely kept pace with population growth, consumption/person declined in sub-Saharan Africa and parts of Asia, food prices were volatile, and over 100 food deficit countries came to depend on the exportable surplus of North America, now the only major grain exporting region. The world fish catch levelled off in the early 1970s and beef production, still dependent mainly on grassland grazing, levelled off in the mid-1970s. With little new land left to plow, satisfying increased food demand now depends on sharp increases in yields on existing crop land. Worldwide, this effort is hampered by loss of topsoil and irrigated land, conversion of cropland to nonfarm uses, rising energy costs, inefficient agrarian structures, particularly in the Soviet Union, the falling yield response to chemical fertilizers in agriculturally advanced countries, and the emerging competition between food and agriculturally based energy crops. Green Revolution successes in some developing countries deomonstrate that, given the right inputs, 3rd world farmers can increase crop yields dramatically. Feeding the world's poor also requires more equitable income and food distribution, including a reduction in the proportion of grain and fish consumed indirectly as livestock products by the affluent. Most important in meeting food needs on a finite planet is braking population growth. The author concludes that every effort should be made to stabilize world production at abour 6 billion by 2020, rather than 10.5 billion by 2110, as is now projected by the UN.     

The End of the Fertility Transition in the Developed World

By the late 1990s the average period total fertility rate in the developed world had declined to 1.6, a level substantially lower than projected in the 1970s and 1980s. This article examines recent trends and patterns in fertility in the developed world with particular emphasis on the effects and implications of changes in the timing of childbearing. The main objective is to demonstrate that while fertility in these countries is indeed low, women's childbearing levels are not as low as period measures such as the total fertility rate suggest. To obtain a full understanding of the various dimensions of fertility change. several indicators are examined, including period and cohort fertility by birth order and childbearing preferences. An analysis of these indicators demonstrates that period fertility measures in many developed countries are temporarily depressed by a rise in the mean age at childbearing. The distortion of the TFR is as great as 0.4 births per woman in Italy and Spain. These effects have been present in many developed countries since the 1970s and could continue for years into the future. But tempo effects are temporary, and once the postponement of childbearing ends—as it eventually must—the corresponding fertility‐depressing effect stops, thus putting upward pressure on period fertility. Countries with very low fertility and substantial tempo effects may well experience rises in fertility in the near future if the timing of childbearing stabilizes. Even if this happens, however, it seems unlikely that fertility will rebound to the replacement level.     

Maternal education and child health: Is there a strong causal relationship?

Using data from the first round of Demographic and Health Surveys for 22 developing countries, we examine the effect of maternal education on three markers of child health: infant mortality, children s height-for-age, and immunization status. In contrast to other studies, we argue that although there is a strong correlation between maternal education and markers of child health, a causal relationship is far from established. Education acts as a proxy for the socioeconomic status of the family and geographic area of residence. Introducing controls for husband’s education and access to piped water and toilet attenuate the impact of maternal education on infant mortality and children’s height-for-age. This effect is further reduced by controlling for area of residence through the use of fixed-effects models. In the final model. maternal education has a statistically significant impact on infant mortality and height-forage in only a handful of countries. In contrast. maternal education remains statistically significant for chidren’s immunization status in about one-half of the countries even after individual-level and community-level controls are introduced.     

Population Studies of Mortality

Population Studies has become the principal outlet for demographic research on mortality. Many of the advances in the measurement of mortality in data-poor countries were reported in its pages. It has also published most of the influential articles which attempted to make a broad-scale assessment of the sources of mortality change. These include special attention to developments in England and Wales and Sri Lanka. Capitalizing on the widespread availability of demographic surveys, articles in the 1980s featured careful analyses of the demographic correlates of child mortality. Such studies have passed the point of diminishing returns, and declines in child mortality have focused increased attention on conditions among adults. Unfortunately, demography has not developed the means for measuring and analysing adult mortality in underdeveloped countries that are equivalent in their power to methods for studying child mortality.     

Is the Relationship between Socioeconomic Status and Health Stronger for Older Children in Developing Countries?

Recent research on the relationship between child health and income in developed countries reveals a positive gradient that is more pronounced for older children, suggesting that the impact of income upon health accumulates. This article examines whether the same is true in a developing country. Using data from the Indonesian Family Life Survey on children aged 0 to 14 years, we find that although low income adversely affects health, its impact does not differ by age. This finding is robust to the use of both subjective and objective health measures, controlling for selective mortality, the use of alternative measures of households’ resources, and the inclusion of indicators of health at birth and parental health. One explanation for the constancy of the health-income relationship that we explore is the dominant role played by acute illness in determining the general health status of children in a developing-country context compared with the more central role played by chronic conditions in developed countries.