Mortality analysis of persons with disabilities in Argentina by age,sex and duration of benefit, 2015–16

This article describes the differential mortality of Argentina’s disability pension beneficiaries during the 2015–16 period, based on National Social Security Administration (Administración Nacional de la Seguridad Social – ANSES) payment records. It compares data for those with an assessed disability with overall population data, as well as with available international data (from Canada, Chile, Mexico, and the United States of America). In addition to breaking down mortality rates for people with disabilities by age and sex, it also factors in duration of benefit, establishing an inverse correlation between benefit duration and mortality.     

Children’s educational attainment,occupation, and income and their parents’ mortality

Using data from Finland, this paper contributes to a small but growing body of research regarding adult children's education, occupation, and income and their parents' mortality at ages 50+ in 1970–2007. Higher levels of children's education are associated with 30–36 per cent lower parental mortality at ages 50–75, controlling for parents' education, occupation, and income. This association is fully mediated by children's occupation and income, except for cancer mortality. Having at least one child educated in healthcare is associated with 11–16 per cent lower all-cause mortality at ages 50–75, an association that is largely driven by mortality from cardiovascular diseases. Children's higher white-collar occupation and higher income is associated with 39–46 per cent lower mortality in the fully adjusted models. At ages 75+, these associations are much smaller overall and children's schooling remains more strongly associated with mortality than children's occupation or income.     

New evidence about effects of reproductive variables on child mortality in sub-Saharan Africa

There is still considerable uncertainty about how reproductive factors affect child mortality. This study, based on Demographic and Health Survey data from 28 countries in sub-Saharan Africa, shows that mortality is highest for firstborn children with very young mothers. Other children with young mothers, or of high birth order, also experience high mortality. Net of maternal age and birth order, a short preceding birth interval is associated with above average mortality. These patterns change, however, if time-invariant unobserved mother-level characteristics of importance for both mortality and fertility are controlled for in a multilevel–multiprocess model. Most importantly, there are smaller advantages associated with longer birth intervals and being older at first birth. The implications of alternative reproductive ‘strategies’ are discussed, taking into account that if the mother is older at birth, the child will also be born in a later calendar year, when mortality may be lower.     

Parental age and offspring mortality: Negative effects of reproductive ageing may be counterbalanced by secular increases in longevity

As parental ages at birth continue to rise, concerns about the effects of fertility postponement on offspring are increasing. Due to reproductive ageing, advanced parental ages have been associated with negative health outcomes for offspring, including decreased longevity. The literature, however, has neglected to examine the potential benefits of being born at a later date. Secular declines in mortality mean that later birth cohorts are living longer. We analyse mortality over ages 30–74 among 1.9 million Swedish men and women born 1938–60, and use a sibling comparison design that accounts for all time-invariant factors shared by the siblings. When incorporating cohort improvements in mortality, we find that those born to older mothers do not suffer any significant mortality disadvantage, and that those born to older fathers have lower mortality. These findings are likely to be explained by secular declines in mortality counterbalancing the negative effects of reproductive ageing.     

Latin American convergence and divergence towards the mortality profiles of developed countries

It is uncertain whether Latin America and Caribbean (LAC) countries are approaching a single mortality regime. Over the last three decades, LAC has experienced major public health interventions and the highest number of homicides in the world. However, these interventions and homicide rates are not evenly shared across countries. This study documents trends in life expectancy and lifespan variability for 20 LAC countries, 2000–14. By extending a previous method, we decompose differences in lifespan variability between LAC and a developed world benchmark into cause-specific effects. For both sexes, dispersion of amenable diseases through the age span makes the largest contribution to the gap between LAC and the benchmark. Additionally, for males, the concentration of homicides, accidents, and suicides in mid-life further impedes mortality convergence. Great disparity exists in the region: while some countries are rapidly approaching the developed regime, others remain far behind and suffer a clear disadvantage in population health.     

Intrapartum cardiotocograph monitoring and perinatal outcomes for women at risk: Literature review

ProblemCaesarean section rates have risen in high-income countries. One of the potential drivers for this is the widespread use of CTG monitoring.BackgroundIntrapartum cardiotocograph monitoring is considered to be indicated for women at risk for poor perinatal outcome.AimThis systematic literature review with meta-analysis examined randomised controlled trials and non-experimental research to determine whether cardiotocograph monitoring rather than intermittent auscultation during labour was associated with changes in perinatal mortality or cerebral palsy rates for high-risk women.MethodsA systematic search for research published up to 2019 was conducted using PubMed, CINAHL, Cochrane, and Web of Science databases. Non-experimental and randomised controlled trial research in populations of women at risk which compared intrapartum cardiotocography with intermittent auscultation and reported on stillbirth, neonatal mortality, perinatal mortality and/or cerebral palsy were included. Relative risks were calculated from extracted data, and meta-analysis of randomised controlled trials was undertaken.FindingsNine randomised controlled trials and 26 non-experimental studies were included. Meta-analysis of pooled data from RCTs in mixed- and high-risk populations found no statistically significant differences in perinatal mortality rates. The majority of non-experimental research was at critical risk of bias and should not be relied on to inform practice. Cardiotocograph monitoring during preterm labour was associated with a higher incidence of cerebral palsy.DiscussionResearch evidence failed to demonstrate perinatal benefits from intrapartum cardiotocograph monitoring for women at risk for poor perinatal outcome.ConclusionThere is an urgent need for well-designed research to consider whether intrapartum cardiotocograph monitoring provides benefits.     

At the intersection of idealized youth and marginalized almost-adulthood: how girls negotiate young motherhood in London,Ontario

This article discusses how young mothers in London, a mid-size city in Canada, utilize a drop-in centre service while attending an alternative programme to acquire secondary school credits. The central arguments made here are informed by key concepts in the field of girlhood studies. With its attention to the interconnections between gender, age, and generation as well as other aspects of social identity, girlhood studies provides crucial insight into the lived experiences of young mothers who straddle the space between girlhood and adulthood. We interpret the experiences of the young mothers who participated in this study in light of shifting meanings and expectations of girls and girlhood in the neoliberal era. Drawing on the concept of the ideal neoliberal girl subject embodied in the ‘can do’ and ‘at risk’ girl, this paper highlights the tensions in accessing a drop-in centre, which functions as both a site of security and surveillance, for a group of young mothers receiving social services. The findings revealed how girls who are mothers struggle to live in the present to assert a legitimate maternal identity even as they are prepared for the future through neoliberal public policies and other disciplinary practices.     

Education,cognitive ability,and cause-specific mortality: A structural approach

Education is negatively associated with most major causes of death. Prior work ignores the premise that cause-specific hazards are interdependent and that both education and mortality depend on cognitive ability. We analyse Swedish men aged 18–63, focusing on months lost due to specific causes—which solves the interdependence problem—and use a structural model that accounts for confounding due to cognitive ability. In a standard Cox model controlling for Intelligence Quotient, improving education is associated with large decreases in mortality for major causes of death. In the structural model, improving education is associated with a small decrease in months lost for most causes and education levels. Among the least educated, however, improving education strongly reduces the months lost, mainly those lost from external causes, such as accidents and suicide. Results suggest that conventional analysis of education and mortality may be biased, even if accounting for observed cognition.