The Importance of Spousal Education for the Self-Rated Health of Married Adults in the United States

Education’s benefits for individuals’ health are well documented, but it is unclear whether health benefits also accrue from the education of others in important social relationships. We assess the extent to which individuals’ own education combines with their spouse’s education to influence self-rated health among married persons aged 25 and older in the United States (N = 337,846) with pooled data from the 1997–2010 National Health Interview Survey. Results from age- and gender-specific models revealed that own education and spouse’s education each share an inverse association with fair/poor self-rated health among married men and women. Controlling for spousal education substantially attenuated the association between individuals’ own education and fair/poor self-rated health and the reduction in this association was greater for married women than married men. The results also suggest that husbands’ education is more important for wives’ self-rated health than vice versa. Spousal education particularly was important for married women aged 45–64. Overall, the results imply that individuals’ own education and spousal education combine to influence self-rated health within marriage. The results highlight the importance of shared resources in marriage for producing health.     

Survey sheds new light on marriage and sexuality in the Philippines

The Young Adults Fertility and Sexuality Study (YAFS-II) was conducted in 1994 by interviewing 10,879 men and women aged 15-24 years in households on dating, marriage, and onset of sexual activity in the Philippines. In addition, screening data were collected on all households visited and on the 959 sampled local communities. Direct questions on premarital sex revealed that at least 52% of married women had sex before marriage. Among married respondents, 57% of men and 51% of women reported having had sex with their spouse before they were married. Only 3% of the women had additional premarital partners vs. 37% of the men. Questions on premarital sex and social patterns showed that about 20% of the single women and 28% of the single men had been in a serious relationship by the time they were 17. By age 20, 44% of the single women and 63% of the single men had been in a serious relationship, while the respective figures by age 24 were 60% and 68%. Altogether 24% of the women and 10% of the men described themselves as married. 34% of all women who either eloped or lived with their spouses had been married in church by the time of the survey, 23% had had civil ceremonies, and 41% designated their marital status as cohabitation. With regard to the risk of HIV/AIDS and other sexually transmitted diseases, 25% of the 24-year old men who never had a girlfriend reported sexual experience and 22% of those still single at age 24 reported that they had visited a commercial sex worker. Marital status was not the best basis for providing family planning services, and the provision of reproductive health services to young people living in consensual union would reduce accidental pregnancy.     

青年人口迁出对农村婚姻的影响

我国当前农村青年外流对地区婚姻问题和自身婚姻的影响主要表现在三个方面:一是对自身婚配的影响,一些大龄未婚农村外流青年择偶难;二是贫困地区女青年婚姻迁移导致当地男性青年成婚困难;三是农村已婚青年流动对婚姻稳定性产生影响。针对农村青年外流带来的婚姻问题,要关心大龄未婚打工仔和打工女的婚姻问题;要关注农村单亲家庭中的孩子;要关注婚姻迁移导致的贫困农村地区“弱势累积”问题。     

Who uses reproductive health services in the Philippines (and who doesn't)?

Data from the 1993 National Demographic Survey and the Safe Motherhood Survey have filled gaps in knowledge about the accessibility and use of reproductive health services in the Philippines. Analysis of the data by the East-West Center's Program on Population has revealed that the number of women using family planning (FP) and maternal health services has risen to 40% in 1993 from 17% in 1973. Modest gains were also seen in the past five years despite disruption to program efforts. Prenatal care showed the greatest maternal care coverage rate increase, but 70% of births occurred at home, with only 51% attended by a trained person, and only 32% of postpartum women received care. Adolescents and women who are over age 40, uneducated, Muslim, and/or live in a rural setting have the most unmet need. In addition, less than half of the women reporting symptoms of a sexually transmitted disease sought treatment from a trained practitioner. Most women use public sector services, including 71% of those using modern contraceptives. While trained midwives provided 58% of prenatal care, traditional birth attendants delivered 52% of all births, and a high incidence of maternal mortality persists (209/100,000). Recommendations arising from this analysis include 1) improving prenatal and delivery care, 2) strengthening postpartum FP services, 3) expanding the program to reach more women, 4) extending the range of reproductive health services offered, 5) integrating traditional practitioners into the reproductive health system, and 6) balancing cost and service variations between the public and private sectors.     

2000年以来人口学研究国际前沿解读——基于CiteSpace对Web of Science数据库的文献计量

为探究国际人口学学科的文献特征与趋势,本文运用科学计量学的前沿研究方法,基于Web of Science数据库(2000—2018年)收录的人口学研究领域的文献数据,应用CiteSpace软件,就被引文献和主题词进行实证分析。结果表明,人口转变、国际移民、低生育率与生育行为是21世纪以来国际人口学最核心的学术研究分支;受教育程度、已婚女性、人口特征、年轻女性、年轻人、生殖健康等主题词是该领域的研究热点,具体来看,“代际问题”、“缓慢衰老”、“结婚与同居”、“生育意图和生育行为”、“移民融合”以及“女性雇佣和生育”等主题是近年来国际人口学界研究的前沿方向。     

Effects of education on reproductive behavior: lessons from Pakistan

Evidence from the Pakistan Demographic and Health Survey 1990/91 (PDHS) and a 1987 study by Zeba A. Sathar and Karen Oppenheim on women's fertility in Karachi and the impact of educational status, corroborates the correlation between improved education for women and fertility decline. PDHS revealed that current fertility is 5.4 children/ever married woman by the end of the reproductive period. 12% currently use a contraceptive method compared to 49% in India, 40% in Bangladesh, and 62% in Sri Lanka. The social environment of high illiteracy, low educational attainment, poverty, high infant and child and maternal mortality, son preference, and low status of women leads to high fertility. Fertility rates vary by educational status; i.e., women with no formal education have 2 more children than women with at least some secondary education. Education also affects infant and child mortality and morbidity. Literacy is 31% for women and 43% for men. 30% of all males and 20% of all females have attended primary school. Although most women know at least 1 contraceptive method, it is the urban educated woman who is twice as likely to know a source of supply and 5 times more likely to be a user. The Karachi study found that lower fertility among better educated urban women is an unintended consequence of women's schooling and deliberate effort to limit the number of children they have. Education-related fertility differentials could not be explained by the length of time women are at risk of becoming pregnant (late marriage age). Fertility limitation may be motivated by the predominant involvement in the formal work force and higher income. The policy implications are the increasing female schooling is a good investment in lowering fertility; broader improvements also need to be made in economic opportunities for women, particularly in the formal sector. Other needs are for increasing availability and accessibility of contraceptive and family planning services and increasing availability and accessibility of contraceptive and family planning services and increasing knowledge of contraception. The investment will impact development and demography and is an adjunct to child health an survival.     

Combining vertical service with horizontal service to promote family planning]

How Bazhong County of Sechuan Province, China, carries out family planning through a combination of what are termed vertical and horizontal services is described. Vertical service refers to assistance such as premarital education, prenatal hygiene, child health care, and family planning, while horizontal service refers to household assistance for married women. Premarital education is designed to help young people acquire sufficent knowledge about family planning, hygiene, and eugenics, and stresses the disadvantages involved in marriages between close relatives. Prenatal hygiene provides safe and convenient medical accommodations for delivery of the child as well as maternal care. Child health services assure that the best facilities are to be made available for physical examinations, vaccinations, and medical treatment. The family planning program involves comprehensive measures such as distribution of contraceptives and safe sterilization. In addition, the county provides medical assistance for couples unable to have children. Horizontal service providing household assistance for married women promotes scientific farming (e.g., how to use fertilizer), helps people increase their income by teaching them skills, and provides social services to improve life style and education. These vertical and horizontal services have brought about substantial improvements in the standard of living, family harmony, and population control.     

<Emphasis Type="Bold">Women’s Progress for Men’s Gain? Gender-Specific Changes in the Return to Education as Measured by Family Standard of Living, 1990 to 2009–2011</Emphasis>

This study investigates gender-specific changes in the total financial return to education among persons of prime working ages (35–44 years) using U.S. Census data from 1990 and 2000, and the 2009–2011 American Community Survey. We define the total financial return to education as the family standard of living as measured by family income adjusted for family size. Our results indicate that women experienced significant progress in educational attainment and labor market outcomes over this time period. Ironically, married women’s progress in education and personal earnings has led to greater improvement in the family standard of living for married men than for women themselves. Gender-specific changes in assortative mating are mostly responsible for this paradoxical trend. Because the number of highly educated women exceeds the number of highly educated men in the marriage market, the likelihood of educational marrying up has substantially increased for men over time while women’s likelihood has decreased. Sensitivity analyses show that the greater improvement in the family standard of living for men than for women is not limited to prime working-age persons but is also evident in the general population. Consequently, women’s return to education through marriage declined while men’s financial gain through marriage increased considerably.     

Sex role effects on female response to illness

This study of sex differentials in health behavior and health service choice among the Korean rural population is based on 1421 individuals aged 14 and over who received medical care at hospitals or clinics, pharmacies, a government health center, or through Chinese medical practices. Logistic regression is used to explore the relationship between the dichotomous variable, the log of the odds of the probability of using formal health care services, and the independent variables (sex, age, education, marital status, perceived health status, perceived medical care need, illness days in bed, limited activity days, total sick days, date of illness). A profile of rural Korea shows for all ages fewer adult females than males, but more females 65 years who have been previously married, which suggests higher male mortality rates in the middle ages. Health service usage is higher among the elderly. Higher level of education is associated with greater use of formal medical service. The results of binomial and multinomial analysis indicate that women receive less medical care from the formal system in spite of complaints and restricted activity, and least of all from health centers. It is suggested that personnel at health centers may reduce the desire for care because of incompatible social backgrounds (young single males who are inexperienced, city bred, and completing required service). A woman must carefully choose from the formal system and may more easily use the informal system of pharmacies and Chinese medicine practice. The responses to self rated health showed many differences; males report better health than females and older people consider themselves more unhealthy than young or adult groups. Those with lower educational attainment also consider themselves unhealthy, and indicate greater need for health services. Females and older age groups also stated their need for professional medical care for an illness within 15 days prior to the survey. The mean number of bed days followed a similar pattern as the perceived need and self rated health. However, women had a lower volume of bed days than men in contrast to typical Western trends. Females reported more restricted days of activity. The old age group had the same restricted days but more bed days than the adult group. Reported chronic diseases were greater for lower socioeconomic groups.     

The marriage of mentally handicapped people and family planning services for them in Shanghai

This brief article discusses findings from a study by the Shanghai Population Information Center on marriage, fertility, and family planning among mentally handicapped adults in Shanghai, China, and population dynamics. The sample included 184 mentally handicapped persons aged 20-49 years (79 men and 116 women). 47 people had mild, 92 had moderate, and 45 had severe mental deficiencies. The mean age was 33 years. About 29% were married or ever married. 49 were married or ever married women. 6 spouses were mentally deficient. About 70% of the married or ever married had children. 43 had ever used contraception. The most commonly used method was the IUD. Several people had the approval of family members and were sterilized. Only 3 women were prevented from use of contraceptive services by family. 38% of the unmarried women's parents or relatives wanted their mentally deficient family members to be married before old age. 48% discouraged marriage because of the mental deficiency.     

广东流动人口性行为及其影响因素

本研究从不同层面、不同角度调查流动人口性与生殖健康的知识、态度和行为的现状．分析影响该人群性和生殖健康水平以及他们在获取生殖健康服务方面所遇到的障碍。研究提示流动人口婚前性行为相当活跃,婚外性行为相对自由,性满意度较高,性行为的影响因素多,存在一定程度的强迫性行和性压抑。     

Women are key players in the economies of East and Southeast Asia

In 1996, the East-West Center's Program on Population investigated the links between population change and economic growth in Japan, South Korea, Taiwan, Singapore, Thailand, and Indonesia. This document discusses the findings pertaining to women's changing marriage and childbearing patterns, education attainment, and labor force participation as well as changes in family life. In eastern and southeastern Asia, women are delaying marriage and having fewer children as a result of their overwhelming acceptance of modern contraception. Concurrently, women's secondary school enrollment has increased dramatically since 1960, and women have accounted for steadily increasing proportions of total labor force growth. Economic development has led to fewer women employed in agriculture and more in clerical positions. Women continue to be marginalized in low-paying manufacturing jobs and to lose these jobs more frequently than do men. Women's labor force participation continues to be dependent upon their child care responsibilities, but women are beginning to combine both activities with the help of live-in grandparents. Women have made an important contribution to economic growth in Asia. Policies should address job discrimination against married women, wage discrimination, the problems faced by young women who leave home for employment in the manufacturing and service sectors, and the lack of child care facilities.     

The Gendered Double Standard of Aging in US Marriage Markets

Using data on marriages collected in most US states between 1970 and 1988, we show that the older men are when they marry, the more years senior to their brides they are, whether it is a first or higher‐order marriage. While older men with more education marry down in age slightly more than less educated older men, the pattern of men marrying further down if they marry later holds strongly for all education groups. We consider several possible explanations for the tendency of men to marry further down in age if they are older at marriage. While we have no direct measure of physical attractiveness, we argue that the most compelling interpretation is that men, more than women, evaluate potential spouses on the basis of appearance. Because the prevailing standard of beauty favors young women, the older men are when they marry, the less they find women their own age attractive relative to younger women, leading them to marry further down in age if they are older at marriage. The consequence for women of men's preference for youth is more often that they remain unmarried than that they end up married to much older or less educated men.     

Son preference, use of maternal health care, and infant mortality in rural China, 1989-2000

This study assesses the effects of socio-economic conditions and the interaction between son preference and China's one-child family planning policy on the use of maternal health care services and their effects on infant mortality in rural China, using nationally representative data from the 2001 National Family Planning and Reproductive Health Survey. The results show that while the use of maternal health care services has continued to increase over time, large gaps still exist in the use of these services and in infant survival by mother's education, community income, and parity. Further improvements in the reproductive health of all women and in infant survival will require effective reduction of the obstacles to the use of maternal health care among those women in rural China who are less educated, poor, and of higher parity.     

Marital Status and Reproductive Performance in Kipsigis Women: Re-evaluating the Polygyny-Fertility Hypothesis

The effects of marital status on fertility and offspring survivorship are examined with data on six marriage cohorts of Kipsigis women, agro-pastoralists of south western Kenya. Neither marriage order, nor the average number of co-wives married to a man during a woman's reproductive years, is associated with completed family size, nor with any of the components of reproductive performance. The mechanisms whereby polygyny might potentially lower the reproductive performance of polygynously married women in the Kipsigis and other populations are discussed in some detail, with particular reference to resource shortages, sexual and economic favouritism, the observance of post partum taboos, disease, husband's age, co-wife co-operation, education, sterility, and age at menarche and marriage.     

Understanding educational sequences and their consequences on the timing of marriage

"This study examines educational sequences and their consequences on the timing of marriage using the life history data from the 1983 Korean National Migration Survey....I find that the educational process in Korea becomes stabilized and institutionalized during middle and high schooling as middle and high school education becomes a mass experience. However, both men and women are likely to undergo a disorderly sequence during the transition period from high school to college due to the very fierce college entrance examination. Men are also likely to experience a disorderly sequence before or after military service. Both men and women who experience an interruption in their schooling after graduation from high school have lesser odds of getting married than those who keep their educational process orderly."     

Opportunities to Meet: Occupational Education and Marriage Formation in Young Adulthood

Explanations for the positive association between education and marriage in the United States emphasize the economic and cultural attractiveness of having a college degree in the marriage market. However, educational attainment may also shape the opportunities that men and women have to meet other college-educated partners, particularly in contexts with significant educational stratification. We focus on work—and the social ties that it supports—and consider whether the educational composition of occupations is important for marriage formation during young adulthood. Employing discrete-time event-history methods using the NLSY-97, we find that occupational education is positively associated with transitioning to first marriage and with marrying a college-educated partner for women but not for men. Moreover, occupational education is positively associated with marriage over cohabitation as a first union for women. Our findings call attention to an unexplored, indirect link between education and marriage that, we argue, offers insight into why college-educated women in the United States enjoy better marriage prospects.     

Differences in the health care needs and service utilization of women in nursing homes: comparison by race/ethnicity

The purpose of this study is to describe health care needs and service utilization among institutionalized women of color. The sample was dichotomized by length of stay to determine how African American, Native American, Asian/Pacific Islander, and Hispanic/Latino women differed at two points in time. Data for this study came from the Current Resident Survey of the 1999 National Nursing Home Survey. The data were analyzed using GLM. The findings suggest that Native American women are the most impaired and Asian/Pacific Islander women are the least impaired. Additionally, very few women received mental health services despite their extensive need.     

The continuation of education after marriage among women in the United States: 1970

Data from the 1970 National Fertility Study are used to assess the extent and determinants of post-nuptial education among women in the United States. Over one-fifth of all women have attended high school or college since marriage; over one-third either have returned to school or anticipate returning to an academic institution sometime in the future. This phenomenon is apparently increasing since women married less than five years have already attended school in as great a proportion as women married 15-19 years. Examination of differentials reveals for both blacks and whites that post-nupital education is higher among women who: (1) attended college before marriage, (2) married early, (3) are currently separated or divorced, (4) support egalitarian sex-role attitudes, or (5) whose most recent occupation is in the professional, managerial, or administrative category. Post-nuptial trends in education undoubtedly reflect the much broader social phenomenon of changing sex-role perceptions.     

How female education affects reproductive behavior in urban Pakistan

Although Pakistan remains in a pretransitional stage (contraceptive prevalence of only 11.9% among married women in 1992), urban women with post-primary levels of education are spearheading the gradual move toward fertility transition. Data collected in the city of Karachi in 1987 were used to determine whether the inverse association between fertility and female education is attributable to child supply variables, demand factors, or fertility regulation costs. Karachi, with its high concentration of women with secondary educations employed in professional occupations, has a contraceptive prevalence rate of 31%. Among women married for less than 20 years, a 10-year increment in education predicts that a woman will average two-fifths of a child less than other women in the previous 5 years. Regression analysis identified 4 significant intervening variables in the education-fertility relationship: marriage duration, net family income, formal sector employment, and age at first marriage. Education appears to affect fertility because it promotes a later age at marriage and thus reduces life-time exposure to the risk of childbearing, induces women to marry men with higher incomes (a phenomenon that either reduces the cost of fertility regulation or the demand for children), leads women to become employed in the formal sector (leading to a reduction in the demand for children), and has other unspecified effects on women's values or opportunities that are captured by their birth cohort. When these intervening variables are held constant, women's attitude toward family planning loses its impact on fertility, as do women's domestic autonomy and their expectations of self-support in old age. These findings lend support to increased investments in female education in urban Pakistan as a means of limiting the childbearing of married women. Although it is not clear if investment in female education would have the same effect in rural Pakistan, such action is important from a human and economic development perspective.