Rural/urban differentials in demographic processes: The Central Asian states

While the populations of the Central Asian successor states are extremely heterogeneous on many indicators, the issue of rural or urban residence is consistently important in terms of differentials in population growth, socio-economic status and public health. In this paper I focus on rural population trends in Kazakhstan, Kyrghyzstan, Turkmenistan, Uzbekistan and Tajikistan. I explore the relatively disadvantaged position of rural inhabitants as well as regional variations within the rural population. The differentials in fertility and mortality rates and the large projected population increases indicate that future policy interventions and data collection efforts should incorporate a specific focus on rural areas.     

Mortality in Poland in the period 1950-1990

"In this paper, crude, specific [mortality] rates as well as nonstandardized and standardized indices of regional mortality differentials are analysed [for Poland] for the period 1950-1990, in order to show mortality differentiation, its increase by age, sex, and place of residence. Taking into account cause specific death rates, the pattern of causes of deaths was found to be similar to that existing in the western countries, although the level of standardized mortality is higher in Poland. Values of calculated indices of regional mortality differentials point to significant differences in mortality by voivodship."     

Fertility differentials as evidence of incipient fertility decline in a developing country

Abstract Age data from the 1960 and earlier censuses of Ghana allow the construction of child-woman ratios which appear to indicate the existence of a substantial urban-rural fertility differential. Plausible assumptions of urban-rural mortality differentials increase the apparent fertility differential. In this paper recently published data for Statistical Areas in the country's larger towns are used to demonstrate that one explanation for the fertility differential is almost certainly the enumeration of some females in the towns, while one or more of their surviving children were enumerated outside. Nevertheless, in 1960 the four largest towns exhibited birth levels which are likely to have been about 11% below those of the population in the surrounding regions. Roughly half the differential can be attributed to a general urban-rural differential and half to socio-economic differentials within the towns. It is shown that most fertility reduction within the towns may be explained by delayed female marriage, and that such delay is associated with extended education. It is also shown that amongst the higher socio-economic status groups a small part of the reduction can probably be attributed to the prevention of pregnancy within marriage, and that the making of such attempts is positively associated with extended education, urban birth, participation in first and monogamous marriages, Protestantism, and the holding of views about the harmful effect of high population growth rates on attempts to raise living standards. It is argued that these fertility differentials are evidence of some fertility decline among key groups in the population and that such declines are likely to become more widespread.     

India's population: second and growing

Attention in this discussion of the population of India is directed to the following: international comparisons, population pressures, trends in population growth (interstate variations), sex ratio and literacy, urban-rural distribution, migration (interstate migration, international migration), fertility and mortality levels, fertility trends (birth rate decline, interstate fertility differentials, rural-urban fertility decline, fertility differentials by education and religion, marriage and fertility), mortality trends (mortality differentials, health care services), population pressures on socioeconomic development (per capita income and poverty, unemployment and employment, increasing foodgrain production, school enrollment shortfalls), the family planning program, implementing population policy statements, what actions would be effective, and goals and prospects for the future. India's population, a total of 684 million persons as of March 1, 1981, is 2nd only to the population of China. The 1981 population was up by 136 million persons, or 24.75%, over the 548 million enumerated in the 1971 census. For 1978, India's birth and death rates were estimated at 33.3 and 14.2/1000 population, down from about 41.1 and 18.9 during the mid-1960s. India's current 5-year plan has set a goal of a birth rate of 30/1000 population by 1985 and "replacement-level" fertility--about 2.3 births per woman--by 1996. The acceleration in India's population growth has come mainly in the past 3 decades and is due primarily to a decline in mortality that has markedly outstripped the fertility decline. The Janata Party which assumed government leadership in March 1977 did not dismantle the family planning program, but emphasis was shifted to promote family planning "without any compulsion, coercion or pressures of any sort." The policy statement stressed that efforts were to be directed towards those currently underserved, mainly in rural areas. Hard targets were rejected. Over the 1978-1981 period the family planning program slowly recovered. By March 1981, 33.4 million sterilizations had been performed since 1956 when statistics were 1st compiled. Another 3 million couples were estimated to be using IUDs and conventional contraceptives.     

United Nations/World Health Organization Meeting on Socio-Economic Determinants and Consequences of Mortality,Mexico City, 19-25 June 1979

The objectives of the United Nations/World Health Organization (WHO) Meeting on Socioeconomic Determinants and Consequences of Mortality, held in Mexico City in June 1979, were the following: to review the knowledge of differential mortality and to identify gaps in the understanding of its socioeconomic determinants and consequences; to discuss the methodological and technical problems associated with data collection and analysis; to consider the policy implications of the findings presented and to promote studies on the implications of socioeconomic differentials in mortality on social policy and international development strategies; to formulate recommendations and guidelines for the utilization of the 1980 round of population censuses for in-depth studies of mortality differentials; and to stimulate national and international research on differential mortality. Participants discussed the state of knowledge of socioeconomic differentials and determinants of mortality and described the socioeconomic measures available, the methods of data collection and analysis used, and the findings themselves. A number of characteristics had been employed in the study of differential mortality, and these could be grouped under the following headings: occupation; education; housing; income, wealth; family size; and place of residence. The techniques or methods used to analyze mortality were direct and indirect methods, and these are examined. Inequalities in mortality were found to be closely associated with inequalities in social and economic conditions. Any effort to reduce or remove those inequalities would have to be based on a clear understanding of their causes and interrelationships in order to succeed. Participants indicated a desire to see a resurgence of mortality research, and some research suggestions are outlined.     

A reconsideration of negro-white mortality differentials in the united states

This paper summarizes the results of an investigation of the validity of Negro-white mortality differentials as reflected in the series of official United States life tables since the turn of the century. Pertinent excerpts from these often-quoted tables are reproduced in Appendix Table A-1 for convenient reference. The paper divides into two main parts.First, mortality levels and differentials beyond early childhood are derived, without use of the existing vital records, by interpreting the series of ten-year cumulative survival rates implicit in the census records for native whites and for Negroes. The results are in general agreement with the official figures, particularly for males.Second, mortality levels and differentials in early childhood are estimated by extrapolating the official 1)5 values via model life tables; that is, by the analytical procedure that would be followed in the absence of direct information on early childhood mortality. Unless it is assumed that age patterns of death for United States Negroes were extremely deviant from those found in populations with reliable census and vital statistics, one must conclude that the official figures grossly underestimate early childhood mortality for Negroes, at least for the period, 1910-40. It follows that, during those decades, Negro-white mortality differentials in terms of expectation of life at birth were also substantially higher than is suggested by the official estimates.     

Recent trends in multiple-caused mortality 1968 to 1982: Age and cohort components

Declines in mortality at advanced ages have been observed recently in the United States. These declines have been related to a reduction in the risk of major circulatory diseases, such as stroke and heart disease. In this paper we examine the contribution of two additional major factors in those declines. The first is the effect of conditions associated with circulatory diseases. This effect can be examined by using multiple-cause mortality data in which all conditions reported by the physician on the death certificates are recorded. The second is the contribution of cohort mortality differentials to temporal changes. If major cohort differentials are identified, we may be able to determine if recent declines in mortality are likely to continue-and to what levels. Such insights would be useful both in improving projections of the size and age structure of the U.S. elderly population and its entitlement groups and in helping to identify future patterns of needs for preventive and other health services.     

Population growth,life-cycle saving,and international differences in steady-state optimal saving rates

Life-cycle savings theories have been a seminal development in analyses of the relationship between rational savings patterns for individuals and the accumulation of wealth or capital at the level of the society as a whole. Applications of the theories in industrialized countries never investigated the significance of large differences in birth and death rates across societies. The strong demographic components of life-cycle saving analysis are here the center of focus. Illustrative general numerical applications of a modified version of the life-cycle approach suggest that mortality differentials comparable to those presently encountered among nations are consistent with very large differentials in steady-state optimal ratios of wealth-to-income. Specific application to Peru of the model estimated by Tobin for the United States indicates that high levels of mortality, current Peruvian birth rates, and Peruvian age-income profiles imply optimal rational savings rates far below those of the United States.     

Sex Differentials in Mortality in the Soviet Union: Regional Differences in Length of Working Life in Comparative Perspective

In this paper we take a different approach from other authors to the study of differences between the mortality of the two sexes in the USSR. First, we use measures of mortality that are not sensitive to the most common types of error in data and that reflect experience in an age range that is important from a policy perspective: the working ages. Secondly, we measure variation in mortality between regions of the USSR. Thirdly, we compare these regional mortality trends with experience in 33 developed countries. The sex differential in mortality in the USSR is an amalgam of very different regional patterns. Its size and rate of change are more extreme in the USSR than in other countries, and are mainly due to the poor and rapidly worsening mortality of men in the Russian Republic. But the widening sex differentials and increasing mortality of men in the older working ages in Soviet regions are similar to trends in many other developed countries.     

The Changing Pattern of Educational Differentials in Divorce in the Context of Gender Egalitarianization: The Case of Taiwan

Regarding educational differentials in divorce, similar trends have been reported across countries. Some report increasing educational differentials, while others identify an educational crossover pattern. The commonality is that education seems to play a role of stabilizing marriage more than ever before. Using data from the Women??s Marriage, Fertility, and Employment Survey, this study investigates the case of Taiwan by portraying the changing pattern of women??s educational differentials in divorce. There are three major findings. First, among previous marriage cohorts, women with relatively higher levels of formal education are significantly more likely to divorce. Second, the marital-dissolution rates for less educated women are rising faster than the corresponding rates for women with more education. Third, this trend does not stop at the catch-up point and eventually leads to a reversal in the association between education and divorce from positive to negative. In short, such educational differentials in divorce vary dramatically across marriage cohorts. A pattern of educational crossover in divorce has been displayed during the rapid social change in Taiwan. Other than William Goode??s argument raised a half-century ago, the marriage model transformation from specialization toward symmetry in the context of gender egalitarianization has to be taken into consideration in order to obtain a full understanding of the phenomenon.     

Adult mortality differentials associated with cigarette smoking in the USA

Although cigarette smoking has been extensively researched, surprising little knowledge has been produced by demographers using demographic perspectives and techniques. Thus, this paper contributes to the literature by extending a demographic framework to an important behavior for mortality research: cigarette smoking. In earlier works, the authors used nationally-representative data to show that cause of death patterns varied by smoking status and that multiple causes of death characterized smokers moreso than non-smokers. The present work extends previous analysis by estimating smoking status mortality differentials by underlying and multiple causes of death and by age and sex. Data from the 1986 National Mortality Followback Survey are related to data from the 1985 and 1987 National Health Interview Survey supplements to assess the smoking-related mortality differentials. We find that cigarette smoking is associated with higher mortality for all population categories studied, that the smoking mortality differentials vary across the different smoking status categories and by demographic group, and that the mortality differentials vary according to whether underlying cause or multiple cause patterns of death are examined. Moreover, the multiple cause analysis highlights otherwise obscured smoking-mortality relations and points to the importance of respiratory diseases and cancers other than lung cancer for cigarette smoking research.     

Measuring and explaining the change in life expectancies

A set of new indices for interpreting change in life expectancies, as well as a technique for explaining change in life expectancies by change in mortality at each age group are presented in the paper. The indices, as well as the new technique for explaining the differences in life expectancies, have been tested and examples using United States life tables are presented. The technique for explaining life expectancy differentials can be used for analyzing change in mortality or mortality differentials by sex, ethnicity, region, or any other subpopulations. The technique can be applied to life expectancies at birth or temporary life expectancies between any desirable ages.     

Mortality,marriage, and growth in pre-industrial populations

It has been widely assumed that in pre-industrial European populations postponement of marriage was a major check on fertility, and that marriage was contingent upon access to a livelihood in the form of a homestead or a craft. Death made room for new families, and the age at inheritance might therefore be an index of the age at marriage. High mortality should then mean early marriage and high fertility. When the effect of a uniform increase in the force of mortality on the “natural rate of growth” is estimated quantitatively, it is found that fertility response is of the same magnitude as the change in mortality so that within a wide range mortality differentials alone would not suffice to account for persistent differentials in growth rates. The assumption of a reasonably effective control through the prudential check is thus strengthened.     

Implications of socio-economic differentials in mortality for the health system

The premise of this discussion is that a systematic and continuous monitoring system is required to assemble data on the social indicator "socio-economic differences in mortality." Attention is directed to 5 particular types of data: secular trends; class differentials and age; linearity versus dichotomy; cross-cutting variables; and downward mobility and biological selection. The following 2 basic questions are examined and answered with a qualified "yes:" 1) does the health care system have any relevance to mortality differentials; and 2) can a health care system have any degree of meaninful autonomy from the overall social system. The policy implications of this analysis are reviewed in terms of the value content of medical education, the organization of the health care system, the emphasis on health, and the focus on the community. The concepts of control and power are analyzed as the key to socioeconomic differentials. Emphasis on differential exposures to "stressors" is rejected for what is termed "a sense of coherence" -- a global orientation which emerges, or fails to emerge among the lower classes, against the background of a high level of generalized resistance resources. Essentially the problem is that the constricted, emergency, powerless, and unpredictable character of lower social class existence prevents individuals of lower class and groups from being able to cope with stressors. Ways that the health care system can strengthen the sense of coherence of the lower classes include the following: a formal monitoring system in each society; caution in assuming that technological advances, environmental control, and health education are egalitarian in their consequences; and the need to identify high-risk groups within the lower classes.     

Differential fertility in Puerto Rico

In spite of high overall fertility Puerto Rico exhibits fertility differentials resembling those in areas where birth rates are low. The fertility of whites exceeds that of non-whites, educational standards influence child-bearing and there is a rural urban differential of long standing. These differences are documented in the paper and their implication for future population development in Puerto Rico is discussed     

Geographic Ancestry and Cause-specific Mortality in a National Population

There are marked differentials in mortality risks across regions in Finland. No exhaustive explanation to this variation has been provided, however. The aim of this paper is to analyse how geographic ancestry, as proxied by persons’ birth region and population group, interrelates with cause-specific mortality risks. Focusing on people aged between their mid-thirties and late-forties, we use longitudinal population register data that offer opportunities to account for variables that represent both persons’ social background and their own social status at young adult age. Results of Cox proportional hazard models say that these variables have substantial effects on mortality of different causes, but only a marginal impact on the variation in death rates by birth region and population group. The geographic mortality pattern is found to be specifically prominent for causes of death that are fairly unrelated to persons’ lifestyles. Our findings suggest that genetic predisposal as expressed in terms of geographic ancestry might play a relevant role in understanding mortality variation within the population of Finland.     

The increase in marital status differences in mortality up to the oldest age in seven European countries, 1990–99

We investigate mortality differentials by marital status among older age groups using a database of mortality rates by marital status at ages 40 and over for seven European countries with 1 billion person-years of exposure. The mortality advantage of married people, both men and women, continues to increase up to at least the age group 85–89, the oldest group we are able to consider. We find the largest absolute differences in mortality levels between marital status groups are at high ages, and that absolute differentials are: (i) greater for men than for women; (ii) similar in magnitude across countries; (iii) increase steadily with age; and (iv) are greatest at older age. We also find that the advantage enjoyed by married people increased over the 1990s in almost all cases. We note that results for groups such as older divorced women need to be interpreted with caution.     

The increase in marital status differences in mortality up to the oldest age in seven European countries, 1990-99

We investigate mortality differentials by marital status among older age groups using a database of mortality rates by marital status at ages 40 and over for seven European countries with 1 billion person-years of exposure. The mortality advantage of married people, both men and women, continues to increase up to at least the age group 85-89, the oldest group we are able to consider. We find the largest absolute differences in mortality levels between marital status groups are at high ages, and that absolute differentials are: (i) greater for men than for women; (ii) similar in magnitude across countries; (iii) increase steadily with age; and (iv) are greatest at older age. We also find that the advantage enjoyed by married people increased over the 1990s in almost all cases. We note that results for groups such as older divorced women need to be interpreted with caution.     

Urban determinants of racial differentiation in infant mortality

This study relates differential socioeconomic status between blacks and whites to racial differentiation in infant mortality rates. The basic assumption is that decreases in socioeconomic differentiation and related variables lead to decreases in the black—white infant mortality differential. A comparative approach based on aggregate measures of socioeconomic differentiation is utilized to compare sixty-one United States urban places. Path analysis shows that neonatal mortality differentiation is virtually unaffected by socioeconomic differentials while decreased racial differences in hospital births tend to increase neonatal mortality differentiation. In contrast, postneonatal differentiation is affected by socioeconomic differentiation, especially along the dimensions of income, education, and regional location. It is concluded that despite some suggestions that infant mortality is no longer responsive to socioeconomic factors, postneonatal differentation is affected by socioeconomic differentials when comparison is based on city units.     

Mortality and Socio-economic Status in Two Eighteenth-century Dutch Villages

This study is an analysis of mortality levels and their patterns of change among different socio-economic groups in two eighteenth-century Dutch villages. In these two villages – Gilze and Rijen – there were substantial mortality differentials between farmers and agricultural labourers. Mortality differentials of this magnitude have not been found in other European villages, although they are not unheard of in cities. The differentials are probably unrelated to malnutrition, or a polluted water supply among the lower class. Relative overcrowding and poor hygiene are more probable causes. During the second half of the eighteenth century mortality levels were lower, especially among the lower class. These changes, however, did not result from a higher standard of living. They were probably related to a diminution in the amount of military activity on land in Europe after the War of the Austrian Succession.