Coerced Care: Thomas Thistlewood's Account of Medical Practice on Enslaved Populations in Colonial Jamaica, 1751–1786

This essay uses the Thistlewood family papers as a health record for the enslaved population in Jamaica. It examines the medical aspects of Thistlewood's journals, contextualising them in the social, political and cultural environment in the latter half of the eighteenth century. Examples of his provisions for medical care throughout his life are investigated systematically. Through counts from the original documents, the author identifies a seasonal pattern of disease and mortality on large and small Jamaican plantations and estimates an infant mortality rate of approximately 420 per 1000 births for Jamaican infants born into slavery.     

Socioeconomic status,psychosocial factors and health in urban Guyana

Individuals of higher socioeconomic status live longer and enjoy better physical and mental health relative to individuals of lower social status. Socioeconomic status differences in health status persist over time. This paper examines the association between socioeconomic status, psychosocial factors, and health in Georgetown, Guyana. The major causes of death are cardiovascular and cerebrovascular disease; life expectancy at birth is 67.3 years for males and 72.3 years for females; and the infant mortality rate is 44 per 1000 live births. Data for the study were drawn from a probability sample of 654 adult residents of Georgetown. A significant inverse association was found between formal education and morbidity for four of the six measures of health status. The authors investigated the extent to which self-concept, health behaviors, stress, and social ties are linked to health status and socioeconomic status, and can explain socioeconomic status differences in health status. Psychosocial factors, especially the self-concept measures of self-esteem and mastery, were found to play a moderate role in accounting for educational differences in health status.     

The implications of the demographic transition theory for fertility change in Nigeria

Data on educated urban women in Nigeria demonstrate the effect women's education and urbanization has on reproductive behavior, marriage, family formation, and family relationships. Available health services contribute to a fall in infant mortality, but most services are in urban areas. Further, people of high socioeconomic status who have access to modern health services are more concerned about public health problems than those in the low group. Urbanization occurs at a rate of about 11%/year. In Lagos, people with primary education delay marriage 1-2 years longer than those who have no education. Further, 71% of uneducated people in Ibadan who were = or + 38 years old were in a polygynous marriage compared to 38% of educated people in the same age group. The actual and desired family size in Nigeria ranks amoung the highest in the world. In addition, only 20% of the total population use modern contraceptives and usage is highest in Lagos and Ibadan. Most acceptors are educated urban middle class who use contraceptives to space births instead of the traditional spacing methods of postpartum abstinence and prolonged lactation. Eventually more and more urban middle class women will use contraceptives to prevent births. 1% of these acceptors are demographic innovators, however. Further they begin to use contraceptives at high parities. Still child mortality among them is lower than others. Since the late 1970s, as people are being exposed to Western culture, the economy has improved, mortality has fallen, more children attend schools, yet fertility has grown substantially in urban and rural areas. With the expansion of Western education to females, the changing pattern of life style of the educated urban middle class, and increase of women in nontraditional professions, expectations and needs of children will change. Around 2000 Nigeria will begin its demographic transition from high to low fertility.     

Mortality patterns among elderly American Jews

"Mortality studies of ethnic and religious subgroups within a nation are of interest as they provide indicators of health differentials that may result from differences in life style and risk-factor exposures. The mortality experience of North American Jews has been documented over many years and is of particular interest because of the unusual pattern that has been observed, a crossover from relatively low rates at younger ages to relatively high rates at older ages. This study examines mortality in 1979-81 among more than 100,000 Medicare enrollees who held 22 surnames common among American Jews. The findings substantiate those of a recent mortality study of a Canadian Jewish population which indicated more rapid improvement in life expectancy among elderly Jewish than non-Jewish males, and a lessening of the relative disadvantage of elderly Jewish women."     

Examining the association between Medicaid coverage and preterm births using 2010–2013 National Vital Statistics Birth Data

Reducing the number of preterm births is a high public health priority in the U.S. Preterm birth, affecting an estimated 380,000 infants annually, is a leading cause of infant mortality and morbidity and is associated with individual and systemic characteristics. Preterm birth is estimated to cost society $26 billion annually. Despite an elevated financial burden caused by preterm birth, very little is known about who bears these costs. This study seeks to understand the relationship between Medicaid and private insurance payment for preterm birth, using multiple years of vital statistics data, which for the first time since 2010 include information on payment source. The nationwide data cover births that occur in all settings, including non-hospital settings, and many maternal characteristics not available in other datasets, improving upon previous analyses. These data can be used to promote better Medicaid coverage of interventions known to be effective in reducing preterm births.     

Racial differences in infant mortality rates: United States, 1969

Using multiple regression analyses, we measured the effects of demographic, health, and socioeconomic variables on race-specific neonatal and postneonatal infant mortality rates. The racial difference in rates in 1969 is due to (1) effects of mean differences in black and white population characteristics, (2) differences in the impact of independent variables, and (3) differences from other causes. Higher black than white infant mortality is the result of unfavorable black means on birthweight, age of mothers at birth, education, and marital stability. Black mortality is also higher because mothers' age at birth, marital stability, and education have more favorable impact on mortality for whites than blacks.     

Age at first birth, health, and mortality

The biodevelopmental view sees the readiness and soundness of the organism at the time of first birth as its prime link to health and survival years and decades later. It suggests an optimum age at first birth shortly after puberty. The biosocial view emphasizes social correlates and consequences of age at first birth that may influence health and survival many years later. It suggests that better health and survival come from delaying motherhood as long as possible, perhaps indefinitely. Analyses consistently find patterns more in keeping with the biosocial view in a U.S. national sample of women ages 25 through 95. The fitted curves show high levels of current health problems among women who first gave birth in or shortly after puberty. Problems drop steadily the longer that first birth was delayed, up to about age 34, then rise increasingly steeply, particularly after about age 40. For women currently of the same age, the ratio of health problems expected given first birth under age 18 versus around age 34 equals that from currently being 14 years older. Health problems rise steeply with length of having delayed beyond age 40. Mortality hazard also declines with having delayed first birth well beyond the end of puberty. The ratio of mortality hazard between mothers with teenage versus late first births equals that from a 10-year difference in current age. Comparison to nonmothers of similar age and race/ethnicity shows that the correlation of motherhood with health problems and mortality hazard switches from detrimental to beneficial with delay beyond about age 22.     

The main features of population development in the Czech Republic during the transformation of society

"The behaviour of the population of the Czech Republic has been changing since 1991. The changes have resulted in a considerable decrease in marriages and births, and a slight fall in mortality rates. The decline in the number of newly-weds and new-born children can be attributed to significant structural changes in society connected with the transformation of the reproductive model established in the post war era. The changes have been initiated most notably by the younger generation...."     

Structural Determinants of Infant Mortality in Metropolitan and Nonmetropolitan America1

Abstract A conceptual model of the impact of structural advantage and disadvantage on infant mortality rates is developed and fitted to countylevel data. This model includes mediating endogenous constructs representing medical care availability, the incidence of teenage childbearing, and low birthweight rates and is estimated for three residence categories. Both direct and indirect effects of social structure and teenage childbearing on infant mortality vary significantly across the categories. Structural advantage exerts a significant and negative direct effect on infant mortality rates in urban areas, but in rural areas this effect is indirect, operating through teenage childbearing and low birthweight. Structural disadvantage significantly increases infant mortality in both rural and urban settings, but the effects operate directly in metropolitan areas and indirectly in rural areas. These results underscore the central role that social structure continues to play in determining infant mortality rates in the United States.     

An investigation into the problems of the ages of marriage and reproduction

Using results of a 6 month 1981 extensive social survey in urban districts of Beijing Municipality this paper shows that there is not only a tendency for young people to shift their actual marriage age to an earlier time but also, their earlier marriage does not necessarily result in earlier reproduction. The key to the success of this work of separating marriage and giving birth after a proper interval lies in propaganda and education. Based on their answers to the question "what do you think is the ideal age for marriage," most young males preferred to get married at 24, 25, and 26 years, with 25 as the peak of desired marriage age. Young females mostly choose to get married at 22 through 26; the desire to get married after 26 declines sharply. The ideal marriage ages indicated by the unmarried youth, though earlier than the actual marriage ages of the married young people, are later than what the married ones desire. The overwhelming majority of people become pregnant and give birth promptly after marriage. More than 70% of the married young couples investigated became pregnant and gave birth within 1 year of their marriage; those who believed it "ideal" to get pregnant and give birth within 1 year of the marriage only account for 25% of those surveyed. 1 of the main factors for both husbands and wives to delay giving births is their need to save some money to avoid economic hardship cause by immediate births after marriage. Overall, there exists a marked difference between the actual times of the 1st births of married young people and their ideal times of 1st births.     

Factors influencing infant/child mortality in Bangladesh: implication for family planning programs and policies

"This study examined a host of socio-economic and demographic factors (including their interactions) that determine infant/child mortality of married women at the different parity levels in Bangladesh [using data from] a multivariate analysis of the 1975-76 Bangladesh Fertility Survey.... The major hypothesis of this research is that the higher the level of fertility of a married woman, the higher will be her experience of infant/child mortality. However, a woman's family planning practice may interact with fertility and affect the total infant/child deaths...."     

Planned and Unplanned Childbearing Among Unmarried Women

This paper uses data from the 1995 National Survey of Family Growth to examine social, demographic, and economic correlates of planned and unplanned childbearing among unmarried women. I look at who has births outside of marriage, who plans births outside of marriage, and how childbearing patterns vary for Whites, Blacks, and Hispanics. I find that low education increases the likelihood of planned and unplanned childbearing outside of marriage for all race and ethnic groups. The same holds for cohabitation, although effects on planned births are notably stronger for Hispanics than others. Finally, spending time in a single‐parent family as a child increases planned and unplanned childbearing among White women, with modest or no effects among Blacks or Hispanics. Results suggest ways in which the meaning of childbearing depends on the context in which it occurs.     

Socioeconomic, medical care, and public health contexts affecting infant mortality: a study of community-level differentials in Peru

Socioeconomic, medical care, and public health contexts are examined in Peruvian communities for their relationship to infant mortality. A deviant case analysis is used to uncover characteristics important in the social structure of Peruvian communities. Results from fieldwork in two "deviant" communities suggest that economic diversity, income disparity, social class fluidity, and women's autonomy, along with refined measures of medical care and public health resources, are important in understanding differentials in mortality. Attention is drawn to the community context and to the interplay of socioeconomic determinants affecting infant mortality.     

Welfare state and infant mortality

This article seeks to understand the effects of welfare-state spending on infant mortality rates. Infant mortality was chosen for its importance as a social indicator and its putative sensitivity to state action over a short time span. Country fixed-effects models are used to determine that public health spending does have a significant impact in lowering infant mortality rates, net of other factors, such as economic development, and that this effect is cumulative over a five-year time span. A net effect of health spending is also found, even when controlling for the level of spending in the year after which the outcome is measured (to account for spurious effects or reverse causation). State spending effects infant mortality both through social mechanisms and through medical ones. This article also shows that the impact of state spending may vary by the institutional structure of the welfare state. Finally, this study tests for structural breaks in the relationship between health spending and infant mortality and finds none over this time period.     

Teen Childbearing and Depression: Do Pregnancy Attitudes Matter?

The relationship between teen childbearing and depression has been extensively studied; however, little is known about how young women's own attitudes toward becoming pregnant shape this association. This study used data from the National Longitudinal Study of Adolescent Health to investigate whether the relationship between teen childbearing and adult depression is moderated by adolescent attitudes toward becoming pregnant. The results showed that although, on average, women who had first births between ages 16 and 19 experienced no more depressive symptoms in adulthood than women who had first births at age 20 or older, the relationship between teen childbearing and adult depression varied significantly based on adolescent pregnancy attitudes. When they had negative adolescent attitudes toward getting pregnant, teen mothers had similar levels of depression as adult mothers, but when they had positive adolescent pregnancy attitudes, teen mothers actually had fewer depressive symptoms than women with adult first births.     

Social‐psychological principles in criminal justice processing

Based on 1979–1981 and 1989–1991 vital registration and 1980 and 1990 census data, we construct increment‐decrement life tables for rural and urban males and females. The analysis is centered on 1980 and 1990 and describes urban‐rural differences in patterns of mortality and nuptiality by age and sex. Our research updates an earlier study that described urban‐rural mortality and marital transition patterns for Tennessee, 1970. The 1980 and 1990 findings parallel the 1970 results. Rural women and men have shorter life expectancies; higher infant mortality rates; younger median ages of entry into first marriage, divorce, and widowhood; a greater proportion of their cohorts ever marrying; lower probabilities of divorce; and higher probabilities of widowhood than urban women and men. However, there was a decline in urban‐rural differences from 1970–1990. These changes suggest that urbanization, technological advances in communication and transportation, and the diffusion of urban lifestyles and values may have blurred the urban‐rural distinction.     

Social learning about levels of perinatal and infant mortality in Niakhar,Senegal

How individuals develop perceptions concerning the risk of infant and child mortality has important consequences for fertility and demographic transition theory and for understanding broader processes of social learning. The role of learning through social interaction in shaping demographic phenomena has been the subject of intense research in the last decade. Much previous research however has been hampered by inadequate measures of individuals’ personal networks, the proximal context in which learning takes place. Using pilot data employing an innovative social network design in conjunction with demographic surveillance data from Niakhar, Senegal, this research models perception of change in the level of infant mortality over time as a function of the experience of social network associates with perinatal and infant mortality. Results suggest relatively strong effects of network members’ mortality experience controlling for own experiences of child mortality as well as neighborhood and community levels of infant mortality among other controls.     

Helping parents to manage infant crying and sleeping: a review of the evidence and its implications for services

Infant crying and night waking are common concerns for parents, costly problems for health services and may trigger infant abuse or lead to serious child disturbances. Parents are given contradictory advice on how to manage infant crying and sleeping, indicating the need for evidence‐based guidance. This review of recent research draws distinctions between infant crying and sleeping problems, between the problem identified by parents and the infant behaviour underlying the problem, between different types of crying behaviour and their causes, and between the types of cases which present at different ages. It proposes that the two main approaches to parenting advocated by baby‐care experts, ‘infant‐demand’ and ‘structured’ parenting, have different benefits, and costs. Comparative studies have found that infant‐demand parenting is associated with low amounts of fussing and crying in the first three months of age, but with night waking which continues beyond three months. Randomised controlled trials have provided evidence that structured parenting leads to more overall fussing and crying during the first three months, but reduced night waking and crying after that. The findings are translated into recommendations for preventing and treating infant crying and sleeping problems, for policy debate, and for further research. Copyright © 2007 John Wiley & Sons, Ltd.     

The impact of family structure and social change on adolescent sexual behavior

This article presents a biophysical perspective on adolescent sexual feelings and behavior. The study particularly analyzes sexual attraction, desire, and mate selection as evolutionary adaptations just as important to species survival. Sex differences in mating strategies are described as part of this evolutionary adaptation. Recent research findings demonstrate how these strategies explain contemporary sexual and reproductive behavior in Western societies today, as they do sexual behavior in the past or across diverse cultures. The implications of this analysis are significant to intervention efforts to postpone sexual initiation and avert nonmarital births. Discussion on demographic and normative changes that affect adolescent sexual behavior included trends in sexual maturation and changing marriage norms. The author urges greater emphasis on the early pubertal years; increased attention to teaching adolescents more about their own sexual development; a less absolutist focus on sexual abstinence, which may be appropriate and more feasible for 12 year olds but not for 16 year olds; better and more widespread sex education at earlier ages and throughout the school curriculum; frank discussion of all the options available for those who experience an unwanted pregnancy; and same level of attention towards adolescent boys and girls.