Family size and maternal health: evidence from the One-Child policy in China

In this paper, we examine the impact of family size on maternal health outcomes by exploiting the tremendous change in family size under the One-Child policy in China. Using data from the China Health and Nutrition Survey 1993–2006, we find that mothers with fewer children have a higher calorie intake and a lower probability of being underweight and having low blood pressure; meanwhile, they have a higher probability of being overweight. This would occur if a smaller family size increases the food consumption of mothers, leading underweight women to attain a normal weight and normal weight women becoming overweight. Robust tests are performed to provide evidence on the hypothesis that the tradeoff between children’s quantity and mother’s “quality” is through a budget constraint mechanism, that is, having more children decreases the resource allocated to mothers and affects their health outcomes.     

Marital protection and marital selection: Evidence from a historical-prospective sample of American men

Whether marriage causes people to live longer or whether healthier people select into marriage is an open question. In this study I followed a sample of men from age 18 to first marriage and ultimately to death. Health in early adulthood was represented by height and weight around age 20. The probability of ever marrying and the conditional probability of marriage in a given time period were lower for smaller men and greater for larger men. Marriage significantly lowered mortality risk even after controlling for health in early adulthood. Thus I found support both for selection into marriage and for protective effects of marriage.     

Family Structure and Self-Rated Health in Adolescence and Young Adulthood

While the relationship between family structure and child well-being is well-established, little is known about the specific impact of family structure on health in adolescence and young adulthood. Using data on 12,737 respondents from Waves I and III of Add Health, we examine the association between family structure (two biological/adoptive, stepfather, and single mother families at Wave I) and self-rated health in adolescence (Wave I) and young adulthood (Wave III). We build on previous literature by investigating whether the relationship between family structure and self-rated health is mediated by demographic background, socioeconomic status, parent–child relationships, external social support, and health characteristics and behaviors, and whether the influence of these factors endures into adulthood. Overall, we find that self-rated health is reduced for respondents who lived in stepfather or single mother families during adolescence, although this effect is attenuated in young adulthood. Family structure effects at both waves are explained by socioeconomic status, social support and competence, and health characteristics and behaviors. We find little evidence that demographic background or mother–child relationships mediate the relationship between family structure and self-rated health. By young adulthood, effects of most adolescent predictors are attenuated, but health assessments are largely influenced by changes in health characteristics and behaviors, and in family type.

Obesity and excess mortality among the elderly in the United States and Mexico

Increasing levels of obesity could compromise future gains in life expectancy in low-and high-income countries. Although excess mortality associated with obesity and, more generally, higher levels of body mass index (BMI) have been investigated in the United States, there is little research about the impact of obesity on mortality in Latin American countries, where very the rapid rate of growth of prevalence of obesity and overweight occur jointly with poor socioeconomic conditions. The aim of this article is to assess the magnitude of excess mortality due to obesity and overweight in Mexico and the United States. For this purpose, we take advantage of two comparable data sets: the Health and Retirement Study 2000 and 2004 for the United States, and the Mexican Health and Aging Study 2001 and 2003 for Mexico. We find higher excess mortality risks among obese and overweight individuals aged 60 and older in Mexico than in the United States. Yet, when analyzing excess mortality among different socioeconomic strata, we observe greater gaps by education in the United States than in Mexico. We also find that although the probability of experiencing obesity-related chronic diseases among individuals with high BMI is larger for the U. S. elderly, the relative risk of dying conditional on experiencing these diseases is higher in Mexico.     

Prenatal Health,Educational Attainment,and Intergenerational Inequality: The Northern Finland Birth Cohort 1966 Study

In this article, we study the effects of prenatal health on educational attainment and on the reproduction of family background inequalities in education. Using Finnish birth cohort data, we analyze several maternal and fetal health variables, many of which have not been featured in the literature on long-term socioeconomic effects of health despite the effects of these variables on birth and short-term health outcomes. We find strong negative effects of mother’s prenatal smoking on educational attainment, which are stronger if the mother smoked heavily but are not significant if she quit during the first trimester. Anemia during pregnancy is also associated with lower levels of attained education. Other indicators of prenatal health (pre-pregnancy obesity, mother’s antenatal depressed mood, hypertension and preeclampsia, early prenatal care visits, premature birth, and small size for gestational age) do not predict educational attainment. Our measures explain little of the educational inequalities by parents’ class or education. However, smoking explains 12%—and all health variables together, 19%—of the lower educational attainment of children born to unmarried mothers. Our findings point to the usefulness of proximate health measures in addition to general ones. They also point to the potentially important role played by early health in intergenerational processes.     

The Long-Term Cognitive and Socioeconomic Consequences of Birth Intervals: A Within-Family Sibling Comparison Using Swedish Register Data

We examine the relationship between birth-to-birth intervals and a variety of mid- and long-term cognitive and socioeconomic outcomes, including high school GPA, cognitive ability, educational attainment, earnings, unemployment status, and receiving government welfare support. Using contemporary Swedish population register data and a within-family sibling comparison design, we find that neither the birth interval preceding the index person nor the birth interval following the index person are associated with any substantively meaningful changes in mid- or long-term outcomes. This is true even for individuals born before or after birth-to-birth intervals of less than 12 months. We conclude that in a contemporary high-income welfare state, there appears to be no relationship between unusually short or long birth intervals and adverse long-term outcomes.     

Reproductive patterns and child mortality in guatemala

In this paper, we investigate the association of child mortality with maternal age, parity, birth spacing, and socioeconomic status, in a sample of Guatemalan children who were included in a public health intervention program. Our results indicate that maternal age, birth order, and the length of the previous and following birth intervals all have a significant impact on the risk of child mortality and that these associations cannot be accounted for by differences in breastfeeding, socioeconomic status, or the survival status of the previous child.     

Origins and Destinations,but How Much and When? Educational Disparities in Smoking and Drinking Across Adolescence and Young Adulthood

Educational inequalities in health behaviors change dynamically across the life course. Yet, how parental and personal education interactively shape age-specific behavioral inequalities across the transition to adulthood has yet to be understood. Drawing on national Add Health data (N?=?12,605; 6,675 women and 5,930 men), we analyze age- and gender-specific trajectories of current smoking and binge drinking from adolescence to young adulthood. In line with previous work, we find that parental education associates with smoking and drinking disparities even after respondents’ own education is completed. Reciprocally, we also find that disparities by eventual educational attainment appear early. During the college years, higher parental education predicts higher—not lower—rates of binge drinking. We find that attaining higher education “against the odds” of an educationally disadvantaged family background circumscribes the lowest rates of smoking and drinking for men and women alike, and especially during the college years, while “falling from grace” by not attaining higher education at levels matching one’s parents predicts the highest levels of smoking and drinking for both genders during or after college. These results shed new light on the interactive socioeconomic processes that help to explain behavioral health gradients across adolescence and adulthood.

     

Birth spacing and fertility limitation: a behavioral analysis of a nineteenth century frontier population

Our analysis of changing birth interval distributions over the course of a fertility transition from natural to controlled fertility has examined three closely related propositions. First, within both natural fertility populations (identified at the aggregate level) and cohorts following the onset of fertility limitation, we hypothesized that substantial groups of women with long birth intervals across the individually specified childbearing careers could be identified. That is, even during periods when fertility behavior at the aggregate level is consistent with a natural fertility regime, birth intervals at all parities are inversely related to completed family size. Our tabular analysis enables us to conclude that birth spacing patterns are parity dependent; there is stability in CEB-parity specific mean and birth interval variance over the entire transition. Our evidence does not suggest that the early group of women limiting and spacing births was marked by infecundity. Secondly, the transition appears to be associated with an increasingly larger proportion of women shifting to the same spacing schedules associated with smaller families in earlier cohorts. Thirdly, variations in birth spacing by age of marriage indicate that changes in birth intervals over time are at least indirectly associated with age of marriage, indicating an additional compositional effect. The evidence we have presented on spacing behavior does not negate the argument that parity-dependent stopping behavior was a powerful factor in the fertility transition. Our data also provide evidence of attempts to truncate childbearing. Specifically, the smaller the completed family size, the longer the ultimate birth interval; and ultimate birth intervals increase across cohorts controlling CEB and parity. But spacing appears to represent an additional strategy of fertility limitation. Thus, it may be necessary to distinguish spacing and stopping behavior if one wishes to clarify behavioral patterns within a population (Edlefsen, 1981; Friedlander et al., 1980; Rodriguez and Hobcraft, 1980). Because fertility transition theories imply increased attempts to limit family sizes, it is important to examine differential behavior within subgroups achieving different family sizes. It is this level of analysis which we have attempted to achieve in utilizing parity-specific birth intervals controlled by children ever born.(ABSTRACT TRUNCATED AT 400 WORDS)     

Males’ Later-Life Mortality Consequences of Coresidence With Paternal Grandparents: Evidence From Northeast China, 1789–1909

In this study, we investigate the effect of early-life coresidence with paternal grandparents on male mortality risks in adulthood and older age in northeast China from 1789 to 1909. Despite growing interest in the influence of grandparents on child outcomes, few studies have examined the effect of coresidence with grandparents in early life on mortality in later life. We find that coresidence with paternal grandmothers in childhood is associated with higher mortality risks for males in adulthood. This may reflect the long-term effects of conflicts between mothers and their mothers-in-law. These results suggest that in extended families, patterns of coresidence in childhood may have long-term consequences for mortality, above and beyond the effects of common environmental and genetic factors, even when effects on childhood mortality are not readily apparent.     

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.     

Birth Spacing and Child Health Trajectories

Using longitudinal data on a cohort of over 4,000 children from four low- and middle-income countries, we document the association between birth spacing and child growth trajectories. We find declines in child height at age 1 among children who are born within three years of an older sibling. However, we also observe catch-up growth for closely spaced children as they age. We find no evidence that catch-up growth is driven by remedial health investments after birth, suggesting substitutability in underlying biological processes. We also find that very widely spaced children (preceding birth interval of more than seven years) are similar in height at age 1 as children who are spaced three to seven years apart, but outgrow their more closely spaced counterparts as they age. However, further sibling comparisons suggest that the growth premium that is observed for very widely spaced children may be driven by unobserved confounding factors.     

Causes and consequences of early-life health

We examine the consequences of child health for economic and health outcomes in adulthood, using height as a marker of childhood health. After reviewing previous evidence, we present a conceptual framework that highlights data limitations and methodological problems that complicate the study of this topic. We then present estimates of the associations between height and a range of outcomes—including schooling, employment, earnings, health, and cognitive ability—measured in five data sets from early to late adulthood. These results indicate that, on average, taller individuals attain higher levels of education. Height is also positively associated with better economic, health, and cognitive outcomes. These associations are only partially explained by the higher average educational attainment of taller individuals. We then use data from the National Longitudinal Survey of Youth 1979 Children and Young Adults survey to document the associations between health, cognitive development, and growth in childhood. Even among children with the same mother, taller siblings score better on cognitive tests and progress through school more quickly. Part of the differences found between siblings arises from differences in their birth weights and lengths attributable to mother’s behaviors while pregnant. Taken together, these results support the hypothesis that childhood health influences health and economic status throughout adulthood.     

The effect of pregnancy intention on child development

In this paper, we use data from the National Longitudinal Survey of Youth to investigate the empirical link between unintended pregnancy and child health and development. An important contribution of our study is the use of information on siblings to control for unmeasured factors that may confound estimates of the effect of pregnancy intentions on infant and child outcomes. Results from our study indicate that unwanted pregnancy is associated with prenatal and postpartum maternal behaviors that adversely affect infant and child health, but that unwanted pregnancy has little association with birth weight and child cognitive outcomes. Estimates of the association between unwanted pregnancy and maternal behaviors were greatly reduced after controls for unmeasured family background were included in the model. Our results also indicate that there are no significant differences in maternal behaviors or child outcomes between mistimed and wanted pregnancies.     

Nepal survey shows that "family planning saves lives"

This article presents the results of the Nepal Family Health Survey (NFHS) conducted from January through June 1996. Data on fertility, family planning, and maternal and child health were collected from 8429 ever-married women aged 15-49 years. These women provided information on 29,156 children. Using the method of regression analysis, findings reveal those factors, such as young mothers, large families, and short birth intervals, substantially increase under-five mortality risks. However, socioeconomic factors have only a limited effect on under-five mortality. Statistics have suggested that much of the urban/rural differences in mortality have been due to factors closely related to residence, mother's level of education and economic status. In addition, although positive effects of interventions (antenatal and postpartum checkups, tetanus immunization and assistance at delivery by a traditional birth attendant) have been documented, statistical results show that few children in Nepal are receiving the benefits of maternal health care. In conclusion, results of the 1996 NFHS show that delaying, spacing, and limiting births can substantially reduce infant and child mortality.     

Maternal Smoking and Infant Low Birth Weight: Exploring the Biological Mechanism Through the Mother’s Pre-pregnancy Weight Status

Maternal smoking has been found to adversely affect birth outcomes, such as increasing the odds of having low birth weight infants. However, the mechanisms explaining how a mother’s smoking is linked to a child’s low birth weight status are underexplored. This study merged two nationally representative datasets in the United States (US)—the National Longitudinal Survey of Youth 1979 (NLSY79) and the NLSY79 Child and Young Adult (NLSYCYA)—to examine whether maternal weight status before pregnancy serves as a biological mechanism. We applied a recently developed mediation analysis technique to a data sample of 6550 mother–child pairs, and we compared the estimated coefficients across nested probability models. We found that maternal body mass index (BMI) (in kg/m²), a widely used measure of weight status, reduces the odds of delivering a low birth weight infant, and this mechanism explains about 10.2% of the adverse impact of maternal smoking on having a low birth weight child. Moreover, when categorizing maternal pre-pregnancy BMI into four weight statuses (i.e., underweight, normal weight, overweight, and obese), we found that, in contrast to mothers with normal weight status, underweight mothers are 70% more likely to have a low birth weight child. Our findings suggest that maternal weight status plays a role in understanding how maternal smoking affects low birth weight outcome, indicating that maintaining a proper weight status for women who plan to give birth may be a possible policy to promote infant health.

     

Resolved Parental Infertility and Children’s Educational Achievement

Although difficulty conceiving a child has long been a major medical and social preoccupation, it has not been considered as a predictor of long-term outcomes in children ultimately conceived. This is consistent with a broader gap in knowledge regarding the consequences of parental health for educational performance in offspring. Here we address that omission, asking how resolved parental infertility relates to children’s academic achievement. In a sample of all Swedish births between 1988 and 1995, we find that involuntary childlessness prior to either a first or a second birth is associated with lower academic achievement (both test scores and GPA) in children at age 16, even if the period of infertility was prior to a sibling’s birth rather than the child’s own. Our results support a conceptualization of infertility as a cumulative physical and social experience with effects extending well beyond the point at which a child is born, and emphasize the need to better understand how specific parental health conditions constrain children’s educational outcomes.     

Child mortality in Malaysia: explaining ethnic differences and the recent decline

Infant and child mortality rates have dropped sharply for all ethnic groups in Malaysia between 1950 and 1988, but persistent ethnic differences remain. In this article we assess the contribution of several potential reasons both for the decline and the remaining differences between the Malay and Chinese sub-populations. Increased use of health inputs is found to explain a substantial part of the decline, but increased education of mothers, and income growth are also important. Longer spacing between births, and, higher average age at birth as a result of lower fertility and higher age at marriage provide only a marginal direct contribution to the fall in mortality. We find that lower mortality among the Chinese is accounted for by their higher incomes and greater propensty to purchase medical care. We also control for self-selection among users of medical care, and find that those who use health care in Malaysia tend to be subject to higher-than-average risks.     

The origins of agriculture: Population growth during a period of declining health

The increase in the Neolithic human population following the development of agriculture has been assumed to result from improvements in health and nutrition. Recent research demonstrates that this assumption is incorrect. With the development of sedentism and the intensification of agriculture, there is an increase in infectious disease and nutritional deficiencies particularly affecting infants and children.Declining health probably increased mortality among infants, children and oldest adults. However, the productive and reproductive core would have been able to respond to this increase in mortality by reducing birth spacing. That is, agricultural populations increased in size, despite higher mortality, because intervals between births became shorter.