Black/white differences in women’s reproductive-related health status: evidence from vital statistics

Maternal-age-specific neonatal mortality risk differs by race, with the mid-20s risk low for whites but not blacks. This may be partially due to worsening health for black relative to white women. We analyzed deaths to young women in the aggregate and classified by causes that are also pregnancy risk factors. Over the predominant child-bearing ages, mortality increases for blacks exceeded those for whites, usually by at least 25%. These indicators that black/white health differences widen as women progress through young adulthood suggest that such discrepancies may play a role in the black/white infant mortality differential, which merits further research.     

The demographic context of recent change in the structure of American households

This article examines recent changes in the structure of American households within the context of broad population changes. Decreases in married-couple households and increases in single-parent households are almost entirely due to the changing patterns of marriage, divorce, fertility, and child custody; headship rates for families have remained relatively stable. Increases in single-person and other nonfamily households are due to increases in the size of the unmarried, childless population and to the aging of this population. Increasing propensities to live alone or with nonrelatives were observed between 1970 and 1980, but these behavioral changes have abated during the early 1980s.     

Population statistics and population registration in Norway. Part 1. The vital statistics of Norway: An historical review

From olden times in Norway, as also in Sweden and Denmark, the church official in each parish has kept the official registers of marriages, births and deaths, and has produced the records which form the basis of Norwegian vital statistics.     

The health of the clergy: A review of demographic literature

A combination of special studies and official statistics permits an evaluation of the health of the clergy over the past century. The mortality experience of clergymen has been consistently more favorable than that of the general male population. It also has been favorable in comparison with the experience of men in the legal and medical professions although this differential has been diminishing. The initially favorable position of the clergy relative to teachers has been reversed. There is some evidence of mortality differentials within the clerical profession by major faith, denomination, or ministerial specialty. Clergymen have a relatively high mortality rate from cardiovascularrenal diseases and malignancies, but a very low rate for non-degenerative diseases and suicide. Morbidity statistics for the clergy are fragmentary. They may be over-represented among persons hospitalized for conditions that are emotional in origin. The clergy has some special advantages for studies of health, primarily that both membership in the study population and mortality can be determined with comparative ease. Several areas of future research are suggested.     

A note on some vital statistics of a primitive peasant community in Sierra Leone

In the course of some work in which a community of 1400 primitive Sierra Leone peasants were being re-examined at two-monthly intervals over a period of a year opportunity was taken to record births, deaths and pregnancies. A birth-rate of 32·9 (P.E. ± 3·27), and a death-rate of 38·4 (P.E. ± 3·52) per thousand per annum were obtained. The infant mortality rate was found to be 417 (P.E. · 48) per thousand live births, and the ratio of miscarriages and stillbirths to live births to be 22·9: 100. Since the community was small the figures are subject to a high statistical error, but they are offered because the data are believed to be accurate, and accurate vital statistics of primitive West African communities are practically non-existent.

The most interesting features in regard to deaths were that deaths in children aged 3 years or under accounted for almost half the total deaths at all ages, and that of these deaths in young children 38·5 % were attributed to an acute febrile illness.     

Public Policies and Suicide Rates in the American States

We are interested in the relationship between public policies and outcomes measuring quality of life. There is no outcome more final than the ending of one’s own life. Accordingly, we test the relationship between public policy regimes and suicide rates in the American states. Controlling for other relevant factors (most notably a state’s stock of social capital), we find that states with higher per capita public assistance expenditures tend to have lower suicide rates. This relationship is of significant magnitude when translated into potential lives saved each year. We also find that general state policy liberalism and the governing ideologies of state governments are linked to suicide rates. In response to a growing literature on the importance of non-political factors such as social connectedness in determining quality of life, these findings demonstrate that government policies remain important determinates as well.

The Association between Health Workforce and Health Outcomes: A Cross-Country Econometric Study

This study investigates the strength and significance of the associations of health workforce with multiple health outcomes and COVID-19 excess deaths across countries, using the latest WHO dataset. Multiple log-linear regression analyses, counterfactual scenarios analyses, and Pearson correlation analyses were performed. The average density of health workforce and the average levels of health outcomes were strongly associated with country income level. A higher density of the health workforce, especially the aggregate density of skilled health workers and density of nursing and midwifery personnel, was significantly associated with better levels of several health outcomes, including maternal mortality ratio, under-five mortality rate, infant mortality rate, and neonatal mortality rate, and was significantly correlated with a lower level of COVID-19 excess deaths per 100 K people, though not robust to weighting by population. The low density of the health workforce, especially in relatively low-income countries, can be a major barrier to improving these health outcomes and achieving health-related SDGs; however, improving the density of the health workforce alone is far from enough to achieve these goals. Our study suggests that investment in health workforce should be an integral part of strategies to achieve health-related SDGs, and achieving non-health SDGs related to poverty alleviation and expansion of female education are complementary to achieving both sets of goals, especially for those low- and middle-income countries. In light of the strains on the health workforce during the current COVID-19 pandemic, more attention should be paid to health workforce to strengthen health system resilience and long-term improvement in health outcomes.

     

Adult mortality in sub-Saharan Africa: Evidence from demographic and health surveys

This article reports levels, trends, and age patterns of adult mortality in 23 sub-Saharan Africa countries, based on the sibling histories and orphanhood data collected by the countries' Demographic and Health Surveys. Adult mortality has risen sharply since HIV became prevalent, but the size and speed of the mortality increase varies greatly among countries. Excess mortality is concentrated among women aged 25-39 and among men aged 30-44. These data suggest that the increase in the number of men who die each year has exceeded somewhat the increase for women. It is time for a systematic attempt to reconcile the demographic and epidemiological evidence concerning AIDS in Africa.     

An American in Berlin: reflections on the German demographic challenge, immigration, and national identity

The “German Demographic Challenge”—an aging society, low birth rates, a falling population size, and a shrinking working-age population—also affects less tangible facets of Germany’s future because these issues may have implications for how Germans see themselves and how they define themselves as a nation-state. This paper explores the complex relationships between national identity, migration, and other population processes in the German context. One consequence of the demographic challenge, acting in concert with immigration, is that the German population will become more diverse over time. Perhaps the more difficult challenge will be how Germany comes to terms with itself given the population changes it will experience.     

Recent health trends in the Native American population

This paper reviews the changes in the health status of Native Americans since the mid-1950s, how the disease pattern differs from non-Natives, and regional differences within the Native American population. Despite some limitations, data from the Indian Health Service indicate that substantial decline in the infant mortality rate and mortality from such infectious diseases as tuberculosis and gastroenteritis has occurred. With the exception of cardiovascular diseases and cancer, the risk of death from most causes are higher among Native Americans than the total US population. Geographic variation in disease rates can be demonstrated, most notable in diabetes. The unique pattern of diseases among Native Americans reflect the interaction of environmental and genetic factors. Genetic susceptibility plays a significant role in some diseases, such as diabetes, while for others, the generally lower socioeconomic status, higher prevalence of certain health risk behaviors and lower utilization of preventive services in the Native American population are important determinants.     

The Income and Health Effects of Tribal Casino Gaming on American Indians

The legalization of American Indian casino gaming in the late 1980s allows examination of the relationship between income and health in a quasi-experimental way. Revenue from gaming accrues to individual tribes and has been used both to supplement tribe members’ income and to finance tribal infrastructure. We assembled annual data from 1988–2003 on tribal gaming, health care access (from the Area Resource File), and individual health and socioeconomic characteristics data (from the Behavioral Risk Factors Surveillance System). We use this information within a structural, difference-in-differences framework to study the effect of casino gaming on tribal members’ income, health status, access to health care, and health-related behaviors. Our difference-in-differences framework relies on before-after comparisons among American Indians whose tribe has at some time operated a casino and with-without comparisons between American Indians whose tribe has and those whose tribe has not initiated gaming. Our results provide identified estimates of the positive effect of gaming on American Indian income and on several indicators of American Indian health, health-related behaviors, and access to health care.     

The demographic impact of Partition in the Punjab in 1947

We use data from the 1931, 1941, and 1951 censuses of India and the 1951 census of Pakistan to examine the demographic consequences of Partition in the Punjab in 1947. Had growth rates for the period 1931-41 for the Punjab as a whole continued to 1951, the population of the Punjab would have been 2.9 million larger than that recorded in 1951. Population losses from migration and mortality above age 20 were approximately 2.7 million greater between 1941 and 1951 than would have been predicted by loss rates between 1931 and 1941. We estimate a net Partition-related population movement out of the combined Punjab of about 400,000. We conclude from several lines of analysis that Partition-related population losses in the Punjab, either from deaths or unrecorded migration, were in the range 2.3-3.2 million. Partition was also marked by a dramatic religious homogenization at the district level.     

The World Health Organization's definition of health: Social versus spiritual health

The World Health Organization formulated its definition of health following World War II, during a period when the social health of societies was in question. Since that definition in 1946, social scientists have dutifully followed its precepts and attempted to operationalize its concepts, including social well-being. But, American social scientists have found that psychosocial well-being may be a more accurate formulation of mental and social well-being, and they have questioned the reasonableness of a definition that requires complete health. It is proposed that scholars refine the WHO definition over the next several years, while at the same time creating bridges between a new conceptual definition and more detailed operational definitions. An expansion of the WHO definition may be necessary to include a spiritual dimension of health if social scientists can agree that spirituality is part of health and not merely an influence.     

The demographic impact of Partition in the Punjab in 1947

We use data from the 1931, 1941, and 1951 censuses of India and the 1951 census of Pakistan to examine the demographic consequences of Partition in the Punjab in 1947. Had growth rates for the period 1931–41 for the Punjab as a whole continued to 1951, the population of the Punjab would have been 2.9 million larger than that recorded in 1951. Population losses from migration and mortality above age 20 were approximately 2.7 million greater between 1941 and 1951 than would have been predicted by loss rates between 1931 and 1941. We estimate a net Partition-related population movement out of the combined Punjab of about 400,000. We conclude from several lines of analysis that Partition-related population losses in the Punjab, either from deaths or unrecorded migration, were in the range 2.3–3.2 million. Partition was also marked by a dramatic religious homogenization at the district level.     

The development and use of demographic models

In this review, we first examine two classical demographic models - conventional life tables and stable populations - and a modern generalization of stable population theory; we then discuss mathematical models of conception and birth. These models involve purely mathematical relations in formal demography as opposed to empirical regularities. Next we consider model age schedules of mortality, nuptialitiy, marital fertility, fertility, and migration that are explicitly based on such empirical patterns. We close this empirical section with a discussion of model stable populations, which are based on model life tables. We next examine the use of demographic models in forecasting future mortality, nuptiality, and fertility and in population projection. Following a discussion of microsimulation models, which gives us the opportunity to mention model age schedules of post partum amenorrhoea and of sterility, we close with observations about the purposes and uses of demographic models.     

The analysis of linkages in demographic theory

Many seemingly different questions that arise in the analysis of population change can be phrased as the same technical question: How, within a given demographic model, would variable y change if the age- or time-specific function f were to change arbitrarily in shape and intensity? At present demography lacks the machinery to answer this question in analytical and general form. This paper suggests a method based on modern functional calculus for deriving closed-form expressions for the sensitivity of demographic variables to changes in input functions or schedules. It uses this “linkage method” to obtain closed-form expressions for the response of the intrinsic growth rate, birth rate, and age composition of a stable population to arbitrary marginal changes in its age patterns of fertility and mortality. It uses it also to obtain expressions for the transient response of the age composition of a nonstable population to time-varying changes in the birth sequence, and to age-specific fertility and mortality patterns that change over time. The problem of “bias” in period vital rates is also looked at.