The influence of cohort effects on mortality trends in India

The inferences drawn from this study are as follows: The stagnation/ increase in mortality rates of adult ages in the recent years in India as well as for the major states may be attributed to food shortages and price hikes experienced in the country during 1960–74. In other words, all those who were adults during 1980s had experienced the crisis of hunger due to nonavailability of food as well as entitlement failure during their childhood. These persons would have had higher risk of dying in their life time and that may be one of the main reasons for the stagnation or increase in adult mortality in India and in most of the states. The findings of the study suggest that, the economic crisis experienced in India during the late eighties, may decrease the survival chances of those born during this period in their future life time. However, successful containment of increase in food prices during the period of crisis would be helpful in protecting the entitlement of vulnerable groups. The policy implication of the study is that it is essential to control the prices of food during the time of food shortages and or economic crisis and even in the period when food is available, measures should be undertaken to evolve efficient distribution system ensuring the supply of food to those vulnerable groups, who were unlucky to be born or were in infancy during the period of economic crisis. Thus, essentially this is a study in interaction of economic factors and demographic trends in an economy where large segments of the population are periodically subject to heightened food insecurities, compression of real wages and entitlement failures.     

Child Mortality and Environment in Developing Countries

This paper studies child mortality and fertility in 61 developing countries including the Central Asian Republics (CARs). To control for simultaneity, an estimated value of fertility was used in the mortality equation and a final specification included only exogenous socio-economic, health and environmental variables. We confirm the importance of female literacy in explaining both fertility and mortality, and also find a measure of consumption for the poorest share of the population to be significant, while controlling for nutrition, health expenditure, and income distribution. Incidence of tuberculosis and female agricultural population proxy for environmental impacts, but in spite of these controls, approximately 41% additional mortality was estimated due to living in the CARs. The results fill gaps in the literature: we use a wider range of socio-economic and environmental health variables than previously in an encompassing analysis of mortality and fertility, and find evidence of excessive mortality in the CARs most likely linked to environmental degradation in the region.

全年龄人口死亡模型构建及应用——以江苏省为例

人口死亡特征不仅具有时间和区域属性,同时也具有年龄属性,多重属性决定了人口死亡规律的复杂性。在研究儿童少年期、青壮年期以及中老年期人口死亡模型的基础上,以江苏省为例构建了基于局部人口死亡模型的全年龄人口死亡模型,并对江苏省人口死亡过程进行了研究。研究表明：基于局部人口死亡模型的全年龄人口死亡模型能够细致刻画人口死亡过程依年龄变化的特点;江苏省儿童少年期、青壮年期和中老年期人口死亡模式可以分别采用威布尔对数线性模型、三次多项式模型和罗吉斯蒂模型来描述;近年来江苏省人口死亡水平不断下降,但各年龄层死亡水平下降特点不尽相同。     

Death Clustering,Mothers' Education and the Determinants of Child Mortality in Rural Punjab,India

In this paper the behavioural factors which make for continuing high levels of child mortality in rural Punjab, despite favourable conditions in terms of nutrition, income, women's literacy and health care facilities are examined. A major factor is that inadequate attention has been paid to improved health care practices within the home. Women's autonomy, social class, and mothers' education significantly influence child survival. One of the pathways by which mothers' education affects child survival is through improved child care. In this society, a woman's autonomy is lowest during that part of her life-cycle which also contains her peak childbearing years: this perverse overlap raises child mortality. The risk of dying is distributed very unevenly amongst children, as the majority of child deaths are clustered amongst a small proportion of the families. The death-clustering variable remained significant even after several possible biological and socio-economic reasons for clustering had been controlled. It is argued that this clustering of deaths is partly due to the poor basic abilities of some mothers and other carers.     

Role of Parental Education in Schooling and Child Labour Decision: Urban India in the Last Decade

This paper uses household level data from National Sample Survey Organization (NSSO) of India, the 55th (1999–2000) and the 61st (2004–05) rounds, to show that even with a significant wage incentive for schooling of urban children, the school drop out rate and child labour incidence are not small over this period. The parents’ level of education plays an important role in reducing this tendency; thus establishing the linkage between social and human capital outcomes in the family. We also look at the incidence of harmful and manual occupations among the child labour. Mother’s education appears as the more important factor in the recent round in curbing the manual work incidences; supporting earlier findings that women’s empowerment (one important indicator of which would be female educational level) is indeed becoming instrumental in increasing parental awareness. Using a pooled data set, we have also analysed the changes in the impact of parental education on these decisions between 1999–2000 and 2004–05.

Caste,Class, and Urbanization: The Shaping of Religious Community in Contemporary India

Building on the implications of qualitative work from India and urbanism theories, I aim to understand whether religious bonding social capital in contemporary India increases with greater urbanization and whether such increases are moderated by caste or social class position. Results from multinomial logistic regression on 1,417 Hindu respondents in a nationally representative sample of India (World Values Survey-India 2001) indicate that religious bonding is fostered by urbanism and that this association is stronger for upper castes. But there is little evidence that social class similarly moderates the association between urbanism and religious bonding. In light of these findings, religious bonding might be better understood as rooted in the interaction of caste dynamics and changes in the urban environment, rather than as a result of greater affluence. The data are also consistent with work underscoring the importance of disentangling social class and caste among Hindus in contemporary India.     

The Differential Effect of Mothers' Education on Mortality of Boys and Girls in India

In this study we consider whether the influence of a mother's education is the same on her daughters and her sons in a society which often treats them differently. Median-polish technique was used with data from the 1981 Census of India to determine the relative effect of mothers' education on mortality of boys and girls in childhood. It was found, as expected, that improved mothers' education reduced mortality at all ages below five years for both sexes. Further, the effect was found to be greater on girl than on boy children, particularly in the northern states. The effect of mothers' education was much greater than that of rural or urban residence. Previous research on the relationship between mothers' education and child mortality in India and elsewhere is discussed, as are possible underlying reasons for the differential treatment of boys and girls, and why it may be altered by education of the mother.     

Health Profiles and Profile-Specific Health Expectancies of Older Women and Men: The Netherlands

SUMMARY

This study focuses on gender differences in health profiles, and examines which health profiles drive gender differences in remaining life expectancy in women and men aged 65 and over in The Netherlands. Data from the first two cycles of the Longitudinal Aging Study Amsterdam (n = 2,141 and 1,659, respectively) were used to calculate health profiles for individuals of 65–85 years. For both women and men, six profiles were found: I. cancer; II. “other” chronic diseases; III. cognitive impairment; IV. frailty or multimorbidity; V. cardiovascular diseases; and VI. good health. The further characterization of these types showed some gender differences. Remaining life expectancy for women was greater than for men in each health profile. A decomposition into health expectancies showed that both women and men could expect to live about 5 years in good health from age 66. The greatest gender differences in years spent with health problems were found for profile IV and for profile III. Their greater number of years spent in these health states have direct consequences for the type and cost of care women need.     

中国与印度未来人口实力比较研究

就中印两国未来50年人口变动趋势,在劳动力人口数量、人口结构即劳动力人口与非劳动力人口的比例变 化以及人口素质等方面,进行中印两国的人口实力比较。     

The Effect of Child Mortality on Contraceptive Use and Fertility in Colombia,Costa Rica and Korea

In this paper the question whether reproductive behaviour is consciously altered by the death of a child is answered by using World Fertility Survey data from Colombia, Costa Rica, and Korea. Alternative strategies are proposed by which women replace children who have died. They may choose to contracept for a shorter period following the death of a child, or they may cease using contraception. Each strategy is analysed separately for selected birth intervals and its effect estimated with loglinear techniques. It is found that the timing and nature of the response to child mortality appear to depend on the stage reached in a country's fertility transition.     

丧偶对中国老人死亡风险的影响——年龄组差异及其健康因素的作用

基于"中国老人健康长寿影响因素研究数据"(1998~2008),利用Cox比例风险模型分析丧偶对老人死亡风险的影响及其健康因素的调节作用,并深入讨论此影响的年龄组差异。结果发现:老人丧偶与其死亡风险有非常显著的关系,在控制健康变量后,这种关系仍然显著存在,不过有很大程度的减弱。此外,长期丧偶对死亡风险的影响不存在显著的年龄组差异,而新丧偶对低龄老人死亡风险的影响要远大于对高龄老人的影响。     

Aging of Indian Women in India: The Experience of Older Women in Formal Care Homes

The feminization of aging is a process that has begun in India but is not occurring uniformly throughout India. Older women are more likely to be widowed, poor, and suffer vulnerability to adverse outcomes like poor health. With the changing social landscape of India, middle-income older women are increasingly opting for ‘pay and stay homes’, an emerging type of old age home in India. Majority of the 97 women residents of ‘pay and stay’ homes reported being widowed (68%), and 25% were childless. Childlessness and widowhood were important considerations in the decision to relocate to an old age home. Older women reported higher degrees of psychological closeness and contact with daughters than sons, and the overall social network size was small. High prevalence of diabetes rates among older women carries implications for potential functional disability. Strong advocacy measures for empowering older women in India should be a priority policy directive.     

社会支持对我国高龄老人死亡风险影响的Cox模型分析

文章运用中国高龄老人健康长寿跟踪调查纵向数据（1998～2005年）,对年龄范围在80～105岁的高龄老人进行考察,并基于Cox模型对社会支持于高龄老人死亡风险的影响机制进行探讨,对西方学者提出的社会支持的影响机制模型进行实证检验。结果表明,从我国的现实意义来看,社会支持对健康的影响是针对不健康的人群起到了缓冲作用,社会支持和健康变量之间存在着交互作用。另外,社会支持中的生活照料和情感支持对改善我国高龄老人的健康状况具有显著效果。     

老年人社区医养融合养老模式选择意愿影响因素分析--基于ISM-AHP方法

老年人社区医养融合养老模式选择意愿受众多因素的影响,这些因素涉及范围广且关系复杂。为厘清各影响因素之间的层次关系和影响程度,本文从身体特征、家庭特征、认知特征和环境特征四个方面构建了影响因素指标体系。首先采用解释性结构模型分析得到由表层直接影响因素、中层间接影响因素和深层根本影响因素组成的3级多层递阶有向图,然后应用层次分析法对各因素指标的影响力进行排序,建立指标综合权重体系。结果表明：表层直接影响因素包括ADL、医疗支出能力、健康自评等8个,中层间接影响因素包括慢性疾病数量、社会关注度、医疗保障水平等8个,深层根本影响因素包括家庭收入水平、政府支持力度和发展阶段3个。其中,家庭收入水平、ADL、医疗保障水平、慢性疾病数量、政府支持力度等是老年人社区医养融合养老模式选择意愿的主要影响因素。     

The Impact of Salmon Bias on the Hispanic Mortality Advantage: New Evidence from Social Security Data

A great deal of research has focused on factors that may contribute to the Hispanic mortality paradox in the United States. In this paper, we examine the role of the salmon bias hypothesis—the selective return of less-healthy Hispanics to their country of birth—on mortality at ages 65 and above. These analyses are based on data drawn from the Master Beneficiary Record and NUMIDENT data files of the Social Security Administration. These data provide the first direct evidence regarding the effect of salmon bias on the Hispanic mortality advantage. Although we confirm the existence of salmon bias, it is of too small a magnitude to be a primary explanation for the lower mortality of Hispanic than non-hispanic (NH)-White primary social security beneficiaries. Longitudinal surveys that follow individuals in and out of the United States are needed to further explore the role of migration in the health and mortality of foreign-born US residents and factors that contribute to the Hispanic mortality paradox.     

2002～2007年上海市人群死亡与节气变化关系研究

文章利用2002～2007年上海市人群死亡资料,计算不同节气的每天死亡数,采用圆形统计分布和超额死亡比,分析不同人群和死因的节气分布。得出:人群死亡的节气超额死亡比从立冬以后增长明显,至小寒、大寒节气达到一年的最高峰。男性和女性死亡节气的分布特点相似,而不同年龄组死亡节气分布不同。研究显示,节气能较准确地综合反映一年中不同时间气象的变化,对在时间上预警某些疾病的死亡危险,保护和干预高危人群具有一定的意义。     

The Potential Impact of Discrimination Fears of Older Gays,Lesbians, Bisexuals and Transgender Individuals Living in Small- to Moderate-Sized Cities on Long-Term Health Care

ABSTRACT

As an exploration of the potential impact of fears of discrimination against GLBTs in long-term health care settings, this study compared perceptions of GLBT persons and heterosexuals. A total of 132 GLBT persons and 187 heterosexuals living in Eastern Washington completed a survey that contained demographic questions and perceptions of discrimination in long-term care settings. Most respondents suspected that staff and residents of care facilities discriminate against GLBTs. GLBT respondents who believed that residents of care facilities are victims of discrimination were more likely to believe that they would have to hide their sexual orientation if admitted to a care facility. GLBT respondents were more likely than heterosexual respondents to believe that GLBTs do not have equal access to health care and social services, that GLBTs residents of care facilities are victims of discrimination, that GLBT sensitivity training programs would benefit staff and residents of care facilities, and that GLBT retirement facilities would be a positive development for older GLBTs. This study is offered as a preliminary investigation of concerns about GLBT discrimination in health care settings, how concerns are expressed, and the implications of those concerns for health care needs.     

我国社区卫生机构功能定位转变的效果评估研究

为实现“人人享有基本医疗卫生服务”的目标,我国医药卫生体制改革将社区卫生服务机构的功能定位为公益性机构。本文通过医改前后社区卫生服务机构的运行与服务提供状况的比较对其功能转变效果进行了评估,结果发现医改政策对社区卫生机构的运行起到了一定的影响,但主要体现在基本公共卫生服务的免费提供方面,对于其提供的医疗服务行为的影响不大。社区卫生机构功能的完全转变尚需同其补偿机制改革、医务人员收入分配机制改革和全科医生的系统培养等配套改革同步进行。