J-Curve? A Meta-Analysis and Meta-Regression of Parity and Parental Mortality

Research suggests that parity and parental health and mortality are associated significantly, although the pattern of association varies across studies. Studies ascribe long-term poor health (and mortality) to either low or high parity, and some studies show that both low and high parity increase the risk of adverse health for parents (i.e., forming a “J-shaped curve”). While a recent meta-analysis (Zeng et al., Sci Rep 6:19351, 2016) has partially addressed this gap in the literature, the present study further extends the literature by using a methodology that allows for more robust control of study heterogeneity and potential confounders. Using data on 223 measures of relative mortality risk from 37 studies, from samples gathered after 1945 from developed nations, meta-analysis and meta-regression (weighted linear regression) results show a nonlinear association (J-shaped curve) between parity and all-cause parental mortality, though the strength of the association varies by both sex and cohort. The results also suggest that the mortality hazard is partially explained by health selection effects.     

Rural–Urban Migration and Cross-National Variation in Infant Mortality in Less Developed Countries

The relationship between migration and child health in individual countries is well known, but the cross-national variation in this relationship is largely untested. Using Demographic and Health Survey (DHS) data from 52 medium and low income countries, this study examines the effect of rural–urban migration on infant mortality and whether its effect varies cross-nationally. A secondary objective is to determine whether there is a relationship between the time a child is born in the migration process and infant mortality. Hypotheses are developed on the basis of competing theories on the relationship between migration and health. There are modest, but significant cross-national effects of rural–urban migration on infant mortality, which were better revealed in the presence of family- and child-level variables. The results also show that the unadjusted effects of rural–urban migration are quite substantial, but were largely accounted for by family- and child-level factors including education, socioeconomic status (SES), marital status, birth order, maternal age at child’s birth, and inter-births intervals. The results largely point to a selection process, which is further confirmed by results showing that the hazards of infant death increase with length of urban residence. Programs that target increasing maternal education, improving household SES, and lengthening interbirth intervals would therefore greatly benefit child survival in less developed countries.     

Mother’s,Household, and Community U.S. Migration Experience and Infant Mortality in Rural and Urban Mexico

This study explores rural and urban differences in the relationship between U.S. migration experience measured at the individual, household, and community levels and individual-level infant mortality outcomes in a national sample of recent births in Mexico. Using 2000 Mexican Census data and multi-level regression models, we find that women’s own U.S. migration experience is associated with lower odds of infant mortality in both rural and urban Mexico, possibly reflecting a process of healthy migrant selectivity. Household migration has mixed blessings for infant health in rural places: remittances are beneficial for infant survival, but recent out-migration is disruptive. Recent community-level migration experience is not significantly associated with infant mortality overall, although in rural places, there is some evidence that higher levels of community migration are associated with lower infant mortality. Household- and community-level migration have no relationship with infant mortality in urban places. Thus, international migration is associated with infant outcomes in Mexico in fairly complex ways, and the relationships are expressed most profoundly in rural areas of Mexico.

Mortality and fertility: How large is the direct child replacement effect in China?

Olsen (1980) proposed a method for quantifying the fertility response to child mortality. He showed how to correct for bias in the OLS estimator. He also proposed the use of mortality rates as an instrumental variable. This method is applied here to a new Chinese microdata set. It appears that the method works well. The bias-corrected direct replacement effect based on the Chinese data is about 0.6, which is three times as large as the effects found by Olsen (1980, 1988) using data for Colombia and Malaysia. Several explanations are provided for this result.I am grateful to Frank Denton, Martin Dooley, Ronald Lee, Lonnie Magee, Byron Spencer and three anonymous referees for many helpful comments and suggestions. I would also like to thank the International Statistical Institute Research Center for supplying the data used in this study.     

Does More Schooling Reduce Hospitalization and Delay Mortality? New Evidence Based on Danish Twins

Schooling generally is positively associated with better health-related outcomes—for example, less hospitalization and later mortality—but these associations do not measure whether schooling causes better health-related outcomes. Schooling may in part be a proxy for unobserved endowments—including family background and genetics—that both are correlated with schooling and have direct causal effects on these outcomes. This study addresses the schooling-health-gradient issue with twins methodology, using rich data from the Danish Twin Registry linked to population-based registries to minimize random and systematic measurement error biases. We find strong, significantly negative associations between schooling and hospitalization and mortality, but generally no causal effects of schooling.     

Trends,Age Patterns and Differentials in Childhood Mortality in Haiti (1960–1987)

This paper examines the trends, patterns and differentials in childhood mortality in Haiti between 1960 and 1987 with data from three surveys and one census. Data comparability is maximized by a series of adjustments, and both direct and indirect techniques are applied. The results indicate that a slow decline in childhood mortality has occurred since 1960 for the country as a whole. Neonatal survival has shown impressive gains, especially in rural Haiti. Post-neonatal mortality has not, however, declined at the same rate. Mortality between the ages of one and five years has declined at about the same pace as infant mortality, maintaining consistency with model patterns of mortality change. The overall national decline in child mortality appears to have consisted of two phases. The first occurred in rural Haiti during the late 1960s and early 1970s and was due largely to a fall in neonatal mortality. The second phase of the decline was concentrated in Port-au-Prince, and seems to have affected all ages of childhood.     

Lower Infant and Child Mortality Rate and Improve Quality of Life of the People——Interview with Professor Gao Ersheng

Gao Ersheng, born in 1943, is a researcher of Shanghai Family Planning Research Institute, PhD supervisor, director of WHO Human Reproductive Health Research and Research Training Cooperation Centre, council member     

Mortality of Under-Five-Year-Olds Between 1991-1995

InitsProgramforChildren'sDevelopment,Chinasetagoaltoreducethemortalityrateofunder-five-year-oldsbyonethirdfrom61.0perthousandin1990to40.6in2000.Forthispurpose,theMinistryofHealthconductedamonitoringsurveyofmortalityofunder-five-year-oldsin81citiesorcountiesnationwidebetween1991-1995.Thefollowingisasummaryofthefindings.MortalityrateTable1Deathrateofnewborns,infantsandunder-five-year-oldsinChinabetween1991-1995(perthousand)RegionNeonatalInfantUnder-five-year-olds9192939495919293949591929394…     

Black–White Disparities in Adult Mortality: Implications of Differential Record Linkage for Understanding the Mortality Crossover

Mortality rates among black individuals exceed those of white individuals throughout much of the life course. The black–white disparity in mortality rates is widest in young adulthood, and then rates converge with increasing age until a crossover occurs at about age 85 years, after which black older adults exhibit a lower mortality rate relative to white older adults. Data quality issues in survey-linked mortality studies may hinder accurate estimation of this disparity and may even be responsible for the observed black–white mortality crossover, especially if the linkage of surveys to death records during mortality follow-up is less accurate for black older adults. This study assesses black–white differences in the linkage of the 1986–2009 National Health Interview Survey to the National Death Index through 2011 and the implications of racial/ethnic differences in record linkage for mortality disparity estimates. Match class and match score (i.e., indicators of linkage quality) differ by race/ethnicity, with black adults exhibiting less certain matches than white adults in all age groups. The magnitude of the black–white mortality disparity varies with alternative linkage scenarios, but convergence and crossover continue to be observed in each case. Beyond black–white differences in linkage quality, this study also identifies declines over time in linkage quality and even eligibility for linkage among all adults. Although linkage quality is lower among black adults than white adults, differential record linkage does not account for the black–white mortality crossover.     

Mortality in Vietnam, 1979–1989

Little is known about past and present mortality in Vietnam, as the first official data on mortality have only recently become available from censuses taken in 1979 and 1989. Using these data, I estimate Vietnamese mortality during the intercensal period using two techniques that rely on age-specific growth rates from two successive age distributions. Intercensal emigration and differential completeness of census enumeration associated with massive outflows of refugees in the wake of the Vietnam War; population-redistribution policies, and a highly mobile population represent important sources of bias for the estimation of intercensal mortality. I incorporate several strategies to minimize bias from these sources and to select the method that is least sensitive to errors associated with them. Life expectancy at birth estimated for the 1979–1989 intercensal period is 61.4 years for males and 63.2 for females. These results suggest a trend of declining mortality between the 1970s and the 1980s and add solid empirical evidence to the debate over whether mortality in Vietnam has been deteriorating or improving.     

Maternal Mortality WatchSheds Light on Causes of Death

To obtain an overall understanding of maternalmortality in different regions of China, particularlycauses and factors leading to maternal mortality, agroup of researchers from 20 provinces formed a team in1989 to monitor local maternal mortality rates at 247spots, covering about 100 million people. The projectspanned seven years (1989-1995), indicating thatmaternal mortality was decreasing. More details aregiven below.A. Maternal mortality rate (MMR) at national andregional levelsIn the seve…     

The Changing Shape of Soviet Mortality, 1958–1985: An Evaluation of Old and New Evidence

Changes in mortality in the Soviet Union have attracted the attention of both scholars and the popular media. After a hiatus of more than ten years, the government of the Soviet Union has released data on mortality for the 1980s, which allow assessment of recent changes. The new life table for 1984–85 shows that mortality of Soviet females has improved at ages below 45 and deteriorated above that age since the last age-specific mortality data were published in the early 1970s, while mortality of males has improved at ages below 25 and deteriorated above that age. At the same time, the official mortality rates for persons aged 60 and over in 1958–59, 1968–71, and 1984–85 are implausibly low. Poor-quality data at the older ages, particularly in rural areas and the less developed regions of the country, contributed to these low mortality rates of the old. As data quality has improved with time, the reported mortality rates at old ages have increased. Adjustment of the official data for error, especially above age 60, shows that whereas the reported value of e₀ for males fell by 1.5 years between 1958–59 and 1984–85, the actual value probably fell by no more than 0.5 years; the corresponding figures for females were a reported rise of one year, and an actual rise of at least two years. Examination of these Soviet data illustrates how important consideration of error in mortality statistics of the old can be in understanding mortality trends.     

Could the EQ-5D be Used to Predict Mortality and Hospitalization Over a Long Term Period?

Although numerous studies have demonstrated that social support affects a range of life experiences, only a few have examined the moderators and mediators such as self-esteem. According to self-control theory, self-control represents one’s ability to override or change one’s inner responses, and to interrupt undesired behavioral tendencies and refrain from acting on them. A high level of self-control may help individuals to mediate or moderate negative affect and thus weaken any adverse effects, contributing to their subjective well-being (SWB) in the long run. The current study explored how this interaction may affect the subjective well-being of the Chinese elderly, for whom self-control and social support are especially important life management issues. The study examined whether self-control mediates and moderates the relationship between social support and SWB among the elderly Chinese population. The data were collected from 335 elderly Chinese people (162 females and 173 males) from ten cities in central China, who completed the Chinese Social Support Scale, Trait Self-control Scale, Life Satisfaction Scale and Positive and Negative Affect Scale. The results showed that self-control, social support and SWB were strongly and significantly related. Hierarchical regression analysis showed that self-control partially mediated the influence of social support on SWB. Moreover, self-control moderated the relationship between social support and positive affect, but not life satisfaction and negative affect. These findings imply that self-control is a critical indicator of SWB and can serve as a basis for differentiating between intervention strategies that promote SWB among the elderly by helping them manage positive and negative affect. Future studies should further examine the internal mechanisms by which self-control influences SWB.     

Marital Fertility Decline in the Netherlands: Child Mortality, Real Wages, and Unemployment, 1860–1939

Previous studies of the fertility decline in Europe are often limited to an earlier stage of the marital fertility decline, when the decline tended to be slower and before the large increase in earnings in the 1920s. Starting in 1860 (before the onset of the decline), this study follows marital fertility trends until 1939, when fertility reached lower levels than ever before. Using data from the Historical Sample of the Netherlands (HSN), this study shows that mortality decline, a rise in real income, and unemployment account for the decline in the Netherlands. This finding suggests that marital fertility decline was an adjustment to social and economic change, leaving little room for attitudinal change that is independent of social and economic change.     

Forced Migration and Mortality in the Very Long Term: Did Perestroika Affect Death Rates Also in Finland?

In this article, we analyze mortality rates of Finns born in areas that were ceded to the Soviet Union after World War II and from which the entire population was evacuated. These internally displaced persons are observed during the period 1971-2004 and compared with people born in the same region but on the adjacent side of the new border. We find that in the 1970s and 1980s, the forced migrants had mortality rates that were on par with those of people in the comparison group. In the late 1980s, the mortality risk of internally displaced men increased by 20% in relation to the expected time trend. This deviation, which manifests particularly in cardiovascular mortality, coincides with perestroika and the demise of the Soviet Union, which were events that resulted in an intense debate in civil society about restitution of the ceded areas. Because state actors were reluctant to engage, the debate declined after some few years, and after the mid-1990s, the death risk again approached the long-term trend. Our findings indicate that when internally displaced persons must adjust to situations for which appropriate coping behaviors are unknown, psychosocial stress might arise several decades after their evacuation.     

How Many More Missing Women? Excess Female Mortality and Prenatal Sex Selection, 1970–2050

Sex‐based discrimination has resulted in severe demographic imbalances between males and females, culminating in a large number of “missing women” in several countries around the world. We provide new estimates and projections of the number of missing females and of the roles played by prenatal and postnatal factors in this imbalance. We estimate time series of the number of missing females, the number of excess female deaths, and the number of missing female births for the world and selected countries. Estimates are provided for 1970–2010 and projections are made from 2010 to 2050. We show that the estimates of these different indicators are consistent with one another and account for the dynamics of the population of missing females over time. We conclude that the number of missing females has steadily risen in the past decades, reaching 126 million in 2010, and the number is expected to peak at 150 million in 2035. Excess mortality was the dominant cause of missing females in the past, and this is expected to remain the case in future decades in spite of the recent rise of prenatal sex selection. The annual number of newly missing females reached 3.4 million in 2010 and is expected to remain above 3 million every year until 2050.     

Living Arrangements and the Elderly: An Analysis of Old-Age Mortality by Household Structure in Casalguidi, 1819–1859

The elevated levels of protection, assistance, and care enjoyed by the elderly living in complex households has long been a key assumption of many family system theories. However, although this hypothesis has been demonstrated for contemporary contexts, quantitative evidence for past populations is particularly scarce, if not nonexistent. This article investigates the relationship between old-age mortality and living arrangements in a mid–nineteenth century Tuscan population, where the joint family system of sharecroppers coexisted alongside the nuclear system of day laborers. Our findings demonstrate that within complex households, the complexity of relationships, gender inequalities, and possible competition for care and resources among the most vulnerable household members—namely, the elderly and the young—weakens the assumption that the elderly benefitted from lower rates of old-age mortality.