New evidence about effects of reproductive variables on child mortality in sub-Saharan Africa

There is still considerable uncertainty about how reproductive factors affect child mortality. This study, based on Demographic and Health Survey data from 28 countries in sub-Saharan Africa, shows that mortality is highest for firstborn children with very young mothers. Other children with young mothers, or of high birth order, also experience high mortality. Net of maternal age and birth order, a short preceding birth interval is associated with above average mortality. These patterns change, however, if time-invariant unobserved mother-level characteristics of importance for both mortality and fertility are controlled for in a multilevel–multiprocess model. Most importantly, there are smaller advantages associated with longer birth intervals and being older at first birth. The implications of alternative reproductive ‘strategies’ are discussed, taking into account that if the mother is older at birth, the child will also be born in a later calendar year, when mortality may be lower.     

The influence of cause-specific mortality conditions on the age pattern of mortality with special reference to Taiwan

Abstract This paper discusses the relationship between the level of mortality at ages one to four, on one hand, and five to 34 on the other. This relationship has been observed to vary considerably among mortality schedules at different levels of mortality and even among schedules at the same general level of mortality. This variation is shown among the modem life table systems of the Regional Model Life Tables and the United Nations Model Life Tables. Controlling for the leyel ofmortality from age five to age 34, the West Tables and the United Nations Tables embody approximately the same 'average' relationship between early childhood and adult mortality. Relatively to this average relationship, the South and East Tables consistently display higher childhood mortality rates for a given level of adult mortality. Indeed, the childhood rates of the South Table are twice those of the West Tables over a range of life expectancy at birth from 40 to 70 years. The relationship between childhood and adult mortality from 1957 to 1968, a period of rapid mortality decline, was investigated in Taiwan. In 1957, the Taiwanese data reflected the severe childhood mortality of the South Model Tables. However, by 1968, due to an especially large decline in childhood mortality, this relationship was more moderate and resembled the mortality pattern of the West or East Model Tables. An analysis of the decline in cause-specific mortality during the period revealed that a dramatic decline in childhood mortality from gastro-enteritis was primarily responsible for the shift in the relationship between childhood and adult mortality in Taiwan. It is asserted that, while any of several diseases which result in fatalities primarily among children of pre-school ages, could cause relatively severe childhood mortality, gastro-enteritis is likely to be a primary contributor to such an age pattern. This assertion is based on the fact that, especially in the developing areas of the world, malnutrition and gastro-enteritis are usually precipitating and complicating factors of other childhood diseases. A limited test of this hypothesis was provided by considering the causal components of childhood mortality rates in two populations known, for certain periods, to have exhibited relatively severe childhood mortality conditions; Spain and Portugal. For the years in which those populations were characterized by the South mortality pattern, gastro-enteritis was a principal cause of mortality in childhood. Moreover, with the decline in mortality from gastro-enteritis, the mortality pattern in Spain and Portugal no longer exhibited childhood mortality rates which were severe relative to those of adult life. The implications of these findings for the analysis of mortality conditions in many areas of the developing world, where the gastro-enteritis malnutrition syndrome annually claims a heavy toll of life in early childhood, are not clear. In those areas, the effect of this syndrome on the age pattern of mortality could be offset by special conditions inflating adult mortality rates. Nevertheless, in circumstances where there is evidence indicating substantial childhood mortality from this syndrome and no evidence indicating compensating severe adult mortality, there is reason to suspect that the existing mortality pattern reflects the relatively severe childhood mortality conditions of the South Model Tables. Additionally, where mortality from the gastro-enteritis malnutrition syndrome has been severe in past years, but has been reduced to low levels in recent years, it is probable that the relationship between childhood and adult mortality will shift in favour of the former - quite possibly, in the manner of Taiwan, from a South to an East or West age pattern.     

Longitudinal indicators of the social context of families: beyond the snapshot

Longitudinal indicators are measures of an individual or family behavior, interaction, attitude, or value that are assessed consistently or comparably across multiple points in time and cumulated over time. Examples include the percentage of time a family lived in poverty or the proportion of childhood a person lived in a single-parent family. Longitudinal indicators reflect exposure not at a “snapshot” moment but over the lifecourse and may also be more reliable assessments of the family environment or experience. We highlight potential longitudinal indicators and discuss methodological issues.     

南京市青年生育意愿调查分析

本文基于问卷调查资料,对南京市青年的理想子女数、性别偏好和预期生育年龄进行了定量分析,并对不同特征人群的生育意愿进行对比研究。结果表明,南京市青年多数不存在明显的生育性别偏好,少生晚生已成为其自觉自愿的选择。     

Quality of life in South Africa – The First Ten Years of Democracy

South Africa celebrated ten years of democracy in 2004. This special issue of Social Indicators Research (SIR) reviews developments that have impacted on the quality of life of ordinary South Africans during the transition period. The issue updates an earlier volume of SIR (Volume 41) published in 1997 and as a stand-alone volume. The earlier volume was initiated following SIR editor Alex Michalos’ first visit to South Africa. This update on quality of life in South Africa follows on his return visit to the country in 2004 to see firsthand the changes that had occured in the meantime. This introductory article outlines major achievements of and setbacks for the new democracy and the challenges facing it in future. It provides the backround for the evaluations of a range of quality of life domains and issues including poverty and inequality, crime, the HIV/AIDS epidemic, migration and housing, religiosity, reconciliation, and optimism for the future which are covered in the eleven articles that follow. The introduction divides the articles under the headings of challenges, achievements, monitoring quality of life, and social capital for the future. The overview article concludes that improvements in quality of life have been uneven but goodwill and a positive outlook bode well for South African quality of life in future.     

The effects of maternal smoking on infant health

Maternal smoking has serious consequences for the developing fetus and infant, including a higher probability that the infant will be born prematurely and at low birth weight, will require admission to neonatal intensive care, and die during infancy. Data from Alabama birth certificates for births occurring between 1988 and 1991 were analyzed using log linear methods to calculate relative risks of adverse pregnancy outcomes and infant death. Smoking by mothers during pregnancy is associated with an elevated risk of infant death, low birth weight, and prematurity, controlling for mother's educational attainment, age, marital status, race, and trimester prenatal care was initiated. Smoking was also associated with a higher rate of admission to neonatal intensive care and to deaths from SIDS and respiratory causes. Reducing maternal smoking can contribute to a reduction of premature and low weight births and infant deaths. Because of the difficulty of stopping smoking, efforts need to be directed at preventing younger women from beginning to smoke.An earlier version of this paper was presented at the Southern Demographic Association annual meeting in New Orleans in October 1993.     

Measurement of Attitudes Toward Bisexual Men and Women Among South African University Students: The Validation of an Instrument

Research was conducted investigating university students' prejudicial attitudes toward bisexual men and women in South Africa. The combined male and female Attitudes Regarding Bisexuality Scale (ARBS) showed unacceptable internal consistency reliabilities, especially for the Black-African participants. An expert focus group was convened in order to elaborate on and clarify the low reliability coefficients. The ARBS was then adapted for the South African population and resulted in two separate instruments designed to measure attitudes regarding bisexual men and bisexual women separately. Five hundred eighty seven university students completed these scales. The results indicated that the attitudes of heterosexual, homosexual, and asexual students toward bisexual men and women are more negative than the attitudes of bisexual students.     

Determinants of infant and child mortality in Kenya: an analysis controlling for frailty effects

In this paper, Weibull unobserved heterogeneity (frailty) survival models are utilized to analyze the determinants of infant and child mortality in Kenya. The results of these models are compared to those of standard Weibull survival models. The study particularly examines the extent to which child survival risks continue to vary net of observed factors and the extent to which nonfrailty models are biased due to the violation of the statistical assumption of independence. The data came from the 1998 Kenya Demographic and Health Survey. The results of the standard Weibull survival models clearly show that biodemographic factors are more important in explaining infant mortality, while socioeconomic, sociocultural and hygienic factors are more important in explaining child mortality. Frailty effects are substantial and highly significant both in infancy and in childhood, but the conclusions remain the same as in the nonfrailty models.     

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.     

Does midwifery continuity of care make a difference to women with perinatal mental health conditions: A cohort study,from Australia

BackgroundPerinatal mental health (PMH) conditions are associated with an increased risk of adverse perinatal outcomes including preterm birth. Midwifery caseload group practice (continuity of care, MCP) improves perinatal outcomes including a 24 % reduction of preterm birth. The evidence is unclear whether MCP has the same effect for women with perinatal mental health conditions.AimTo compare perinatal outcomes in women with a mental health history between MCP and standard models of maternity care. The primary outcome measured the rates of preterm birth.MethodsA retrospective cohort study using routinely collected data of women with PMH conditions between 1st January 2018 – 31st January 2021 was conducted. We compared characteristics and outcomes between groups. Multivariate logistic regression models were performed adjusting for a-priori selected variables and factors that differ between models of care.ResultsThe cohort included 3028 women with PMH, 352 (11.6 %) received MCP. The most common diagnosis was anxiety and depression (n = 723, 23.9 %). Women receiving MCP were younger (mean 30.9 vs 31.3, p = 0.03), Caucasian (37.8 vs 27.1, p < 0.001), socio-economically advantaged (31.0 % vs 20.2, p < 0.001); less likely to smoke (5.1 vs 11.9, p < 0.001) and with lower BMI (mean 24.3 vs 26.5, p < 0.001) than those in the standard care group. Women in MCP had lower odds of preterm birth (adjOR 0.46, 95 % CI 0.24–0.86), higher odds of vaginal birth (adjOR 2.55, 95 % CI 1.93–3.36), breastfeeding at discharge (adj OR 3.06, 95 % CI 2.10–4.55) with no difference in severe adverse neonatal outcome (adj OR 0.79, 95 % CI 0.57–1.09).ConclusionsThis evidence supports MCP for women with PMH. Future RCTs on model of care for this group of women is needed to establish causation.     

20世纪末中国家庭结构及其社会功能的变迁

20世纪末期中国的家庭结构和功能发生了较大的变化。具体表现为:家庭规模持续缩小;核心家庭仍占中国家庭模式的主导,三代及以上的大家庭基本保持不变,空巢家庭异军突起;隔代家庭呈现增加趋势;单亲家庭日益增加;家庭生育功能降低;家庭生产功能有复归的趋势;教育功能提高;消费功能大大增强;养老功能削弱。     

The influence of women’s work opportunities on marriage rates

Several authors have argued that increased work opportunities for women have helped to produce a reduction in the average age at marriage in the United States. This paper tests this proposition on data for the 100 largest SMSA's in 1960. Using ordinary least-squares regression, we find that areas of relatively attractive female employment opportunities had relatively low proportions of women ever married in the age interval 22-24. Other variables significantly related to the proportion married in an SMSA are its sex ratio, percent Catholic, and number of inhabitants. A decline in the sex ratio and improvements in female employment opportunities appear to have been equally influential in producing declines in proportions married between 1960 and 1970.     

计划生育法制建设与生殖健康——兼论生殖健康理念的国际比较

我国的婚育制度为计划生育与生殖健康建立了良好的发展环境,我国相关法律规范中体现了《国际人口与发展大会》对生殖健康的要求,为生殖健康事业的发展提供了有力的法律保障和广阔的发展空间。     

中西部农村地区人口计划生育调查之分析

利用有关数据对中国中西部农村地区的人口“计划外生育”(超生)现象进行研究。研究发现,社会经济基础、生育文化和计划生育政策强度是影响不同地区“计划外生育”的主要因素。研究还发现,这些地区的人口生育水平实际上已经处于较低的水平。事实上,“计划外生育”或“超生”现象与计划生育政策的不同界定标准有很大关系,这与上世纪八、九十年代出现的“超生”现象不具有可比性。     

The Use of Defence Mechanisms as Precursors to Coming Out in Post-Apartheid South Africa: A Gay and Lesbian Youth Perspective

ABSTRACT

This article comprises one facet of a larger, three-year phenomenological study (1997–2000) of gay and lesbian youth coming out in post-apartheid South Africa. A nonprobability sample of 18 young people, aged between 16 and 21 years, was interviewed. The resultant data was content analyzed, and the trustworthiness of the information was ensured via member checking and utilizing an independent coder. Results consistently revealed that gay and lesbian youth use defense mechanisms, such as denial, avoidance, compartmentalization, suppression, compensation, sublimation, undoing, displacement, rationalization, and intellectualization, in a conscious manner during their coming out process. The young people in this study demonstrated resilience despite the prejudice and inner turmoil that they had experienced. Practice guidelines are suggested in terms of how health and social care practitioners can support gay and lesbian youth in coping with their coming out process.     

The effect of antenatal screening for depression on neonatal birthweight and gestation

BackgroundAntenatal depression has been associated with poor perinatal outcomes such as preterm birth and low birth weight. Universal screening of perinatal depression has been recommended to improve maternal and pregnancy outcomes.Hypothesis and aimWe hypothesise that screening for antenatal depressive symptoms may reduce the risk of preterm birth and low birth weight. To assess the hypothesis, we explore the association between antenatal depression screening using the Edinburgh Postnatal Depression Scale and neonatal outcomes.MethodsA retrospective analysis of state-wide population-based health administrative data. Inclusion criteria were pregnant women who gave birth to a singleton in Queensland in the second half of 2015 (29,543 women). Logistic regression analyses were run in 27,817 women with information in all variables. Main outcomes were preterm birth (<37 weeks of gestation) and low birth weight (<2500 grs).ResultsWomen who did not complete the screening had increased odds of preterm birth (AOR, 1.56; 95% CI, 1.39–1.74; p < 0.001) and low birth weight (AOR, 1.48; 95% CI, 1.30–1.68; p < 0.001) before and after adjustments for relevant confounders when compared to women who completed the screening. Sensitivity analyses performed in women with spontaneous labour and in women without a diagnosis of depression showed similar results.Conclusion(s)We found an association between screening for depressive symptoms during pregnancy and better neonatal outcomes. However, this result does not necessarily infer causality. Any association may represent a previously unknown benefit to screening, which could support the case for universal antenatal depression screening.     

浙江临安市生育文化变迁的调查与研究--关于浙江省临安市5561对双农独女户的调查与分析

本文通过走访、座谈和问卷调查等方式对临安市的生育文化变迁作了深入的研究。首先对临安生育文化变迁的现象进行了描述,然后,从经济、文化、社会等多角度对临安生育文化变迁的原因进行了宏观和微观的分析;最后,我们从社会保障、独生子女优惠措施的落实、计划生育工作等方面对临安生育文化建设提出了一些建议。     

20世纪90年代关于我国出生性别比问题的研究

我国在人口生育率下降的过程中出现了较为严重的出生性别比偏高现象。针对这一问题,学术界就我国出生性别比的通常值域、出生性别比偏高的原因进行讨论。这场学术讨论具有非常重要的意义:认识到我国出生性别比是“真性”失衡,为认识和解决这一问题提供了最基本的依据;弄清了我国出生性别比偏高的原因;拓展了我国出生性别比及相关问题的研究范畴;推动了国家有关部门采取措施治理这一问题。     

The Optimal Trade-Off Between Quality and Quantity with Unknown Number of Survivors

In a model of endogenous fertility where individuals know the probability of child survival but not the final number of survivors, parents do not always formulate a precautionary demand for children. For some utility functions, parents have fewer children than what they would have in a situation in which the number of survivors is known earlier. The properties of the optimal economic policy depend on the degree to which the social welfare function takes ignorance into account. If social welfare is evaluated after parents know how many children survived, the parental response to uncertainty is socially inefficient. Individual decisions then should be corrected through tax or transfer on both births and education. This property helps determine the optimal public response to mortality crisis in the presence of educational externalities.     

The relative effects of shocks in early- and later-life conditions on mortality

The relative importance of cohorts' early-life conditions, compared to later period conditions, on adult and old-age mortality is not known. This article studies how cohort-level mortality depends on shocks in cohorts' early- and later-life (period) conditions. I use cohorts' own mortality as a proxy for the early-life conditions, and define shocks as deviations from trend. Using historical data for five European Countries i find that shocks in early-life conditions are only weakly associated with cohorts' later mortality. This may be because individual-level health is robust to early-life conditions, or because at the cohort level scarring, selection, and immunity cancel each other. Shocks in period conditions, measured as deviations from trend in period child mortality, are strongly and positively correlated with mortality at all older ages. The results suggest that at the cohort level changing period conditions drive mortality variation and change.