Measuring socioeconomic status in health research in developing countries: Should we be focusing on households,communities or both?

Research on the effects of socioeconomic well-being on health is important for policy makers in developing countries, where limited resources make it crucial to use existing health care resources to the best advantage. This paper develops and tests a set of measures of socioeconomic status indicators for predicting health status in developing countries. We construct socioeconomic indexes that capture both household and community attributes so as to allow us to separate the social from the purely economic dimensions of the socioeconomic status within a cross-national perspective, with applications to data from Demographic and Health Surveys (DHS) fielded in five African countries in the 1990s. This study demonstrates the distinctive contributions of socioeconomic indexes measured at the household vs. community level in understanding inequalities in health and survival and underlines the importance of going beyond the purely economic view of socioeconomic status to cover the multidimensional as well as multilevel concept of economic and social inequality.     

Young Women Migrants in Beijing：Major data from a survey on the migrant population

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Can fertility be estimated from current pregnancy data?

Summary This paper explores the feasibility of estimating fertility from reports on current pregnancies collected in single-round sample surveys. Data from 15 countries in the World Fertility Survey are used to evaluate the possibilities. The results indicate that neither the age pattern of fertility nor the total fertility ratio can be reliably estimated from current pregnancy data. For almost all countries, the total fertility ratio based on recent births is higher than that based on current pregnancies, even when the latter estimate is restricted to higher durations of pregnancy.     

Should i stay or should i go? The impact of age norms on leaving home

This article studies the association between social norms and the timing of leaving home. Although largely overlooked by most recent studies on leaving home, life-course theory suggests that age norms and age grading influence life-course decisions in general and leaving home in particular. We use Fishbein and Ajzen's model of "reasoned behavior" to integrate this strand of research with the more individualistic view that dominates current thinking. Using data from a Dutch panel survey, we use a Cox regression model with a control for sample selection to estimate the association between perceived age norms and the timing of leaving home. We show that perceived opinions of parents are associated with the actual timing of leaving the parental home but that societal norms and friends' norms concerning the timing of leaving home are not. In addition, the timing of leaving home is also associated with the perceived costs and benefits of leaving home and with the perceived housing market situation.     

Can expanding access to basic healthcare improve children's health status? Lessons from Indonesia's 'midwife in the village' programme

In the 1990s, the Indonesian government placed over 50,000 midwives in communities throughout the country. We examine how this expansion in health services affected children's height-for-age. To address the problem that midwives were not randomly allocated to communities, the estimation exploits the biology of childhood growth, the timing of the introduction of midwives to communities, and rich longitudinal data. The evidence indicates that the nutritional status of children fully exposed to a midwife during early childhood is significantly better than that of their peers of the same age and cohort in communities without a midwife. The former are also better off than children assessed at the same age from the same communities but who were born before the midwife arrived. Within communities, the improvement in nutritional status across cohorts is greater where midwives were introduced than where they were not. This result is robust to the inclusion of community fixed effects.     

Donating Time or Money? The Effects of Religiosity and Social Capital on Civic Engagement in Qatar

Few studies have examined the role of religiosity and social capital on civic engagement in the context of a Muslim country. In this paper, we explore the impact of religiosity and social capital on charitable donations and volunteerism in Qatar. Drawing on a nationally representative survey from Qatar, we consider various attitudinal and behavioral measures for capturing religiosity and social capital. The results indicate that, even after controlling for a wide range of demographic variables, behavioral measures have a stronger effect than attitudes. Individuals who regularly perform daily prayers are more likely to donate than those individuals who simply describe themselves as religious. Similarly, individuals who are more active in their neighborhood engagement are more likely to volunteer than those who merely report high levels of social trust. These results suggest that when it comes to the relationship between religiosity, social capital and civic engagement, individual behavior is much more predictive than attitudes alone. We also find that even in the case of Qatar, where citizen wealth has rapidly increased in the last few decades, there is little evidence of substitution effects: citizens do not appear to trade-off or substitute between time and money. Instead, more religious and active citizens are likely to do both.     

Can NFP be taught in two short,easy lessons? Simplified NFP for isolated and/or busy couples

Researchers used life table rates from study and comparison groups from rural and urban areas of Cagayan de Oro City, the Philippines to test a simplified method of teaching natural family planning (NFP) defined by calendar, mucus, and cervix indicators. This method included a 6 page booklet, 2 30-minute training sessions, and a question and answer period. Fear of side effects from other contraceptive methods was the leading reason for using NFP (79.4% urban, 85.8% rural). Religious motivation and fear of side effects followed for urban couples, but the percentage was low (14.6%). In rural areas, religious motivation place 3rd (4.1%) preceded by other reasons (6.9%). User error resulted in low accidental pregnancy rates (.8%). Method failure was responsible for higher failure rates than user error, but they were still relatively low (3.4% total). In rural areas, the reason for failure was unclear in 2.6% of couples, but it was only .9% among urban couples. Rural couples who used NFP to space births (spacers) had 2 times the failure rate of those rural couples who used NFP to limit births (limiters) [69% vs. 31%]. Urban spacers had a higher failure rate than urban limiters, but the difference was smaller than it was for rural couples (54.8% vs. 45.2%). Lactation did not have a clear effect on failure rates. For example, in urban areas, partially lactating women had a lower failure rate than nonlactating women (41.9% vs. 58.1%), but in rural areas, lactation had the opposite effect (63.6% for lactating women and 36.4% for nonlactating women). Risk taking resulted in more 6 month pregnancy rates among urban couples than rural couples (12.3% vs. 8.2%). At the end of 6 months, 67.5% of all couples still used the new simplified NFP method (70.3% rural vs. 64.7% urban). Therefore the new simplified NFP method was an effective method for spacing or limiting births.     

“You’re a ‘high-risk’ customer”: A qualitative study of women’s experiences of receiving information from health professionals regarding health problems or complications in pregnancy

BackgroundExperiencing complications in pregnancy is stressful for women and can impact on fetal and maternal outcomes. Supportive encounters with health professionals can reduce the worry women experience. Further research is needed to understand women’s perspectives on communicating with their healthcare providers about their concerns.AimThis study explored women’s experiences of receiving information about pregnancy complications from healthcare providers and their interactions with multiple professionals and services during pregnancy.MethodsThis was a qualitative interpretive study. Semi-structured interviews were conducted with 20 women experiencing pregnancy complications recruited from antenatal services at two hospitals in Sydney. Inductive thematic analysis was used to analyse the data.FindingsWomen had a range of reactions to their diagnoses, including concern for their baby, for themselves and for their labour. Most women reported that communication with healthcare providers was distressing, they were not listened to and staff used insensitive, abrupt language. Women were also distressed by delays in education, receiving contradictory information and having to repeatedly share their stories with different health professionals. In some cases, this damaged the therapeutic relationship and reduced trust towards healthcare providers. Midwives were generally preferred over doctors because they had a more woman-centred approach.ConclusionTo improve women’s experiences of care for pregnancy complications, it is critical to improve the communication skills of maternity service providers. Women’s need for information, resources and support can best be provided by continuity of care with a named health professional, for example, a midwife working within an integrated multidisciplinary antenatal service model.     

Small Fish in a Big Pond or Big Fish in a Small Pond? The Effects of Educational Mismatch on Subjective Wellbeing

This paper analyzes the effects of educational mismatch on subjective wellbeing. We first analyze whether a discrepancy exists between the aspirations associated with the level of education acquired by the individuals and the opportunities found in the labor market. Consistent with education generating certain aspirations, we find that educational mismatch has a sizable significant negative impact on life satisfaction for over-educated individuals while the effect is positive for under-educated workers. Next, we focus on workers with different educational levels but who perform similar jobs. In this case we only find under-education to negatively affect life satisfaction levels, a result which is consistent either with the existence of an inferiority complex or a struggle to perform a job for which the individual is not adequately trained. The effects are economically relevant and amount between one-fifth and one-fourth of the impact produced by other negative life events such as unemployment.     

Is it God or Just the Data that Moves in Mysterious Ways? How Well-Being Research may be Mistaking Faith for Virtue

Opinion is mixed regarding the link between spiritual faith-based beliefs (SFBBs) and psychological well-being—however, most published field studies suggest a positive link. Controlled experiments demonstrate that spirituality promotes social cohesion and deters excessive self-interested behaviour. Yet past research has largely overlooked virtues (which are related to, yet distinct from, SFBB) as a rival explanation for these observations. Reviewed papers almost exclusively employed bi-variate designs incapable of answering the question “Is it God, or just missing variables?” This paper redresses this oversight by simultaneously including virtue (e.g., kindness, etc.,) and SFBB as predictors of well-being. Although simple analyses (.02 ≤ β ≤ .28) replicate the typical SFBB findings, multivariate analyses reveal that virtues (spirituality) positively (negatively) predict well-being. Since multivariate analyses (which are rarely conducted in this field) are appropriate for testing competing theories, past claims that SFBBs improve well-being appear spurious.     

Up and on or down and out? Gender, immigration and the consequences of temporary employment in Canada

What happens to temporary workers when their jobs end? Is temporary employment a fleeting way station to a better job, or does it herald an ongoing cycle of precariousness? What are the implications of temporary employment dynamics for broader patterns of inequality in labour markets? European researchers have focused increasing attention on these issues in the context of concern about the relationship between inequality and insecurity in labour markets with strong regulatory protections for insiders. However, research on the outcomes of temporary employment in the less regulated labour markets of North America remains limited. This paper draws on rich representative panel data from Statistics Canada's Survey of Labour and Income Dynamics (SLID) and competing risks Cox regression to assess the outcomes and dynamics of temporary employment in this understudied context. Key contributions include more precise estimates of transitions, consideration of multiple theoretically relevant outcomes (permanent jobs; new temporary jobs; and periods of unemployment and labour force withdrawal), and situation of the effect of gender and immigration status on temporary employment transitions in the context of the dynamics of permanent jobs. Findings present a more pessimistic picture of overall temporary job outcomes than prior research but suggest that the dynamics of temporary work do not magnify inequalities of gender and immigration status.     

Is education a risk factor or social vaccine against HIV/AIDS in Sub-Saharan Africa? The effect of schooling across public health periods

Early in the 30-year HIV/AIDS pandemic in Sub-Saharan Africa, epidemiological studies identified formal education attainment as a risk factor: educated Sub-Saharan Africans had a higher risk of contracting HIV/AIDS than their less educated peers. Later demographic research reported that by the mid-1990s the education effect had reversed, and education began to function as a social vaccine. Recent counter-evidence finds a curvilinear pattern, with the association between educational attainment and HIV/AIDS infection changing from positive to negative across the education gradient. To reconcile these inconsistent conclusions, a hypothesis is developed and tested that education at early stages functioned as a risk factor and later functioned (and continues to function) as a social vaccine. We reason that this shift in the direction of the education effect was concurrent with changes in the public health environment in SSA that early on heightened material benefits from educational attainment but later heightened cognitive benefits from schooling. Using the 2003/2004 Demographic Health Surveys from four Sub-Saharan African countries (Cameroon, Ghana, Kenya and Tanzania), we tested this hypothesis (differential effects of schooling) using non-linear regression analysis (probit), identifying the different public health periods and controlling for confounding factors. The results support the hypothesis that the education effect shifted historically in the HIV/AIDS pandemic in SSA as we hypothesized.     

Who benefits from paid family leave? Impact of expansions in Canadian paid family leave on maternal employment and transfer income

This paper estimates the impact of a recent expansion in Canadian paid family leave from 25 to 50 weeks on maternal employment and transfer income. It finds the expansion coincided with increases in transfers to mothers of children age zero to one relative to mothers of children age three to four, and with decreases in returns to work in the year after birth. These changes were concentrated among economically advantaged groups of women, defined by marital status, education, and non-wage income. Despite these changes, there was no evidence of a decrease in returns to work or relative employment for mothers of children age one.

“Scratchin’ and Surviving” or “Movin’ on Up?” Two Sources of Change in Children’s Neighborhood SES

This research investigates the extent to which racial and ethnic inequality in children’s neighborhood socioeconomic status (SES) is exacerbated or attenuated via two mechanisms: changing neighborhood characteristics for residentially nonmobile children, and differences in the SES of destination versus origin neighborhoods for residentially mobile children. I use longitudinal data to estimate year-to-year change via these two mechanisms in four measures of neighborhood SES for white, black, and Latino children. I find that nonmobile white children experience greater improvement in neighborhood SES than statistically comparable black and Latino children. However, I find lower levels of inequality in neighborhood SES returns to residential mobility; in fact, in many cases those returns are greater for minority children than for white children. These findings suggest that continued inequality in children’s neighborhood contexts is not due primarily to inequality in outcomes of residential moves, but rather to the greater tendency of white children to reside in neighborhoods with higher levels of SES, and the greater likelihood of those neighborhoods to maintain or improve their levels of SES over time.

Soon, later, or ever? The impact of anomie and social capital on fertility intentions in Bulgaria (2002) and Hungary (2001)

We use survey data from Bulgaria and Hungary to investigate the determinants of whether women intend to have a first or a second child and, if so, whether they intend to have the child within the ensuing 2 years or later. These determinants differ significantly by the order and timing of the intended birth. The variables used include measures of anomie and social capital and these appear to be among the factors that determine both whether to have a child and when. There is some evidence that these measures and economic factors are relatively more important in Bulgaria than in Hungary, and that ideational factors are more important in Hungary, particularly in the case of voluntary childlessness.     

Cyberbullying,conflict management or just messing? Teenage girls’ understandings and experiences of gender,friendship, and conflict on Facebook in an Irish second-level school

In recent years, there have been growing concerns worldwide about young people’s safety online, much of which focuses on social media sites such as Facebook and Instagram. Moral panics about sexting and cyberbullying have constructed public discourses about social media as dangerous to adolescents’ safety and relationships. In the academic literature, there are conflicting perspectives on the nature of online relationships, behaviour, and risks, and on the causes and nature of cyberbullying. Less attention is paid—in both public and academic debates—to the role played by gender in online aggression, in spite of the fact that existing scholarship demonstrates that it is an important factor in the dynamics of young people’s online friendships and conflicts. This article presents the findings of an empirical, qualitative and quantitative study of teenage girls’ experiences and understandings of online friendship, conflict, and bullying in an Irish, single-sex secondary school. Questionnaires (n=116), individual in-depth interviews with students (n=26), and a focus group with teachers were used. Our study indicates that significant communicative phenomena within girls’ everyday lives remain unreported and frequently misunderstood.     

Is a significant socio-economic structural change a pre-requisite for "inital" fertility decline in the LDCs? Evidence from Thailand based on a multivariate cointegration / vector error correction modelling approach

This study is the first attempt at placing the analysis of fertility in a temporal dynamic framework in the case of a developing Asian economy such as Thailand by binding the relationship between fertility and its determinants within a cointegrated system. The analysis is based on the application of the following recently developed dynamic time series techniques: cointegration, vector error-correction modelling, variance decompositions and the impulse response functions. The results tend to indicate that in the complex dynamic interactions, the importance of the conventional `structural' hypothesis as a significant factor in bringing fertility down in the longer term cannot be denied. However, in the short to longer term, our findings, although not fully supportive of any particular hypothesis, appear to be broadly consistent more with the hypothesis emphasising the critical role played by the `ideational' or diffusion forces along with the demographic variables in ensuring `initial' fertility decline than with the conventional `structural' hypothesis emphasising a significant socio-economic structural change as a pre-condition for `initial' fertility decline. Received: 7 April 1995/Accepted: 15 May 1998