Aging and political decision making on public pensions

In this paper decision making on public pensions in a representative democracy is modeled within the framework of the well-known two-overlapping-generations (OLG) general-equilibrium model with rational expectations. The model is used to analyze the effects of aging on the economy in general and on the evolution of public pension schemes in particular, where aging is interpreted as a combination of a decrease in the rate of population growth and an increase in the political influence of pensioners. Analytical results are derived for the long run as well as for the short run by the method of comparative statics and comparative dynamics respectively. It appears that an increase in transfers to the old is not guaranteed if due to aging their political power increases. JEL classification: J14, H55 Received April 5, 1995 / Accepted September 4, 1995     

Exploring unwarranted clinical variation: The attitudes of midwives and obstetric medical staff regarding induction of labour and planned caesarean section

BackgroundUnexplained clinical variation is a major issue in planned birth i.e. induction of labour and planned caesarean section.AimTo map attitudes and knowledge of maternity care professionals regarding indications for planned birth, and assess inter-professional (midwifery versus medical) and intra-professional variation.MethodsA custom-created survey of medical and midwifery staff at eight Sydney hospitals. Staff were asked to rate their level of agreement with 45 “evidence-based” statements regarding caesareans and inductions on a five-point Likert scale. Responses were grouped by profession, and comparisons made of inter- and intra-professional responses.FindingsTotal 275 respondents, 78% midwifery and 21% medical. Considerable inter- and intra-professional variation was noted, with midwives generally less likely to consider any of the planned birth indications “valid” compared to medical staff. Indications for induction with most variation in midwifery responses included maternal characteristics (age≥40, obesity, ethnicity) and fetal macrosomia; and for medical personnel in-vitro fertilisation, maternal request, and routine induction at 39 weeks gestation. Indications for caesarean with most variation in midwifery responses included previous lower segment caesarean section, previous shoulder dystocia, and uncomplicated breech; and for medical personnel uncomplicated dichorionic twins. Indications with most inter-professional variation were induction at 41+ weeks versus 42+ weeks and cesarean for previous lower segment caesarean section.DiscussionBoth inter- and intra-professional variation in what were considered valid indications reflected inconsistency in underlying evidence and/or guidelines.ConclusionGreater focus on interdisciplinary education and consensus, as well as on shared decision-making with women, may be helpful in resolving these tensions.     

The Expectation-Threshold model of reproductive decision making

It is proposed that as expectations about parenting become increasingly high, couples have an increasing tendency to decide to have a(or another) child. Similarly, as parenting expectations become increasingly low, couples have an increasing tendency to decide on sterilization. Couples without extremely high or low expectations continue to use contraceptives. Expectations are defined as Subjective Expected Utilities (SEUs) for having or not having a child. Preliminary results support the model and suggest that the threshold for making these decisions is not at neutral, but is conservative so that couples must have fairly high or low expectations before making such binding decisions are parenting or sterilization. The fact that data reveal that this exists supports the Expectancy-Threshold model, but it also requires a change in SEU Theory's maximization rule for some kinds of decisions.The authors wish to thank Carole Baker, former executive Director of the National Alliance for Optional Parenthood, and the board members of that organization for their cooperation, and Dr. Barbara Beach who helped with the data analysis. Funding was provided, in part, by The Center for Studies in Demography and Ecology, University of Washington, through a grant, No. 5 P30 HDO 9397, from the National Institute for Child Health and Human Development     

Economic and cultural influences on the decision to leave home in Peninsular Malaysia

Although the departure of children from the parental home is an important life-cycle event, few studies have investigated nest-leaving in developing countries. Using retrospective data from the Second Malaysian Family Life Survey, we estimate hazard models of nest-leaving in Peninsular Malaysia. We find that the departure of children, especially sons, responds to economic incentives, including housing costs, family businesses, education, and economic growth, and that ethnic differences in nest-leaving are important. We also find that the median age of departure from home has declined sharply over the past 40 years, a period of rapid social and economic change in Malaysia.     

Residential mobility on skid row: Disaffiliation,powerlessness, and decision making

Individual-level models of residential mobility emphasize (a) the stabilizing effects of various social, demographic, and housing characteristics and (b) the important mediating role played by decision-making variables. Data from a sample of skid row residents are analyzed to determine if these models retain their accuracy under conditions of disaffiliation and powerlessness. The findings indicate that, while older age, employment, and other characteristics may encourage residential stability on skid row, such factors influence mobility behavior in a direct fashion rather than through the intervening decision variables of residential evaluation and mobility expectation. In general, persons with weakened social attachments and little control over their lives and resources find it difficult to engage in the calculated, long-term type of decision-making process implied by mobility theory.     

Counting women's labour: a reanalysis of children's net production using Cain's data from a Bangladeshi village

The economic contribution of children to their parents' households has long interested demographers because of its potential to influence fertility levels. Valuing children's labour in pre-industrial economies, however, is inherently difficult. The same is true of women's labour, a crucial component of any analysis of net production. Here we use Mead Cain's seminal study (Population and Development Review 3(3): 201-227, 1977) of children's economic contributions in a Bangladeshi village to illustrate these points. We combine Cain's data on landless women's and men's hours of work with data on the efficiency per hour of work from other pre-industrial settings (Mueller, Population and Development: The Search for Selective Interventions. Baltimore, MD: Johns Hopkins University Press, pp. 98-153, 1976; Kramer, Dissertation, Department of Anthropology, University of New Mexico, 1998). When women's labour is incorporated, we find that the Bangladeshi children begin to produce as much as they consume by ages 10 (girls) or 11 (boys). Despite these productive contributions, neither women nor men 'pay' for their cumulative consumption until their early 20s. We believe our methods could be usefully applied in other contexts.     

Role of women in schooling and child labour decision: the case of urban boys in India

This paper uses household level data from National Sample Survey Organization (NSSO) of India, the 55th round (1999–2000), to show that for urban male children there exists significant wage incentive for schooling, though school dropout rate and child labour incidence are not so small. 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 now appears as a very important factor in curbing these incidences; supporting earlier findings that women’s empowerment (one important indicator of which would be female educational level) is indeed instrumental in increasing parental awareness.     

Demographic data and geographic information systems for decision making: The case of public health

Recent changes in the United States health care system include a broadened definition of health and renewed focus on public health. Increasingly, demographic analyses are incorporated into public health decision-making. Analysts also are using geographic information more routinely, because Geographic Information System (GIS) software is becoming easier to use. The paper describes three cases in which demographers used GIS to analyze the spatial distribution of public health data. The first case, from Santa Clara County, California, focuses on adolescent sexually transmitted diseases in secondary school districts. The second case, also from Santa Clara County, maps preventable hospitalizations of senior citizens. The third examines the distribution of premature births in Tennessee counties. The researchers applied demographic techniques and perspectives in each case, and each case produced information that is being used by officials who plan health education campaigns and services.     

Impact of acupressure on onset of labour and labour duration: A systematic review

BackgroundThere is worldwide concern with increasing rates of pharmacologically induced labour and operative birth. Many women would like to avoid medical or surgical interventions in childbirth; a desire that may contribute towards the popularity of complementary and alternative medicine/therapies.MethodThis systematic review examines the effects of acupressure on labour onset and duration of labour. We searched MEDLINE, CINAHL, AMED, Cochrane Collaboration, and Science Direct from 1999 to 2013 for published randomised controlled trials and controlled trials comparing acupressure with placebo and no treatment. Studies recruited primiparous and/or multiparous women with either spontaneous or induced onset of labour. The outcome measures were labour onset and duration of all stages of labour.FindingsSeven trials with data reporting on 748 women using different acupressure points and methods of administration were included in the review. One study examined the initiation of labour and six studies examined labour duration and/or pain levels. The two most studied acupoints were Sanyinjiao/Spleen 6 and Hegu/Large Intestine 4. Results suggest acupressure may reduce the length of labour particularly in the first stage.ConclusionFurther research is required on whether acupressure can shorten labour duration, augment prolonged labour or initiate onset of labour by stimulating uterine contractions. Clinical trials should report the basis for acupressure treatment described in the STRICTA (minus needling) and CONSORT non-pharmaceutical guidelines.     

Trends and characteristics of women undergoing induction of labour in a tertiary hospital setting: A cross-sectional study

BackgroundIn many well-resourced countries, rising rates of intervention are being observed during pregnancy, labour and childbirth with induction of labour (IOL) fast becoming one of the most common. In Australia, the rate of induction of labour has increased by over 30% since 2007, and today one in three women have their labours induced. We do not however have a good understanding of the contribution of specific obstetric populations to this trend.MethodsWe examine the contribution of specific obstetric populations to induction of labour over a six-year period at one tertiary maternity service, using the Nippita classification system. Average Annual Percentage Changes (AAPC) were calculated along with 95% confidence intervals and P values set at 0.05.ResultsThe overall rate of induction of labour increased from 21.3% in 2012 to 30.9% in 2017, representing an Average Annual Percent Change of 8.1, P < 0.0001 (95% CI 7–9.6). The greatest AAPC was seen in group 5 (parous, no previous caesarean section, 39–40 weeks, single cephalic), followed by group 2 (nulliparous, 39–40 weeks, single cephalic) and 1 (nulliparous, 37–38 weeks, single cephalic).ConclusionsThe use of the Nippita classification system allowed for standardised comparison across timepoints, facilitating identification of the subpopulations driving changes in rates of induction of labour. Rates of induction of labour saw a year on year increase which in this maternity service, it is not being driven by post-dates pregnancies. Further work is required to understand the role of other potential contributors such as diabetes.