The Importance of Spousal Education for the Self-Rated Health of Married Adults in the United States

Education’s benefits for individuals’ health are well documented, but it is unclear whether health benefits also accrue from the education of others in important social relationships. We assess the extent to which individuals’ own education combines with their spouse’s education to influence self-rated health among married persons aged 25 and older in the United States (N = 337,846) with pooled data from the 1997–2010 National Health Interview Survey. Results from age- and gender-specific models revealed that own education and spouse’s education each share an inverse association with fair/poor self-rated health among married men and women. Controlling for spousal education substantially attenuated the association between individuals’ own education and fair/poor self-rated health and the reduction in this association was greater for married women than married men. The results also suggest that husbands’ education is more important for wives’ self-rated health than vice versa. Spousal education particularly was important for married women aged 45–64. Overall, the results imply that individuals’ own education and spousal education combine to influence self-rated health within marriage. The results highlight the importance of shared resources in marriage for producing health.     

<Emphasis Type="Bold">Women’s Progress for Men’s Gain? Gender-Specific Changes in the Return to Education as Measured by Family Standard of Living, 1990 to 2009–2011</Emphasis>

This study investigates gender-specific changes in the total financial return to education among persons of prime working ages (35–44 years) using U.S. Census data from 1990 and 2000, and the 2009–2011 American Community Survey. We define the total financial return to education as the family standard of living as measured by family income adjusted for family size. Our results indicate that women experienced significant progress in educational attainment and labor market outcomes over this time period. Ironically, married women’s progress in education and personal earnings has led to greater improvement in the family standard of living for married men than for women themselves. Gender-specific changes in assortative mating are mostly responsible for this paradoxical trend. Because the number of highly educated women exceeds the number of highly educated men in the marriage market, the likelihood of educational marrying up has substantially increased for men over time while women’s likelihood has decreased. Sensitivity analyses show that the greater improvement in the family standard of living for men than for women is not limited to prime working-age persons but is also evident in the general population. Consequently, women’s return to education through marriage declined while men’s financial gain through marriage increased considerably.     

From Privilege to Prevalence: Contextual Effects of Women’s Schooling on African Marital Timing

In Africa and elsewhere, educated women tend to marry later than their less-educated peers. Beyond being an attribute of individual women, education is also an aggregate phenomenon: the social meaning of a woman’s educational attainment depends on the educational attainments of her age-mates. Using data from 30 countries and 246 birth cohorts across sub-Saharan Africa, we investigate the impact of educational context (the percentage of women in a country cohort who ever attended school) on the relationship between a woman’s educational attainment and her marital timing. In contexts where access to education is prevalent, the marital timing of uneducated and highly educated women is more similar than in contexts where attending school is limited to a privileged minority. This across-country convergence is driven by uneducated women marrying later in high-education contexts, especially through lower rates of very early marriages. However, within countries over time, the marital ages of women from different educational groups tend to diverge as educational access expands. This within-country divergence is most often driven by later marriage among highly educated women, although divergence in some countries is driven by earlier marriage among women who never attended school.     

Schooling,marriage, and age at first birth in Madagascar

The low school attainment, early marriage, and low age at first birth of females are major policy concerns in less developed countries. This study jointly estimated the determinants of educational attainment, marriage age, and age at first birth among females aged 12–25 in Madagascar, explicitly accounting for the endogeneities that arose from modelling these related outcomes simultaneously. An additional year of schooling results in a delay to marriage of 1.5?years and marrying 1?year later delays age at first birth by 0.5?years. Parents’ education and wealth also have important effects on schooling, marriage, and age at first birth, with a woman's first birth being delayed by 0.75?years if her mother had 4 additional years of schooling. Overall, our results provide rigorous evidence for the critical role of education—both individual women's own and that of their parents—in delaying the marriage and fertility of young women.     

The Gendered Double Standard of Aging in US Marriage Markets

Using data on marriages collected in most US states between 1970 and 1988, we show that the older men are when they marry, the more years senior to their brides they are, whether it is a first or higher‐order marriage. While older men with more education marry down in age slightly more than less educated older men, the pattern of men marrying further down if they marry later holds strongly for all education groups. We consider several possible explanations for the tendency of men to marry further down in age if they are older at marriage. While we have no direct measure of physical attractiveness, we argue that the most compelling interpretation is that men, more than women, evaluate potential spouses on the basis of appearance. Because the prevailing standard of beauty favors young women, the older men are when they marry, the less they find women their own age attractive relative to younger women, leading them to marry further down in age if they are older at marriage. The consequence for women of men's preference for youth is more often that they remain unmarried than that they end up married to much older or less educated men.     

A historical narrative of the development of midwifery education in Indonesia

AimTo describe the history of midwifery education, present the current education programmes and explore the ways that have been undertaken to advance the midwifery profession in Indonesia.MethodsHistorical and contemporary government documents were reviewed.FindingsThe history of midwifery education in Indonesia shows a complex picture during and since colonisation with government, education institutes and association proposing different ways in which midwives were to be educated. Advocacy from the midwifery profession in Indonesia meant increasingly it is midwives who are determining how midwifery education is provided. Recent initiatives have resulted in a diploma, advanced diploma, bachelor’s degree, and a master’s degree in midwifery. The work of the midwifery profession advocating for midwifery education culminated in the Midwifery Act 2019. These changes in this Act will ensure that midwifery education meets the needs of women and their families but also lead to competent midwives who have the knowledge and skills to provide midwifery services at all levels of health provision. The history of midwifery in Indonesia illustrates the importance of the ICM pillars of association, regulation, and education.ConclusionThe history of midwifery education in Indonesia shows that for too long midwifery education was decided, determined and even regulated by authorities and disciplines other than midwifery. However, when the midwifery association and regulation inform and regulate midwifery education then there is an opportunity to provide care that will make a difference in outcomes for women and their families. The historical analysis of the story of Indonesia midwifery gives insight into what is required for quality education.     

Indonesian survey looks at adolescent reproductive health

The Baseline Survey of Young Adult Reproductive Welfare in Indonesia, conducted from September to December 1998, provides information about young Indonesians on topics concerning work, education, marriage, family life, sexuality, fertility, and HIV/AIDS and other sexually transmitted diseases. The survey interviewed 4106 men and 3978 women aged 15-24 years in three provinces of Java. Survey findings showed that 42% of the women and 8% of the men are currently or have been married. There was a strong inverse relationship between marriage and schooling, which suggests that greater educational attainment and a higher average age at marriage are likely to go together. Although most young couples prefer to delay and space births, only half of currently married young women are using any type of contraception. These results indicate that there is a need for better reproductive health care as well as improved reproductive health education. Moreover, the current economic crisis has lead to a decline in the use of the private sector for health care. Instead, young people are using the less-expensive government services, and young women are turning to pharmacies and midwives rather than to private doctors to obtain contraceptives. These findings have several policy implications including the need for reproductive health programs that provide services needed by young people.     

Socio-economic correlates of fecundability in a sample of taiwanese women

Estimates of fecundability (monthly probability of conception) in the absence of contraception are derived from the frequency distribution of conceptive delays immediately following marriage, reported by 2,443 married women aged 20 to 39 included in the Taichung (Taiwan) Intensive Fertility Survey of 1962. Average fecundability of women is positively associated with their socio-economic status. These differentials are not accounted for by differences among socio-economic groups with respect to memory and truncation biases (associated with the marriage duration), wife’s age at marriage, or unreported premarital conceptions. A Multiple Classification Analysis suggests that among the socio-economic characteristics, husband’s education, rural background, and modern family type are the more important predictors of fecundability. The importance of genetic factors as opposed to cultural factors in producing these socio-economic differences in fecundability can not be evaluated systematically. Moreover, the relation of a couple’s privacy, their attitude toward family building, and patterns of mate selection to their socioeconomic status would have to be taken into account before the differences in fecundability could be attributed to factors such as nutrition, health, or infections which might directly influence their physiological ability to conceive.     

Changes in assortative mating: The impact of age and education, 1970–1890

Data from the U.S. Census and Current Population Survey are used to examine trends in the propensity to marry or to cohabit by the age and educational attainment of potential partners. Marriage rates declined sharply across all age and educational combinations between 1970 and 1980 and declined more sharply for less-educated persons between 1980 and 1990. The rise in cohabitation compensated somewhat for the decline in marriage rates, but the compensation was unequally spread among age and educational combinations. Highly educated men were more likely, and highly educated women were no more or less likely, to marry than to cohabit with less-educated partners in 1970 and 1980. By 1990, however, educational assortative-mating patterns between these two types of unions were similar. In 1990, marriages and cohabitations involving women who were better educated than their partners were more common than those involving women who were less educated than their partners. In addition, men and women in their early 20s tend to have partners better educated than themselves, but persons in their 30s tend to cross the less-than-high-school/ more-than-high-school educational barrier when partners differ in educational attainment.     

中国女性初婚模式变动趋势研究

20世纪80年代以来我国女性的初婚模式发生了显著的变化。本文使用人口普查资料、全国1%人口抽样调查数据、人口变动情况抽样调查数据以及IPUMS数据,通过女性平均初婚年龄、曾婚比例、年龄别初婚概率、终身结婚期待率和预期单身寿命等指标探究我国女性自20世纪80年代以来的初婚模式变动情况。研究发现30多年来我国女性平均初婚年龄在波动中上升,到2017年女性平均初婚年龄已经达到25.60岁,而教育程度的提高会推迟女性进入婚姻的时间,接受过高等教育的女性平均初婚年龄明显高于未受过高等教育的女性;另外,通过对各教育程度平均初婚年龄标准化与分解看到随着时间的推移,教育对女性的平均初婚年龄影响作用增大;20-30岁年龄段女性婚姻推迟明显,曾婚比例不断降低,但女性终身未婚比例很低,其中受过高等教育的女性婚姻推迟现象最为明显,但其自身的结婚意愿并未降低,大部分女性只是推迟结婚时间,并不是不结婚。对净婚姻表各指标进行计算发现1982-2010年女性的年龄别初婚概率下降,尤其在20-30岁年龄段下降明显,初婚峰值年龄推迟,结婚年龄集中现象减弱。终身结婚期待率下降速度趋缓,随着女性初婚年龄的推迟,2010年27岁之后的终身结婚期待率要高于1990年与2000年,29-35岁女性的预期单身寿命也较前30年低,较大年龄未婚女性结婚等待时间缩短。     

Clinical outcomes for women who had continuity of care experiences with midwifery students

BackgroundPre-registration midwifery students in Australia are required to engage in a minimum of ten continuity of care experiences (CoCE). Students recruit and gain consent of each woman to provide CoCE under direct supervision of a registered health professional, usually a midwife. Clinical outcomes for women who had CoCE with a midwifery student placed in a continuity of midwifery care (CMC) or fragmented models are rarely reported.Aims1. analyse clinical outcomes for women experiencing CMC with CoCE by students; 2. analyse clinical outcomes for women in a fragmented care model with CoCE by students; and 3. compare clinical outcomes according to women’s primary model of care.MethodsStudents undertaking a Bachelor of Midwifery program at one Australian university recorded clinical outcomes for women experiencing CoCE during pregnancy [n = 5972] and labour and birth [n = 3933] in an e-portfolio. A retrospective, cohort design compared student recorded maternal data with National Core Maternity Indicators and Queensland Perinatal Data.ResultsMidwifery students providing CoCE reported better or equal clinical outcomes for women compared to population data. Women receiving CoCE had reduced likelihood of tobacco smoking after 20 weeks of pregnancy, episiotomy, and third and fourth degree tears.ConclusionsClinical outcomes for women in fragmented models of care and receiving CoCE by undergraduate, pre-registration midwifery students are equal to or better than State data across 12 variables. CoCE should be offered to all women early in their pregnancy to ensure optimal benefits. Acknowledging midwifery students’ potential to make positive impacts on women’s clinical outcomes may prompt more health services to reconceptualise and foster CoCE.     

Effects of education on reproductive behavior: lessons from Pakistan

Evidence from the Pakistan Demographic and Health Survey 1990/91 (PDHS) and a 1987 study by Zeba A. Sathar and Karen Oppenheim on women's fertility in Karachi and the impact of educational status, corroborates the correlation between improved education for women and fertility decline. PDHS revealed that current fertility is 5.4 children/ever married woman by the end of the reproductive period. 12% currently use a contraceptive method compared to 49% in India, 40% in Bangladesh, and 62% in Sri Lanka. The social environment of high illiteracy, low educational attainment, poverty, high infant and child and maternal mortality, son preference, and low status of women leads to high fertility. Fertility rates vary by educational status; i.e., women with no formal education have 2 more children than women with at least some secondary education. Education also affects infant and child mortality and morbidity. Literacy is 31% for women and 43% for men. 30% of all males and 20% of all females have attended primary school. Although most women know at least 1 contraceptive method, it is the urban educated woman who is twice as likely to know a source of supply and 5 times more likely to be a user. The Karachi study found that lower fertility among better educated urban women is an unintended consequence of women's schooling and deliberate effort to limit the number of children they have. Education-related fertility differentials could not be explained by the length of time women are at risk of becoming pregnant (late marriage age). Fertility limitation may be motivated by the predominant involvement in the formal work force and higher income. The policy implications are the increasing female schooling is a good investment in lowering fertility; broader improvements also need to be made in economic opportunities for women, particularly in the formal sector. Other needs are for increasing availability and accessibility of contraceptive and family planning services and increasing availability and accessibility of contraceptive and family planning services and increasing knowledge of contraception. The investment will impact development and demography and is an adjunct to child health an survival.     

Older women and the internet

This study was designed to explore the effects that training had on older adults' willingness to use the Internet to manage their health care. The most interesting result was that out of 70 self-volunteers, 58 were women. Results show that highly educated women who either own a computer or have access to one, and have low levels of anxiety toward computers, with strong feelings of self-efficacy toward computers and the Internet, and an internal locus of control, are more willing than men to use the Internet to find medical information to manage a chronic health problem.     

The reversal of the gender gap in education and relative divorce risks: A matter of alternatives in partner choice?

Recent evidence from the United States suggests that the reversal of the gender gap in education was associated with changes in relative divorce risks: hypogamous marriages, where the wife was more educated than the husband, used to have a higher divorce risk than hypergamous marriages, where the husband was more educated, but this difference has disappeared. One interpretation holds that this may result from cultural change, involving increasing social acceptance of hypogamy. We propose an alternative mechanism that need not presuppose cultural change: the gender-gap reversal in education has changed the availability of alternatives from which highly educated women and men can choose new partners. This may have lowered the likelihood of women leaving husbands with less education and encouraged men to leave less educated spouses. We applied an agent-based model to twelve European national marriage markets to illustrate that this could be sufficient to create a convergence in divorce risks.     

Childbearing within Marriage and Consensual Union in Latin America, 1980–2010

This article compares the fertility patterns of women in consensual union and marriage in 13 Latin American countries, using census microdata from the four most recent census rounds and a methodological approach that combines the own‐children method and Poisson regression. Results show that in all these countries, fertility is slightly higher within consensual union than marriage and that the age pattern of fertility is very similar in marital and non‐marital unions. Further analyses show that over the period considered, childbearing within a consensual union has changed from rare to increasingly common, although not yet mainstream, for highly educated women in most countries examined. Results show that in Latin America, at least since the 1980s, women's childbearing patterns depend on their age and on their being in a conjugal relationship, but not on the legal nature of this relationship. The similarities in reproductive behavior between marital and non‐marital unions are not confined to the socially disadvantaged groups, but apply as well to the better off.     

The Changing Pattern of Educational Differentials in Divorce in the Context of Gender Egalitarianization: The Case of Taiwan

Regarding educational differentials in divorce, similar trends have been reported across countries. Some report increasing educational differentials, while others identify an educational crossover pattern. The commonality is that education seems to play a role of stabilizing marriage more than ever before. Using data from the Women??s Marriage, Fertility, and Employment Survey, this study investigates the case of Taiwan by portraying the changing pattern of women??s educational differentials in divorce. There are three major findings. First, among previous marriage cohorts, women with relatively higher levels of formal education are significantly more likely to divorce. Second, the marital-dissolution rates for less educated women are rising faster than the corresponding rates for women with more education. Third, this trend does not stop at the catch-up point and eventually leads to a reversal in the association between education and divorce from positive to negative. In short, such educational differentials in divorce vary dramatically across marriage cohorts. A pattern of educational crossover in divorce has been displayed during the rapid social change in Taiwan. Other than William Goode??s argument raised a half-century ago, the marriage model transformation from specialization toward symmetry in the context of gender egalitarianization has to be taken into consideration in order to obtain a full understanding of the phenomenon.     

“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.     

Education and Cohabitation in Britain: A Return to Traditional Patterns?

Cohabitation is sometimes thought of as being inversely associated with education, but in Britain a more complex picture emerges. Educational group differences in cohabitation vary by age, time period, cohort, and indicator used. Well‐educated women pioneered cohabitation in Britain in the 1970s and 1980s. In the most recent cohorts, however, the less educated have exceeded the best educated in the proportions ever having cohabited at young ages. But the main difference by education currently seems largely a matter of timing—that is, the less educated start cohabiting earlier than the best educated. In Britain, educational differentials in cohabitation appear to be reinstating longstanding social patterns in the level and timing of marriage. Taking partnerships as a whole, social differentials have been fairly stable. Following a period of innovation and diffusion, there is much continuity with the past.     

已婚流动妇女的性生活及其影响因素实证研究

基于"流动人口的婚姻家庭问题研究"课题组收集的数据,描述当代已婚流动妇女的性生活状况及其与从未外出打工已婚女性和已婚流动男性的性生活水平差异,通过建立多视角、多因素的综合解释模型,对已婚流动妇女性生活的影响因素进行估计和检验。多元分析结果表明,年龄、受教育程度、月收入、家庭经济支配权、与配偶居住情况、打工当地朋友数等是已婚流动妇女性生活质量的主要影响因素。