The changing face of the Maltese population

In the last decade the Maltese population has seen an influx of overseas-born individuals. This has been largely due to Malta’s access to the European Union and the increased intake of refugee immigrants. These immigration trends have resulted in changes in population composition, with the overseas-born population increasing from 17,740 (4.7%) in 1995 to 24,560 (6.1%) in 2005. There has also been an increase in the proportion of births registered in Malta to overseas citizens, including citizens of non-EU Europe (1.1%); the African continent (1.5%); America (0.3%); and Asia (0.8%). About ten per cent of marriages in Malta are between a Maltese spouse and a foreigner. The data suggest that the Maltese population is slowly becoming more cosmopolitan, a trend that is gradually changing the ethnic composition of the Maltese community.     

Cultural Activities,Identities, and Mental Health Among Urban American Indians with Mixed Racial/Ethnic Ancestries

Focus groups were conducted to appreciate the voices of Urban American Indians (UAI) who have mixed ancestries residing in Philadelphia, Pennsylvania. Participants (15 women and 10 men, 19–83 years of age) with a variety of Native ancestries coming from different nations (i.e., blackfeet, blackminkwa, Cherokee, Creek, Delaware, Lakota, Powhatan, Seminole, and Shawnee) reported to also have a Non-Native racial/ethnic ancestry such as African/black, Hispanic, and/or Caucasian/white. Specifically, this study provided evidence about (a) the complexity and challenge of being “mixed” UAI (e.g., “living a culture” as opposed to blood quantum in determining a personal identity) (b) the linkage of cultural identities to mental health (c) contributions of cultural activities to identities and mental health (e.g., therapeutic and healing functions of cultural activities), and (d) very limited urban Native-oriented mental health service (e.g., visions for Native American-centered mental health clinic in an urban setting). Building on those UAI’s voices, this paper provides a context for the need of a culturally respectful transformation of urban mental health system by highlighting the clinical significance of cultural identity and mental health promotion for UAI.     

Racial and Ethnic Differentials in Idleness,Highest-Risk Idleness,and Dropping Out of High School

This research investigates three different indicators of at-risk socio-demographic conditions including dropping out of high school, being idle, and being in highest-risk idleness among non-immigrant persons aged 19–24. Using data from the 2000 US Census, our results detail the differentials in these characteristics for 30 different racial/ethnic groups that are further broken down by gender. The findings indicate a wide range in the prevalence of these at-risk socio-demographic conditions. Groups that tend to be the most at-risk in terms of these indicators include African Americans, Cambodians, Laotians, Native Americans, other Hispanic whites, and white Mexicans. With the exception of the other Pacific Islander and Thai, young women have lower high school dropout rates than do young men. However, young women are substantially more likely than young men to be idle which we define as not being in school, the labor force, or the military. After defining highest-risk idleness as never-married persons without children who are idle, however, the rates are slightly lower for young women than for young men.     

Choice of study discipline and the postponement of motherhood in Europe: The impact of expected earnings,gender composition,and family attitudes

Theory suggests that the field of study may be at least as consequential for fertility behavior as the duration and level of education. Yet, this qualitative dimension of educational achievement has been largely neglected in demographic studies. This article analyzes the mechanisms relating the field of study with the postponement of motherhood by European college-graduate women aged 20–40. The second round of the European Social Survey is used to assess the impact of four features of study disciplines that are identified as key to reproductive decision making: the expected starting wage, the steepness of the earning profile, attitudes toward gendered family roles, and gender composition. The results indicate that the postponement of motherhood is relatively limited among graduates from study disciplines in which stereotypical attitudes about family roles prevail and in which a large share of the graduates are female. Both the level of the starting wage and the steepness of the earning profile are found to be associated with greater postponement. These results are robust to controlling for the partnership situation and the age at entry into the labor market.     

Early life exposures and the occurrence and timing of heart disease among the older adult Puerto Rican population

Few studies have examined the effects of early life conditions on the timing of the onset of heart disease. We use the remarkable example of a representative sample of the population of older Puerto Ricans aged 60– 74 who lived in the countryside during childhood (n = 1,438) to examine the effects of seasonal exposures to poor nutrition and infectious diseases during late gestation on the timing of the onset and the probability of ever experiencing adult heart disease. Cox and log logistic hazard models controlling for childhood conditions (self-reported childhood health status and socioeconomic status [SES], rheumatic fever, and knee height) and adult risk factors (adult SES, obesity, smoking, texercise, and self-reported diabetes) showed that the risk of onset of heart disease was 65% higher among those born during high-exposure periods compared with unexposed individuals. However, there were no significant differences in median time of onset for those ever experiencing heart disease. As a comparison, we found that there were no significant seasonality effects for those who lived in urban areas during childhood. We conclude that early exposures in utero have important ramifications for adult heart disease among the older Puerto Rican population. We show, however, that while exposure is associated with the probability of ever experiencing adult heart disease, it is not associated with the timing of onset among those who do experience it.     

Health,wartime stress,and unit cohesion: Evidence from Union Army veterans

We find that Union Army veterans of the American Civil War who faced greater wartime stress (as measured by higher battlefield mortality rates) experienced higher mortality rates at older ages, but that men who were from more cohesive companies were statistically significantly less likely to be affected by wartime stress. Our results hold for overall mortality, mortality from ischemic heart disease and stroke, and new diagnoses of arteriosclerosis. Our findings represent one of the first long-run health follow-ups of the interaction between stress and social networks in a human population in which both stress and social networks are arguably exogenous.     

Knox meets Cox: Adapting epidemiological space-time statistics to demographic studies

Many important questions and theories in demography focus on changes over time, and on how those changes differ over geographic and social space. Space-time analysis has always been important in studying fertility transitions, for example. However, demographers have seldom used formal statistical methods to describe and analyze time series of maps. One formal method, used widely in epidemiology, criminology, and public health, is Knox’s space-time interaction test. In this article, we discuss the potential of the Knox test in demographic research and note some possible pitfalls. We demonstrate how to use familiar proportional hazards models to adapt the Knox test for demographic applications. These adaptations allow for nonrepeatable events and for the incorporation of structural variables that change in space and time. We apply the modified test to data on the onset of fertility decline in Brazil over 1960–2000 and show how the modified method can produce maps indicating where and when diffusion effects seem strongest, net of covariate effects.     

The Migrant–Nonmigrant Differentials in Prenatal Care Utilization: Evidence from Indonesia

Using the 2000 wave of Indonesian Family Life Survey (IFLS3), this study attempts to further complement studies that seek to analyze the relationship between migration and prenatal care utilization in Indonesia. The major conclusion from the multilevel logistic regression suggests that migrants are less likely than non-migrants to seek prenatal care in a public or private hospital but are more likely than non-migrants to initiate prenatal care in their first trimester and to receive four or more prenatal visits. Several measures of child, woman, household and community characteristics are also significant predictors of the location, timing and frequency of prenatal care. It is evident that the design of effective and efficient policies requires a more comprehensive knowledge of the determinants of migration and maternal healthcare services utilization. The assessment of whether the extent of the location, timing and frequency of prenatal care differs between migrants and non-migrants would have important policy implications for both individuals and society at large.     

Birth Outcome Measures and Infant Mortality

Recent studies have proposed alternative birth outcome measures as means of assessing infant mortality risk; nevertheless, there hasn’t yet been an integrated analysis of these approaches. We review 14 strategies, including various combinations of birth weight, gestational age, fetal growth rate, and Apgar scores—as predictors of early neonatal, late neonatal, and postneonatal mortality, and infant mortality. Using the NCHS linked birth/infant death file for 2001, we construct multivariate logit models and assess the associations between each of the 14 key birth outcome measures and four mortality outcomes. We find that all evaluated birth outcome measures are strong predictors, but Apgar scores are the strongest among all models for all outcomes, independent of birth weight and gestational age. Apgar scores’ predictive power is stronger for Mexican-, white-, and female-infants than for black- and male-infants. Second, all birth outcome measures remain significantly associated with mortality, but their predictive power reduces drastically over time. These findings suggest a rule of thumb for predicting infant mortality odds: when available, Apgar scores should always be included along with birth weight (or LBW status) and gestational age. Additionally, these findings argue for the continued study of low birthweight, gestational age, and Apgar scores as independently salient health outcomes.