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Childless and single-childed women in early twentieth-century America.

Over the course of this century, there have been marked fluctuations in the extent of childlessness and single child fertility. In this article, data from the 1960 U.S. Census are used to examine cohort trends in childlessness and single child motherhood among women born in the years 1891-1925. A marked rise in low parity fertility is found among women who reached prime reproductive ages during the 1930s; cohorts born prior to or after these women had much lower levels of childlessness and single child fertility. This rise and fall in low parity fertility is examined in the light of theories that see its cause as due to changes in 1) demographic composition across cohorts, 2) health levels that affect fecundity and hence fertility, 3) normative prescriptions to bear children and countervailing norms, and 4) economic conditions that affect the degree to which women limit reproduction. A log linear analysis of changes in the composition of cohorts in race, age at marriage, marital history, and education shows that sociodemographic changes do not explain the upturn in low parity fertility. Through an analysis of health statistics and the medical literature, the theory that changing health levels are responsible for the rise and fall in low parity fertility is rejected. The normative and economic theories are found to be most useful in explaining trends in low parity fertility. It is argued that over the course of this century, an interaction between economic conditions and reproductive ideology has both necessitated women limiting their childbearing in times of economic depression and provided justification for this.

Behavior↗

Tuberculosis in developing countries and methods for its control.

Tuberculosis is a major cause of morbidity and mortality in developing countries. It is estimated that one-fifth of the world population is infected, 12-16 million people have the disease, every year 6-8 million develop tuberculosis and 2-3 million die from it. Four methods for the prevention of tuberculosis are available: improvement of socio-economic conditions, case-finding and treatment, chemoprophylaxis, and vaccination. Each of these methods is examined in relation to a model of the chain of transmission and development of disease. Improvement of socio-economic conditions, responsible for the decline of tuberculosis in the developed world, must be seen as a long-term solution. Case-finding and treatment is the only method expected to have an important short-term impact on transmission. A summary of the results of 35 studies shows the estimated efficacy of bacillus Calmette-Guérin (BCG) vaccination ranging from 96% to none. Follow-up results from 10 controlled trials are consistent with waning of BCG protective efficacy with time since vaccination. Chemoprophylaxis and vaccination are expected to protect the individual but not to have a significant short-term impact on transmission.

Antitubercular Agents↗

Measles case fatality among the under-fives: a multivariate analysis of risk factors in a rural area of Bangladesh.

This study investigated the relationship of measles case fatality among the under-fives with age, case type, complications, sex, mother's education, and household economic condition in a rural area of Bangladesh. A total of 3465 measles cases were detected during 1980 and 61 of them died of measles associated complications within 45 days of rash onset. Case type, sex, mother's education and household economic condition were found to have statistically significant impact on case fatality. Risk of death among the secondary cases was 1.87 times higher than in the primary cases, girls had 2.73 times higher risk of death than boys. Children of mothers without any formal schooling and those from the poorest households experienced 1.83 and 2.18 times higher risk of death than their counterparts whose mothers had at least one year of schooling and from economically better off households respectively.

Bangladesh↗

The determinants and patterns of married women's labor force participation in Korea.

The present study investigates the determinants and patterns of married women's labor force participation in Korea. Married women's employment in Korea is largely determined by age, urban residence, household characteristics of the husband's socioeconomic status, family income, fertility, and the lagged effect of work. Older age, rural residence, inferior household economic condition, and recent work experience are the major positive causes of married women's participation in the market work. On the other hand, younger women with preschool children, who currently reside in urban areas, enjoying better household economic conditions (due to higher socioeconomic status of husbands and/or higher family income) are the groups of women with the smallest probability of working in the market. Married women's employment pattern in Korea shows a pattern typical of less-developed and low-income countries in two aspects: married women working and characterized by a low level of education; the difference between urban and rural areas in terms of work participation pattern is remarkable. Although Korea belongs to the advanced group of currently industrializing countries, she lags behind with other developing countries in terms of married women's employment. Moreover, it is difficult to predict in advance that Korea would have similar experiences as those of contemporary advanced countries.

Age Factors↗

International migration in Western Europe since 1973: developments, mechanisms and controls.

"This presentation describes the development of migration to and from Western Europe and seeks to determine to what extent such immigration and return migration movements are influenced by governmental action and regulation." It is observed that the basic factors determining immigration and return migration flows are the characteristics of the migrants themselves, policies of the receiving countries, and economic conditions in the sending and receiving countries. Data comparing alien populations and migration trends in selected European countries are provided

Demography↗

Body height and weight of children in Novi Sad.

BACKGROUND: Height and weight are the most important measures of growth and development and indirect indicators of living conditions. The socio-economic conditions in Serbia have varied drastically. In 1990, a political and economic crisis started causing a rapid fall of standards of living. AIM: The study aimed to determine the height and weight of children aged 3-11 in the periods between 1971, 1981, 1991 and 2001 in Novi Sad, Serbia. SUBJECTS AND METHODS: This investigation was carried out in the same primary schools and pre-school institutions. The data included children of Serbian nationality born in Novi Sad whose parents were also born there and had the same socio-economic background. RESULTS: Positive changes in height and weight were recorded in the decades 1971-1981 and 1981-1991, except for the height of 8-year-old children. In the period 1991-2001, an increase in height was observed only at the age of 8 in boys and until the age of 9 in girls. As for weight, an increase was recorded in 9-year-old boys, while in girls it was present at all ages except for the ages of 7 and 10. Considering the period 1971-2001, positive changes in height were recorded from the age of 6 in boys and 5 in girls. The changes in weight were positive at all ages except the age of 5 in boys and after the age of 6 in girls. CONCLUSION: Lower values of height and weight recorded in 2001 are probably due to the changes in living conditions or they indicate that the acceleration reached its peak.

Body Height↗

The social distribution of explanations of health and illness among adolescents in São Paulo, Brazil.

The present paper reports on a study, which investigated explanations of health and illness among adolescents from three socio-economic backgrounds in São Paulo, Brazil. Interviews and group discussions were used to elicit definitions of health and illness, explanations of illness causality and prevention and maintenance of health among 31 deprived adolescents with recent experience of living on the streets, 20 adolescents from poor families and 20 adolescents from privileged families. The findings showed that adolescents from different socio-economic conditions draw upon similar explanatory models to make sense of health and illness. There were also clear distinctions between the groups. Health and illness were presented as being dependent upon multiple factors such as resistance of the body and socio-economic status among privileged adolescents. In contrast, the explanations offered by deprived and poor adolescents for both health and illness rested on behaviour or exposure to environmental hazards. Moreover, drugs, sexually transmitted diseases and faith in God were prominent features of the accounts from deprived adolescents. The findings suggest a need for health professionals to be sensitive to people's perspectives of health and illness and their link to socio-economic conditions. To emphasize individuals' behaviour in the provision of health-related information among deprived adolescents might be counter productive and reinforce victim blaming.

Adolescent↗

Multilevel modelling of the incidence of visceral leishmaniasis in Teresina, Brazil.

Epidemics of visceral leishmaniasis (VL) in major Brazilian cities are new phenomena since 1980. As determinants of transmission in urban settings probably operate at different geographic scales, and information is not available for each scale, a multilevel approach was used to examine the effect of canine infection and environmental and socio-economic factors on the spatial variability of incidence rates of VL in the city of Teresina. Details on an outbreak of greater than 1200 cases of VL in Teresina during 1993-1996 were available at two hierarchical levels: census tracts (socio-economic characteristics, incidence rates of human VL) and districts, which encompass census tracts (prevalence of canine infection). Remotely sensed data obtained by satellite generated environmental information at both levels. Data from census tracts and districts were analysed simultaneously by multilevel modelling. Poor socio-economic conditions and increased vegetation were associated with a high incidence of human VL. Increasing prevalence of canine infection also predicted a high incidence of human VL, as did high prevalence of canine infection before and during the epidemic. Poor socio-economic conditions had an amplifying effect on the association between canine infection and the incidence of human VL. Focusing interventions on areas with characteristics identified by multilevel analysis could be a cost-effective strategy for controlling VL. Because risk factors for infectious diseases operate simultaneously at several levels and ecological data usually are available at different geographical scales, multilevel modelling is a valuable tool for epidemiological investigation of disease transmission.

Animals↗

Geographical variations in the incidence of colorectal cancer in Britain.

The incidence of colorectal cancer was compared in nine towns in England and Wales, chosen to encompass a range of socio-economic conditions and spread of latitude in the country. Cases were ascertained through pathology records, supplemented by clinical notes. The pattern of variation in incidence was different for men and women. Among men incidences were highest in towns with better socio-economic conditions, whereas among women the trend was reversed. This supports the hypothesis that the dominant aetiological influences causing colorectal cancer differ in the two sexes. Mortality rates did not correlate closely with incidence. This, together with the markedly different patterns of incidence of colorectal cancer and appendicitis in the nine towns, casts doubt on the significance of a reported inverse correlation between regional mortality from colonic cancer and the consumption of pentosic fibre.

Adult↗

Hepatitis A outbreaks--methods of intervention in South-East Asian countries.

INTRODUCTION: In many Asian countries, improved hygiene standards and socio-economic conditions have led to a reduction in exposure to the hepatitis A virus (HAV) in childhood. However, the persistence of circulating HAV may lead to hepatitis A outbreaks, particularly in adolescents and adults. In other countries and specific areas, where socio-economic conditions have not improved as markedly, HAV endemicity remains medium-to-high. A systematic approach to outbreak control is therefore urgently needed. METHODS: The Steering Committee for Prevention and Control of Infectious Diseases reviewed reports on recent hepatitis A outbreaks in South-East Asian countries and determined that there is no systematic regional plan for the containment of such outbreaks. By contrast, on reviewing reports on outbreaks in several North American and European countries, it was found that the most important elements of successful outbreak control are a plan of action, rapid and widespread communication, public education and vaccination of household contacts to prevent secondary cases. RESULTS: This investigation proposes an outbreak control programme consisting of six key stages -- initiation, planning, set-up, implementation, vaccination of at-risk populations and evaluation. Outbreak control requires the formation of an outbreak management team, plus a task force to implement intervention and educate the public. The vaccination of family members and close contacts is a central element of the programme. CONCLUSION: This model programme for hepatitis A outbreak control provides a framework for action in countries and specific areas where the disease remains a problem.

Asia, Southeastern↗

"White aliens": the control of European immigration to Australia 1920-30.

The author reviews Australian and British policies restricting non-British immigration to Australia after World War I. "The intense desire in many quarters to maintain a 'white Australia' led not only to the active encouragement of British immigrants but to the restrictions and regulations upon European immigration in the period under review. These restrictions took two forms. Statutory powers of exclusion and restriction were conferred through...legislation.... At the same time...administrative techniques were used to limit further and control 'white alien' immigration. These techniques, such as quotas and the discretionary power of the Minister to limit visas and landing permits, changing in response to economic conditions and public opinion, were perhaps more important in the government's policy of ensuring Australia's racial purity."

Attitude↗

Child mortality in a collapsing African society.

A cohort study of mortality among under-5-year-olds was carried out in two Somali villages in 1987-89, a period of economic and political collapse in the rural parts of the country. Analysed was the relative importance of the social characteristics for under-5-year-old mortality against a background of deteriorating political and economic conditions. Mortality increased among under-5-year-olds from 1987 (211 per 1000) to 1988 (323 per 1000) to 1989 (414 per 1000). The mortality risk was more pronounced for boys than girls and was more so for infants than children aged 1-4 years. The major signs prior to death were respiratory infections, diarrhoeal diseases, fever/malaria and tetanus in the neonatal period. Over the 3-year study period mortality rates for diarrhoeal diseases increased significantly, while those for respiratory infections and diseases preventable by immunization increased more slowly. The increasing trend in under-5-year-old mortality was more pronounced in instances when the mother derived her major income from sources other than farming and in larger households.

Child, Preschool↗

The quantity and quality of children, labor supply and wages of married women in postwar Japan.

"The purpose of this paper is...to build a simultaneous estimation model of fertility, child quality, wife's labor supply and female wage, and to test the applicability of this model using time-series data from postwar Japan." The results imply "that fertility and employment have generally been [an] alternative behavior for... Japanese women; that their behavioral choice has depended on economic conditions; and that the quantity and quality of children have been substitutes." (SUMMARY IN JPN)

Adolescent↗

[Nonbiologic risk factors of pulmonary tuberculosis among adults in Henan: a case-control study].

OBJECTIVE: To study the nonbiologic risk factors of tuberculosis (TB) among adults. METHODS: 1:2 matched case-control study was conducted. 158 new smear positive pulmonary TB patients with 25 - 60 years of age were notified and registered from three county anti-TB institutions in Henan from October 2002-March 2004, were selected as cases. Two healthy persons were selected to match each case, with the same sex and age group, from the nearest neighbors of the case as controls. Interview was carried out with a uniform designed questionnaire at the residence of the object. Univariate and multivariate condition logistic regression models were used. RESULTS: The results of univariate analysis showed that marital status, education, self-employed occupation, smoking, out-migration for work away from hometown, household annual income level and household property were significantly associated with TB prevalence (P < 0.05); multivariate analysis showed that marital status, self-employed occupation, smoking, household economic condition and out-migration for work, away from home were also associated with TB (P < 0.05), and OR values were 2.826, 2.350, 1.536, 0.707, 2.096, respectively. CONCLUSION: Being single, smoking, self-employed occupation and out-migration for work were nonbiologic risk factors of TB while good household economic condition was a protective factor.

Adult↗

Factors affecting acceptance of immunization among children in rural Bangladesh.

This paper uses the Bangladesh Fertility Survey 1989 data to identify the factors affecting acceptance of immunization among children in rural Bangladesh. Acceptance of DPT, measles and BCG vaccinations were the dependent variables. The independent variables included proximity to health facilities, frequency of visit by health worker, respondent's mobility, media exposure, education, age, economic status of household, region of residence, and gender of child. Logistic regression analysis was performed to assess the net effects of the variables in addition to univariate analysis. Among the independent variables, proximity to health facility, frequency of health worker's visit, mother's mobility, education, age, gender of child, ownership of radio, economic condition of household, and region of residence showed statistically significant association with acceptance of immunization. The effect of frequency of health worker's visit was dependent on region of residence, possession of radio, and mother's education. The effect of mother's ability to visit health centre alone was also dependent on ownership of radio, economic condition of household, and mother's education.

Adult↗

Incidence of diabetes amongst people aged 18-50 years in nine British towns: a collaborative study.

The incidence of diabetes among people aged 18-50 years has been studied prospectively in nine towns, chosen to encompass the range of socio-economic conditions and spread of latitude in England and Wales. The incidence of Type 1 (insulin-dependent) diabetes in this age group varied little between the towns. However, the incidence of Type 2 (non-insulin-dependent) diabetes was markedly higher in the towns with 'worse' socio-economic conditions. The mean incidences were 23 per 100 000 for the three 'worse' towns and 10 per 100 000 for the three 'better' towns. This was not explicable by an association between the disease and social class. This finding has to be reconciled with known and hypothesised influences in the aetiology of Type 2 diabetes.

Adolescent↗

Release criteria from hospitals of 131I thyrotoxicosis therapy patients in developing countries--case study.

The current release limit, recommended by the International Atomic Energy Agency (IAEA)(1), from hospitals of patients undergoing 131I thyrotoxicosis therapy is approximately 1100 MBq (approximately 30 mCi). Owing to the difference in socio-economic conditions, literacy rate, family system, etc., this release limit may not be applicable in most of the developing countries like Pakistan. Therefore, the prime objective of this case study was to re-evaluate the release criteria for 131I thyrotoxicosis therapy patients by taking into account their lifestyle, economic conditions and other facilities such as availability of private/public transport, etc. In this context, systematic studies were carried out and 50 patients (i.e. 35 outpatients and 15 inpatients) at the Nuclear Medicine Oncology and Radiotherapy Institute (NORI), Islamabad, were studied. Exposure rate at the surface of the body and at a distance of 1 m from the standing patient was measured. Results obtained from this study showed that the dose equivalent delivered by these patients to their family members (particularly children) and general public was higher than annual dose limits recommended by the International Commission for Radiation Protection in their report ICRP Publication 60(2). In the light of this study, it is recommended that the release activity limit of approximately 370 MBq (or dose rate level of approximately 10 microSv h-1 at 1 m from the patient) be adopted instead of approximately 1100 MBq in developing countries like Pakistan.

Developing Countries↗

Actuarial status of the old-age and survivors insurance and disability insurance trust funds.

The 1982 Annual Report of the Board of Trustees of the Old-Age and Survivors Insurance (OASI) and Disability Insurance (DI) Trust Funds indicates sever financial problems in both the short and the long range. The short-range financial status is significantly worse than was estimated last year, after enactment of the 1981 legislation, because of continuing unfavorable economic conditions. The estimated long-range deficit is the same as the deficit that was estimated last year before the 1981 legislation and is therefore somewhat worse than was estimated immediately after enactment of the legislation. Under present law, which authorizes temporary interfund borrowing amount the OASI, DI, and Hospital Insurance (HI) Trust Funds, the OASI Trust Fund would become unable to pay benefits on time by July 1983. The assets of the DI Trust Fund, on the other hand, are expected to grow rapidly in both the short and long range. If the assets of both the OASI and DI Trust Funds were combined, however, the two funds would still become unable to pay benefits on time by the latter half of 1983, based on all four sets of economic and demographic assumptions in the 1982 report. Even if the temporary interfund borrowing authority in present law were extended, the combined assets of the OASI, DI, and HI Trust Funds would become insufficient to pay benefits on time by 1984, based on the two less favorable sets of assumptions in the 1982 report. Based on the other two, more favorable, sets of assumptions, the three combined funds could pay benefits on time through the 1980's but there would be little or no margin of safety to permit timely payment of benefits if economic conditions are even slightly less favorable.

Costs and Cost Analysis↗