Teenage mothers in nuclear and extended households. Differences by marital status and race / ethnicity

As an initial step in expanding our understanding of the influence of family context on adolescent mothers, this article investigates the patterns of, and factors associated with, their household arrangements. Although adolescent mothers are at great risk of eventually living in female-headed households and facing economic hardship, past research has said little about the households of these young mothers while they are teenagers. Using individual-level data from the 1980 U.S. Census, we show household arrangements vary by marital status, race/ethnicity, age, number of children, and central city residence. And there are important differences by race/ethnicity in the way the other variables are related to household arrangements. Importantly, household arrangements are related to school enrollment, labor force participation, poverty status, and receiving public assistance.

Race differences in changing family demographics in the 1980s

Traditional demarcators of family formation and dissolution have changed dramatically over the past few decades and Black-White differences have become pronounced. In this article, we explore the degree to which a relatively small set of variables can account for racial difference in timing of initiation of sexual activity, first marriage, first birth, and divorce. The independent variables included in the model are adolescent living arrangements (single-parent vs. two-parent), mother's educational level, religion, region of the country, area of residency (urban, suburban, rural), birth cohort, and year of the survey. Based on hazard models for the rate of occurrence of each event, we estimate how Blacks would differ if they had mean values on covariates equal to White observed means. Although the results differ for the four dependent variables, this particular set of independent variables does not provide a satisfactory explanation of the differences between Black and White family formation and dissolution. Blacks and Whites may be responding to different structural and cultural constraints not easily captured by basic demographic variables.

Sex preference and fertility in Peninsular Malaysia

This study uses data from the Second Malaysian Family Life Survey, conducted in 1988, to examine parents' preferences for the sex of their children within each of Malaysia's three ethnic groups. While Malay and Indian parents do not show a consistent sex preference, Chinese parents prefer to have all sons, or a combination of sons and daughters, with more sons than daughters, or at least an equal number of them. Son preference among the Chinese does not seem to be a constraint to fertility decline among that population. Since 1970, Chinese fertility has dropped rapidly; at the same time, Chinese son preference has become more pronounced. Evidence indicates that further reductions in Chinese fertility, through the reduction in sex preference, would be small.

Birth spacing, breastfeeding, and early child mortality in a traditional Indian society: a hazards model analysis

There are few studies of the interrelationships among breastfeeding, child spacing, and child mortality in traditional societies that incorporate extensive controls for social and demographic characteristics of the mother and child. In this paper, we investigate the impact of breastfeeding and the length of the preceding birth interval on early child mortality (defined as a death in the first two years of life) using data from a traditional society of India. Multivariate hazards models are used to analyze the data. Most prior analyses related the impact of breastfeeding duration to the duration of child survivability by taking breastfeeding as a fixed covariate. The present study has a methodological focus in the sense that breastfeeding information from retrospective survey data is treated as a time-dependent covariate both as a status variate as well as a duration--with empirical findings compared across the two specifications. The effects of postpartum amenorrhoea and various other demographic and socioeconomic characteristics of mother and child are also studied. The results suggest that breastfeeding duration has a strong impact in reducing the relative risk of early child mortality; but it does not explain the effect of the length of the preceding birth interval on early child mortality.

Effects on Navajo birthrate from loss of the intrauterine device

The concerns of relatively powerless groups may not be adequately addressed by health-care decisions based on market forces and on considerations of the general population. Calculations of the number of Navajo women at risk of unintended pregnancy suggest that several hundred such pregnancies would have occurred as a result of the withdrawal of intrauterine devices from the United States' market. Analysis of birthrate data confirms this estimate: approximately four to five percent of Navajo births in 1988 may have been due to this market withdrawal. Available data are limited in their ability to assess impacts on small groups of health-policy decisions made for the population as a whole. A mechanism for surveilling such effects needs to be established to protect the interests of such groups, particularly when they have restricted alternatives.

Drinking-water quality, sanitation, and breast-feeding: their interactive effects on infant health

The promotion of proper infant feeding practices and the improvement of environmental sanitation have been two important strategies in the effort to reduce diarrhoeal morbidity among infants. Breast-feeding protects infants by decreasing their exposure to water- and foodborne pathogens and by improving their resistance to infection; good sanitation isolates faecal material from the human environment, reducing exposures to enteric pathogens. Taken together, breast-feeding and good sanitation form a set of sequential barriers that protect infants from diarrhoeal pathogens. As a result, breast-feeding may be most important if the sanitation barrier is not in place. This issue is explored using data from a prospective study of 2355 urban Filipino infants during the first 6 months of life. Longitudinal multivariate analyses are used to estimate the effects of full breast-feeding and mixed feeding on diarrhoeal disease at different levels of sanitation. Breast-feeding provides significant protection against diarrhoeal disease for infants in all environments. Administration of even small portions of contaminated water supplements to fully breast-fed infants nearly doubles their risk of diarrhoea. Mixed-fed and weaned infants consume much greater quantities of supplemental liquids, and as a result, the protective effect of full breast-feeding is greatest when drinking-water is contaminated. Similarly, full breast-feeding has stronger protective effects among infants living in crowded, highly contaminated settings.

Determinants of racial fertility differentials in some urban areas of South Africa

Results of a survey of some urban areas in the Pretoria-Witwatersrand-Vereenining region show differential impacts of proximate and socioeconomic factors on the fertility of urban blacks and whites. Timing of starting and ending of childbearing and the reproductive behaviour of women who have never been married account for the major differences in fertility levels. White women confine their childbearing career to the 20-39 age range, while black women utilise the entire 15-49 age range. The fertility level is quite high among black women who have never been married (in contrast to never married white women). With the exception of breast-feeding, racial patterns in other proximate determinants of fertility do not suggest the observed racial differentials in fertility.

Determinants of night blindness in Bangladesh

A cross-sectional study was conducted to evaluate the effect of a community-based health education intervention programme and to study the determinants of night blindness in Bangladesh. The intervention programme was implemented to reduce the morbidity of nutritional blindness (night blindness) in the northern part of Bangladesh (Ranjpure district) during 1986-1989. A baseline study in 1986 covered 2010 households with a total population of 11,600, and the evaluation study in 1989 covered 2011 households with a total population of 10,456. Prevalence of night blindness was studied among children aged < 9 years in these households. The prevalence of night blindness per 1000 children was reduced significantly during the intervention period from 50.7 in 1986 to 26.7 in 1989. However, the post-intervention prevalence varied significantly between areas. Multivariate analyses showed that consumption of fish, meat, milk or eggs, dark green leaf vegetables, yellow fruits and vitamin A capsules were significant predictors of night blindness. In addition, family income, mother's literacy, family size and area of residence exhibited strong and statistically significant associations with night blindness in the 1989 cross-sectional study. The prevalence of night blindness was highest among 4-6 year old girls and 7-8 year old boys. The sex difference was, however, not statistically significant.

Some factors affecting birth weights in Morogoro, Tanzania

Three hundred and thirty two pregnant women who were attending three antenatal clinics in Morogoro Municipality in Tanzania were followed in their third trimester of pregnancy in a study which aimed at finding if there was any association between weight gain in third trimester and birth weight of singleton deliveries. The relationship between weight and gestational period, age of the mother, parity and maternal weight near term were also studied. Univariate regression analysis showed that there was a strong positive correlation between birth weight and gestational period. Correlation was also found between birth weight and age of the mother, parity and weight near term, while a week correlation was found between birth weight and maternal weight gain in the third trimester. Multiple regression analysis showed that only the gestation period and weight near term were independently related to birth weight. Despite low maternal weight gain, birth weight was not affected, this shows that there might be some physiological adaptation which come into play to protect the foetus where a woman is subjected to inadequate nutrition during pregnancy.

Socio-economic and urbanization profiles of internal migration in Egypt: a canonical correlation analysis

"Data on in- and out-migration in Egypt by governorate and on variables believed to interact with migration are examined. The purpose is to identify the dimensions through which the basic demographic phenomenon can be rationally structured. This objective is approached through a general multivariate analysis technique known as canonical correlation analysis....A number of variables believed to act as determinants of migration are used and arbitrarily classified into four groups to represent four distinct migration profiles, namely, sociodemographic, economic, urbanization, and health profiles.... The analysis shows that the economic profile of migration is the most pronounced one of the four profiles examined."

The polygyny-fertility hypothesis revisited: the situation in Ghana

Re-examination of the polygyny-fertility hypothesis, by multiple regression analysis of the 1988 Ghana DHS data, reveals that polygyny has no effect on the number of children ever born; i.e. polygynously married women are as fertile as those monogamously married. Husband's age has no significant role in determining the number of children ever born to a woman.

Factors associated with use of safer sex practices among college freshmen

The purpose of this exploratory study was to examine the relationship of knowledge of AIDS, misconceptions about AIDS, knowledge of safer sex practices, perceived susceptibility, and future time perspective to the practice of safer sex behaviors in 352 single, sexually active, college freshmen. Data were analyzed using stepwise multiple regression analysis and discriminant analysis. There were too few black females for analysis. Future time perspective explained the most variance in safer sex practices for black males. Knowledge of AIDS, perceived susceptibility, misconceptions about AIDS, knowledge of safer sex practices, and future time perspective did not explain a significant amount of variance in use of safer sex practices for either white males or females. However, perceived susceptibility and future time perspective differentiated sexually active from nonsexually active white males and females.

Socioeconomic factors affecting marriage, divorce and birth rates in a Japanese population

The effects of low income, urbanisation and young age population on age-adjusted rates of first marriage, divorce and live birth among the Japanese population in 46 prefectures were analysed by stepwise regression for 1970 and for 1975. During this period, Japanese society experienced a drastic change from long-lasting economic growth to serious recession in 1973. In both 1970 and 1975, the first marriage rate for females was inversely related to low income and the divorce rates for both males and females were positively related to low income. The live birth rate was significantly related to low income, urbanisation and young age population only in 1975. The first marriage rate for females and the divorce rates for both sexes increased significantly but the first marriage rate for males and live birth rate significantly decreased between 1970 and 1975. These findings suggest that low income was the essential factor affecting first marriage for females and divorce for males and females.

Urban nuptiality patterns and marital fertility in Nigeria

This study indicates that urban marital patterns in nine Nigerian cities influence fertility. Fertility is also influenced by age at marriage, region of residence, ethnicity and religion; education and employment lead to marriage delay and tend to conflict with childbearing by enhancing the status of women.

HIV-1 infection in young men in northern Thailand

OBJECTIVES

To determine risk factors for HIV-1 infection in young men in northern Thailand.

METHODS

At enrollment into a prospective study, data were collected from a self-administered questionnaire and serologic testing on a cohort of 1115 young men selected by lottery for conscription.

RESULTS

The overall HIV-1 infection rate was 6.9%; however, the rate was 15.3% among the 387 (34.7%) men who had been living in the upper north subregion of Thailand compared with 2.5% for the remaining 728 men (P < 0.001). A history of sex with female prostitutes was reported by 74.7% of men and increased frequency of this type of sex was highly associated with HIV-1 infection and a history of sexually transmitted disease (STD) symptoms (chi 2 for trend, P < 0.001). In stratified and multivariate analyses, however, history of STD symptoms, reported by 42.5% of the cohort, was most strongly associated with HIV-1 infection. Only 42.8% of men who reported sex with prostitutes had used condoms more than half the time.

CONCLUSIONS

Young men in the general population in northern Thailand are at high risk for HIV-1 infection via sex with female prostitutes; STD are highly associated with HIV-1 infection. Increasing condom use and controlling STD should be immediate goals of HIV control programs.

The epidemiology of HIV infection in a rural area of Guinea-Bissau

OBJECTIVES

To determine the prevalence of HIV infection and its relationship to age, sex and other factors.

DESIGN AND SETTING

Cross-sectional survey of a rural community in Guinea-Bissau.

METHODS

Questionnaire-administration and screening of sera from subjects aged > or = 15 years.

RESULTS

Of the 2770 subjects tested, 220 (7.9%) were HIV-2-seropositive, four (0.1%) were HIV-1-seropositive and 10 (0.4%) were dually reactive. Overall prevalence of HIV-2 was 9.3% in women, peaking at 17.2% in the 35-44 age group, and 6.6% in men, peaking at 19.1% in the 45-54 age group. The mean age of the four subjects with HIV-1 infection was 24 years, which was significantly lower than those with HIV-2 infection. HIV-2 infection was more prevalent among women who were widowed or divorced, women whose husbands were living away from the study area, and women who had lived in the capital, Bissau. The majority of subjects with an infected spouse remained uninfected and none of the women aged < 25 years whose husbands were infected were seropositive. The prevalence varied significantly between settlements within the study area.

CONCLUSIONS

The pattern of HIV-2 infection in this rural community has similarities to that found in urban Bissau, and prevalence in both areas peaks in older subjects than in HIV-1 foci. The findings support previous suggestions that HIV-2 is not a recent introduction to Guinea-Bissau, and that it is less pathogenic and less readily transmitted than HIV-1.

Efficacy of measles vaccines after controlling for exposure

The clinical efficacy of measles vaccines was investigated in Niakhar, a rural area of Senegal under demographic surveillance in 1987-1990. Three measles vaccines were tested: a standard Schwarz, a high-titer Edmonston-Zagreb, and a high-titer Schwarz. The two high-titer vaccines were administered at 5 months of age and the standard Schwarz vaccine at 10 months. In addition to a formal randomized vaccine trial, data from national campaigns using the standard Schwarz vaccine were also analyzed. Clinical efficacy was estimated after controlling for exposure. In the randomized trial, the estimate of the efficacy of the standard Schwarz vaccine was 97.2% (95% confidence interval (CI) 91.3-98.1). In the 1986-1987 national campaign, the efficacy of the standard Schwarz vaccine was lower: 92.5% (95% CI 88.8-94.6). In the randomized trial, the efficacy of the high-titer vaccines was lower than that of the standard vaccine. High-titer vaccines were not used in national campaigns. Other factors associated with vaccine efficacy were age at exposure, intensity of exposure, and age at vaccination. Controlling for the intensity of exposure did not change the relative ranking of the efficacy of the three vaccination strategies. The theoretical efficacy of the standard measles vaccine for a single unit of exposure was estimated at 98.0%.

Why do homosexual men relapse into unsafe sex? Predictors of resumption of unprotected anogenital intercourse with casual partners

OBJECTIVE

To assess predictors of relapse into unprotected anogenital intercourse with casual partners among homosexual men in Amsterdam, The Netherlands.

DESIGN

A prospective study ongoing since October 1984.

METHODS

Self-reported data on sexual behaviour were obtained at 12 semi-annual intervals. Participants who reported unprotected anogenital intercourse with casual partners at wave 12 but not at wave 11 were considered to have relapsed into unsafe sex (n = 47). Men who did not report unprotected anogenital intercourse at wave 11 or at wave 12 were considered to have maintained behaviour change (n = 197).

RESULTS

Relapse into unsafe sex with casual partners occurred more frequently among men with a less positive attitude towards condom use, lower personal efficacy with respect to using condoms with casual partners, a weaker intention to avoid anogenital intercourse with casual partners and those who were not involved in a primary relationship. Intention to avoid anogenital intercourse with casual partners was related to an individual's attitude, normative beliefs and personal efficacy with respect to avoiding anogenital intercourse.

CONCLUSIONS

In order to improve motivation it is important to support homosexual men in their personal decision-making process, which may be more resolute when the outcome is in accordance with individual preferences. Therefore, health education should be community-based and sensitive to individual needs.

Immigrant fertility: an examination of social characteristics and assimilation

"This study compares the fertility patterns of foreign-born and native-born women in Canada and examines whether [the] same set of social characteristics accounts for differential fertility among both the groups. The study also assesses the importance of social characteristics and assimilation on immigrant fertility behavior. Two generations of currently married/cohabiting women with spouse present are analyzed using multiple regressions. The results reveal similar effects on fertility of social characteristics for foreign-born and native-born, while in the case of younger generations the effects are stronger."

Excess mortality for the unmarried in rural Bangladesh

Prospective data from the Matlab surveillance area in rural Bangladesh, 1974-1982, were used in this study to show that divorced and never-married adults (aged 15-44 years) had significantly higher mortality than their currently married peers with differences in disability status accounting for some of this excess risk. Widowed individuals on the other hand had no excess mortality relative to the currently married. A certain proportion of the sharp reduction in mortality associated with remarriage after divorce for men could be attributed to differences in disability between the remarried group and those who remained divorced. Household economic status indicators could account for little of the excess mortality of divorced and never-married individuals relative to their married counterparts. These findings provide support for the hypothesis that a certain proportion of mortality differentials by marital status in this population can be attributed to selection into marriage and remarriage on the basis of underlying disability status. The evidence for the protective effect of increased economic status associated with the currently married state is less convincing.

The ethnographic context of illness among single-women-headed households in rural Peru

Peru is undergoing many deleterious economic and social changes, and the health consequences for families headed by single women is of special concern. However, not all single mothers' families may be at similar risk of morbidity. My purpose in the present study was to determine whether variation in illness prevalence was associated with ostensibly small differences in socioeconomic resources and physical living conditions in areas like Peru. I used both qualitative and quantitative methods in this study. The sample included single-women-headed households from the rural Nuñoa District, located in the southern Peruvian Andes (N = 22 families with 90 individuals). Quantitative cross-sectional survey results suggested that the mother's formal education, the availability of a latrine, drinking water contamination, the gender ratio of the household, and the quality of the social support network were key risk factors. They statistically predicted 35-91% of the morbidity variance between families (p < or = .03-.0001). I illustrate these findings in three ethnographic case studies. The case studies show how the degree of illness among single-women-headed families was affected by small differences in their social and physical living conditions.