Due to the high population growth rate in the mid-20th century, the government of Ghana introduced population policies to reduce the growth rate. Encouraging girls’ education and increasing contraceptive use were the two main policy measures to reduce population growth. In order to get a clear picture of the childbearing dynamics of Ghanaian women in response to the population policy of 1994, we analyzed individual reproductive histories from 1969 to 2003 using 2003 Ghana Demographic Health survey data to disentangle patterns by parity, calendar period, and educational groups. Exponential hazard regression models were used to estimate the relative risk of births. We find some evidence of a critical juncture in fertility trends, particularly for the fifth child. In addition, higher parity transition rates continuously declined for women with secondary or higher education and these educational levels were achieved by a higher share of the population after the policy was implemented. The 1994 population policy was successful if only by virtue of the increasing number of women with secondary or higher education. Belonging to this group is not only associated with lower fertility, but this suppressing effect strengthened in the years following the policy implementation. We also suspect that the increasing similarity between women with no education and with primary education reflects the diffusion of contraceptive knowledge and norms related to childbearing. The educational reform and contraceptive initiatives did result in increased education and contraceptive awareness and are therefore beneficial programs.
Existing research on cancer screening utilization among sexual minority women in the U.S. has mostly relied on non-random samples that combine lesbian and bisexual women into a single group. We respond to these limitations by examining the relationship between sexual orientation and cancer screening among a sample of U.S. women from the Behavioral Risk Factor Surveillance System (BRFSS). Our analytic sample includes 2273 lesbian, 1689 bisexual, and 174,839 heterosexual women interviewed in 15 U.S. states between 2000 and 2010. We examine two cancer screening measures: timely mammogram and pap tests, defined as having had a mammogram in the past 2 years for women aged 40 and older, and having had a pap test in the past 3 years for women aged 21–65. For mammogram, results showed that rates of timely use did not significantly differ by sexual orientation. However, lesbian and bisexual women report significantly lower rates of timely pap testing than heterosexual women. Logistic regression results on timely pap testing showed that lower pap test use for bisexual women is primarily driven by their poorer socioeconomic status relative to heterosexual women, while the significantly lower odds of timely pap testing for lesbian women were unaffected by control measures. Better understanding of cancer screening utilization disparities among lesbian and bisexual women is necessary to address morbidity and mortality disparities by sexual orientation.
This study examines whether the receptivity climate toward immigrants varies across traditional, new, and emerging Hispanic immigrant destinations in the U.S. and whether that climate is related to local unemployment rates and to the job-skill level of immigrants who settle in these places. We utilize unique, newly collected data to measure local labor market area immigrant receptivity climate based on content analysis of a random sample of all articles addressing immigrants/immigration which were published by local area newspapers from 1995 to 2010. The descriptive data show considerable diversity in local and regional immigrant receptivity patterns across the 380 U.S. labor market areas. Using annual labor market-specific unemployment rates, decadal measures of the educational attainment of immigrants and natives in the labor market area, and an annual summary measure of the immigrant receptivity climate, controlling for theoretically relevant labor market contextual characteristics, results from our regression models show that the immigrant receptivity climate is more negative where unemployment rates are higher. However, this relationship is evident only for new and non-destination areas compared with established immigrant destinations when control variables are considered. While a higher skill level of immigrants (a labor competition argument) is related to less negativity toward them, it does not explain the relationship between unemployment and immigrant receptivity climate. Overall, a high skill level of natives is the better explanation for a more positive immigrant receptivity climate.
By the end of 2014, twenty-four states rejected Medicaid expansion, providing a unique opportunity to examine changes in insurance coverage rates after the implementation of the Affordable Care Act within and between states that did versus did not expand Medicaid. Using multilevel regression analyses of county-level non-elderly adult small area health insurance estimates (N = 3135) from the US Census Bureau, several important findings emerge. Compared to counties located in states that did not expand Medicaid, counties located in states that did expand experienced significantly larger increases in adult health insurance coverage rates between 2013 and 2014, net of the county baseline insurance coverage rate, socioeconomic and demographic composition, and labor market characteristics. In states that did not expand Medicaid, counties with larger shares of vulnerable residents (i.e., poor adults and low education) experienced lagging improvements in health insurance coverage. However, counties in states that expanded Medicaid were protected from several of these exacerbated disparities, and in some cases, experienced larger insurance coverage improvements than counties with less disadvantaged populations. These findings suggest that although insurance coverage increased in nearly all counties between 2013 and 2014, increases would have been larger and disparities would have been further alleviated if more states with highly concentrated vulnerable populations had expanded Medicaid.
Mortality rates among black individuals exceed those of white individuals throughout much of the life course. The black–white disparity in mortality rates is widest in young adulthood, and then rates converge with increasing age until a crossover occurs at about age 85 years, after which black older adults exhibit a lower mortality rate relative to white older adults. Data quality issues in survey-linked mortality studies may hinder accurate estimation of this disparity and may even be responsible for the observed black–white mortality crossover, especially if the linkage of surveys to death records during mortality follow-up is less accurate for black older adults. This study assesses black–white differences in the linkage of the 1986–2009 National Health Interview Survey to the National Death Index through 2011 and the implications of racial/ethnic differences in record linkage for mortality disparity estimates. Match class and match score (i.e., indicators of linkage quality) differ by race/ethnicity, with black adults exhibiting less certain matches than white adults in all age groups. The magnitude of the black–white mortality disparity varies with alternative linkage scenarios, but convergence and crossover continue to be observed in each case. Beyond black–white differences in linkage quality, this study also identifies declines over time in linkage quality and even eligibility for linkage among all adults. Although linkage quality is lower among black adults than white adults, differential record linkage does not account for the black–white mortality crossover.
Associations between unemployment, work, and disability have been researched in many studies. The findings are often based on cross-sectional data and single outcomes. The present study analysed multiple outcomes over a period of 15 years among long-term unemployed individuals. Based on all individuals aged 20–40 living in Sweden in 1995, prospective cohort analyses were conducted. Individual annual labour market proximity 1995–2010 was estimated and categorised into three mutually exclusive categories: “Jobless”, “Self-sufficient” (i.e. main income from work), or “Disabled”. Individuals in the category “Jobless” (n = 638,622) in 1995 constituted the study population. Using autoregressive multinomial logistic regression, transitions between the three states during 1997–2010 were analysed. Socio-economic factors, previous inpatient care, and national unemployment rates in different time periods were included in the regression models. Among those “Jobless” in 1995, 17 % were also “Jobless” in 2010, while 10 % were “Disabled” and 61 % “Self-sufficient”. The transitions were stable over time periods for transitions into “Self-sufficient” and “Disabled” but less so for “Jobless”. Previous state was the best predictor of subsequent state. “Jobless” individuals with previous morbidity had a higher transition probability into “Disabled” and a lower transition probability into “Self-sufficient”. The transition rates into “Self-sufficient” were higher in periods with lower unemployment levels. The study supports the interpretation that return to work was affected both by the individuals’ previous health status and by the national unemployment level. Transition from being “Jobless” into “Disability” may be influenced by previous ill health and by negative health effects of being “Jobless”.
Mortality rates are often disaggregated by different attributes, such as sex, state, education, religion, or ethnicity. Forecasting mortality rates at the national and sub-national levels plays an important role in making social policies associated with the national and sub-national levels. However, base forecasts at the sub-national levels may not add up to the forecasts at the national level. To address this issue, we consider the problem of reconciling mortality rate forecasts from the viewpoint of grouped time-series forecasting methods (Hyndman et al. in, Comput Stat Data Anal 55(9):2579–2589, 2011). A bottom-up method and an optimal combination method are applied to produce point forecasts of infant mortality rates that are aggregated appropriately across the different levels of a hierarchy. We extend these two methods by considering the reconciliation of interval forecasts through a bootstrap procedure. Using the regional infant mortality rates in Australia, we investigate the one-step-ahead to 20-step-ahead point and interval forecast accuracies among the independent and these two grouped time-series forecasting methods. The proposed methods are shown to be useful for reconciling point and interval forecasts of demographic rates at the national and sub-national levels, and would be beneficial for government policy decisions regarding the allocations of current and future resources at both the national and sub-national levels.
In 2009 Argentina introduced a large poverty-alleviation program (AUH) that provides monthly cash transfers per child to households without workers in the formal sector. In this paper we study the potential unintended effect of this program on fertility. We apply a difference-in-difference strategy comparing the probability of having a new child among eligible and ineligible mothers both before and after the program inception. The intention to treat estimations suggest a significant positive impact on fertility in households with at least one child (around 2 percentage points), but no significant effect on childless households. Given the short time window since the implementation of the AUH, we are unable to identify whether this positive effect reflects changes in the timing of births or in the equilibrium number of children.
South Korea was among the first countries to report both an abnormally high sex ratio at birth (SRB) and its subsequent normalization. We examine the role of son preference in driving fertility intentions during a period of declining SRB and consider the contribution of individual characteristics and broader social context to explaining changes in intentions. We employ data from the National Survey on Fertility, Family Health and Welfare that span 1991–2012. We find that reported son preference declined to a great extent but remained substantial by the end of the observation period, and that the intention to have a third child still differed by sex of existing children. Change in individual-level factors does not explain the decline in son preference, suggesting that broad social changes were also important. This study provides a better understanding of how son preference evolves in the post-transitional context of very low fertility.
Widening of educational disparities and a narrowing female advantage in mortality stem in good part from disparities in smoking. The changes in smoking and mortality disparities across cohorts and countries have been explained by an epidemic model of cigarette use but are also related to life course changes. To better describe and understand changing disparities over the life course, we compare age patterns of smoking in three cohorts and two nations (France and the US) using smoking history measures from the 2010 French health barometer (N = 20,940) and the 2010 US National Health Interview Survey Sample Adult File (N = 20,444). The results demonstrate statistically significant widening of gender and educational differences from adolescence to early and middle adulthood, thus accentuating the disparities already emerging during adolescence. In addition, the widening disparities over the life course have been changing across cohorts: age differences in educational disparities have grown in recent cohorts (especially in France), while age differences in gender disparities have narrowed. The findings highlight the multiple sources of inequality in smoking and health in high-income nations.
This study uses multi-state cohort component projections and detailed vital statistics data to project the future Taiwanese population by age, sex, and education up to 2050. These are the first education-specific population projections for Taiwan, and they reveal how young highly educated cohorts during the next decades will replace older cohorts with lower levels of educational attainment. The results of the population projections enter our estimation of the future composition of the Taiwanese labor force. Incorporating education as an extra dimension in labor force projections allows us to make inferences about the quality of future labor supply in a rapidly aging Taiwan and the leverage of expanding economic activity across the life course, particularly of women. At present, women’s economic activity above age 25 in Taiwan is significantly lower than men’s and also much lower than women's in Western developed nations. Some of the expected adverse economic consequences of population aging can likely be alleviated by having a more educated and consequently more productive labor force. The overall results and conclusions of our study, though based on the Taiwanese context, apply to other Asian economies with rapidly aging populations and currently comparatively low levels of female labor force participation as well.
Adolescents of Mexican origin have higher than average school dropout rates, but the risk of school non-enrollment among this subgroup varies substantially across geographic areas. This study conducts a multilevel logistic regression analysis of data from the 2005–2009 American Community Survey to evaluate whether spatial heterogeneity in school non-enrollment rates among Mexican-origin youth (n = 71,269) can be attributed to the histories of states and local areas as Mexican Latino/a receiving gateways. This study also determines whether the association between new destinations and school non-enrollment varies within the Mexican-origin population by nativity and duration of residence. Net of background controls, the risk of non-enrollment does not differ significantly between Mexican-origin youth living in states that are newer Mexican Latino/a gateways versus those in more established destinations, in part because Mexican-origin school non-enrollment rates are heterogeneous across newer destination states. At the more local Public Use Microdata Area level, however, Mexican-origin youth in newer gateways have a higher risk of non-enrollment than those in established destinations, revealing the importance of local-level contexts as venues for integration. The disparity in non-enrollment between Mexican-origin youth in new versus established destination PUMAs is apparent for all generational groups, but is widest among 1.25-generation adolescents who arrived in the country as teenagers, suggesting that local new destinations are particularly ill-equipped to deal with the educational needs of migrant newcomers.
Research suggests that parity and parental health and mortality are associated significantly, although the pattern of association varies across studies. Studies ascribe long-term poor health (and mortality) to either low or high parity, and some studies show that both low and high parity increase the risk of adverse health for parents (i.e., forming a “J-shaped curve”). While a recent meta-analysis (Zeng et al., Sci Rep 6:19351, 2016) has partially addressed this gap in the literature, the present study further extends the literature by using a methodology that allows for more robust control of study heterogeneity and potential confounders. Using data on 223 measures of relative mortality risk from 37 studies, from samples gathered after 1945 from developed nations, meta-analysis and meta-regression (weighted linear regression) results show a nonlinear association (J-shaped curve) between parity and all-cause parental mortality, though the strength of the association varies by both sex and cohort. The results also suggest that the mortality hazard is partially explained by health selection effects.
Despite increases in research on the migration of skilled Africans to the developed world, few studies have examined the specific mechanisms of departure contributing to these trends. Previous studies further contain limited analysis of how these mechanisms respond to Africa’s changing social and demographic trends. This study uses data from various sources to examine these issues. The results indicate that, in absolute terms, overall emigration flows of highly skilled Africans to the US more than doubled between 1980 and 2010. In addition, they suggest that previous arguments indicating that the recruitment of African professionals drives these flows understate the role of student migration in driving these movements. In the past three decades, more skilled Africans migrated to the US through student migration mechanisms than through any mechanism associated with the recruitment of workers. Furthermore, in recent years, the Diversity Visa Program has become the second most important mechanism through which skilled emigration from Africa occurs. Finally, the analysis finds that trends in African student emigration are highly responsive to youth population growth and that, surprisingly, the migration of skilled professionals is less influenced by African economic trends than by economic trends in the US.
The interactions between the processes of urbanization and international migration in less developed and transition countries have important repercussions for socioeconomic development, but are not well understood. Based on the retrospective data from the Albanian Living Standards Measurement Survey 2008, we first assess the geography of migration in terms of the rural–urban continuum, the urban hierarchy and the outside world since 1990. We then investigate the spatio-temporal diffusion of rural-to-urban and international movements using survival models. Results reveal an immediate onset of large-scale rural exodus, despite the post-communist crisis. Internal migrants mainly moved to the capital, bypassing secondary cities, and were predominantly female. Initially, international migrants were primarily men who tended to originate from the main urban agglomerations. The diffusion of opportunities to emigrate down the urban hierarchy and across the sexes then redirected the rural exodus abroad, despite domestic economic development. This evolution in population mobility is related to the gendered patterns and interlinkages of the two flows, as well as to rising inequalities within the urban hierarchy.
A mounting body of evidence suggests that the life course sequence that once defined contemporary US women’s lives is changing as an increasing number of women now complete their education after the transition to motherhood. Despite such evidence, we know little about this changing pattern of life course events for many US women. The aim of this study, therefore, is to produce population-based estimates that describe the prevalence of mothers’ school reentry and secondary and college degree attainment, the timing of women’s post-childbearing education vis-à-vis their transition into motherhood, and the characteristics of mothers who pursue additional schooling. To do so, the study draws on data from a nationally representative cohort of US women participating in the National Longitudinal Survey of Youth (n = 4925) and descriptive and event-history techniques. Findings suggest that a substantial proportion of mothers (17 %) completed additional education after the transition to motherhood, especially mothers who had the lowest levels of education at their time of first birth (high school dropouts) (43 %). These mothers, who overwhelmingly earned high school degrees/GEDs, were most likely to do so within 5 years of giving birth, while mothers pursuing higher levels were more likely to do so when children were older. Mothers who pursued schooling after the transition to motherhood were remarkably more disadvantaged than women who followed the traditional sequencing of life course events. Compared to women who had the same education upon being mothers, they were also younger, more often poor, and had greater job instability but higher cognitive test scores.
Rapid growth in the population of children of immigrants has occurred during an era of soaring college costs in the United States. Despite well-established knowledge that immigrant parents hold high educational expectations for their children and that children of immigrants will make up a large share of the U.S. college-aged population, little is known about how immigrant families prepare financially for their children’s postsecondary education. We use data from the Education Longitudinal Study of 2002 to examine the patterns and predictors of college savings behavior among Asian and Latino foreign-born parents of high school students in the United States. Relative to white U.S.-born parents, Asian immigrant parents have higher odds of saving and have more money saved for their 10th-grader’s college education. In contrast, Latino immigrant parents are less likely than white U.S.-born parents to save for their children’s college education. However, among parents who save, Latino immigrant parents do not differ from white U.S.-born parents in the amount saved. For both Asian and Latino immigrant parents, income is less predictive of saving than it is for white U.S.-born parents, and the odds of saving increase with U.S. experience. Findings improve understanding of college access and the long-term socioeconomic prospects of children of immigrants in the U.S.
Administrative data from multiple sources are combined to measure pregnancy (excluding those ending in abortion or miscarriage) and high school dropout in a cohort of girls who were 9th graders in the 1994–1995 academic year. Rates of pregnancy (as identified in the data) and dropout are substantially higher among Hispanic high school students than among African-Americans or non-Hispanic whites. Previous studies of teen pregnancy and dropout typically focus on pregnancy rates conditional on dropout status, or dropout rates conditional on fertility. This paper presents estimates of pregnancy and dropout as a joint-dependent variable. Estimates of their joint probability distribution conditional on individual, family, neighborhood, and high school characteristics are reported. The estimates use longitudinal administrative data collected as annual censuses of all public school students in Texas with individual-level ids. Neighborhood characteristics (from the US Census data geographically linked to Texas high schools) have large effects on pregnancy and dropout. Immigrant Hispanic girls’ pregnancy rates are significantly lower than native-born Hispanic girls’ pregnancy rates. Above-normal-age status in the 9th grade is among the strongest predictors of pregnancy and dropout in later years. Ethnic differences in age distributions within grade level appear to explain a large share of ethnic differences in pregnancy and dropout rates.
In China, hypergamy is a socially desirable marriage but an understudied topic. Less has been written on how personal traits and structural factors are intertwined to shape such marriage. Using national-survey data and employing a binary endogenous regressor probit model, this paper investigates three forms of hypergamous marriages: women marrying men from more prosperous families, women marrying men who are more economically established, and women marrying men with an urban hukou. We assess the interaction of ascribed and achieved personal traits with institutional factors in explaining these upward marriages. Particular attention is paid to the role of hukou status in the making of hypergamy. Our results suggest that most of rural women have to stick to endogamy within their socioeconomic category. Ascribed and achieved traits work on marital outcomes in different ways in the changing socioeconomic contexts, mediated by the endogeneity of hukou status conversion. The likelihood of hypergamous marriages of Chinese women is largely constrained by the role of hukou status.