What is the cost of living in the Papua New Guinea highlands? An answer is sought using a time and energy accounting approach. The subsistence regime of Wola-speaking highlanders, the subjects of this investigation, comprises three components. The principal one is horticulture: people clearing gardens from forest and grassland, with tuberous crops predominating, notably sweet potato. The second component comprises animal rearing, notably of domestic pigs. The third, and least important, is hunting and gathering for food in the forest. The calculated returns on investments in these subsistence domains vary considerably. Gardens return in their crops between ten and fifteen times the energy expended in cultivation. Pigs may also give a good return, of four to five times the energy invested in rearing them, if slaughtered when adult, but people regularly keep animals for years and may incur negative energy returns on their labour investments. This relates to the high cultural premium put on pigs. Foraging for food is also energetically costly, the Wola expending four times more energy on these activities than they gain in return from the food they secure. This analysis of energy gains and losses challenges the relative notion of affluence as applied to foragers, by reviewing it in the comparative context of subsistence horticulture.

Societal gender inequality and a preference for male children has been shown to be detrimental to girls’ health. This is despite females’ innate biological advantage early in life. The negative effects of gender inequity on female health are most pronounced in resource-poor countries, where cultural norms supporting a preference for male children are strongest. However, most of what is known about gender inequality and child health comes from studies of singleton births. There is little evidence for how, or if, the disadvantages associated with gender bias and son preference extend to multiple births, a population inherently at risk for a number of health challenges. This analysis examines whether gender bias in health outcomes exists for twins. Data on live twin births from 38 Demographic and Health Surveys were compiled (n=11,528 individuals) and twins were categorized as girl/girl, girl/boy, boy/girl or girl/girl. Gender inequality was measured via the Gender Inequality Index. Multilevel logistic regression models examined associations between twin sex composition, gender inequality and eight outcomes of infant and child morbidity, mortality and mother’s treatment-seeking behaviours. Twin pairs containing girls had significantly lower odds of first-year mortality. Higher country-level gender inequality was associated with higher odds of reporting diarrhoea and fever/cough, as well as an increased odds of post-neonatal mortality. Results suggest that the biological advantage for females may be stronger than son preference and gender inequality in the first year of life. Understanding these relationships has the potential to inform efforts to curb the influence of gender preference on the health of female children in resource-poor settings.

In recent years, studies show that obesity has become an important health condition, especially among adults. The first aim of this study is to examine socio-demographic and behavioural factors on body mass index distribution of male and female adults over 20 years old in Turkey. The second aim is to determine the body mass index disparity by gender and the socio-demographic and behavioural factors that might wider or narrow it. This study adopts unconditional quantile regression and decomposition methods, and the data set covers the Turkish Health Surveys for 2014, 2016, and 2019. The findings document that high level of body mass index are associated with being married, aging, and physical inactivity. Interestingly, employment status has different contributions on the body mass index of males and females. The results also claim a body mass index gap among males and females as a result of differences in some potential socio-demographic and behavioural factors, and the gap gets higher at the upper and lower quantiles of BMI distribution. This study may provide a clear understanding for policymakers on how to design efficacious obesity policies considering the differences in the effect of socio-demographic and behavioural factors on the distribution of body mass index across females and males. The results suggest that the Ministry of Health should specifically target different groups for males and females and should reduce the differences in socio-demographic and behavioural determinants between females and males to prevent and reduce obesity prevalence in Turkey.

Uttar Pradesh (UP), with more than 220 million people, is the most populous state in India. Despite a high unmet need for modern family planning methods, the state has experienced a substantial decline in fertility. India has also seen a decline during this period which can be attributed to the increased prevalence of modern methods of family planning, particularly female sterilisation, but in UP, the corresponding increase was marginal. At the same time, Traditional Family Planning Methods (TMs) increased significantly in UP in contrast to India, where it was marginal. The trends in UP raise questions about the drivers in fertility decline and question the conventional wisdom that fertility declines are driven by modern methods, and the paper aims to understand this paradox. Fertility trends and family planning practices in UP were analysed using data from different rounds of National Family Health Surveys (NFHS) and the two UP Family Planning Surveys conducted by the UP Technical Support Unit to understand whether the use of TMs played a role in the fertility decline. As per NFHS-4, the prevalence of TM in India (6%) was less than half that of UP (13%). The UP Family Planning Survey in 25 High Priority Districts estimated that 22% of women used TMs. The analysis also suggested that availability and accessibiility of modern contraceptives might have played a role in the increased use of TMs in UP. If there are still couples who make a choice in favour of TMs, they should be well informed about the risks associated with the use of traditional methods as higher failure rate is observed among TMs users.

There has been a secular decline in age at menarche since the 19th century. Early-maturing women are more likely to have their sexual debut at a younger age, which in turn gives rise to a host of reproductive health and social problems. This study used data from five waves of National Demographic and Health Surveys conducted in the Philippines between 1993 and 2013 to examine the trends and socioeconomic differentials in age at menarche and sexual debut. The changing trend in age at menarche and sexual debut was examined across birth cohorts, and logistic regressions were used to identify the determinants of early sexual debut. In the Philippines, the mean and median ages at menarche declined from 13.2 years and 12.6 years, respectively, among young women born in 1973–1977, to 12.9 years and 12.3 years, respectively, among those born in 1993–1997. The proportion who had their sexual debut by age 20 increased from 41.2% for the 1968–1972 birth cohort to 53.4% for the 1988–1992 birth cohort. Filipino women with low education, from poor families and living in rural areas were more likely to have earlier sexual debut despite attaining menarche at a later age as compared with their higher educated counterparts, and those from wealthier families and urban areas. Logistic regression analysis showed that, besides marital status, women’s education and age at menarche were important determinants of early sexual debut. However, ethnicity, place of residence and family wealth had no significant effects on age at menarche. An increasing proportion of young women were found to be having unprotected sexual debut and at a younger age, with health and social ramifications. Hence, apart from increasing the enrolment of girls in schools and discouraging teenage marriage, there is a need for social and health agencies to implement appropriate adolescent sexual and reproductive health programmes such as counselling and educational campaigns, as well as support services, to address sexual problems among the youth.

Many of the studies on the sex ratio at birth (SRB) are based on a small number of cases over a short period of time. Taking a multivariate approach to a dataset consisting of nearly 199 million birth records in the United States from 1968 to 2019, we present a detailed analysis of several possible factors that might affect the sex ratio at birth (SRB) and its patterns of variation. We found that race/ethnicity is the variable with the strongest influence on this index. Parental age, birth order and solar radiation also have a bearing on the SRB, albeit only to a moderate degree. The historical evolution of the SRB among Black and American Indian and Alaska Native populations remains unexplained.

Despite persistent efforts, unmet need for contraceptives in India has declined only slightly from 14% to 13% between 2005–06 and 2015–16. Many women using a family planning method discontinue it without switching to another method and continue to have unmet need. This study quantified the share of current unmet need for modern contraceptive methods attributed to past users of these methods in India. Data were drawn from two rounds of the National Family Health Survey conducted in 2005–06 and 2015–16. Using information on women with current unmet need, and whether they used any modern method in the past, the share of past users with current unmet need for modern methods was calculated. Bivariate and multivariate analyses were performed. Among 46 million women with unmet need, 11 million were past users of modern methods in 2015–16. The share of current unmet need attributed to past users of modern contraceptive methods declined from 27% in 2005–06 to 24% in 2015–16. Share of current unmet need attributed to past users was associated with reversible method use. This share rose with increased use of modern reversible methods. With the Indian family planning programme’s focus on increasing modern reversible method use, the share of unmet need attributed to past users of modern methods is likely to increase in the future. The programme’s emphasis on continuation of contraceptive use, along with bringing in new users, could be one of the key strategies for India to achieve the FP2020 goals.

This is a retrospective study of 1754 patients seen at the Brook Pregnancy Advice Service (Avon) in the 3½ years January 1971 to June 1974; 1653 patients were referred for termination of pregnancy. The ages of the patients ranged from 13 to 44 years; the age peak was 19 years. Most patients attended between the 7th and 10th weeks of pregnancy; the peak was at 8 weeks. The majority of patients from outside the clinical area were referred for abortion privately. Patients from within the clinical area were referred to the NHS slightly more often than privately. There is a delay of 2–4 weeks for an NHS gynaecological appointment and a further 1–4 weeks before termination. Private patients are seen within 7 days and their abortions are performed within a few days. Patients from within the clinical area are more likely to return to the clinic for follow-up. There is a considerable fall-off in the continuation of follow-up for all patients returning to the clinic.

Visual acuity was tested and the anterior portion of the eye inspected among the Gidra in Lowland Papua New Guinea, who depend on hunting for their animal food. The visual acuity of the youths and adults was as high as that of hunters and gatherers; 88% of the males and 81% of the females had an acuity of 1·2 or better. The elders had far lower acuity, correlated with the advance of cataract (or corneal opacity). The senescent visual acuity is discussed in relation to little practice and low productivity of the elders' hunting, and to the Gidra traditional age-grade system.

Contraceptive knowledge and behaviour of mothers of large (five of more children) and small (under three children) families in four subcu;tures were compared with white Protestants. Four hundred and forty-nine mothers aged 35–45 years were studied from black, Cuban, Indian, Chicano, and white groups. With social class, knowledge of birth control, and degree of religiosity held constant, the best predictors of family size were the mother's desited family size (expressed as desired minus actual children) age at childbirth, and age at mariage. Data suggest that family size is not purely a function of birth control knoeledge but related to early marrage and pregnancy and in keeping with attitudes about an ideal family size. In general, factors related to size were stronger in the white group than in the subcultures, and in a few instances certain cultures were not consostent with others in overall trends.

Vaccines for COVID-19 began to be available in Africa from mid-2021. This paper reports on local reactions to the possibility of vaccination in one West African country, Sierra Leone. We show that the history of institutionalisation of vaccine is highly relevant to understanding these reactions. Given lack of testing for the disease, medical authorities could not be sure whether there was a hidden epidemic. In addition, many people associate vaccination with care of children under 5 years, and not adults, and an emphasis on vaccinating the old at first seemed strange and worrying. This paper examines evidence from ethnographic studies in two rural areas selected for varying exposure to Ebola Virus Disease (EVD), supplemented by some interviews in two provincial urban centres, Bo and Kenema. We describe local ideas about vaccination (maklet) and body marking with leaf medicine (tεwi). We asked about attitudes to the idea of COVID-19 vaccination both before and after vaccines were available. A number of reasons were given for scepticism and hesitation. These included lack of experience with vaccines for adults and lack of experience of COVID-19 as a severe disease. Medical evidence suggests the vaccination protects against serious illness, but local people had their own views about control of infection, based both recent experience (notably EVD) and the history and institutionalisation of vaccination and public health measures in Sierra Leone more broadly.

This article examines the relationship between the height of adult males and marital outcomes, including likelihood of marrying, age at marriage, and marital fertility, in rural Spain. For this analysis, a sample of 4,501 men born between 1835 and 1975 living in 14 villages in northeastern Spain was taken. Previous research has shown that shorter individuals are less likely to marry. However, it is still disputed whether differences exist in the timing of marrying based on height, and little attention has been paid to the effect(s) of height on offspring. Family data were obtained from parish records and interviews with individuals and their families, while height data were obtained from military records, with individuals in Spain being conscripted at the age of 21 years. The data were linked according to nominative criteria using family reconstitution methods. The results confirm that shorter individuals were less likely to marry. Individuals of medium and medium-high height were the first to marry, with a small gap between them and shorter individuals. With regard to marital fertility, no difference in terms of average fertility by height were found, but there were small differences in timing of childbirth, possibly as a result of delayed marriage.

The part played by radio and television coverage of sport in developing public appreciation of sports is covered, and consideration is given to the responsibilities involved in dealing with sports in which violence occurs. The duties of the television producer in relation to the players, the viewers and the sponsors of sport are discussed.

The pseudo-genetic analysis of given names shows that, in the Scilly Isles, coefficients of relationship of first names are similar on St Mary's, the Outer Isles, and in the total sample of 5666 individuals married there in two and a half centuries. Comparable coefficients of relationship of a sample of 1658 given names in marriages in England and Wales in 1975 are considerably smaller, but similar within and between districts. The coefficients of relationship of given names on the Scilly Isles decreased during the 19th and especially the 20th centuries in parallel with decreases in random relationship from surnames. The genetic versus cultural–linguistic factors cannot be distinguished in the temporal variation in names, but the geographic differentiation virtually always reported in surnames is not present in these examples of given names and the geographic pattern in the surnames thus seems to result from the hereditary aspect of surnames. This result supports the validity of use of surnames in models of human genetic geography.

Adult mortality in Burundi during the 1970s and 1980s is estimated using data from the 1987 Demographic and Health Survey (DHS). Estimates from traditional indirect methods are compared with those from the inter-survey method using data on the number of years since the respondent's parent died. Life expectancy at birth was estimated as 48.55 years for males and 51·23 years for females.

This paper is based on the author's experiences during first, participation in an anthropological study of migrants, particularly Samoan migrants, in New Zealand over a period of 10 years in the late 1960s–mid- 1970s (Pitt & MacPherson, 1975) and secondly, participation over the last 3 years in a World Health Organization programme concerned with promoting the health and welfare of children, many of whom were migrants living in poverty.