Mongolian fertility decline has received only limited analysis in the demographic literature. Using the 2003 Reproductive Health Survey of Mongolia the classical proximate determinants of fertility framework proposed by Bongaarts is applied here in order to analyse which factors shape period fertility. The results indicate that the fertility-inhibiting effect of contraception contributed to reduce period fertility by 54.2% from its theoretical maximum, while induced abortion accounted for only 6.1% of the reduction in fertility. Compared with previous studies made in the early 1990s, these results show that important changes in the control of reproduction took place in Mongolia during the fertility transition. In order to assess the changes implied by the transition to democracy and market economy, the proximate determinants of fertility are estimated for the year 1994. The results show that the importance of induced abortion in the determination of fertility level has reduced and that the use of modern contraception has increased progressively and contributed most in determining fertility level in 2003.

This paper investigates height and weight differences between the two Koreas by comparing national anthropometric data published by the South Korean Research Institute of Standard and Science with United Nations survey data collected inside North Korea in 2002. For socioeconomic reasons, pre-school children raised in the developing country of North Korea are up to 13 cm shorter and up to 7 kg lighter than children who were brought up in South Korea – an OECD member. North Korean women were also found to weigh up to 9 kg less than their Southern counterparts.

This study was carried out in two medical facilities in Enugu, Nigeria, from September to November 2007. An interviewer-administered questionnaire was used to collect data from HIV-positive pregnant women accessing PMTCT (prevention of maternal-to-child transmission) services at the two centres. Ninety-two women were interviewed: 89 (96.7%) had disclosed their status, while 3 (3.3%) had not. Of the 89 women who had disclosed, 84 (94.4%) had disclosed to partners, 82 (92.1%) to husbands, 2 (2.2%) to fiancés, 18 (20.2%) to sisters, 13 (14.6%) to mothers, 10 (11.2%) to brothers, 10 (11.2%) to fathers and 10 (11.2%) to priests. Fifty-two (58.4%) gave emotional support as the reason for disclosure and 46 (51.7%) gave economic and financial support as reasons. Fifty-six (62.9%) reported understanding from partner as a positive outcome and 44 (49.4%) reported financial support. Forty-six (51.7%) reported no negative outcome. Serostatus disclosure rate in this study was high with most women disclosing to their partners.

This study sought to determine which factors among the indicators of socioeconomic status have the most influence on physical, mental and social functions, and on subjective well-being, all of which are components of successful ageing. A representative random sample of 1825 persons aged 65 years or older was surveyed by face-to-face interview. Socioeconomic status was measured by educational level, family household income, personal income and property ownership. The factors measured were chronic diseases, activities of daily living (ADL) for physical functioning, history of mental disease, Mini-Mental Status Examination questionnaire (MMSE) scores for mental functioning, social activity participation per week for social functioning, and the Philadelphia Geriatric Center Morale Scale (PGCMS) for subjective well-being. Multiple logistic regression analyses were performed. Education level was the most important factor in physical and mental functioning, whereas personal income was the most important in social functioning. Educational level, household income and personal income were significantly associated with subjective well-being as assessed by PGCMS scores. Subjects who demonstrated successful ageing were more likely to have a higher education and higher personal income. The results point to the importance of focusing on disparities in each component of successful ageing, which may point to appropriate health-promotion strategies for eliminating inequality in successful ageing.

The life course perspective in social inequalities in health research has resulted in an increased interest in status attainment processes. Adult status is commonly measured as occupational class, income level or educational attainment, and the latter was applied in this study. The study objective was to estimate the relative contribution of parental and early individual characteristics on educational attainment. The study population comprised all males born in Norway in 1967–1971, and alive at age 28 years (n=160,914). Data on social and biological variables were compiled from birth onwards in several national registers. Information on educational attainment at age 28 years was derived from Statistics Norway. Mean years of education was 12.62 years (SD 2.24). Educational attainment was strongly associated with general ability score at age 18 years and parental educational attainment. Parental income had more limited influence; all other early factors had only marginal effect. Path analysis results suggest that the direct effect of general ability was of the same size as the combined direct and indirect effect of parental education and income. The results suggest that status attainment in this young male population is mainly dependent on general ability and parental education level.

The union of individuals with a common ancestor may lead to serious health consequences in their offspring. Consanguinity is high in Middle Eastern communities; it was around 26% in 1988. The objective of this study was to determine the prevalence of consanguinity in Beirut and other Lebanese regions, and its associated factors in different subgroups. The cross-sectional study was performed on a convenience sample of married women in Lebanon. The women were administered a standardized questionnaire in a face-to-face interview by independent enquirers. Among 1556 women, the overall prevalence of consanguineous marriages was 35·5%, and the consanguinity coefficient was 0·020; 968 marriages (62·2%) were not consanguineous, 492 (31·6%) were first cousin, 61 (3·9%) were second cousin and 36 (2·3%) had lower degrees of consanguinity. Beirut suburb dwelling, low education subgroups, women working in the home and non-Christian religion presented the highest rates of consanguinity (p<0·05). Consanguinity is associated with couples' nulliparity and child chronic morbidity. Factors that could affect consanguinity are having consanguineous parents, having a favourable opinion towards consanguinity, choosing a spouse for religious reasons, particularly in Islam, woman having a low education, woman working in the home and women thinking that consanguinity would not lead to serious diseases. Consanguinity is therefore still a prevailing problem in Lebanon. Specific health education, and genetic counselling in particular, are suggested to explain the consequences of consanguinity to the general population and to help couples make informed choices.

This paper evaluates exposure to mass media family planning (FP) messages among the Garo, an indigenous community in Bangladesh. A sample of 223 currently married Garo women were selected purposively from two districts where most of the Garo population live. The analysis demonstrated that television was the most significant form of mass media to disseminate FP messages among the recipients – more so than radio and newspapers. About 80·6% of the respondents had heard of FP messages through television, while for the radio and newspapers the percentages were 55·3% and 22·7% respectively. The contraceptive prevalence rate is much higher (79·5%) in the study area than the national level (55·8%). A linear logistic regression model was employed to identify the confluence of different demographic and socioeconomic characteristics on mass media FP messages. Regarding exposure to FP messages, four independent variables out of six had significant effects on the exposure to FP messages through any one of the types of media, i.e. radio, television and newspapers. These independent variables were age, level of education, occupation and number of children.

This paper examines the trends in utilization of five indicators of reproductive and child health services, namely, childhood immunization, medical assistance at delivery, antenatal care, contraceptive use and unmet need for contraception, by wealth index of the household in India and two disparate states, Uttar Pradesh and Maharashtra. The data from three rounds of the National Family and Health Survey conducted during 1992–2005 are analysed. The wealth index is computed using principal component derived weights from a set of consumer durables, land size, housing quality and water and sanitation facilities of the household, and classified into quintiles for all three rounds. Bivariate analyses, rich–poor ratio and concentration index are used to understand the trends in utilization of, and inequality in, reproductive and child health services. The results indicate huge disparities in utilization of these services, largely to the disadvantage of the poor. Utilization of basic childhood immunization among the poorest and the poor stagnated in India, as well as in both states, during 1998–2005 compared with 1992–1998. The use of maternal care services such as medical assistance at delivery and antenatal care remained at a low level among the poor over this period. However, contraceptive use increased relatively faster among the poor, even with higher unmet need. Of all these services, the inequality in medical assistance at delivery is consistently large, while that of contraceptive use is small. The state-level differences in service coverage by wealth quintiles over time are large.

This paper examines the gender differential in health and its socioeconomic and demographic determinants in the old-age population of India based on the National Sample Survey 60th round data collected in 2004. As in developed countries, older women in India report poorer self-reported health and experience greater immobility compared with men. Stepwise logistic regression analysis shows that the gender differential in health is linked to various socioeconomic and demographic variables and that the gender gap could be narrowed with appropriate policy intervention. Specifically, paying special attention towards improving the socioeconomic status of widowed/separated women could attenuate a substantial portion of the observed gender gap in the health of the old-age population.

This study assessed the role of mother’s religious affiliation in child immunization status of surviving children 12 months of age and older in Nigeria, using data from the 2003 Nigeria Demographic and Health Survey (NDHS). Guided by two competing hypotheses – the ‘characteristics hypothesis’ and the ‘particularized theology hypothesis’ – variations in the risks of child immunization in Nigeria were examined using logistic regression analysis. The results indicate that religion plays a role in the risk of non-immunization; religion was not associated with the risk of partial immunization; however, religion was significantly associated with the reduced risk of full immunization.

This paper demonstrates that although modern BMIs have increased, 19th century Middle-Atlantic black and white BMIs were in the normal range; neither underweight nor obese individuals were common. Farmers’ BMIs were consistently heavier than non-farmers. Philadelphia residents’ BMIs were lower than elsewhere within Pennsylvania, indicating that urbanization and agricultural commercialization were associated with current biological living standards in urbanized areas.

Demographic trends in today's world are dominated by large fertility differentials between nations, with ‘less developed’ nations having higher fertility than the more advanced nations. The present study investigates whether these fertility differences are related primarily to indicators of economic development, the intellectual level of the population, or political modernity in the form of liberal democracy. Results obtained with multiple regression, path models and latent variable models are compared. Both log-transformed GDP and measures of intelligence independently reduce fertility across all methods, whereas the effects of liberal democracy are weak and inconsistent. At present rates of fertility and mortality and in the absence of changes within countries, the average IQ of the young world population would decline by 1.34 points per decade and the average per capita income would decline by 0.79% per year.

In this study, sex ratios at birth (male/female births) were found to vary according to family composition. Using Demographic and Health Survey (DHS) maternity histories from sub-Saharan Africa, the study shows that the sex ratio at birth increases with the number of previous male births and decreases with the number of previous female births. For families with only males, the sex ratio increases from 1·046 for the first birth to 1·083 for the 8th birth. For families with only females, the sex ratio decreases from 1·046 for the first birth to 0·942 for the 8th birth. The differences were highly significant when tested with a linear logistic model (p=0·018 for males; p=1·85✕10−11 for females). The effect was not symmetrical, and was found to be significantly stronger for females. These effects could be reproduced assuming a strong heterogeneity between couples. The distribution of sex ratios was fitted with an asymmetrical log-gamma function, which revealed a wide range of variation in the sex ratio between 0·50 and 1·30, and a peak around 1·14. The results and their implications are discussed in the light of former findings in France and in the United States of America.

Access to health care in lesser-developed countries is often quite limited, especially in rural areas. However, less is known about how different factors, such as household structure, parental income and parental education, modify such access to care. This study uses individual-level data from rural Bangladesh during and following a period of major flooding to examine factors associated with reports of illness and demand for doctors in households with children less than 10 years of age. Using information about the number of children who were reported sick and also those who were taken to a doctor, a model was estimated for such reports and decisions to visit a doctor. Overall, 74% of households reported an illness in a child during the study period. The likelihood of reports was significantly greater for boys (36%) than girls (31%). In most analyses, there was no association between parental education and reports of child illness after adjusting for village- and household-level heterogeneity. However, in analyses limited to female children, greater education of the household head was associated with lower odds of such a report (odds ratio [OR] 0.95, 95% confidence interval [CI] 0.91–1.00). Parental education and income were also related to household decisions to seek medical care, though results once again differed based on the sex of the child. There was a particularly strong effect between maternal education level and demand for medical care for boys (OR 1.13; CI 1.01–1.27), though not for girls (OR 0.96; CI 0.84–1.09). Overall, the likelihood of a doctor's visit for a sick child was positively related to household income and at the highest levels of income was a virtual certainty.

Female genital cutting (FGC) is a widespread cultural practice in Africa and the Middle East, with a number of potential adverse health consequences for women. It was hypothesized by Kun (1997) that FGC increases the risk of HIV transmission through a number of different mechanisms. Using the 2003 data from the Kenyan Demographic and Health Survey (KDHS), this study investigates the potential association between FGC and HIV. The 2003 KDHS provides a unique opportunity to link the HIV test results with a large number of demographic, social, economic and behavioural characteristics of women, including women's FGC status. It is hypothesized that FGC increases the risk of HIV infection if HIV/AIDS is present in the community. A multilevel binary logistic regression technique is used to model the HIV status of women, controlling for selected individual characteristics of women and interaction effects. The results demonstrate evidence of a statistically significant association between FGC and HIV, after controlling for the hierarchical structure of the data, potential confounding factors and interaction effects. The results show that women who had had FGC and a younger or the same-age first-union partner have higher odds of being HIV positive than women with a younger or same-age first-union partner but without FGC; whereas women who had had FGC and an older first-union partner have lower odds of being HIV positive than women with an older first-union partner but without FGC. The findings suggest the behavioural pathway of association between FGC and HIV as well as an underlying complex interplay of bio-behavioural and social variables being important in disentangling the association between FGC and HIV.

In the Kingdom of Tonga, migration to overseas developed countries has prevailed. To elucidate the effects of migration on population dynamics, an interview survey was conducted in the migrant-sending community of Kolovai, in the outer region of Tongatapu Island. All births, deaths, marriages and in- and out-migrations that took place between 1983 and 2002 were recorded for all members of the ‘Kolovai population’, consisting of persons who had lived in this community for at least a one-year period during this 20 years. The ‘Kolovai population’ members, numbering 1184 (564 males and 620 females), were divided into three groups based on residence at the end of each year, i.e. Kolovai (called KK), other places in Tonga (KT) or overseas countries (KO). The KK population decreased from 774 in 1982 to 570 in 2002, owing mostly to an increase of 167 persons as the natural balance and a decrease of 324 persons as the balance of international migration. Comparison of total fertility rate (TFR) between KK and KO women revealed that the mean TFR of the former decreased from 3·460 in the earlier 10-year period (1983–1992) to 2·240 in the later 10-year period (1993–2002), while that of the latter was more than 3·5 in both 10-year periods. This difference was largely due to the decrease in the proportion married among KK women. If the current trends of international migration and fertility continue, the population of Kolovai will be reduced and its age composition will become cylinder-shaped in the near future.

The origin of values and preferences is an unresolved theoretical question in behavioural and social sciences. The Savanna-IQ Interaction Hypothesis, derived from the Savanna Principle and a theory of the evolution of general intelligence, suggests that more intelligent individuals may be more likely to acquire and espouse evolutionarily novel values and preferences (such as liberalism and atheism and, for men, sexual exclusivity) than less intelligent individuals, but that general intelligence may have no effect on the acquisition and espousal of evolutionarily familiar values. Macro-level analyses show that nations with higher average intelligence are more liberal (have greater highest marginal individual tax rate and, as a result, lower income inequality), less religious (a smaller proportion of the population believes in God or considers themselves religious) and more monogamous. The average intelligence of a population appears to be the strongest predictor of its level of liberalism, atheism and monogamy.

It is still unclear if and how biological factors contribute to excess male mortality due to ‘external causes’ (accidents, injuries, homicides and suicides). Sex hormones and reproductive roles are supposed to drive sex differences in behaviours increasing the male external cause mortality risk. This study analyses the external cause mortality of Catholic nuns and monks from three Bavarian cloisters whose similar environments allow the impact of biological factors to be isolated from a number of confounding causes. Using obituaries, entries in the profession books of religious orders and cemetery registers 2533 deaths of nuns and monks could be linked to a specific cause of death for the years 1946–2005, of which 69 belong to the group of external cause deaths. External cause mortality of the Bavarian cloistered and the West German general population has been compared by means of standardized mortality rates (SMRs) for ages 45 onwards using the European age standard for the age groups 45–64, 65–74 and 75+. Whereas nuns show statistically significantly lower external cause mortality than the general female population, monks' external cause mortality parallels or even exceeds that of general population males. These findings contradict the reproductive role hypothesis and provide some evidence for the sex hormones hypothesis.

The timing of transitions to sexual activity, marriage and childbearing in sub-Saharan Africa is undergoing profound changes. This study investigates the determinants of adolescent transitions in South Nyanza, a socioeconomically deprived setting in Kenya where adolescent reproductive health is a particular concern. The analysis is based on Cox regression of timing of first sexual intercourse, first marriage and first pregnancy, using data from a survey of 1247 females aged 12–19 years. The results show that higher household socioeconomic status and educational attainment are associated with delayed onset of all three transition events. Furthermore, mother’s higher educational attainment is protective for initiation of sexual intercourse while rural residence is protective for pregnancy experience. Other protective factors include communication with parents or with fellow girlfriends. However, discussing sexual matters with boyfriends, high internal locus of control, and gender bias are associated with early onset of the three transition events.

The purpose of this study was to show the differences in the mortality rates of children from Catholic and Lutheran families in 19th century Poznań, and to elucidate the causes of these differences. Data from Catholic and Lutheran parish death registers were used. The infant death rate (IDR), neonatal and postneonatal death rates and life table biometric functions were calculated and causes of deaths were characterized. The worst child mortality values (IDR=394.4; neonatal and postneonatal death rates, respectively, 117.1 and 277.4; e0=16.14 years; Crow's Index=2.47) were obtained for the poor Catholic Parish of St Margaret. The lowest infant and neonatal and postneonatal death rates were observed to have occurred in the Catholic Parish of St Maria Magdalena situated in the city's more affluent central area (mortality rates, respectively, 269.9, 93.1 and 176.9; e0=24.63 years; Crow's Index=0.96). The widest range of differences with regard to death rates was found for the Lutheran Parish of St Cross (the infant, neonatal and postneonatal death rates were, respectively, 293.1, 99.1 and 193.9; e0=28.03 years; Crow's Index=0.92). The St Cross Parish encompassed a fairly large area of the city characterized by varying ecological conditions. Among infants and young children from the three studied populations a high frequency of deaths due to infectious diseases, diarrhoeas, dysenteries and tuberculosis were observed. Differences in the mortality of children from Catholic and Lutheran families in 19th century Poznań resulted from ecological conditions, among which water played the most important role, rather than from religious differences.