There is growing international interest in the choice of socioeconomic indicators for health research. This study used a combination of standard and novel methods to compare three occupation-based measures of social position in terms of their ability to explain variation and measure inequality in self-assessed health. The recently developed National Statistics Socioeconomic Classification (NS-SEC) is compared with its predecessor, the Registrar General’s Social Class schema (RGSC), and with another occupation-based measure, the Cambridge Social Interaction and Stratification Scale (CAMSIS). With data from two large, independent, nationally representative samples of adults aged 16–64 living in private households in Scotland, logistic regression models are used to compare the classifications' ability to predict self-assessed health. Concentration indices are estimated to compare how well they capture inequality in self-assessed health. The study shows that all three classifications are strongly associated with self-assessed health, though the associations are heavily attenuated by adjustment for one another and for other measures of social position. Despite their differing theoretical bases, the three are closely related. No evidence is found that any of them systematically under- or overstate the extent of inequality in self-assessed health in either men or women, and the extent to which they measure independent dimensions of social inequality is questioned. It is concluded that the availability of the new classifications is unlikely to transform our understanding of the extent or the causes of socioeconomic inequality in health, but provides useful opportunities for sensitivity analysis.

This study investigated the effect of family planning on the levels of women’s anaemia and child undernutrition at the aggregate level using the compiled databases of the World Bank, UNICEF and the Economist Intelligence Unit. Correlation scatter matrix plots and multivariate OLS regression models were employed to assess the effect of family planning on women’s anaemia and child nutritional status across countries. At the aggregate level, the bivariate correlation estimates found that the Contraceptive Prevalence Rate (CPR) was negatively associated with women’s anaemia (r=−0.62, p<0.01), child underweight (r=−0.57, p<0.01) and child stunting (r=−0.63, p<0.01). The results of the OLS regression showed that the independent effect of CPR on women’s anaemia (β=−0.35, p<0.01), child underweight (β=−0.13, p<0.01) and child stunting (β=−0.18, p<0.05) was negative, even after controlling for child marriage, female literacy, per capita GDP, poverty ratio, health expenditure and food security. The synthesis of these findings with the existing literature based on micro-data suggests pathways through which family planning influences the nutritional status of women and children. Family planning helps in avoiding shorter birth intervals, unintended pregnancy and unsafe abortion, which would otherwise result in nutrient depletion among mothers and further increase the risk of undernutrition in their children.

Male involvement in maternal health care utilization is an important contributor to maternal health, especially in male-dominated societies. This study aimed to understand the variations and determinants of women’s antenatal care (ANC) utilization and institutional delivery in India and three socioeconomically less-developed states (Bihar, Madhya Pradesh and Uttar Pradesh) using NFHS-4 data (2015–16). Husband’s knowledge of pregnancy care and delivery, having a non-violent marital relationship and a respectful attitude towards his wife, better education and wealth, higher exposure to mass media and fewer children substantially enhanced the probability of him being present at his wife’s ANC visits. Furthermore, men’s presence at any ANC visit was shown to be an important factor influencing institutional delivery in India as a whole, as well as in the three less-developed states. The two major hurdles in maternal and child health care utilization in India were incorrect perception of ‘unnecessary’ maternal health care by families and high cost as reported by husbands. Furthermore, the proportion of husbands who received knowledge from health workers on maternal and child health was too low to achieve the maternal health SDGs by 2030. The dissemination of knowledge on maternal care among husbands, and encouraging their presence during antenatal care, may help secure better maternal health outcomes in India. It is imperative that the husband-involvement agenda is strengthened in India if the SDGs for maternal care are to be achieved.

This study examined the effect of Asian nativity and duration of residence in Australia on the odds of reporting a chronic health condition (cancer, respiratory problems, cardiovascular disease (CVD) and diabetes mellitus). Data were from waves 3, 7 and 9 of the Household Income and Labour Dynamics in Australia (HILDA) longitudinal survey, and multi-level group-mean-centred logistic regression models were used for the analysis. After covariate adjustment, Asian immigrants were less likely to report cancer and respiratory problem compared with native-born Australians. While there was no significant difference in reporting CVD, they were more likely to report diabetes than native-born people. Asian immigrants maintained their health advantage with respect to cancer regardless of duration of residence. However, after 20 years of stay, Asian immigrants lost their earlier advantage and were not significantly different from native-born people in terms of reporting a respiratory problem. In contrast, Asian immigrants were not measurably different from native-born Australians in reporting diabetes if their length of stay in Australia was less than 20 years, but became disadvantaged after staying for 20 years or longer. There was no measurable difference in the odds of reporting CVD between Asian immigrants and native-born Australians for any duration of residence. On the whole this study found that health advantage, existence of healthy immigrant effect and subsequent erosion of it with increasing duration of residence among Asian immigrants depends upon the chronic health condition.

The menopause clearly marks the end of the reproductive phase in the female, but no comparable event of sudden discontinuity in fertility occurs in the male. Successful paternity in man has been recorded at the age of 94 (Seymour, Duffy & Koerner, 1935). This difference between the sexes is rather surprising, as the male does not seem to age in a fundamentally different way from the female and as, moreover, the death rate for males is higher in all age groups, than for females. This may be related to the presence of only one X chromosome, the eventual defects of which cannot be compensated for by the activity of the homologue. The Y chromosome does not appear to bear vital genes, as it is not essential for life, XO individuals being perfectly viable, in distinction to the YO genotype. Moreover in the absence of male inducers, the phenotype is female, suggesting that the male phenotype is a more complex differentiation. For whatever reason, the lower viability of the male remains a striking fact: males represent only 35% of the age group over 75 years. The persistence of reproductive function into old age is therefore the more surprising. This does not mean, however, that a gradual decrease in sexual activity and testicular function in the ageing male does not occur. From adolescence onwards, there is a continuous decline in sexual interest, arousal and activity, without a sudden discontinuity in any age group.

Data are employed from six surveys carried out in Ibadan City, Nigeria, during two survey programmes: the Nigerian segment of the Changing African Family Project in 1973, and the Nigerian Family Study in 1974–5. A distinction is made between contraceptive innovators, those who use any means to control fertility except the traditional Yoruba sexual abstinence, and demographic innovators, those who succeed in limiting their family size. It is shown that contraceptive innovation is now proceeding rapidly but has little connection with demographic innovation. Contraceptive innovation is a response to social change which has increased the likelihood of premarital and extramarital sexual relations and the desire to shorten the period of postnatal sexual abstinence while not increasing the interval between births. Such innovation has proceeded more rapidly because of the increased availability of contraceptives since about 1960 and because of the types of contraceptives which have been developed since then. Demographic innovation is on the increase but its incidence is still minute. Fertility restriction within marriages seems to take place only after profound changes have occurred in the economic relationships within both the extended and nuclear families which for the first time make the small family the economically rational choice. Such change probably depends more on the import of cultural patterns than on necessary cultural adjustments to imported economic change, but a strengthening of the conjugal bond is involved and this may be hastened by contraceptive innovation. Little innovational trauma or even awareness of profound change was detected, largely because the profound, and even disruptive, innovations are preceding social ones, but partly too because peer group behaviour changes at much the same time.

Data were collected from 1044 mothers resident in the rural areas of Zambia during a National Nutrition Status Survey, to determine the effect of lactation on the interval between conceptions. Lactation is very prolonged with a small proportion of mothers continuing up to 33 months. A main reason for cessation of breast-feeding appears to be a new pregnancy, only 1.5% of mothers being neither pregnant nor lactating up to 12 months. During lactation, conception is delayed for at least 12 months. The peak in new conceptions occurs between 25 and 27 months. The normal interval between births is 3 years for rural Zambian mothers.

The ‘helpers at the nest’ hypothesis suggests that individuals who are not currently reproducing often help kin by caretaking and thereby increase their inclusive fitness. Using a large scale historical dataset (Integrated Public Use Microdata Series sample of 1910; n=13,935), the hypothesis is tested that childless couples are more likely to fulfil such a role by taking care of a niece or nephew, but not a parent, than couples with children. Childless couples were significantly more likely to take care of a niece or nephew than couples with children. In contrast, couples with children and childless couples did not differ in caretaking of parents. Childless couples were also more likely to have more and younger nieces/nephews in their home than couples with children.

The prevalence of consanguinity in eight provinces of Afghanistan has recently been reported by Saify & Saadat (2012). The present cross-sectional study was done in order to illustrate the prevalence and types of consanguineous marriages among other populations of Afghanistan. Data on types of marriages were collected using a simple questionnaire. The total number of couples in this study was 5200 from the following provinces: Farah, Ghazni, Herat, Hilmand, Kabul, Kandahar, Logar, Parwan and Wardak. Consanguineous marriages were classified by the degree of relationship between couples: double first cousins, first cousins, first cousins once removed, second cousins and beyond second cousins. The coefficient of inbreeding (F) was calculated for each couple and the mean coefficient of inbreeding (α) estimated for each population. The α in the country was 0.0226, ranging from 0.0203 in Farah province to 0.0246 in Herat province. There were significant differences between provinces for frequencies of different types of marriages (p<0.001). First cousin marriages (21.7%) were the most common type of consanguineous marriages, followed by second cousins (16.0%), first cousins once removed (14.0%), beyond second cousins (6.9%) and double first cousins (1.6%). There was significant difference between ethnic groups for the types of marriages (p<0.001). Tajiks (Soni) and Sadats showed the lowest (α=0.0215) and highest (α=0.0242) levels of consanguinity among ethnic groups in Afghanistan, respectively. The present study shows that the Afghani populations, the same as other Islamic populations, have high levels of consanguinity.

This study assessed caste differentials in family-level death clustering, linked survival prospects of siblings (scarring) and mother-level unobserved heterogeneity affecting infant mortality risk in the central and eastern Indian states of Jharkhand, Madhya Pradesh, Odisha and Chhattisgarh. Family-level infant death clustering was examined using bivariate analysis, and the linkages between the survival prospects of siblings and mother-specific unobserved heterogeneity were captured by applying a random effects logit model in the selected Indian states using micro-data from the National Family Health Survey-III (2005–06). The raw data clustering analysis showed the existence of clustering in all four states and among all caste groups with the highest clustering found in the Scheduled Castes of Jharkhand. The important factor from the model that increased the risk of infant deaths in all four states was the causal effect of a previous infant death on the risk of infant death of the subsequent sibling, after controlling for mother-level heterogeneity and unobserved factors. The results show that among the Scheduled Castes and Scheduled Tribes, infant death clustering is mainly affected by the scarring factor in Jharkhand and Madhya Pradesh, while mother-level unobserved factors were important in Odisha and both (scarring and mother-level unobserved factors) were key factors in Chhattisgarh. Similarly, the Other Caste Group was mainly influenced by the scarring factor only in Odisha, mother-level unobserved factors in Jharkhand and Chhattisgarh and both (scarring and mother-level unobserved factors) in Madhya Pradesh. From a government policy perspective, these results would help in identifying high-risk clusters of women among all caste groups in the four central and eastern Indian states that should be targeted to address maternal and child health related indicators.

Most studies on birth intervals and infant mortality ignore pregnancies that do not result in live births. Yet, fetal deaths are important in infant mortality analyses for three reasons: ignoring fetal deaths between two live births lengthens the measured interval between births, implying that short intervals are underestimated; the recommended inter-pregnancy interval (IPI) after a fetal loss is shorter (6 months) than after a live birth (24 months), as the effect of IPI on outcomes might differ according to the previous type of pregnancy outcome; fetal death will selectively reduce the population at risk of neonatal mortality, leading to biased results. This study uses the Heckman selection model to simultaneously estimate the combined effect of IPI duration and the type of pregnancy outcome at the start of the interval on pregnancy survival and neonatal mortality. The analysis is based on retrospective data from the Rwanda Demographic Health Surveys of 2000, 2005 and 2010. The results show a significant selection effect. After controlling for the selection bias, short (<6 months) and long (>60 months) intervals after a fetal death reduce the chances of pregnancy survival, but no longer have an effect on neonatal mortality. For intervals starting with a live birth, the reverse is true. Short intervals (<24 months) do not affect pregnancy survival but increase the odds of neonatal mortality. If the previous child died in infancy, the highest odds are found for neonatal death regardless of the IPI duration.

A study is reported of physical growth of Jamaican schoolboys who had been admitted to hospital with severe malnutrition during infancy (index cases). Height, weight and head circumference of the index cases was compared with that of male siblings close in age (siblings), with unrelated classmates or neighbours matched for sex and age (comparisons) and with Jamaican or US growth standards. Index boys were significantly smaller in height and head circumference than comparisons and significantly smaller than sibs only in head circumference. Sibs were intermediate in stature to the index and comparison boys. When the boys were divided into three age groups there was evidence of complete catch-up in height and weight after 7 years of age, but catch-up was incomplete for head circumference in the oldest group. No significant differences in stature at follow-up of the index boys were found in relation to age when admitted to hospital.

The sex composition of 862 sets of Australian triplets was independent of decade and State of birth during the period 1920–69. The triplet rate increased by 40% during the 50 years in contrast with declining rates reported elsewhere. The increase was due to dizygotic and trizygotic types, together but not individually, and occurred despite an 8·6% decrease in the average national maternal age over the same period. Adjustment for age led to standardized individual zygosity rates, estimates of which were compared with reported values obtained elsewhere. The dependence of zygosity rates on maternal age was shown to rise progressively as the number of ova released in triplet formation increases.

Data from the 1971 Census records included in the OPCS Longitudinal Study were used to examine the relationship between geographic mobility and marriage termination and remarriage. Remarried women had high rates of mobility and there seemed to be a clear ‘excess’ of moves made around the time of remarriage, shortly after the end of the first marriage. There was a suggestion too of a peak in movements following widowhood but no indication of excess movement at the time of de jure divorce. The data were not adequate to allow examination of moves made at the the time of separation. Additional data from linked 1971–81 Census information showed that changes of marital status were strongly associated with changes of tenure. Other characteristics of divorced, widowed and remarried women were also examined to see how they might affect their patterns of geographic movement.

It is argued that the author's hypothesis relating timing of insemination (and hence coital rate) to the sex ratio of the resulting children is supported by the available data on the variation of sex ratio with (1) sibship size, (2) the presence of twin sibs, and (3) parental adherence to the Jewish faith.

The traditional preference for sons may be the main hindrance to India's current population policy of two children per family. In this study, the effects of various sociodemographic covariates, particularly sex preference, on the length of the third birth interval are examined for the scheduled caste population in Assam, India. Life table and hazards regression techniques are applied to retrospective sample data. The analysis shows that couples having two surviving sons are less likely to have a third child than those without a surviving son and those with only one surviving son. Age at first marriage, length of preceding birth intervals, age of mother, and household income have strong effects on the length of the third birth interval.

There is a great deal of interest in the relation between the status of women and fertility—by humanists, academics and policy-makers concerned with bringing about fertility declines. The three aspects of women's status most frequently linked to fertility are their education, employment and type of husband-wife interaction. Research to date has not given us a clear and consistent explanation of these relationships and has not confirmed causality. The effects of these three factors on fertility vary considerably across national boundaries and even within different sectors of the same society. Some of the assumptions held by both researchers and policymakers must be re-thought in the interests of more useful future research and of sounder policy.

Tackling malnutrition is a major health priority for a developing country like Bangladesh. This study explored the differences in prevalence of having only one form, and multiple forms, of severe malnutrition (stunting, wasting and underweight) among under-5 children in Bangladesh, and aimed to identify the important factors affecting these. Data were extracted from the Bangladesh Demographic Health Surveys conducted in 2007, 2011 and 2014. The outcome measures were ‘only one form’ and ‘multiple forms’ of severe malnutrition in children aged under 5 years. A Chi-squared test was performed to find the association of outcome variables with selected socio-demographic factors and logistic regression models were applied to identify risk factors. A total of 19,874 children aged under 5 years were included in the analysis. The overall proportion with one form of severe child malnutrition was approximately 12%, and the proportion with multiple forms was 8%. Age, mother’s education, father’s occupation, mother currently working, watching television, source of water, solid waste used in cooking, intimate partner violence (IPV), wealth index, urban/rural place of residence and birth cohort were found to be significant factors for both having only one and having multiple forms of severe child malnutrition. Children with an uneducated mother of poor socioeconomic class had a higher risk of severe malnutrition. Children of fathers with a professional occupation were at lower risk of having multiple forms of severe malnutrition. The proportions of children aged under 5 years with one or multiple forms of severe malnutrition were shown to be high in Bangladesh. The prevention of malnutrition in the country should be seen as a significant public health issue and given top priority.

The link between socioeconomic status and health has long been recognised. This study of deaths among Australian men aged 15–59 years demonstrates that during the 20-year period, 1966–86 the number of premature deaths was dramatically reduced among all socioeconomic groups, primarily as a result of falls in death rates due to heart disease, stroke and trauma. However, the marked differences in death rates according to social class remain, to the extent that if men of all social classes had the same mortality experiences as professional and technical workers the overall death rates for Australian men would be reduced by 60%. Socioeconomic status is the most important indicator of health status among Australians.

This study examines the relationship between family size and children’s education in Bangladesh for two periods – 1982 with high fertility and 1996 with low fertility – using data from the Matlab Health and Demographic Surveillance System of the ICDDR,B: Centre for Health and Population Research. Children aged 8–17 years (27,448 in 1982 and 32,635 in 1996) were selected from households where the mother was aged 30–49 years and the father was the head of household. Children’s education was measured in terms of completed years of schooling: at least class 1 (among 8–17 year olds), at least class 5 (among 12–17 year olds) and at least class 7 (among 15–17 year olds). After controlling for all variables in the multivariate analyses, level of children’s education was not found to be associated with family size during the high fertility period. The family size–education relationship became negative during the low fertility period. In both periods children of educated mothers from wealthier households and those who lived close to primary/high schools had more education, but this socioeconomic difference reduced substantially over time. Boys had more education than girls during the high fertility period but this difference disappeared during the low fertility period. As birth rates fall and the proportion of children from small families increases an increase in children’s education is to be expected.