Consanguineous marriage is a controversial topic in many Western societies, with attention mainly focused on the health of immigrant communities from Asia and Africa. In the UK consanguinity is especially prevalent in the Pakistani community, which now numbers over 1.1 million. Less attention has been paid to the influence of hereditary population stratification within Pakistani communities, in particular biraderi (literally brotherhood) membership, which denotes male lineages that largely govern marriage partner choice and hence the transmission of disease genes. The various roles played by biraderi and their relationship to other socio-occupational and kinship terms, such as caste, quom and zat, are often overlooked in health-based studies. The interchangeable use of these different kinship terms without rigorous definition can create identity uncertainty and hinders inter-study comparisons. Where feasible, standardization of terminology would be both desirable and beneficial, with biraderi the preferred default term to identify specific social and genetic relationships within the Pakistani diaspora.

Data on 2972 marriages in rural areas and 1180 marriages in urban areas of North Arcot Ambedkar district of South India, during 1982–88, were analysed. The mean age at marriage of females was 18·6 in the rural and 19·6 in the urban area. The proportion of females married before attaining the legal age of 18 years was higher among the rural community (36·8%) than in the urban community (28·9%). Univariate analysis revealed an association between early age at marriage and the socioeconomic variables religion, caste, consanguinity, marital distance, spousal age difference, education and occupation of both bride and bridegroom, and socioeconomic status of the family. Multivariate analysis showed an independent relationship of marital distance and bridegroom's occupation with early age at marriage of females in the rural area alone and the bridegroom's education in the urban area alone. Consanguinity, spousal age difference and bride's education were found to be independently related with early age at marriage of females in both rural and urban areas.

This paper investigates whether community-level wealth inequality predicts HIV serostatus using DHS household survey and HIV biomarker data for men and women ages 15–59 pooled from six sub-Saharan African countries with HIV prevalence rates exceeding 5%. The analysis relates the binary dependent variable HIV-positive serostatus and two weighted aggregate predictors generated from the DHS Wealth Index: the Gini coefficient, and the ratio of the wealth of households in the top 20% wealth quintile to that of those in the bottom 20%. In separate multilevel logistic regression models, wealth inequality is used to predict HIV prevalence within each statistical enumeration area, controlling for known individual-level demographic predictors of HIV serostatus. Potential individual-level sexual behaviour mediating variables are added to assess attenuation, and ordered logit models investigate whether the effect is mediated through extramarital sexual partnerships. Both the cluster-level wealth Gini coefficient and wealth ratio significantly predict positive HIV serostatus: a 1 point increase in the cluster-level Gini coefficient and in the cluster-level wealth ratio is associated with a 2.35 and 1.3 times increased likelihood of being HIV positive, respectively, controlling for individual-level demographic predictors, and associations are stronger in models including only males. Adding sexual behaviour variables attenuates the effects of both inequality measures. Reporting eleven plus lifetime sexual partners increases the odds of being HIV positive over five-fold. The likelihood of having more extramarital partners is significantly higher in clusters with greater wealth inequality measured by the wealth ratio. Disaggregating logit models by sex indicates important risk behaviour differences. Household wealth inequality within DHS clusters predicts HIV serostatus, and the relationship is partially mediated by more extramarital partners. These results emphasize the importance of incorporating higher-level contextual factors, investigating behavioural mediators, and disaggregating by sex in assessing HIV risk in order to uncover potential mechanisms of action and points of preventive intervention.

The data in this paper are drawn from interviews with a stratified probability sample of 2996 Yoruba men and women aged 17 or above living in Lagos and Western States in June–July 1973. Although drawing upon other material from the 1 ½-hour interviews the discussion concentrates upon the family size ideals of these individuals. In addition to the customary measures of ideal family size, new measures of the limits of acceptable family size are described, together with the reactions of the whole sample to a wide range of statements relating to family size and the value of children. It is shown that the smallest family which would be acceptable to any appreciable proportion of the population is four children, which would be acceptable to 18% of all respondents. Comparative data from elsewhere in the developing world are presented to show that African family size ideals are amongst the highest in the world. Age, educational and occupational differentials in perceptions of different family sizes are also discussed.

In order to investigate the association between mean inbreeding coefficient (α) and healthy life expectancy at birth (HALE; years) the present ecological study on 63 countries was done. Statistical analysis showed that HALE negatively and positively correlated with log10α and log10GNI per capita, respectively (p<0.001). It should be noted that log10α and log10GNI per capita were significantly correlated with each other (p<0.001). After controlling for log10GNI per capita, significant negative correlations between log10α and HALE were observed. The countries were stratified according to their GNI per capita into low- and high-income countries. In countries with high income, after controlling for log10GNI per capita, the correlation between HALE at birth and log10α was significant (for males r=−0.399, df=32, p=0.001; for females r=−0.683, df=32, p<0.001). In high-income Asian and African countries, where consanguineous marriage is common, after controlling for log10GNI per capita, the correlation between HALE at birth and log10α was significant (for males r=−0.819, df=8, p=0.004; for females r=−0.936, df=8, p<0.001). It seems that consanguinity influences HALE independent of country income.

A semi-longitudinal study of factors influencing child growth in a rural community in Jamaica provided an opportunity to explore the relationships between diarrhoea, respiratory infections and body weight.

Respiratory infections and diarrhoea both reached peak incidences between the ages of 6 and 24 months when children are at highest risk of malnutrition. Respiratory infections had no demonstrable influence on growth. Diarrhoea was more common in boys than in girls and more common in underweight children. It had no influence on long-term weight increases, though it did have the expected influence on short-term increments.

The findings suggested that much of the diarrhoea seen in this community of children may have been secondary to undernutrition rather than a cause of it.

The ratio of second-to-fourth digit length (2D:4D), which is generally higher in women compared with men, is a putative marker of prenatal testosterone (PT) exposure. Lower 2D:4D is linked with greater physical ability and strength, better sporting performance and a propensity towards jobs demanding greater physical ability. The objectives of this paper were to examine the sexual dimorphism in 2D:4D in both hands 1and compare this dimorphism in the students of military and civil courses at the General Kuściuszko Military Academy of Land Forces in Wrocław. The cross-sectional study compared 59 female and 118 male students from the military courses and 53 females and 64 male students from the civil courses. Besides calculating 2D:4D (2D/4D) for each hand, height and weight were also recorded. Physical fitness and endurance were assessed using Eurofit tests. Handgrip strength was measured using a standardized isometric dynamometer. In almost all physical tests, students in the military cohort showed highly significant greater physical ability and strength (e.g. handgrip strength) when compared with the civil cohort. Male participants had a significantly lower 2D:4D than females for each hand, as well as for the average value for both hands. The sexual dimorphism was, however, a little more pronounced in the right hand than in the left. Both sex and course type were significant predictors of 2D:4D. There were significant interactions between sex and the student type. Among females, but not in males, the military cohort had a significantly lower, i.e. more ‘masculine’, 2D:4D for the left hand and right hand and average for both hands (t=3.290, p<0.001) than the civil cohort. This was not the case in males. However, the sex difference in 2D:4D was only significant among the civil students, and not among the military cadets. In conclusion, higher PT exposure, as represented by a lower 2D:4D, among the Polish females might be an indicator of relatively increased physical ability and motivation to choose professions that require higher strength and endurance.

Short sleep duration is associated with obesity in young children. This study develops the hypothesis that parental rules play a role in this association. Participants were 3-year-old children and their parents, recruited at nursery schools in socioeconomically deprived and non-deprived areas of a North-East England town. Parents were interviewed to assess their use of sleep, television-viewing and dietary rules, and given diaries to document their child's sleep for 4 days/5 nights. Children were measured for height, weight, waist circumference and triceps and subscapular skinfold thicknesses. One-hundred and eight families participated (84 with complete sleep data and 96 with complete body composition data). Parental rules were significantly associated together, were associated with longer night-time sleep and were more prevalent in the non-deprived-area compared with the deprived-area group. Television-viewing and dietary rules were associated with leaner body composition. Parental rules may in part confound the association between night-time sleep duration and obesity in young children, as rules cluster together across behavioural domains and are associated with both sleep duration and body composition. This hypothesis should be tested rigorously in large representative samples.

After contraceptive use, breast-feeding duration is the major determinant of the birth interval length. Three methods of estimating births averted by breast-feeding, and the increase in contraceptive use needed to substitute for breast-feeding, are presented. Method 1 simply utilizes Bongaarts’ Ci, and the other two are based on mean birth intervals with and without breast-feeding. Estimates for each method are derived for six countries with DHS surveys from the mid-1990s: Burkina Faso, Uganda, India, Indonesia, Brazil and Peru. The estimated percentage of additional births that would occur if there were no breast-feeding ranged from 1–4% in Brazil to about 50% in Burkina Faso and Uganda, reflecting very low breast-feeding in Brazil and very high levels in the sub-Saharan African nations. Strengths and limitations of the three methods are considered.

Evidence on the impact of the quality of prenatal care on childhood mortality is limited in developing countries, including India. Therefore, using nationally representative data from the latest round of the National Family Health Survey (2015–16), this study examined the impact of the quality of prenatal care on neonatal and infant mortality in India using a multivariable binary logistic regression model. The effect of the essential components of prenatal care services on neonatal and infant mortality were also investigated. The results indicate that improvement in the quality of prenatal care is associated with a decrease in neonatal (OR: 0.93, 95% CI: 0.91–0.97) and infant (OR: 0.94, 95% CI: 0.92–0.96) mortality in India. Tetanus toxoid vaccination, consumption of iron–folic acid tablets during pregnancy and having been weighed during pregnancy were statistically associated with a lower risk of neonatal and infant mortality. Educating women on pregnancy complications was also associated with a lower risk of neonatal mortality. No effect of blood pressure examination, blood test and examination of the abdomen during pregnancy were found on either of the two indicators of childhood mortality. Although the coverage of prenatal care has increased dramatically in India, the quality of prenatal care is still an area of concern. There is therefore a need to ensure high-quality prenatal care in India.

Males and females differ in their preference for occupations and sporting activities, and differ also in risk-taking attitudes. In addition to other explanations, prenatal hormone exposure has been implicated in these gender-associated differences. The ratio of the relative lengths of the second-to-fourth digits (2D:4D) is a proxy indicator of prenatal exposure to testosterone relative to oestrogen. The 2D:4D ratio has been found to be associated with choice of occupation, particularly among females. This study investigated whether 2D:4D differed between police officers and a control group of civilians in Wrocław, Poland. Participants were 147 male and 55 female police officers and 91 male and 75 female civilian controls. The police officers had to undergo rigorous physical ability tests during recruitment and their job bore relatively higher risk, whereas the controls had a normal civilian lifestyle. Height, weight, hand grip strength and lengths of the second and fourth digits were measured. Analyses of variance and covariance were employed to assess the significance of difference in digit ratio between groups (police officers and civilians) allowing for interaction with sex. The policewomen, compared with the female controls, were taller and had stronger hand grip strength, but had lower 2D:4D in the right hand and average 2D:4D of both hands. However, male and female police officers slightly differed only in the right hand digit ratio but not in the left hand ratio or the average for the two hands. However, the control group showed significant sex differences in all digit ratios with higher (feminine) mean values in females. The study provides further evidence that prenatal testosterone exposure, as reflected in the 2D:4D ratio, might have an association with choice of occupation, particularly among females.

Scientists commonly use world average data on sex ratio at birth for India for want of dependable ones. Here an attempt is made to redress the problem to some extent. It is shown that this ratio has been high in India since the 1950s. The ratio has been strikingly high, even prior to the time of inception of prenatal sex identification technologies. The ratio shows a rising trend due to several biological reasons. In addition, it has been rising sharply for a couple of decades due to some socio-medical factors. The natural sex ratio at birth in India is noticeably higher than the world average.

Of 50 women who were having their third or subsequent legal abortion, 23 were pregnant because their contraceptive method had failed, 24 because of erratic contraceptive use, and three had changed their mind about an initially welcome pregnancy. There was a significant relationship between erratic use and a history of medical consultation for psychiatric reasons, and a suggestion that unsettled relationships and low educational status are also related to erratic use.

Inappropriate contraceptive advice was an important factor in several cases. Since the perfect contraceptive does not exist, and since some people are more unlucky than others, repeated abortion cannot be eliminated, but it may be reduced by giving especially careful contraceptive advice to those who are clearly at risk.

There is no evidence that abortion is being deliberately used as a method of birth control.

This study examines effects and interactions of socioeconomic status, access to water supply and sanitation, and breast-feeding practices in relation to child growth in two provincial cities in the Philippines. Multivariate analysis identified food expenditure per head, education of the household head and gender of the child as significant predictors of nutritional status. The duration of partial and full breast-feeding was negatively (though non-significantly) associated with growth. Sanitation facilities and breast-feeding are, however, important determinants during the first year of life. Among children over 1 year of age, socioeconomic variables and gender are the most important predictors. Breast-feeding is shown to provide more important health benefits for children in lower income households. The need for further studies on the causes of gender differences in nutritional status was apparent.

Data are presented on a representative sample of legitimate live-born first infants in England, Scotland and Wales. When they are categorized simultaneously by paternal age, maternal age and social class of the father, it is found that:

(1) Mean parental age difference (father's age — mother's age) is higher in upper class births than in other births.

(2) If a man is younger than his wife, he is probably more likely than otherwise to come from the lower social classes, though this conclusion becomes less secure as the age difference increases in this direction.

(3) Mean parental age difference increases with paternal age and decreases with maternal age.

(4) For a given paternal age, parental age difference increases with a decline in social class, and for a given maternal age, parental age difference increases with a rise in social class.

(5) In general, young parents have smaller mean parental age differences than old parents.

If such mating patterns are characteristic of white North Americans one would infer:

(1) that the risks of neonatal death and stillbirth previously reported in association with aged paternity are the result of biological rather than sociological phenomena, and

(2) that the risks of neonatal death and stillbirth previously reported in association with youthful paternity are the result of sociological rather than biological phenomena.

In general, it seems that mean parental age difference is unlikely to be a fruitful clue to the aetiologies of pathological conditions unless there are simultaneous controls on the age of at least one parent and on social class.

The question is raised whether age disparity between spouses is associated with childlessness as well as with perinatal death and congenital malformations.

This study investigates the socio-demographic differentials in mortality during the 1974–75 famine in a rural area of Bangladesh. It is based on household socioeconomic information collected in the 1974 census and registration data on births, deaths and migrations for the period 1974–79 from the Demographic Surveillance System of the International Centre for Diarrhoeal Disease Research, Bangladesh. Ownership of selected household items was considered in the analysis as an indicator of household socioeconomic status. Mortality was 62% higher during the famine period and 31% higher during the post-famine period compared to the non-famine period. The mortality of both the poor and the rich increased during the famine period, by 117% and 28% respectively compared to the non-famine period. The poor suffered significantly in all age groups except 5–14 years, while the rich suffered only for ages 65 and over. Poor males suffered more than poor females except for ages 65 and over, while rich females suffered more than rich males except for ages under 1 year.

The geographic distribution of the Smiths and Joneses among all persons married in England and Wales in 3 months of 1975 showed well defined frequency clines comparable to those of blood group distributions. Polynomial regressions of relative frequencies of these surnames on latitude and longitude account for 12% and 36% of the variation among registration districts in frequency of Smiths and Joneses, respectively.

This paper investigates the normative and behavioural dimensions of son preference in Morocco and Tunisia, using data from the Demographic and Health Surveys of the two countries. It considers three measures of son preference: (1) mothers' ideal number of children, and any preference for having more sons than daughters; (2) the desire for additional children, given their existing family; (3) reported use of contraception in relation to the existing number of children of each sex. The analyses indicate a moderate preference for sons in both countries, and suggest that this preference is somewhat stronger in Tunisia. These findings are interpreted within the cultural context of the two countries, and in particular societal notions of women's status.

This study examines the association between a household's degree of vulnerability to food crisis and the incidence of deaths using primary survey data carried out to look at the demographic consequences of drought and famine in the drought-prone areas of northern Ethiopia. Retrospective data on the occurrences of deaths within a household were collected for the period 1984 to 1994. Consistent with previous studies, the findings confirm that mortality was clustered among the age groups 1–4 and 5–9 and varied considerably by famine and non-famine years. Enormous variation in incidence of deaths was also observed by region, ethnicity and religion. Most importantly, the analysis provides substantial evidence that the level of household vulnerability to food crisis is strongly related to the number of hunger-related deaths reported in a household.

Very little is known, at national and state levels, about how much information women in India are receiving about the method of contraception they are using. The purpose of this study was to fill this gap in knowledge. A Method Information Index (MII) was calculated from the responses of women who started using a modern contraceptive method five years prior to interview, and who were still using it at the time of interview, in the third National Family Health Survey conducted in India in 2005–06. The women were asked whether at the time they initiated contraceptive use they were told about other methods they could use, the side-effects of their selected method and what to do if they experienced these side-effects. The MII values (percentages of women who responded ‘yes’ to all three questions) were calculated for each category of women’s characteristics to show the relationship between MII and each characteristic. Mixed-effect logistic regression models were used to assess the independent effect of each variable after controlling for the effects of other variables on MII. The results indicate that contraceptive users in India in 2005–06 were receiving very little information about the method they were using: only 15.6% of contraceptive users reported receiving information on all three items. This low level was prevalent across different socioeconomic strata and across all the major states. There were a few exceptions, but the level was still quite low. Clearly, there is plenty of scope to improve the content of information exchanged between service providers and clients in order to ensure the rights of women to receive services of good quality, as well as improve informed choice and continuity of contraceptive use. Such a focus on improving quality of services is likely to help the Ministry of Health and Family Welfare in making its stated transition from a ‘population control centric’ to a ‘reproductive rights based’ approach to family planning in India.