Population and Health [Working Papers]

Permanent URI for this collectionhttps://hdl.handle.net/10125/3164

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Multivariate life table methodology for estimating the effect of child mortality on the total fertility rate and its components
(Honolulu, HI: East-West Center, 2011-02) Eini-Zinab, Hassan
This paper develops, validates, and applies new multivariate methodology to assess the effect of child mortality on both period and cohort measures of fertility. The methodology, which can be applied to period data as well as cohort data, is based on discrete-time survival models of parity progression that enable construction of a multivariate life table of fertility covering all parity transitions. The five dimensions of this life table are woman's age, parity, duration in parity, and two dimensions representing lagged child mortality (number of dead children at the beginning and end of the previous year when the woman was one year younger). Additional socioeconomic predictor variables are also included in the underlying survival models. The life table is multivariate in the sense that it can be specified for values or categories of one socioeconomic predictor variable while holding other socioeconomic predictors constant. The life table yields a number of measures of both the quantum and the tempo of fertility and child mortality. It also yields a replacement rate, which measures the extent to which child deaths are replaced by additional births. Because the life table is multivariate, all measures calculated from it are also multivariate. By way of illustration, the methodology is applied to three Indian National Family Health Surveys conducted in 1992-93 (NFHS-1), 1998-99 (NFHS-2), and 2005-06 (NFHS-3). Major findings are that dead children are incompletely replaced, and that the replacement rate rises as the total fertility rate falls over the three surveys, reflecting women's increasing ability to achieve their wanted number of surviving children.
Further development of methodology for multivariate analysis of the total fertility rate and its components based on birth-history data
(Honolulu, HI: East-West Center, 2010-11) Retherford, Robert D.; Eini-Zinab, Hassan; Choe, Minja Kim; Ogawa, Naohiro; Matsukura, Rikiya
A discrete-time survival model (the complementary log-log model) is used to model parity progression from woman's own birth to first marriage, from first marriage to first birth, from first birth to second birth, and so on, with one model for each parity transition. Predictor variables in each model include woman's age and duration in parity as well as socioeconomic characteristics. The models are applied to birth history data. Collectively the models yield estimates of marriage and birth probabilities by age, parity, and duration in parity, denoted Pait, by socioeconomic characteristics. The probabilities Pait are multivariate in the sense that they can be tabulated by one socioeconomic characteristic while holding other socioeconomic characteristics constant. The probabilities Pait allow construction of a life table that follows women by age, parity, and duration in parity from age 10 to age 50 one year at a time. This life table is referred to as a "global life table," because it spans all ages, parities, and durations in parity within the reproductive age span. Because the Pait are multivariate, the global life table is also multivariate, as are all measures derived from it. The derived measures considered here include both period and cohort estimates of parity progression ratios (PPRs), age-specific fertility rates (ASFRs), mean and median ages at first marriage, mean and median closed birth intervals, mean and median ages at childbearing (both overall and by child's birth order), total fertility rate (TFR), and total marital fertility rate (TMFR). The methodology is tested on data from the 2003 Demographic and Health Survey of the Philippines.
Population aging and economic progress : a bumpy road ahead?
(Honolulu, HI: East-West Center, 2010-06) Mason, Andrew; Lee, Sang-Hyop
Over the next forty years, the most important demographic trend in Asia and the Pacific will be population aging. This has primarily been an industrialized country phenomenon to this point, but by 2050 many other countries in the region will have aged dramatically. Rapid increase in elderly populations may bring two important goals of countries in the region into sharp conflict. The first is to develop socioeconomic systems that will provide economic security to a growing number of elderly people. The second is to sustain strong economic growth over the next forty years. The ultimate economic success of these two goals will rely on policies yet to be implemented, and the most important ones will be policies that encourage savings, investment in human capital, and well-functioning financial and labor markets.
Multivariate analysis of parity progression-based measures of the total fertility rate and its components using individual-level data
(Honolulu, HI : East-West Center, 2010-01) Retherford, Robert D.; Ogawa, Naohiro; Matsukura, Rikiya; Eini-Zinab, Hassan
This paper develops multivariate methods for analyzing (1) effects of socioeconomic variables on the total fertility rate and its components and (2) effects of socioeconomic variables on the trend in the total fertility rate and its components. For the multivariate methods to be applicable, the total fertility rate must be calculated from parity progression ratios (PPRs), pertaining here to transitions from birth to first marriage, first marriage to first birth, first birth to second birth, and so on. The components of the TFR include PPRs, the total marital fertility rate (TMFR), and the TFR itself as measures of the quantum of fertility, and mean and median ages at first marriage and mean and median closed birth intervals by birth order as measures of the tempo or timing of fertility. The multivariate methods are applicable to both period measures and cohort measures of these quantities. The methods are illustrated by application to data from the 1993, 1998, and 2003 Demographic and Health Surveys (DHS) in the Philippines.
Population policy, economic reform, and fertility decline in Guangdong province, China
(Honolulu, HI: East-West Center, 2009-05) Chen, Jiajian; Retherford, Robert D.; Choe, Minja Kim; Li, Xiru; Cui, Hongyan
This paper examines Guangdong's fertility decline between 1975 and 2005 and analyzes how it has been influenced by both fertility policy and economic development. Guangdong's economic development has been very rapid and has attracted huge numbers of migrants from other provinces. The effect of this migration on Guangdong's fertility is an important part of the story. Measures of fertility and nuptiality employed in the analysis include the total fertility rate, parity progression ratios, mean age at first marriage, mean age at first birth, and mean closed birth interval between first and second birth. These measures are calculated from birth histories reconstructed from data from China's 1990 and 2000 censuses and 2005 mini-census. An overlapping-trend analysis provides indications of the accuracy of the estimates.
Multivariate analysis of parity progression-based measures of the total fertility rate and its components using individual-level data
(Honolulu, HI: East-West Center, 2009-03) Retherford, Robert D.; Ogawa, Naohiro; Matsukura, Rikiya; Eini-Zinab, Hassan
This paper develops multivariate methods for analyzing (1) effects of socioeconomic variables on the total fertility rate and its components and (2) effects of socioeconomic variables on the trend in the total fertility rate and its components. For the multivariate methods to be applicable, the total fertility rate must be calculated from parity progression ratios (PPRs), pertaining in this paper to transitions from birth to first marriage, first marriage to first birth, first birth to second birth, and so on. The components of the TFR include PPRs, the total marital fertility rate (TMFR), and the TFR itself as measures of the quantum of fertility, and mean and median ages at first marriage and mean and median closed birth intervals by birth order as measures of the tempo or timing of fertility. The multivariate methods are applicable to both period measures and cohort measures of these quantities. The methods are illustrated by application to data from the 1993, 1998, and 2003 Demographic and Health Surveys (DHS) in the Philippines.
Multivariate analysis of parity progression-based measures of the total fertility rate and its components using individual-level data
(East-West Center, 2008-10) Retherford, Robert D.; Ogawa, Naohiro; Matsukura, Rikira; Eini-Zinab, Hassan
This paper develops multivariate methods for analyzing (1) effects of socioeconomic variables on the total fertility rate and its components and (2) effects of socioeconomic variables on the trend in the total fertility rate and its components. For the multivariate methods to be applicable, the total fertility rate must be calculated from parity progression ratios (PPRs), pertaining in this paper to transitions from birth to first marriage, first marriage to first birth, first birth to second birth, and so on. The components of the TFR include PPRs, the total marital fertility rate (TMFR), and the TFR itself as measures of the quantum of fertility, and mean and median ages at first marriage and mean and median closed birth intervals by birth order as measures of the tempo or timing of fertility. The multivariate methods are applicable to both period measures and cohort measures of these quantities. The methods are illustrated by application to data from the 1993, 1998, and 2003 Demographic and Health Surveys (DHS) in the Philippines.
Japan's baby bust : causes, implications, and policy responses
(Honolulu: East-West Center, 2005) Retherford, Robert D.; Ogawa, Naohiro
This paper describes the trend in fertility in Japan, analyzes the causes and implications of the baby bust after 1973, and discusses the Japanese government's efforts to raise fertility, which by 2003 had fallen to 1.29 children (i.e., births) per woman, as indicated by the total fertility rate. Also addressed are the questions of why the government's efforts to raise fertility have not been effective and what additional steps the government might take.
Multivariate analysis of parity progression-based measures of the total fertility rate and its components using individual-level data
(Honolulu: East-West Center, 2008) Retherford, Robert D.
This paper develops multivariate methods for analyzing (1) effects of socioeconomic variables on the total fertility rate and its components and (2) effects of socioeconomic variables on the trend in the total fertility rate and its components. For the multivariate methods to be applicable, the total fertility rate must be calculated from parity progression ratios (PPRs), pertaining in this paper to transitions from birth to first marriage, first marriage to first birth, first birth to second birth, and so on. The components of the TFR include PPRs, the total marital fertility rate (TMFR), and the TFR itself as measures of the quantum of fertility, and mean and median ages at first marriage and mean and median closed birth intervals by birth order as measures of the tempo or timing of fertility. The multivariate methods are applicable to both period measures and cohort measures of these quantities. The methods are illustrated by application to data from the 1993, 1998, and 2003 Demographic and Health Surveys (DHS) in the Philippines.
Multivariate analysis of parity progression-based measures of the total fertility rate and its components using individual-level data
(Honolulu: East-West Center, 2007) Retherford, Robert D.
This paper develops multivariate methods for analyzing (1) effects of socioeconomic variables on the total fertility rate and its components and (2) effects of socioeconomic variables on the trend in the total fertility rate and its components. For the multivariate methods to be applicable, the total fertility rate must be calculated from parity progression ratios (PPRs), pertaining in this paper to transitions from birth to first marriage, first marriage to first birth, first birth to second birth, and so on. The components of the TFR include PPRs, the total marital fertility rate (TMFR), and the TFR itself as measures of the quantum of fertility, and mean and median ages at first marriage and mean and median closed birth intervals by birth order as measures of the tempo or timing of fertility. The multivariate methods are applicable to both period measures and cohort measures of these quantities. The methods are illustrated by application to data from the 1993, 1998, and 2003 Demographic and Health Surveys (DHS) in the Philippines.
Fertility in Nepal 1981-2000 : levels, trends, and components of change
(Honolulu: East-West Center, 2003) Retherford, Robert D.; Thapa, Shyam
The objectives of this paper are, first, to provide improved estimates of recent fertility levels and trend in Nepal and, second, to analyze the components of fertility change. The analysis is based on data from Nepal's 1996 and 2001 Demographic and Health Surveys. The first part of the analysis assesses the quality of the data from the 1996 and 2001 Nepal Demographic and Health Surveys (DHS) on which the fertility estimates are based. Fertility levels and trends are then estimated using the own-children method of fertility estimation. The own-children estimates incorporate additional adjustments to compensate for displacement of births, and they are compared with previously published estimates derived by the birth-history method. Fertility is estimated not only for the whole country but also by ecological region, development region, urban/rural residence, and woman's education. The own-children estimates indicate that the total fertility rate (TFR) fell from 4.96 to 4.69 births per woman between the 3-year period preceding the 1996 survey and the 3?year period preceding the 2001 survey. About three-quarters of the decline stems from reductions in age-specific marital fertility rates and about one-quarter from changes in age-specific proportions currently married. Further decomposition of the decline in marital fertility, as measured by births per currently married woman during the 5-year period before each survey, indicates that almost half of the decline in marital fertility is accounted for by changes in population composition by ecological region, development region, urban/rural residence, education, age at first cohabitation with husband, time elapsed since first cohabitation, number of living children at the start of the 5-year period, and media exposure. With these variables controlled, another one-third of the decline is accounted for by increase in the proportion sterilized at the start of the 5-year period. About one-fifth of the fertility decline is not accounted for by any of these variables, but this remaining unexplained component does not differ significantly from zero.
What do we know about health effects of smoke from solid fuel combustion?
(Honolulu: East-West Center, 2004) Mishra, Vinod K.
Household use of unprocessed solid fuels (wood, dung, crop residues/grasses, and coal) for cooking and heating exposes large proportions of people in developing countries to high levels of toxic air pollutants indoors. Indoor smoke contains some of the same pollutants found in tobacco smoke and in ambient air, which have been linked with serious health consequences. There is growing evidence that exposure to indoor smoke can cause serious respiratory and other adverse health effects, but the quantity and quality of scientific literature vary considerably by type of health outcome. There is compelling evidence linking indoor smoke to acute respiratory infections in children and chronic obstructive pulmonary disease (COPD) or chronic bronchitis in women. But, the evidence linking indoor smoke to asthma, tuberculosis, lung cancer, and adverse pregnancy outcomes is limited and sometimes conflicting; and evidence linking indoor smoke to cataract and blindness, otitis media, lung fibrosis, and cardiovascular disease is weak or nonexistent. Many of the studies use indirect measures of smoke exposure and reported measures of health outcomes, do not adequately account for confounding and interactions, and few address gender aspects of smoke exposure and its health effects. Differences in gender roles result in differential exposures to indoor smoke among males and females; and gender differences in nutritional status, treatment, and care result in differential effects of these exposures. Moreover, there are biological and genetic differences between males and females that mediate the effects of smoke exposure on health. There is need to improve both the quality and quantity of research in this area, using better study designs, direct measures of smoke exposure, and clinical measures of health outcomes. To reduce exposures to indoor smoke, there is need to promote widespread use of cleaner fuels, provide improved cookstoves, and inform people about potential health risks, especially to women and young children.
Sex differentials in childhood feeding, health care, and nutritional status in India
(Honolulu: East-West Center, 2004) Mishra, Vinod K.; Roy, T.K.; Retherford, Robert D.
Strong preference for sons in South Asia is well documented, but evidence on female disadvantage in childhood feeding, health care, and nutritional status is inconclusive. This paper examines sex differentials in indicators of childhood feeding, health care, and nutritional status of children under age 3 by birth order and sex composition of older living siblings. Data are from India's 1992-93 and 1998-99 National Family Health Surveys. The analysis finds three reasons for inconclusive evidence on female disadvantage in aggregate analyses. First, discrimination against girls is limited to children of certain birth orders and sex compositions of older siblings, who constitute a relatively small fraction of all children. Second, discrimination against girls when boys are in short supply and discrimination against boys when girls are in short supply cancel each other to some extent. Third, some discrimination against girls (e.g., in exclusive breastfeeding at 6-9 months) is nutritionally beneficial to girls. Separate analyses for north and south India find that gender discrimination is as common in south India as in the north, where son preference is generally much stronger.
Effect of obesity on asthma among adult Indian women
(Honolulu: East-West Center, 2004) Mishra, Vinod K.
Both obesity and asthma are on the rise worldwide. This paper examines the association between obesity and asthma prevalence in adult women in India. Information on 82,464 non-pregnant, ever-married women age 15-49, included in India's 1998-99 National Family Health Survey was analyzed. Obese women were about twice as likely as those with a normal BMI to report suffering from asthma. The association between obesity and asthma remained strong and statistically significant even when the effects of other selected risk factors and potential confounders were controlled. Overweight women also reported significantly higher adjusted asthma prevalence than those with a normal BMI. Results hold in separate analysis for younger and older women. Prospective epidemiological studies, with better measures of overweight conditions and clinical measures of asthma, are needed in developing country settings to validate this relationship and to establish causality.
Multivariate analysis of parity progression-based measures of the total fertility rate and its components using individual-level data
(Honolulu: East-West Center, 2006) Retherford, Robert D.; Ogawa, Naohiro; Matsukura, Rikiya
This paper develops multivariate methods for analyzing (1) effects of socioeconomic variables on the total fertility rate and its components and (2) effects of socioeconomic variables on the trend in the total fertility rate and its components. For the multivariate methods to be applicable, the total fertility rate must be calculated from parity progression ratios (PPRs), pertaining in this paper to transitions from birth to first marriage, first marriage to first birth, first birth to second birth, and so on. The components of the TFR include PPRs, the total marital fertility rate (TMFR), and the TFR itself as measures of the quantum of fertility, and mean and median ages at first marriage and mean and median closed birth intervals by birth order as measures of the tempo or timing of fertility. The multivariate methods are applicable to both period measures and cohort measures of these quantities. The methods are illustrated by application to data from the 1993, 1998, and 2003 Demographic and Health Surveys (DHS) in the Philippines.
Muslim/non-Muslim differentials in fertility and family planning in India
(Honolulu: East-West Center, 2004) Mishra, Vinod K.
Reasons for lower contraceptive use and higher fertility among Muslims than among non-Muslims in India are highly debated. This paper examines differentials in fertility and contraceptive use by religion using data from India's 1992-93 and 1998-99 National Family Health Surveys. The analysis shows that socioeconomic factors do not explain lower use of family planning and higher fertility among Muslims. A reason may be heavy reliance of India's family planning program on sterilization and Muslims' preference for temporary methods over sterilization. Another reason may be heavy reliance of the program on public-sector sources of supply of family planning and Muslims' preference for private-sector services due to greater privacy needs. A third reason may be greater opposition to family planning among Muslims, which is indicated in surveys as their main reason for not currently using and not intending to use family planning in the future. The findings suggest that greater availability of modern temporary methods and expansion of private-sector family planning services may increase contraceptive use and lower fertility among Muslims in India. Education and motivation programs aimed at reducing opposition to family planning may also help achieve these objectives.
Covariates of overweight and obesity among women in north India
(Honolulu: East-West Center, 2004) Agrawal, Praween; Mishra, Vinod K.
This paper studies the covariates of overweight and obesity among adult women in north India and suggests that overweight and obesity may increase the risk of adverse pregnancy outcomes. Data on 5,273 ever-married women of reproductive age (15-49) in the states of Delhi and Punjab, included in India's second National Family Health Survey (NFHS-2), conducted in 1998-1999, was analyzed. The study found that age, urban residence, media habits, anemia status, and economic living standard are most important covariates of overweight and obesity among women in India. A separate analysis by women's age found that media habits and living standard are more important covariates for older women (30-49), whereas place of residence and education are more important covariates for younger women (15-29). The study also found that overweight and obese women age 15-29 are significantly more likely to have experienced a miscarriage or stillbirth; this relationship is not observed among older women. Prospective epidemiological studies are needed to better understand the causes and consequences of the growing obesity epidemic in India.
Maternal exposure to biomass smoke and reduced birth weight in Zimbabwe
(Honolulu: East-West Center, 2004) Mishra, Vinod K.
Household use of high pollution cooking fuels may cause reduced birth weight. This paper analyses 3,559 childbirths in the five years preceding the 1999 Zimbabwe Demographic and Health Survey. Birth weights, recorded by trained professionals at local health clinics, were derived from health cards at home or from mother's recall. Multiple regression method was used to estimate the effect of household use of biomass cooking fuels (wood, dung, or straw) on birth weight, after controlling for child's sex and birth order, mother's education and nutritional status, pregnancy care, household living standard, and other potentially confounding factors. Babies born to mothers cooking with wood, dung, or straw were lighter, on average, compared with babies born to mothers using LPG, natural gas, or electricity. The relationship needs to be further investigated using more direct measures of smoke exposure and birth weight and accounting for environmental tobacco smoke.

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