Early Marriage among young girls in Eastern Ethiopia: trend during 2008-2018

Early marriage practices undermine girls' autonomy and seriously affect their physical and mental wellbeing. Monitoring the trends and understanding the drivers is essential in intervening against early marriage. However, many studies on early marriage in Ethiopia are cross-sectional, focusing only on the magnitude at a single point in time. Hence, we extracted data of girls of 10-17 years from Kersa Health and Demographic Surveillance System (Kersa HDSS) database for the period of 2008-2018 in order to examine the trends of early marriage. In this data note we provide the details of a research database of 24,452 girls in the age group of 10-17 years. The extracted data include date of marriage and the girls' socio-demographic variables. Other variables considered to be potentially associated with timing of marriage were also extracted. The purpose of this publication is to describe the dataset for external researchers who may be interested in making use of it as a secondary use of their routinely collected data. This dataset is available at    https://doi.org/10.6084/m9.figshare.15034812.

Key drivers of fertility levels and differentials in India, at the national, state and population subgroup levels, 2015-2016: An application of Bongaarts' proximate determinants model

OBJECTIVES

The transition to small family size is at an advanced phase in India, with a national TFR of 2.2 in 2015-16. This paper examines the roles of four key determinants of fertility-marriage, contraception, abortion and postpartum infecundability-for India, all 29 states and population subgroups.

METHODS

Data from the most recent available national survey, the National Family Health Survey, conducted in 2015-16, were used. The Bongaarts proximate determinants model was used to quantify the roles of the four key factors that largely determine fertility. Methodological contributions of this analysis are: adaptations of the model to the Indian context; measurement of the role of abortion; and provision of estimates for sub-groups nationally and by state: age, education, residence, wealth status and caste.

RESULTS

Nationally, marriage is the most important determinant of the reduction in fertility from the biological maximum, contributing 36%, followed by contraception and abortion, contributing 24% and 23% respectively, and post-partum infecundability contributed 16%. This national pattern of contributions characterizes most states and subgroups. Abortion makes a larger contribution than contraception among young women and better educated women. Findings suggest that sterility and infertility play a greater than average role in Southern states; marriage practices in some Northeastern states; and male migration for less-educated women. The absence of stronger relationships between the key proximate fertility determinants and geography or socio-economic status suggests that as family size declined, the role of these determinants is increasingly homogenous.

CONCLUSIONS

Findings argue for improvements across all states and subgroups, in provision of contraceptive care and safe abortion services, given the importance of these mechanisms for implementing fertility preferences. In-depth studies are needed to identify policy and program needs that depend on the barriers and vulnerabilities that exist in specific areas and population groups.

Banned by the law, practiced by the society: The study of factors associated with dowry payments among adolescent girls in Uttar Pradesh and Bihar, India

Background

Despite the prohibition by the law in 1961, dowry is widely prevalent in India. Dowry stems from the early concept of ’Stridhana,’ in which gifts were given to the bride by her family to secure some personal wealth for her when she married. However, with the transition of time, the practice of dowry is becoming more common, and the demand for a higher dowry becomes a burden to the bride’s family. Therefore, this study aimed to determine the factors associated with the practice of dowry in Bihar and Uttar Pradesh.

Methods

We utilized information from 5206 married adolescent girls from the Understanding the lives of adolescents and young adults (UDAYA) project survey conducted in two Indian states, namely, Uttar Pradesh and Bihar. Dowry was the outcome variable of this study. Univariate, bivariate, and multivariate logistic regression analyses were performed to explore the factors associated with dowry payment during the marriage.

Results

The study reveals that dowry is still prevalent in the state of Uttar Pradesh and Bihar. Also, the proportion of dowry varies by adolescent’s age at marriage, spousal education, and household socioeconomic status. The likelihood of paid dowry was 48 percent significantly less likely (OR: 0.52; CI: 0.44–0.61) among adolescents who knew their husbands before marriage compared to those who do not know their husbands before marriage. Adolescents with age at marriage more than equal to legal age had higher odds to pay dowry (OR: 1.60; CI: 1.14–2.14) than their counterparts. Adolescents with mother’s who had ten and above years of education, the likelihood of dowry was 33 percent less likely (OR: 0.67; CI: 0.45–0.98) than their counterparts. Adolescents belonging to the richest households (OR: 1.48; CI: 1.13–1.93) were more likely to make dowry payments than adolescents belonging to poor households.

Conclusion

Limitation of the dowry prohibition act is one of the causes of continued practices of dowry, but major causes are deeply rooted in the social and cultural customs, which cannot be changed only using laws. Our study suggests that only the socio-economic development of women will not protect her from the dowry system, however higher dowry payment is more likely among women from better socio-economic class.

COVID-19 and the surge of child marriages: A phenomenon in Nusa Tenggara Barat, Indonesia

BACKGROUND

Worldwide, there has been a massive increase in child marriages following the COVID-19 crisis. In Indonesia, too, this figure has risen with Indonesia ranked amongst ten countries with the highest rates of child marriage in the world. One of the Indonesian provinces with a high incidence of child marriage cases is in Nusa Tenggara Barat (NTB).

OBJECTIVE

This study aims to examine what is causing the rate of child marriages to increase since the outbreak of COVID-19 in NTB.

PARTICIPANTS AND SETTING

Using snowball sampling techniques, the researcher selected 23 study participants, including ten parents (seven mothers and three fathers) with children who were married underage and 13 adolescents aged 14 to 17 years old (ten females and three males) who were married between March and December 2020. They came from two different regencies of NTB: Lombok Barat and Lombok Utara.

METHODS

This study employed qualitative phenomenology as the method of inquiry. Data was obtained through semi-structured in-depth interviews and analyzed in a two-stage coding model. The results of the analysis were asserted on phenomenological themes.

RESULTS

The data reveals that teenagers get married because: 1) they believe that marriage is an escape-from schoolwork, house chores, and the stress and boredom of studying and staying at home during the pandemic; 2) the customary law- some local customs encourage or permit child marriage; 3) there is a lack of understanding of the impact and long term implications of underage marriage; 4) economic problems- financial problems trigger parents to marry their children at a young age; and 5) the influence of the surrounding environment and peers, which encourages early marriage.

CONCLUSIONS

The findings suggest a number of recommendations for the prevention of child marriage: 1) socializing the prevention of child marriage; 2) offering alternative activities and support systems for adolescents to overcome frustration and pressure due to online learning and staying at home; 3) changing society's view that marrying children solves adolescent promiscuity, prevents pregnancy, and addresses the issue of non-marital pregnancy.

The herbivore's dilemma: Trends in and factors associated with heterosexual relationship status and interest in romantic relationships among young adults in Japan-Analysis of national surveys, 1987-2015

BACKGROUND

It has been suggested that an increasing proportion of young adults in Japan have lost interest in romantic relationships, a phenomenon termed "herbivorization". We assessed trends in heterosexual relationship status and self-reported interest in heterosexual romantic relationships in nationally representative data.

METHODS

We used data from seven rounds of the National Fertility Survey (1987-2015) and included adults aged 18-39 years (18-34 years in the 1987 survey; sample size 11,683-17,675). Current heterosexual relationship status (married; unmarried but in a relationship; single) was estimated by sex, age group and survey year, with singles further categorized into those reporting interest vs. no interest in heterosexual romantic relationships. Information about same-sex relationships were not available.

RESULTS

Between 1992 and 2015, the age-standardized proportion of 18-39-year-old Japanese adults who were single had increased steadily, from 27.4 to 40.7% among women and from 40.3 to 50.8% among men. This increase was largely driven by decreases in the proportion of married women aged 25-39 years and men aged 30-39 years, while those in a relationship had increased only slightly for women and remained stable for men. By 2015, the proportion of single women was 30.2% in those aged 30-34 years and 24.4% in those aged 35-39 years. The corresponding numbers for men were 39.3% and 32.4%. Around half of the singles (21.4% of all women and 25.1% of all men aged 18-39 years) reported that they had no interest in heterosexual romantic relationships. Single women and men who reported no interest in romantic relationships had lower income and educational levels and were less likely to have regular employment compared to those who reported such an interest.

CONCLUSIONS

In this analysis of heterosexual relationships in nationally representative data from Japan, singlehood among young adults had steadily increased over the last three decades. In 2015 around one in four women and one in three men in their thirties were unmarried and not in a heterosexual relationship. Half of the singles reported no interest in romantic relationships and these women and men had lower income and educational levels and were less likely to have regular employment.

Defining and deconstructing girl child marriage and applications to global public health

An estimated 650 million girls and women alive today married before their 18th birthday. Referred to as girl child marriage, the formal or informal union of the girl-child before age 18, the practice is increasingly recognized as a key roadblock to global health, development, and gender equality. Although more research than ever has focused on girl child marriage, an important gap remains in deconstructing the construct. Through an extensive review of primary and secondary sources, including legal documents, peer-reviewed articles, books, and grey literature across disciplines, we explore what the term "girl child marriage" means and why it more accurately captures current global efforts than other terms like early, teenage, or adolescent marriage. To do this, we dive into different framings on marriage, children, and gender. We find that there has been historical change in the understanding of girl child marriage in published literature since the late 1800s, and that it is a political, sociocultural, and value-laden term that serves a purpose in different contexts at different moments in time. The lack of harmonized terminology, particularly in the global public health, prevents alignment amongst different stakeholders in understanding what the problem is in order to determine how to measure it and create solutions on how to address it. Our intent is to encourage more intentional use of language in global public health research.

Semi-arranged marriages and dowry ambivalence: Tensions in the changing landscape of marriage formation in South Asia

Marriage is a point of change in young people's lives, especially in parts of the world that place high value on it, such as in South Asian countries including Nepal. However, marriage practices are changing, with a move towards more love marriage; this is likely to have important implications on women's status and agency, household and couple dynamics, and mental and physical health. The aim of this paper is to describe how changing marriage formation patterns and traditional practices such as co-residence and dowry are intersecting and impacting relationships post-marriage. In-depth qualitative interviews took place with 20 intact triads of newly married women, their husbands and their mothers-in-law, in one district of Nepal in 2017. Many marriages remain arranged; however, couples often talk or meet before marriage and feel that they are able to build a foundation of love before marrying. Access to technology facilitates this practice, although some couples are reluctant to admit their communication, suggesting stigma about this practice. Husbands have growing ambivalence about dowry, leading to confusion and negatively impacting on relationships post-marriage. A clash of traditional and modern ideas and practices is occurring in Nepal, influencing newly married women's household status and relationship quality, and potentially impacting women's health.

Extramarital relationships in the Vietnamese migrant community in Laos: reasserting patriarchal ideologies and double standards

Undocumented migration from Central Vietnam to Laos stretches Vietnamese families and generates marital tensions and social anxieties around the extramarital relationships that migrant husbands establish with vợ hầu (second wives), an emic term that encompasses mistresses and more stable partners. This paper sheds light on these processes via an ethnographic study on how migration from Central Vietnam to Savannakhet - a town located in Central Laos bordering Thailand - shapes family formation, marital relationships and double standards in gender and sexuality. It argues that husbands and first and second wives manage these issues by preserving family integrity, negotiating extramarital relationships and retreating from marriage. These strategies are shaped by and constitutive of normative double standards that families refer to, reinforce and in some cases transcend to make sense of the marital challenges and disruptions caused by dislocation, translocality and the intrusion of second wives in their marriages. Overall, the study emphasises that families remain committed to a domestic division of labour and to the institutions of marriage and family, albeit with some adjustments. This argument resonates with broader discussions about migration, gender and sexuality in Vietnam.

Marriage Decline in Korea: Changing Composition of the Domestic Marriage Market and Growth in International Marriage

Explanations for the substantial decline in rates of marriage in East Asian countries often emphasize the role of rapid educational expansion for women in reducing the desirability of marriages characterized by a strong gender-based division of labor. Focusing on South Korea, we consider a very different scenario in which changing educational composition of the marriage market reduces the demographic feasibility of such marriages. Analyses of 1% microsamples of the 1990 and 2010 Korean censuses show that changes in the availability of potential spouses accounted for part of the decline in marriage rates over a period of 20 years (1985-1989 to 2005-2009) for highly educated women and less-educated men. We also show that growth in international marriages played a role in preventing an even more dramatic decline in marriage among low-educated men. These findings support the general relevance of marriage market mismatches in gender-inegalitarian societies and highlight the declining feasibility of marriage for low-educated men in such contexts. Findings also hint at important implications for inequality in a society such as Korea, where marriage remains a symbol of social success and is closely related to women's economic well-being and men's health and subjective well-being.

Reproductive preferences during middle childhood and early adolescence in Guatemala

Reproductive preferences and the spread of low fertility norms occupy a key position in debates regarding the causal mechanisms underlying sustained fertility declines. Most of the literature on reproductive preferences focuses on stability and variability of adult fertility preferences, and their relationship with behavioural outcomes. Little work has focused on the developmental origins of these preferences, particularly in populations undergoing rapid social and demographic change. This study explores the utility of integrating the ontogeny of fertility preferences into accounts of fertility declines. We analyse data on child and adolescent (age 8-15) reproductive preferences collected from a semi-rural community in the Guatemalan Highlands. We explore (1) the distribution of reproductive preferences across age and gender, (2) relationships between family structure and preferences, (3) the relationship between personal economic and occupational aspirations and reproductive preferences, and (4) the effects of parental investments in education on reproductive preferences. Findings reveal the early development of gender and ethnic differences in reported reproductive preferences, as well as evidence for the differential impact of family background and personal aspirations on the timing of reproductive events and ideal family size.

Proximate Sources of Change in Trajectories of First Marriage in the United States, 1960-2010

This study examines proximate sources of change in first-marriage trajectories in the United States between 1960 and 2010. This was a period of tremendous social change: divorce became more common, people started marrying later or not marrying at all, innovations in medicine and changes in social and behavioral factors led to reduced mortality, inequality grew stronger and was reflected by more intense assortative mating, and the country underwent a massive educational expansion. Each of these factors influenced the formation and dissolution of first marriages over this period. This article extends the multiple-decrement life table to incorporate heterogeneity and assortative mating, which allows the quantification of how changes in the incidence of marriage, divorce, and mortality, along with changes in educational attainment and assortative mating, have shaped trends in first-marriage trajectories. The model is used to prove that stronger educational assortative mating leads to longer average durations of first marriage. Using data from multiple sources and this model, this study shows that although the incidence of divorce was the primary determinant of changes in first-marriage trajectories between 1960 and 1980, it has played a relatively smaller role in driving change in marital trajectories between 1980 and 2010. Instead, factors such as later age at first marriage, educational expansion, declining mortality, narrowing sex differences in mortality, and more intense educational assortative mating have been the major drivers of changes in first-marriage trajectories since 1980.

A Cohort Comparison of Predictors of Young Adult Union Formation and Dissolution in the US

The theory of the second demographic transition argues that as educated Americans began valuing self-actualization and individual autonomy, delays in union formation spread through the US. The accelerated adulthood theory suggests that socioeconomic disadvantage distinguishes young adulthood such that those with fewer resources have shorter, more informal (i.e. cohabitation) unions, and those with more resources delay but achieve marriage and have greater union stability. We use two large, nationally representative samples of young adults collected about twenty years apart, the National Longitudinal Surveys of Youth 1979 and 1997 cohorts to examine cohort differences in union formation and dissolution and test interaction effects in demographic and socioeconomic correlates. We found that the NLSY97 cohort 1) entered into unions earlier than the NLSY79 cohort, 2) entered direct marriage (marriage without premarital cohabitation) later than the NLSY79 cohort, and 3) entered cohabiting unions earlier than the NLSY79 cohort. A greater proportion of young adults in the NLSY97 cohort dissolved their first union between ages 16 and 30. We found that socioeconomically disadvantaged young adults had earlier unions by some indicators (e.g. lower maternal education) and later unions by other indicators (e.g. unemployment) in both cohorts. We also found that in both cohorts, socioeconomic disadvantage undermined union stability. We also found evidence for interaction effects; some indicators of socioeconomic disadvantage (e.g. income, employment, and maternal education) had exacerbated effects on union formation and stability in the NLSY97 as compared to the NLSY79 cohorts perhaps because inequality grew over the twenty years between cohorts.

Marital Status as a Partial Mediator of the Associations Between Young Adult Substance Use and Subsequent Substance Use Disorder: Application of Causal Inference Methods

OBJECTIVE

Young adult substance use is linked with the risk of substance use disorders (SUDs) later in adulthood. Marriage may be part of this pathway because of both selection effects (early substance use reducing marriage) and socialization effects (marriage reducing later substance use and disorder). We examine whether marital status mediates the association between young adult substance use and subsequent SUDs, using causal mediation methods to strengthen inferences.

METHOD

Using panel data from high school seniors in 1990-1998, we examined whether the effects of two exposures (level of alcohol/marijuana use at age 19/20) on the outcomes (alcohol use disorder [AUD]/ marijuana use disorder [MUD], nondisordered use, or abstinence at age 35) were mediated by marital status at age 29/30. Propensity score weights adjusted for potential confounding regarding both the exposures and the mediator.

RESULTS

Moderate and heavy alcohol/marijuana use at age 19/20 were associated with higher odds of AUD/MUD and lower odds of abstinence, each relative to nondisordered use, at age 35. The association between heavy alcohol use at age 19/20 and subsequent AUD was partially mediated by being unmarried at age 29/30; the associations between moderate and heavy marijuana use at age 19/20 and subsequent marijuana abstinence were partially mediated by being unmarried at age 29/30.

CONCLUSIONS

Both selection and socialization effects related to marriage explain the perpetuation of substance use behaviors across adulthood. Selection effects on marriage seem to occur at different thresholds for young adult alcohol and marijuana use.

Adverse birth outcomes in relation to maternal marital and cohabitation status in Canada

PURPOSE

An increasing percentage of children are born to couples who cohabit but are not legally married. Using data from a nationally representative Canadian sample, we estimated associations of maternal marital and cohabitation status with stillbirth, infant mortality, preterm birth (PTB), and small- and large-for-gestational-age (SGA and LGA) birth.

METHODS

The 2006 Canadian Birth-Census Cohort was created by linking birth registration data with the 2006 long-form census. We used log-binomial regression to estimate risk ratios (RRs) for adverse birth outcomes associated with being single or living with a common-law partner. Analyses were adjusted for maternal age and education.

RESULTS

Data were analyzed for 130,931 singleton births. Adjusted RRs (95% confidence intervals) for single mothers compared with married mothers were 1.92 (1.51-2.42) for stillbirth, 2.08 (1.55-2.81) for infant mortality, 1.36 (1.27-1.46) for PTB, 1.31 (1.22-1.39) for SGA birth, and 0.95 (0.90-1.01) for LGA birth. Adjusted RRs for cohabiting mothers compared with married mothers were 0.93 (0.74-1.16) for stillbirth, 1.05 (0.81-1.35) for infant mortality, 1.09 (1.03-1.15) for PTB, 1.05 (0.99-1.10) for SGA birth, and 0.96 (0.92-1.00) for LGA birth.

CONCLUSIONS

In a nationally representative Canadian birth cohort, cohabiting and legally married women experienced similar birth outcomes, but most outcomes for single women were substantially worse.

Midpregnancy Marriage and Divorce: Why the Death of Shotgun Marriage Has Been Greatly Exaggerated

Conventional wisdom holds that births following the colloquially termed "shotgun marriage"-that is, births to parents who married between conception and the birth-are nearing obsolescence. To investigate trends in shotgun marriage, we matched North Carolina administrative data on nearly 800,000 first births among white and black mothers to marriage and divorce records. We found that among married births, midpregnancy-married births (our preferred term for shotgun-married births) have been relatively stable at about 10 % over the past quarter-century while increasing substantially for vulnerable population subgroups. In 2012, among black and white less-educated and younger women, midpregnancy-married births accounted for approximately 20 % to 25 % of married first births. The increasing representation of midpregnancy-married births among married births raises concerns about well-being among at-risk families because midpregnancy marriages may be quite fragile. Our analysis revealed, however, that midpregnancy marriages were more likely to dissolve only among more advantaged groups. Of those groups considered to be most at risk of divorce-namely, black women with lower levels of education and who were younger-midpregnancy marriages had the same or lower likelihood of divorce as preconception marriages. Our results suggest an overlooked resiliency in a type of marriage that has only increased in salience.

Marital Satisfaction Trends in Hong Kong Between 2002 and 2012

Macrosocial changes may generate influences on marital quality. This study used data from the 2002-2012 Knowledge, Attitude, and Practice surveys conducted by the Family Planning Association of Hong Kong to track the trends of marital satisfaction of both husbands and wives over a 10-year period in Hong Kong, with associated factors. Results indicated that 85% of the husbands and around 80% of the wives reported that they were satisfied with their marital relationships, and no significant changes in general were observed for them between 2002 and 2012 except for some subgroups. Husbands aged 45-49 years, in employment and whose monthly household income between 25,000 HKD and 39,999 HKD, reported marital satisfaction decreased over the past 10 years and wives with primary education or below also reported a decreasing trend during this period. Education and family income had positive influences on the husbands' and wives' marital satisfaction, and husbands were more likely to be sensitive to the unemployment. Less than one-third of couples needed professional counseling on family-related issues, and couple conflicts and work-family conflicts were the urgent needs that should be given priority in delivering services. The implications of this study are discussed in the Chinese context of Hong Kong.

Family Inequality: Diverging Patterns in Marriage, Cohabitation, and Childbearing

Popular discussions of changes in American families over the past 60 years have revolved around the “retreat from marriage.” Concern has focused on increasing levels of nonmarital childbearing, as well as falling marriage rates that stem from both increases in the age at first marriage and greater marital instability. Often lost in these discussions is the fact that the decline of marriage has coincided with a rise in cohabitation. Many “single” Americans now live with a domestic partner and a substantial fraction of “single” mothers are cohabiting, often with the child's father. The share of women who have ever cohabited has nearly doubled over the past 25 years, and the majority of nonmarital births now occur to cohabiting rather than to unpartnered mothers at all levels of education. The emergence of cohabitation as an alternative to marriage has been a key feature of the post–World War II transformation of the American family. These changes in the patterns and trajectories of family structure have a strong socioeconomic gradient. The important divide is between college graduates and others: individuals who have attended college but do not have a four-year degree have family patterns and trajectories that are very similar to those of high school graduates.

The associations between bridal pregnancy and obstetric outcomes among live births in Korea: population-based study

Objective

In East Asia the recently increased number of marriages in response to pregnancy is an important social issue. This study evaluated the association of marriage preceded by pregnancy (bridal pregnancy) with obstetric outcomes among live births in Korea.

Methods

In this population-based study, 1,152,593 first singleton births were evaluated from data registered in the national birth registration database from 2004 to 2008 in Korea. In the study population, the pregnancy outcomes among live births from the bridal pregnancy group (N = 62,590) were compared with the outcomes of the post-marital pregnancy group (N = 564,749), composed of women who gave birth after 10 months but before 24 months of marriage. The variables preterm birth (PTB; <37 weeks gestation) and low birth weight (LBW; <2.5 kg) were used to determine the primary outcome. The adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated after controlling for socio-demographic factors.

Results

The socio-demographic factors among the bridal pregnancy group were associated with a social disadvantage and particular risk factors. In the subgroup analyses of maternal age, differences in adverse pregnancy outcomes from bridal pregnancy were identified between women in the following age group: (i) ≤19, (ii) 20–39, and (iii) ≥40 years. After the multivariate analysis, the aORs for each age group were 1.47 (95% CI: 1.15–1.89), 1.76 (1.70–1.83), and 1.13 (0.77–1.66), respectively, for PTB and 0.92 (0.70–1.21), 1.60 (1.53–1.66), and 1.11 (0.71–1.74), respectively, for LBW. In the adjusted logistic regression models, bridal pregnancy was associated with PTB (1.76, 1.69–1.82) and LBW (1.53, 1.48–1.59).

Conclusion

Pregnancy outcomes among live births from bridal pregnancies are associated with higher risks for PTB and LBW in Korea.

Is consanguinity prevalence decreasing in Saudis?: A study in two generations

BACKGROUND

Saudi population is unique in that there is a strong preference for cousin marriages in the general population. We studied the prevalence of consanguinity in educated Saudi females and compared the results with the results obtained in their parents, to access if a generation difference in which extensive educational activities have prevailed to inform the people of the influence of cousin marriages on health, has made any difference in prevalence of consanguineous marriages.

METHOD

A total of 600 Saudi women (421 university students and 179 women attending outpatients' clinics) were interviewed about their own and their parents' consanguinity.

RESULTS

The total consanguinity (first and second cousins) was 29.7% in the parents. Consanguinity was significantly higher among the daughters than the parents, where 37.9% of the 293 married women had consanguineous marriages. The prevalence of consanguinity was studied in different age groups, though no significant pattern was observed. A strong correlation was found between consanguinity of parents and their daughters; consanguinity was highest (52.3%) in the daughters of parents who were themselves consanguineous.

CONCLUSION

The results did not reveal any decrease in the prevalence of consanguinity over a generation. This shows that the tradition of marrying within the family is a preferred practice, despite the awareness that certain genetic disorders occur at a higher frequency in cousin marriages. There is a need at the primary health care level to inform the public of the consequences of this common practice.

Trends in ages at key reproductive transitions in the United States, 1951-2010

BACKGROUND

Key sexual and reproductive health milestones typically mark changing life stages with different fertility intentions and family planning needs. Knowing the typical ages at such events contributes to our understanding of changes in family formation and transition to adulthood and helps inform needs for reproductive health services.

METHODS

We used data from the 1982-2010 National Surveys of Family Growth and the 1995 National Survey of Adolescent Males and event history methods to examine trends over time for women and men in the median ages at several reproductive and demographic events.

FINDINGS

Women's reports indicate that age at menarche has changed little since 1951. Women's and men's median ages at first sex declined through the 1978 birth cohort, but increased slightly since then, to 17.8 years for women and 18.1 for men. The interval from first sex to first contraceptive use has narrowed, although Hispanic women have a longer interval. Age at first union (defined as the earlier of first marriage or first cohabiting relationship) has remained relatively stable, but the time between median age at first sex and median age at first birth has increased to 9.2 years for women and 11.4 for men. For some women and men born in the late 1970s, median age at first birth was earlier than median age at first marriage for the first time in at least the past several decades.

CONCLUSION

The large majority of the reproductive years are spent sexually active. Thus, women have a lengthy period during which they require effective methods. In particular, the period between first sex and first childbearing has lengthened, but long-acting method use, although increasing, has not kept up with this shift. Moving the contraceptive method mix toward underutilized but highly effective contraceptive methods has the potential to reduce the unintended pregnancy rate.

Marital age homogamy in China: a reversal of trend in the reform era?

This paper reports on a study of trends in marital age homogamy in China from 1960 to 2005 that uses data from the China 2005 1% Population Inter-census Survey. Instead of a consistent increase in age homogamy, results show an inverted U-shaped trend. One plausible explanation is that intensified economic pressure, rising consumerism, and a shrinking gender gap in education during the post-1990s reform era have acted to increase women's desire to marry men who are more economically established, and thus usually older, than less financially secure men. We argue that age hypergamy maintains status hypergamy, a deeply rooted norm for couples in China. An auxiliary analysis based on the human capital model for earnings supports this interpretation. A continued trend in age hypergamy implies a future "marriage squeeze" for men of low socioeconomic status.

Dowry in 21st-century India: the sociocultural face of exploitation

The World Health Organization (2009) implicates deep-rooted cultural and social norms as influential contributing factors toward physical and intimate partner violence against women. The dowry system is a social practice that perpetuates the oppression, torture, and murder of women in India. The practice of dowry is an expected part of marriage in cultures where arranged marriages are the norm. Violence can occur when the dowry or bride-price is deemed unsatisfactory by the recipient. In India, in spite of laws prohibiting the practice, not much has changed over the last 30 years. The National Crime Records Bureau of India, recorded a total of 8,618 female deaths related to dowry disputes in 2011, and the Asian Women's Human Rights Council (2009) estimates that the practice of dowry is implicated in 25,000 deaths and maiming of women between the ages of 15-34 in India every year. The current review of literature reveals that despite efforts on the part of the Indian government, social activists and feminists organizations in India, not much has changed over the past decade, in fact, the problem has increased, resulting in an unprecedented amount of mortality and morbidity among women in India.

Health policies and intervention strategies: a description of current issues and approaches to care of the public health and health care system in the United Arab emirates

The demographic factors of the United Arab Emirates (UAE) have changed drastically within one generation. This is evident in how quickly it has moved from a developing nation, where fishing was once the main source of income, to a country that is quite developed, competing on a global level. From one perspective, socio-economic progress has brought many benefits to the population. These include improved education, better access to health care, and safe drinking water. However, on the other hand, economic development has been the cause for changes in lifestyles, eating habits, and traditional societal and family structures. Over time, these changes have added up, creating an unprecedented impact on the population's health. This impact has crept up onto the society until suddenly a notable epidemic has become recognized in the country. According to the UAE Ministry of Health, 19.5 percent of the UAE population has diabetes, making it the second highest rate in the world. The structure and responsibilities of the current UAE health care systems along with other cultural factors were investigated in order to determine their impact on the growing epidemic.

Marital processes, arranged marriage, and contraception to limit fertility

An international transition away from familially arranged marriages toward participation in spouse choice has endured for decades and continues to spread through rural Asia today. Although we know that this transformation has important consequences for childbearing early in marriage, we know much less about longer-term consequences of this marital revolution. Drawing on theories of family and fertility change and a rural Asian panel study designed to measure changes in both marital and childbearing behaviors, this study seeks to investigate these long-term consequences. Controlling for social changes that shape both marital practices and childbearing behaviors, and explicitly considering multiple dimensions of marital processes, we find evidence consistent with an independent, long-standing association of participation in spouse choice with higher rates of contraception to terminate childbearing. These results add a new dimension to the evidence linking revolutions in marital behavior to long-term declines in fertility and suggest that new research should consider a broader range of long-term consequences of changing marital processes.

Cohabitation patterns among patients with severe psychiatric disorders in the entire Danish population

BACKGROUND

Assortative mating has been demonstrated in mental disorders but the extent of cohabitation between patients with clinically diagnosed psychiatric disease has been poorly explored. Method We conducted a register-based study of all Danes between 18 and 70 years of age in a 13-year observational period, linking data on individuals' contacts with psychiatric services with data on individuals' cohabitation status. Two different Poisson regression analyses were performed: the first comparing the rates of commencing cohabitation with a psychiatric patient between individuals, depending on whether the individuals themselves had, or did not have, a psychiatric diagnosis; the second comparing the incidence rates of psychiatric diagnoses for individuals cohabitating with psychiatric patients with the similar rates for individuals living with unaffected cohabitants.

RESULTS

In total, 159 929 (5.0%) out of 3 204 633 individuals were given a psychiatric diagnosis during the study period. Diagnosed individuals had an overall rate ratio (RR) of commencing cohabitation with a psychiatric patient of 1.95 [95% confidence interval (CI) 1.90-2.00] for women and 1.65 (95% CI 1.61-1.69) for men, when compared with unaffected individuals. The overall RR of receiving a psychiatric diagnosis while cohabitating with a psychiatric patient was 2.40 (95% CI 2.31-2.49) for women and 2.91 (95% CI 2.81-3.01) for men, when compared with those cohabitating with unaffected individuals. Individuals with schizophrenia and men with bipolar disorder had the highest RR of commencing cohabitation with a cohabitant with a similar diagnosis.

CONCLUSIONS

Cohabitation among individuals with severe psychiatric disorders is increased. This has implications for research and for the clinical management of patients.

First premarital cohabitation in the United States: 2006-2010 National Survey of Family Growth

OBJECTIVE

This report provides an updated description of trends and patterns in first premarital cohabitations among women aged 15-44 in the United States using the National Survey of Family Growth (NSFG). Trends in pregnancies within first premarital cohabiting unions and differences by Hispanic origin and race, and education are also presented.

METHODS

Data for 2006-2010 were collected through in-person interviews with 22,682 women and men aged 15-44 in the household population of the United States. This report is based primarily on the sample of 12,279 women interviewed in 2006-2010, and is supplemented by data from the 1995 and 2002 NSFGs.

RESULTS

Forty-eight percent of women interviewed in 2006-2010 cohabited with a partner as a first union, compared with 34% of women in 1995. Between 1995 and 2006-2010, the percentage of women who cohabited as a first union increased for all Hispanic origin and race groups, except for Asian women. In 2006-2010, 70% of women with less than a high school diploma cohabited as a first union, compared with 47% of women with a bachelor's degree or higher. First premarital cohabitations were longest for foreign-born Hispanic women (33 months) and shortest for white women (19 months). In 2006-2010, 40% of first premarital cohabitations among women transitioned to marriage by 3 years, 32% remained intact, and 27% dissolved. Nearly 20% of women experienced a pregnancy in the first year of their first premarital cohabitation.

Crossing boundaries: nativity, ethnicity, and mate selection

The influx of immigrants has increased diversity among ethnic minorities and indicates that they may take multiple integration paths in American society. Previous research on ethnic integration has often focused on panethnic differences, and few have explored ethnic diversity within a racial or panethnic context. Using 2000 U.S. census data for Puerto Rican-, Mexican-, Chinese-, and Filipino-origin individuals, we examine differences in marriage and cohabitation with whites, with other minorities, within a panethnic group, and within an ethnic group by nativity status. Ethnic endogamy is strong and, to a lesser extent, so is panethnic endogamy. Yet, marital or cohabiting unions with whites remain an important path of integration but differ significantly by ethnicity, nativity, age at arrival, and educational attainment. Meanwhile, ethnic differences in marriage and cohabitation with other racial or ethnic minorities are strong. Our analysis supports that unions with whites remain a major path of integration, but other paths of integration also become viable options for all ethnic groups.

Early marriage in Africa--trends, harmful effects and interventions

This article explores the pattern of early marriage in Africa. It focuses on the sub-Saharan region as an area with the highest rates of early marriage in the world. The harmful effects of early marriage are explored in terms of impact on the health, education and economic well-being of young girls. The paper outlines a framework for analyzing global, regional and local initiatives to curb early marriage and examines the application of these interventions in sub-Saharan countries. Regional patterns are then examined and countries which have made progress in reducing age of marriage are compared to countries in which age of marriage amongst girls has reminded low. The paper concludes on the note that countries with the highest rates of early marriage are also the countries with the highest rates of poverty and highest population growth rates. The paper argues for a sub-regional strategy to address the problem of early marriage in the zone with the highest incidence.

Natural and sexual selection in a monogamous historical human population

Whether and how human populations exposed to the agricultural revolution are still affected by Darwinian selection remains controversial among social scientists, biologists, and the general public. Although methods of studying selection in natural populations are well established, our understanding of selection in humans has been limited by the availability of suitable datasets. Here, we present a study comparing the maximum strengths of natural and sexual selection in humans that includes the effects of sex and wealth on different episodes of selection. Our dataset was compiled from church records of preindustrial Finnish populations characterized by socially imposed monogamy, and it contains a complete distribution of survival, mating, and reproductive success for 5,923 individuals born 1760-1849. Individual differences in early survival and fertility (natural selection) were responsible for most variation in fitness, even among wealthier individuals. Variance in mating success explained most of the higher variance in reproductive success in males compared with females, but mating success also influenced reproductive success in females, allowing for sexual selection to operate in both sexes. The detected opportunity for selection is in line with measurements for other species but higher than most previous reports for human samples. This disparity results from biological, demographic, economic, and social differences across populations as well as from failures by most previous studies to account for variation in fitness introduced by nonreproductive individuals. Our results emphasize that the demographic, cultural, and technological changes of the last 10,000 y did not preclude the potential for natural and sexual selection in our species.

Marriage characteristics and reproductive health of adolescents in Turkey: findings from Demographic and Health Surveys 1998 and 2008

Adolescent marriage is an important issue given its social and medical consequences. This study focuses on the recent trends in adolescent marriage and reproductive health in Turkey to provide insights for action. Data from the Demographic and Health Surveys of 1998 and 2008 were used. Adolescent marriage and reproductive health indicators were assessed for urban-rural residences, demographic regions and educational levels. Logistic regression was used to predict marriage and birth in adolescence. Despite the decrease in the proportion of married adolescents from 1998 to 2008, the findings suggest no improvement in some marriage characteristics. In both surveys, over 60% of ever-married adolescents had been pregnant at least once. There is an increase in contraceptive use and antenatal care. Our findings showed that in Turkey, women living in rural areas, from poor households, with more traditional parental families, with less education, and who are not working are more likely to get married in their adolescent ages.

First marriages in the United States: data from the 2006-2010 National Survey of Family Growth

OBJECTIVES

This report shows trends and group differences in current marital status, with a focus on first marriages among women and men aged 15-44 years in the United States. Trends and group differences in the timing and duration of first marriages are also discussed. These data are based on the 2006-2010 National Survey of Family Growth (NSFG). National estimates of probabilities of first marriage by age and probabilities of separation and divorce for women and men's first marriages are presented by a variety of demographic characteristics. Data are compared with similar measures for 1982, 1995, and 2002.

METHODS

The analyses presented in this report are based on a nationally representative sample of 12,279 women and 10,403 men aged 15-44 years in the household population of the United States. The overall response rate for the 2006-2010 NSFG was 77%-78% for women and 75% for men.

RESULTS

The percentage of women who were currently cohabiting (living with a man in a sexual relationship) rose from 3.0% in 1982 to 11% in 2006-2010; it was higher in some groups, including Hispanic groups, and the less educated. In 2006-2010, women and men married for the first time at older ages than in previous years. The median age at first marriage was 25.8 for women and 28.3 for men. Premarital cohabitation contributed to the delay in first marriage for both women and men.

The implications of marital history change on women's eligibility for Social Security wife and widow benefits, 1990-2009

Social Security retirement benefits in the United States (US) reflect marital histories and lifetime earnings of current and former married couples. Focusing on the link between marital history and benefit eligibility, this article examines women's marital patterns over the past two decades. Using the 1990 and 2009 Marital History Modules to the Census Bureau's Survey of Income and Program Participation, descriptive/regression analysis reveals substantial changes in women's marital patterns among baby boomers and generation Xers. Those changes have prompted a decline in qualifying marital histories for Social Security spouse and widow benefits. The findings also reveal substantial variation by race/ethnicity. Black women are significantly more likely to be potentially ineligible for a marriage-based benefit than white women, particularly in more recent cohorts. Hispanic women's marriage-based eligibility is between that of black and white women. US-born Hispanic women had higher shares without a qualifying marital history compared with the foreign born.

Growing support for gay and lesbian equality since 1990

Since 1991, public acceptance of gays and lesbians has grown dramatically. We use two approaches to examine changing attitudes in U.S. survey data. First, we conduct cohort analyses showing that both generational replacement and period effects are having impacts. Since 1991, older, less accepting generations of Americans have been dying and being replaced by younger, more tolerant Americans, and all age groups have been becoming more tolerant. Second, we pool cross-sectional, time series survey data to show that there has been a broad, dramatic increase in virtually every group's acceptance of gays and lesbians over time.

Wealth and the marital divide

Marriage patterns differ dramatically in the United States by race and education. The author identifies a novel explanation for these marital divides, namely, the important role of personal wealth in marriage entry. Using event-history models and data from the National Longitudinal Survey of Youth 1979 cohort, the author shows that wealth is an important predictor of first marriage and that differences in asset ownership by race and education help to explain a significant portion of the race and education gaps in first marriage. The article also tests possible explanations for why wealth plays an important role in first marriage entry.

Impacts of inter- and intra- ethnic partnerships/relationships on traditional gift giving in a cohort of Pacific mothers

Traditional gift-giving (TGG) is an important element of familial obligations among Pacific families. Migration from Pacific homelands to New Zealand and other countries has had an impact on participation in TGG., Many anecdotal accounts have suggested that TGG diminishes when Pacific persons marry outside their ethnic groups. While TGG is an indicator of social cohesion TGG can have direct influence on disposable income. The practice of TGG impacts on health as Income and social cohesion are key determinants of health. Thus TGG Health and social cohesion are closely interrelated and interdependent. The data for this paper is taken from a longitudinal cohort study of 1,398 Pacific children and their families in South Auckland, New Zealand. The study sought participants' responses to questions pertaining to the amounts gifted, the frequency of giving, recipients of the gifting and their reasons for participating and not participating in TGG. The assumption explored in this paper is that as Pacific peoples move outside their social sphere and become more acculturated with other ethnic groups, TGG was more likely to diminish rather than increase. This paper addresses the TGG participation rates among Pacific peoples in inter-ethnic relationships and intra-ethnic relationships. It argues that couples in an intra-ethnic intimate relationship are more likely to participate in traditional gift-giving than those who are in inter-ethnic intimate relationships. While this is true for most PI inter ethnic relationships the level of participation increases further with inter-ethnic intimate relationships among Tongans and Samoans who are also the largest participators of all ethnic groups in traditional gift-giving.

Compatibility or restraint? The effects of sexual timing on marriage relationships

Very little is known about the influence of sexual timing on relationship outcomes. Is it better to test sexual compatibility as early as possible or show sexual restraint so that other areas of the relationship can develop? In this study, we explore this question with a sample of 2035 married individuals by examining how soon they became sexually involved as a couple and how this timing is related to their current sexual quality, relationship communication, and relationship satisfaction and perceived stability. Both structural equation and group comparison analyses demonstrated that sexual restraint was associated with better relationship outcomes, even when controlling for education, the number of sexual partners, religiosity, and relationship length.

Pain and functioning of rheumatoid arthritis patients based on marital status: is a distressed marriage preferable to no marriage?

Relationships may influence adjustment to chronic pain conditions such as rheumatoid arthritis (RA). We examined how both marital status and marital adjustment were related to pain, physical disability, and psychological disability in 255 adults with RA. Among married participants (n = 158), better marital adjustment (assessed using the Locke-Wallace Marital Adjustment Scale) was correlated with less pain and physical and psychological disability (all P values < .05). Married participants were divided into distressed (n = 44) and nondistressed (n = 114) subgroups and compared with unmarried participants (n = 97). Controlling for demographics and disease severity, unmarried participants had higher affective pain (P = .009) and higher psychological disability (P = .02) than only the nondistressed married participants, but unmarried participants did not differ from distressed married participants. These findings suggest that being married in itself is not associated with better health in RA but that being in a well-adjusted or nondistressed marriage is linked with less pain and better functioning.

PERSPECTIVE

This study examined relationships of marital status and marital adjustment to pain and physical and psychological disability in RA. Findings underscore the importance of considering not only marital status but also degree of marital adjustment in RA and may inform clinical interventions in this population.

[The demographic policy on the regional level]

The study and assessment of demographic processes in the Republic of Bashkortostan during 1984-2008 was implemented. During the examined period, the decrease of marriage rate, the increase of divorce rate and mortality rate accompanied with the decrease of birth rate. From 2001, the positive trend is noted, especially in the area of marriage rate increase. However, the instability of the divorce rate index continues to persist. The important demographic target is to proceed with the reduction of reproductive losses, primarily at the expense of the decrease of the postneonatal losses and mortinatality.

Who intermarries in Britain? Explaining ethnic diversity in intermarriage patterns

This paper investigates trends, patterns and determinants of intermarriage (and partnership) comparing patterns among men and women and among different ethnic groups in Britain. We distinguish between endogamous (co-ethnic), majority/minority and minority/minority marriages. Hypotheses are derived from the theoretical literatures on assimilation, segmented assimilation and opportunity structures. The empirical analysis is based on the 1988-2006 General Household Surveys (N = 115,494). Consistent with assimilation theory we find that, for all ethnic minority groups, the propensity to intermarry is higher in the second generation than in the first. Consistent with ideas drawn from segmented assimilation theory, we also find that substantial differences in propensity to form majority/minority marriages persist after controls for individual characteristics such as age, educational level, generation and length of residence in Britain, with men and women of Indian, Pakistani or Bangladeshi background having higher propensities to form endogamous partnerships. However, we also find that opportunity structures affect intermarriage propensities for all groups alike, with individuals in more diverse residential areas (as measured by the ratio of majority to minority residents in the area) having higher likelihood to form majority/minority partnerships. We conclude then that, beginning from very different starting points, all groups, both minority and the majority groups exhibit common patterns of generational change and response to opportunity structures. Even the groups that are believed to have the strongest community structures and the strongest norms supporting endogamy appear to be experiencing increasing exogamy in the second generation and in more diverse residential settings. This suggests that a weak rather than a strong version of segmented assimilation provides the best account of British patterns.

Evolution in health and medicine Sackler colloquium: Consanguinity, human evolution, and complex diseases

There is little information on inbreeding during the critical early years of human existence. However, given the small founding group sizes and restricted mate choices it seems inevitable that intrafamilial reproduction occurred and the resultant levels of inbreeding would have been substantial. Currently, couples related as second cousins or closer (F >or= 0.0156) and their progeny account for an estimated 10.4% of the global population. The highest rates of consanguineous marriage occur in north and sub-Saharan Africa, the Middle East, and west, central, and south Asia. In these regions even couples who regard themselves as unrelated may exhibit high levels of homozygosity, because marriage within clan, tribe, caste, or biraderi boundaries has been a long-established tradition. Mortality in first-cousin progeny is approximately 3.5% higher than in nonconsanguineous offspring, although demographic, social, and economic factors can significantly influence the outcome. Improving socioeconomic conditions and better access to health care will impact the effects of consanguinity, with a shift from infant and childhood mortality to extended morbidity. At the same time, a range of primarily social factors, including urbanization, improved female education, and smaller family sizes indicate that the global prevalence of consanguineous unions will decline. This shift in marriage patterns will initially result in decreased homozygosity, accompanied by a reduction in the expression of recessive single-gene disorders. Although the roles of common and rare gene variants in the etiology of complex disease remain contentious, it would be expected that declining consanguinity would also be reflected in reduced prevalence of complex diseases, especially in population isolates.

Who marries and when? Age at first marriage in the United States: 2002

During the latter half of the 20th century, there were notable increases in the age at first marriage among Americans and related increases in the proportion of unmarried and never-married adults. Research finds that, in comparison with unmarried persons, married persons tend to exhibit greater physical, emotional, and economic wellbeing, although the association may vary by outcome, sex, and other factors. Children in households with two married parents differ from those in other types of households on measures such as child achievement, but the causal processes are complex. Given the potential benefits of marriage, concerns over a decline in marriage have prompted a great deal of attention as well as investment in marriage promotion programs, such as the Department of Health and Human Services' Healthy Marriage Initiative. This report highlights what we know about the incidence and timing of first marriage among women and men 15-44 years of age in the United States, based on data from the National Survey of Family Growth (NSFG) conducted in 2002.