1
|
Segawa HK, Uematsu H, Dorji N, Wangdi U, Dorjee C, Yangchen P, Kunisawa S, Sakamoto R, Imanaka Y. Gender with marital status, cultural differences, and vulnerability to hypertension: Findings from the national survey for noncommunicable disease risk factors and mental health using WHO STEPS in Bhutan. PLoS One 2021; 16:e0256811. [PMID: 34464428 PMCID: PMC8407566 DOI: 10.1371/journal.pone.0256811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 08/17/2021] [Indexed: 11/19/2022] Open
Abstract
Cardiovascular disease is the leading cause of death in the Kingdom of Bhutan. Thus, the early detection and prevention of hypertension is critical for reducing cardiovascular disease. However, the influence of sociocultural factors on vulnerability to hypertension needs further investigation. This study performed secondary data analysis on 1,909 individuals in a cross-sectional study (the National survey for noncommunicable disease risk factors and mental health using World Health Organization (WHO) STEPS approach in Bhutan- 2014). Multivariate logistic regression demonstrated a significant association between gender with marital status and hypertension. Women had a higher odds ratio than men (Ref) when married (AOR: 1.27, 95% confidence intervals (CI): 1.23-1.31), and when separated, divorced, or widowed (AOR: 1.18, 95% CI: 1.12-1.26). People who speak the Tshanglakha language scored the highest odds (AOR: 1.24, 95% CI: 1.20-1.27), followed by Lhotshamkha (AOR: 1.09, 95% CI: 1.06-1.12) and Dzongkha (Ref) after adjusting for various social and biomedical factors. Additionally, tobacco use displayed decreased odds for hypertension. To promote the early detection and prevention of hypertension, these cultural factors should be considered even within small geographic areas, such as Bhutan. It is necessary to strengthen hypertension preventive strategies for people who speak Tshanglakha and Lhotshamkha. Furthermore, careful consideration should be given to preventing hypertension among adults aged 40 years or more, women who are married, separated, divorced, or widowed, and men who never married in Bhutan.
Collapse
Affiliation(s)
- Hiromi Kohori Segawa
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan
- Kokoro Research Center, Kyoto University, Kyoto City, Kyoto, Japan
| | - Hironori Uematsu
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan
| | - Nidup Dorji
- Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Kingdom of Bhutan
| | - Ugyen Wangdi
- Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Kingdom of Bhutan
| | - Chencho Dorjee
- Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Kingdom of Bhutan
| | - Pemba Yangchen
- Department of Non-Communicable Disease, Ministry of Health in Bhutan, Thimphu, Kingdom of Bhutan
| | - Susumu Kunisawa
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan
| | - Ryota Sakamoto
- Centre for Southeast Asian Studies, Kyoto University, Kyoto City, Kyoto, Japan
| | - Yuichi Imanaka
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan
- * E-mail:
| |
Collapse
|
2
|
Zaki SA, Naous J, Ghanem A, Abou Abbas D, Tomb R, Ghosn J, Assi A. Prevalence of STIs, sexual practices and substance use among 2083 sexually active unmarried women in Lebanon. Sci Rep 2021; 11:9855. [PMID: 33972604 PMCID: PMC8110545 DOI: 10.1038/s41598-021-89258-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 04/21/2021] [Indexed: 11/13/2022] Open
Abstract
Access to sexual and reproductive health in conservative communities and in the MENA region are particularly limited and, as such, increase women's vulnerability to unwanted pregnancies, unsafe abortions, and sexually transmitted infections (STIs). The aim was to assess the prevalence of STIs, sexual practices, recreational drug-use and their possible associations among cisgender unmarried women residing in Lebanon. Data on demographics, sexual practices and substance-use were collected from 2083 unmarried cisgender women who voluntarily attended a sexual health clinic in Lebanon between 2015 and 2019. They tested for HIV, Hepatitis B, Hepatitis C and Syphilis through rapid testing. Other infections (genital warts, Neisseria gonorrhea/Chlamydia trachomatis) were screened for. Regression models were computed between variables. There were two cases of HIV, one of Hepatitis B and syphilis, and no cases of Hepatitis C. Genital warts were present in 15% and symptoms indicative of Neisseria gonorrhea/Chlamydia trachomatis in 14%. Inconsistent condom-use (81%) was significantly associated with number of partners (adj. OR: 0.4). Inconsistent condom-use discussion with partners (33%) was significantly associated with unemployment (adj OR: 1.7), recreational drug-use (adj. OR: 1.4), and number of partners (adj. ORs 3.7-4.4). Unwanted pregnancies (11%) were significantly associated with age (adj. ORs 0.1-0.37), recreational drug-use (adj. OR: 2), using intrauterine device (adj. OR:2.9) and natural birth control methods (adj. OR: 2.4). Recreational drug-use (33%) was significantly associated with age (adj ORs 1.9-2.2), and smoking status (adj. OR: 0.6). The results indicate an urgent need for: (1) Accessible, non-stigmatizing, and inclusive sexual health services dedicated to women's sexual health; (2) Comprehensive and non-stigmatizing sexual health education for all, but especially women, in order to promote safer sexual practices and effective decision making with regards to contraception and condom-use.
Collapse
Affiliation(s)
| | - Jihane Naous
- Marsa Sexual Health Center, Beirut, Lebanon
- Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Antoine Ghanem
- Marsa Sexual Health Center, Beirut, Lebanon
- Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon
| | | | - Roland Tomb
- Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon
| | - Jade Ghosn
- Service des Maladies Infectieuses et Tropicales, AP-HP Nord, Hôpital Bichat - Claude Bernard, Paris, France
- INSERM IAME - UMR 1137, Université de Paris, Paris, France
- Faculté de Médecine Site Paris Nord, Université de Paris, Paris, France
| | - Ayman Assi
- Marsa Sexual Health Center, Beirut, Lebanon.
- Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon.
| |
Collapse
|
3
|
Crawford EE, Atchison CJ, Ajayi YP, Doyle AM. Modern contraceptive use among unmarried girls aged 15-19 years in South Western Nigeria: results from a cross-sectional baseline survey for the Adolescent 360 (A360) impact evaluation. Reprod Health 2021; 18:6. [PMID: 33407604 PMCID: PMC7789376 DOI: 10.1186/s12978-020-01056-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 12/09/2020] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Adolescents 360 (A360) is an initiative being rolled out across Nigeria with the aim of increasing voluntary modern contraception use among women aged 15 to 19 years. Using evaluation study baseline data, we identified sexuality, fertility and contraceptive use characteristics of young unmarried girls in South Western Nigeria. METHODS A cross-sectional baseline survey of unmarried girls aged 15 to 19 years was conducted in Ogun state, Nigeria in August 2017. A clustered sampling design was used. We identified determinants of modern contraceptive use in this subpopulation using logistic regression. RESULTS Of 12,024 women interviewed, 15.3% reported sexual intercourse in the past year. The majority of respondents (79.6%, 9525/11,967) had heard of contraception. 45.3% of sexually active respondents were using a modern contraceptive method. Of those using any method of contraception, male condoms (50.3%) were the most widely used modern method followed by the emergency contraceptive pill (16.7%). Following adjustment for socio-demographic characteristics, there was evidence that the use of modern contraception was positively associated with having never given birth, living in an urban area, current enrolment in education, high level of education, high socioeconomic status, exposure to information about contraception, perceived social support for contraception, and self-efficacy for contraception. CONCLUSIONS In South Western Nigeria, unmarried sexually active adolescent girls have relatively low levels of modern contraceptive use. Programmes should aim to increase access to modern contraception and to increase social support and acceptability of contraceptive use.
Collapse
Affiliation(s)
- Emily E. Crawford
- Binomial Optimus Limited, Blue Hill, PLOT 538 Natasha Akpoti Street Kado, Abuja, FCT Nigeria
| | - Christina J. Atchison
- Imperial College London, School of Public Health, St Mary’s Hospital, Norfolk Place, London, W2 1PG UK
| | - Yewande P. Ajayi
- Binomial Optimus Limited, Blue Hill, PLOT 538 Natasha Akpoti Street Kado, Abuja, FCT Nigeria
| | - Aoife M. Doyle
- MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT UK
| |
Collapse
|
4
|
Tomono M, Yamauchi T, Suka M, Yanagisawa H. Impact of overtime working and social interaction on the deterioration of mental well-being among full-time workers during the COVID-19 pandemic in Japan: Focusing on social isolation by household composition. J Occup Health 2021; 63:e12254. [PMID: 34302306 PMCID: PMC8302453 DOI: 10.1002/1348-9585.12254] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/22/2021] [Accepted: 06/30/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The coronavirus disease (COVID-19) pandemic has forced many employees to alter both their work style and lifestyle. This study aimed to examine how the combination of changes in overtime working hours and social interaction affects the full-time employees' mental well-being, focusing on the difference in household composition. METHODS In November 2020, we conducted a cross-sectional Internet survey that included 4388 Japanese men and women aged 25-64 years, who continued the same full-time job during the pandemic. We performed a logistic regression analysis using a combination of the changes in overtime working hours and social interaction as an independent variable, and the presence/absence of deterioration of mental well-being as the dependent variable. RESULTS Overall, 44% of participants reported the deterioration of mental well-being compared to before the outbreak. The multivariate analysis revealed that the participants coded as "increased overtime/decreased interaction" were significantly associated with the deterioration of mental well-being compared to those with "unchanged overtime/unchanged interaction" (odds ratio [OR] 2.14, 95% confidence interval [CI] 1.59-2.89). Moreover, this association was relatively stronger among single-person households (OR 2.66, 95% CI 1.50-4.69). CONCLUSIONS The negative combination of increasing overtime working hours and decreasing social interaction may have an impact on the deterioration of mental well-being during the COVID-19 pandemic, and this association was comparably strong among single-person households. In the pandemic, it is necessary to pay close attention to both overtime working hours and the presence of social interaction to address the mental well-being among employees.
Collapse
Affiliation(s)
- Misa Tomono
- Department of Public Health and Environmental MedicineThe Jikei University School of MedicineTokyoJapan
| | - Takashi Yamauchi
- Department of Public Health and Environmental MedicineThe Jikei University School of MedicineTokyoJapan
| | - Machi Suka
- Department of Public Health and Environmental MedicineThe Jikei University School of MedicineTokyoJapan
| | | |
Collapse
|
5
|
Zhang M, Anglewicz P, VanLandingham M. Migration and sexual partnerships among unmarried young men in Thailand: a longitudinal approach. Int J Public Health 2020; 65:1681-1688. [PMID: 33033850 PMCID: PMC7718348 DOI: 10.1007/s00038-020-01491-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/16/2020] [Accepted: 09/20/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Migrants typically report more sexual behavior than non-migrants. In existing work, the potentially confounding effects of selection loom large. Our objective is to discern whether migrants actually do engage in more sexual activity than their non-migrating counterparts, once selection is accounted for. METHODS We used three waves of data from a longitudinal panel study in Thailand. Panel members were rural unmarried men, some of whom subsequently migrated to urban areas and were re-interviewed there. Migrants were compared to their non-migrant counterparts and to a separate sample of long-term urban dwellers. RESULTS There were no differences between eventual migrants and non-migrant counterparts in sexual partnerships before migration. Migration increased sexual partnerships with stable partners and strangers, compared with rural non-migrants. CONCLUSIONS Unmarried men who moved to urban areas had increased sexual partnerships with stable partners and strangers. Without proper means of protection, this pattern of behavior puts these men and their sexual partners at elevated risk of unwanted pregnancy and sexually transmitted infections (STIs). Public health programs should target unmarried male migrants for pregnancy control and STI prevention.
Collapse
Affiliation(s)
- Mengxi Zhang
- Department of Nutrition and Health Science, Ball State University College of Health, Muncie, IN, USA.
| | - Philip Anglewicz
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mark VanLandingham
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health, New Orleans, LA, USA
| |
Collapse
|
6
|
Abstract
In China, suicide accounts for twenty-six percent of all suicides worldwide; however, researches on the suicidal ideation among older people living alone in the rural region are few. We performed a cross-sectional study to explore the prevalence and influence factors of suicidal ideation, and provide a theoretical basis for suicide prevention among older people living alone in rural region.695 older people living alone in rural region were selected by using stratified cluster sampling. Chi-square for categorical variables, T-test for continuous variables, and path analysis were conducted to statistical analysis.The prevalence of suicidal ideation among the elderly living alone in rural China was 23.6%. Path analyses showed that depression had the most substantial influence on suicidal ideation among the elderly living alone, it was also as a mediator between physical, economic status, social support, anxiety, and suicidal ideation; anxiety and social support had both direct and indirect influence on suicidal ideation; physical status and economic status had indirection impact.The incidence of suicidal ideation among the elderly living alone was high in Dangtu county. Psychological disorders (anxiety and depression) had the strongest impact on suicidal ideation. Strategies and measures targeting these relevant factors (economic status, physical status, and social support) should be taken to reduce the burdens of suicidal ideation among the elderly living alone in China.
Collapse
Affiliation(s)
- Caiyun Hu
- Department of Scientific Research, The First Affiliated Hospital of Anhui Chinese Medical University, Heffei
| | - Dongdong Zhao
- The First Affiliated Hospital of Anhui Medical University, Hefei
| | - Fengfeng Gong
- Medical department, Fuyang Hospital of Anhui Medical University, Fuyang
| | - Yuanyuan Zhao
- The Fifth Sanatorium for Retired Cadres, Anhui Provincial Military Region, Hefei
| | - Jie Li
- School of Public Health, Anhui Medical University, Hefei
| | - Yehuan Sun
- School of Public Health, Anhui Medical University, Hefei
| |
Collapse
|
7
|
Zueras P, Rutigliano R, Trias-Llimós S. Marital status, living arrangements, and mortality in middle and older age in Europe. Int J Public Health 2020; 65:627-636. [PMID: 32350551 PMCID: PMC7360666 DOI: 10.1007/s00038-020-01371-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 04/02/2020] [Accepted: 04/06/2020] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES We study the role of marital status and living arrangements in mortality among a 50+ population living in Europe by gender and welfare states. METHODS Using data from waves 4, 5, and 6 of the Survey of Health Age and Retirement in Europe (n = 54,171), we implemented Cox proportional hazard models by gender and age groups (50-64 and 65-84). We estimated pooled models and separated models for two regions representing different welfare states (South-East and North-West). RESULTS Among people aged 50-64, nonpartnered individuals (except never-married women) showed a higher mortality risk as compared with those partnered. Among the older population (65-84), divorce was associated with higher mortality among men, but not among women, and living with someone other than a partner was associated with higher mortality risk as compared to those partnered. In the South-East region living with a partner at ages 50-64 was associated with lower mortality. CONCLUSIONS Partnership and residential status are complementary for understanding the role of family dimensions in mortality. The presence of a partner is mortality protective, especially among 50-64-year-old men in South-East Europe.
Collapse
Affiliation(s)
- Pilar Zueras
- Centre d’Estudis Demogràfics (a Member of the CERCA Programme/Generalitat de Catalunya), Barcelona, Spain
| | - Roberta Rutigliano
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
| | - Sergi Trias-Llimós
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| |
Collapse
|
8
|
Abstract
Historically, the family planning practices and needs of married women have been monitored and reported uniformly. However, the same uniformity does not hold for unmarried women. Because key data and information platforms employ different measurement approaches-namely, different definitions of sexual recency-reports of contraceptive prevalence and unmet need among unmarried women are inconsistent. We examine how the measurement approaches employed by 3 large organizations yield such divergent estimates. We find that contraceptive prevalence and unmet need estimates among married women do not vary much by sexual recency. For unmarried women, contraceptive prevalence is systematically lower and unmet need is systematically higher as the sexual recency window widens. In the short term, we recommend using the 1-month cutoff as analyses reveal it yields the most precise estimates for better recognizing the needs of this important demographic group.
Collapse
Affiliation(s)
| | - Apoorva Jadhav
- United States Agency for International Development, Washington, DC, USA
| |
Collapse
|
9
|
Koman PD, Romo F, Swinton P, Mentz GB, de Majo RF, Sampson NR, Battaglia MJ, Hill-Knott K, Williams GO, O'Neill MS, Schulz AJ. MI-Environment: Geospatial patterns and inequality of relative heat stress vulnerability in Michigan. Health Place 2019; 60:102228. [PMID: 31654921 PMCID: PMC6944282 DOI: 10.1016/j.healthplace.2019.102228] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 09/16/2019] [Accepted: 09/20/2019] [Indexed: 10/25/2022]
Abstract
Heat stress causes morbidity and mortality and is increasing with climate change. Heat stress can pose particular challenges in northern regions not well adapted to heat. To assist decision makers, we identified the relative vulnerability of census tracts within Michigan to factors that increase exposure to heat stress or reflect susceptibilities in the population based on a California heat vulnerability index. In the MI-Environment assessment, we used a Geographic Information System (GIS) to combine future ensemble climate model projections to create a total of 9 geospatial and demographic variables. As part of a broader planned cumulative environmental exposure assessment, the statewide heat vulnerability index (HVI) maps display the location and relative magnitude of exposure on three metrics: built environment (Place), future expected long-term temperature averages (Temperature), and population susceptibility (People). We observed varied and distinct patterns for each of the three component indices. We assessed how equitably those exposures are distributed by racial and socioeconomic factors. This analysis showed that each of the component indices and the aggregate HVI are disproportionately distributed along racial and socioeconomic lines in Michigan. Census tracts with higher percentages of people of color had larger exposure to HVI factors with a deviation from equity of -0.115 [95% CI -0.108, -0.122]. Similarly, for census tracts with higher percentage of people experiencing poverty, the deviation from equity was -0.101 [95% CI -0.094, -0.107]. The MI-Environment visualization tool can help communities prepare for climate change and resolve inequities by identifying census tracts with the most vulnerable residents and highest potential exposures.
Collapse
Affiliation(s)
- Patricia D Koman
- University of Michigan School of Public Health, Environmental Health Sciences Department, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| | - Frank Romo
- University of Michigan Taubman College of Architecture and Urban Planning, 2000 Bonisteel Blvd, Ann Arbor, MI, 48109, USA.
| | - Peter Swinton
- University of Michigan Taubman College of Architecture and Urban Planning, 2000 Bonisteel Blvd, Ann Arbor, MI, 48109, USA.
| | - Graciela B Mentz
- University of Michigan School of Public Health, Department of Health Behavior and Health Education, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| | - Ricardo F de Majo
- University of Michigan School of Public Health, Department of Health Behavior and Health Education, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| | - Natalie R Sampson
- University of Michigan -Dearborn, Department of Health & Human Services, 19000 Hubbard Drive, Fairlane Center South, Dearborn, MI, 48126, USA.
| | - Michael J Battaglia
- Michigan Technological Research Institute, Michigan Technological University, 3600 Green Road, Suite 100, Ann Arbor, MI, 48105, USA.
| | - Kimberly Hill-Knott
- Detroiters Working for Environmental Justice, 4750 Woodward Ave, Detroit, MI, 48201, USA.
| | - Guy O Williams
- Detroiters Working for Environmental Justice, 4750 Woodward Ave, Detroit, MI, 48201, USA.
| | - Marie S O'Neill
- University of Michigan School of Public Health, Department of Epidemiology and Environmental Health Sciences Department, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| | - Amy J Schulz
- University of Michigan School of Public Health, Department of Health Behavior and Health Education, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| |
Collapse
|
10
|
Zhou Z, Verdery AM, Margolis R. No Spouse, No Son, No Daughter, No Kin in Contemporary China: Prevalence, Correlates, and Differences in Economic Support. J Gerontol B Psychol Sci Soc Sci 2019; 74:1453-1462. [PMID: 29688560 PMCID: PMC6777770 DOI: 10.1093/geronb/gby051] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 04/21/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES China's recent demographic and social changes might undermine the sustainability of its family-oriented system for elder care. We investigate kin availability among adults aged 45+ in contemporary China, with an emphasis on child gender. METHOD Using nationally representative survey data from the China Health and Retirement Longitudinal Study (2011), we examine the prevalence and correlates of lacking different kin types and combinations, and we test associations between kin availability and received economic support. RESULTS Kinlessness is low in China (less than 2% lack a spouse/partner and children), but kin availability is patterned by gender, age group, and sociodemographic characteristics. More than twice as many older adults have no spouse/partner and no daughter (3.2%) as those who have no spouse/partner and no son (1.4%). Adults without close kin are disadvantaged across health, wealth, and economic support. In contrast to traditional expectations, we find that those with only daughters are more similar to those with mixed sex children, whereas those with only sons are more similar to those without children in receipt of economic support. DISCUSSION Access to kin forms the basis of an emergent system of stratification in China, which will be amplified as cohorts with only one child age into older adulthood.
Collapse
Affiliation(s)
- Zhangjun Zhou
- Department of Sociology and Criminology, The Pennsylvania State University, University Park
| | - Ashton M Verdery
- Department of Sociology and Criminology, The Pennsylvania State University, University Park
| | - Rachel Margolis
- Department of Sociology, The University of Western Ontario, London, Canada
| |
Collapse
|
11
|
Li X, Curran M, Paschall K, Barnett M, Kopystynska O. Pregnancy intentions and family functioning among low-income, unmarried couples: Person-centered analyses. J Fam Psychol 2019; 33:830-840. [PMID: 31219271 DOI: 10.1037/fam0000547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Guided by family systems theory and using 2-wave data from 4,843 low-income, unmarried couples in the Building Strong Families study, we examined paths from paternal and maternal pregnancy intentions to family functioning in personal, relationship, and coparenting domains. Using 3-step Latent Class Analysis, we first identified 3 subgroups of couples based on both parents' pregnancy intentions: Both Wanted/Both On-time (33.8%), Both Wanted/Both Mistimed (56.1%), and Women Wanted/Both Mistimed (10.1%). We then examined how family functioning varied across these 3 classes. We found that fathers and mothers in the Women Wanted/Both Mistimed class experienced the lowest levels of family functioning. Mothers in the Both Wanted/Both On-time class reported higher family functioning than mothers in the Both Wanted/Both Mistimed class, whereas few differences were identified between fathers in the Both Wanted/Both On-time class and the Both Wanted/Both Mistimed class. We discussed implications for families transitioning to parenthood of this nuanced understanding of associations between pregnancy intentions and family functioning. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Collapse
Affiliation(s)
- Xiaomin Li
- Department of Family Studies and Human Development
| | | | | | | | | |
Collapse
|
12
|
Yang X, Jing W, Gao C, Attané I. Smoking behavior of "marriage squeezed" men and its impact on their quality of life: A survey study in China. Am J Mens Health 2019; 13:1557988319859733. [PMID: 31221046 PMCID: PMC6589983 DOI: 10.1177/1557988319859733] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 05/19/2019] [Accepted: 05/22/2019] [Indexed: 12/01/2022] Open
Abstract
From the 1980s, along with the wide application of the "one-child policy" and new technologies for prenatal sex determination, China's population has experienced a growing male population. China will thus face an increasingly serious male "marriage squeeze," possibly resulting in decreased psychological and sexual well-being of involuntary bachelors, which, in turn, may result in decreased quality of life (QoL). This study used data from the Social Survey on Gender Role and Family Life, which was conducted from August 2014 to January 2015 in Shaanxi Province (N = 1,144; 516 never-married and 628 married rural men). Descriptive analyses, crosstab analyses, and independent sample t-tests were used to compare the scores of three dimensions of QoL (physical and psychological health, and social relationships) and the overall QoL of rural men. Using the linear regression analysis method, this study analyzed involuntary bachelors' smoking behavior and its impact on their QoL. Results indicate that smoking not only fails to alleviate the psychological or sexual problems of involuntary bachelors, it has an independent and negative impact on the physical and psychological health of married and never-married men, which negatively affects their overall QoL. Subjective and objective exposure to marriage squeeze negatively impacts three dimensions of QoL and overall QoL of married and never-married men; however, this influence was moderated by sexual satisfaction. In addition, sexual satisfaction positively affected the three dimensions of QoL and overall QoL of married and never-married men. Since involuntary bachelors may be a high-risk group, further research is warranted.
Collapse
Affiliation(s)
- Xueyan Yang
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi Province, People’s Republic of China
| | - Wen Jing
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi Province, People’s Republic of China
- ShaanXi Provincial Party School of The CPC, Xi’an, Shaanxi Province, People’s Republic of China
| | - Chenzhuo Gao
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi Province, People’s Republic of China
| | - Isabelle Attané
- French National Institute for Demographic Studies, INED, Paris, France
| |
Collapse
|
13
|
Tur-Sinai A, Magnezi R, Grinvald-Fogel H. Assessing the determinants of healthcare expenditures in single-person households. Isr J Health Policy Res 2018; 7:48. [PMID: 30318017 PMCID: PMC6191996 DOI: 10.1186/s13584-018-0246-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 08/06/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The study documents a direct relationship between individuals' health and patterns of healthcare expenditure by isolating single-person households and creating a new reference group in which household healthcare expenditure is based on one person's expenditure patterns in accordance with his or her own state of health. METHOD The study matched two surveys using Propensity Score Matching based on single-person household, age, and gender. Structural Equation Modeling (SEM) explores paths of relation between the population's income and socioeconomic level and its health self-assessment and expenditure. RESULTS Single-person households' health expenditure increases with age and the differences in most expenditure categories are significant. The current study looks into the direct and indirect effects of income, gender, and SES on health insurance and other out-of-pocket health expenses among single-person households. A direct link exists between income, gender, and socioeconomic status (SES) and several aspects of health expenditure, depending on the specific age group. The indirect effects are attested via health status assessment, in which a negative correlation is found between self-assessed health status and various health-expenditure categories. CONCLUSIONS The last-mentioned result may support the general perception that single-person households who feel that they are doing better than their near-equals enjoy better health. This line of inquiry yields a better examination of how a single-person household's state of health affects expenditure patterns without assuming ab initio that expenditure patterns attest to state of health.
Collapse
Affiliation(s)
- Aviad Tur-Sinai
- Department of Health Systems Management, The Max Stern Yezreel Valley College, Yezreel Valley, Israel
| | - Racheli Magnezi
- Department of Management, Faculty of Social Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Haya Grinvald-Fogel
- Department of Management, Faculty of Social Sciences, Bar-Ilan University, Ramat Gan, Israel
| |
Collapse
|
14
|
Abstract
INTRODUCTION Institutional care has been strongly promoted in China to meet seniors' long-term care needs. Empty-nest elderly, in comparison with their counterparts, have less social support and fewer caring networks. This study aimed to compare the utilisation willingness for institutional care and its predictors between empty-nest and non-empty-nest seniors. METHODS A total of 3923 seniors were included in the analysis. Binary logistic regression models were used to understand the association between the living arrangements of the elderly households and willingness for institutional care and to identify the predictors of the utilisation willingness for institutional care among empty nesters and non-empty nesters. RESULTS Our study found that approximately 8.5% of the seniors had a willingness for institutional care in Shandong, China. Empty-nest singles (OR 5.301; 95% CI 2.838 to 9.904) and empty-nest couples (OR 1.547; 95% CI 1.135 to 2.107) were found to be more willing to receive institutional care. Our results also showed that residence was a key determinant for institutionalisation willingness in empty-nest and non-empty-nest elderly. Among empty-nest singles, psychological stress was a positive determinant for institutional care. Factors, including education attainment, relationship with adult children, household income and per capita living space, were determinants for empty-nest couple willingness for institutionalisation. Age, number of children and self-reported health status were found to be associated factors for willingness among non-empty nesters. CONCLUSIONS The government should pay more attention to institutional care in rural areas where there is still a gap in elder care compared with that in urban areas. Targeted policies should be made for different types of seniors to offer appropriate institutional care.
Collapse
Affiliation(s)
- Yangyang Qian
- School of Public Health, Shandong University, Jinan, China
| | - Wen Qin
- Shandong University Hospital, Shandong University, Jinan, Shandong, China
| | - Chengchao Zhou
- School of Public Health, Shandong University, Jinan, China
- Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Dandan Ge
- School of Public Health, Shandong University, Jinan, China
| | - Li Zhang
- School of Public Health, Shandong University, Jinan, China
| | - Long Sun
- School of Public Health, Shandong University, Jinan, China
| |
Collapse
|
15
|
Sommerlad A, Ruegger J, Singh-Manoux A, Lewis G, Livingston G. Marriage and risk of dementia: systematic review and meta-analysis of observational studies. J Neurol Neurosurg Psychiatry 2018; 89:231-238. [PMID: 29183957 PMCID: PMC5869449 DOI: 10.1136/jnnp-2017-316274] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 07/25/2017] [Accepted: 08/30/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Being married is associated with healthier lifestyle behaviours and lower mortality and may reduce risk for dementia due to life-course factors. We conducted a systematic review and meta-analysis of studies of the association between marital status and the risk of developing dementia. METHODS We searched medical databases and contacted experts in the field for relevant studies reporting the relationship, adjusted for age and sex, between marital status and dementia. We rated methodological quality and conducted random-effects meta-analyses to summarise relative risks of being widowed, divorced or lifelong single, compared with being married. Secondary stratified analyses with meta-regression examined the impact of clinical and social context and study methodology on findings. RESULTS We included 15 studies with 812 047 participants. Compared with those who are married, lifelong single (relative risk=1.42 (95% CI 1.07 to 1.90)) and widowed (1.20 (1.02 to 1.41)) people have elevated risk of dementia. We did not find an association in divorced people.Further analyses showed that less education partially confounds the risk in widowhood and worse physical health the elevated risk in lifelong single people. Compared with studies that used clinical registers for ascertaining dementia diagnoses, those which clinically examined all participants found higher risk for being unmarried. CONCLUSIONS Being married is associated with reduced risk of dementia than widowed and lifelong single people, who are also underdiagnosed in routine clinical practice. Dementia prevention in unmarried people should focus on education and physical health and should consider the possible effect of social engagement as a modifiable risk factor.
Collapse
Affiliation(s)
- Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | | | - Archana Singh-Manoux
- INSERM U 1018, Epidemiology of Ageing and Age-Related Diseases, Villejuif, France
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| |
Collapse
|
16
|
Aguilar-Velázquez DG, González-Castro TB, Tovilla-Zárate CA, Juárez-Rojop IE, López-Narváez ML, Frésan A, Hernández-Díaz Y, Guzmán-Priego CG. Gender differences of suicides in children and adolescents: Analysis of 167 suicides in a Mexican population from 2003 to 2013. Psychiatry Res 2017; 258:83-87. [PMID: 28992550 DOI: 10.1016/j.psychres.2017.09.083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 07/12/2017] [Accepted: 09/27/2017] [Indexed: 12/26/2022]
Abstract
Suicide is the second cause of death in youth population. The aim of the present study was to analyze demographic characteristics and suicide methods used, as well as to identify gender differences among Mexican children and adolescents (aged 10-17 years) that committed suicide. Between January 2003 and December 2013, 167 suicides of children and adolescents between 10 and 17 years of age were documented by the Secretary of Health of the state of Tabasco, Mexico. All sociodemographic characteristics were compared according to gender. Our sample included 67.7% males and 32.3% females (male to female 2.1:1). The predominant marital status was single (89.6%) and hanging (93.7%) was the principal method of suicide used. Both female and male adolescents were predominantly students (50%); however, female adolescents were more frequently married (17%) and were housewives (26.4%). Our results identified that hanging is the principal suicide method used by children and adolescents in Mexican population; we also detected main gender differences in terms of poisoning/drug toxicity as the method used, occupation and marital status. These results should be taken into consideration when designing suicide prevention programs due to the differences found by gender.
Collapse
Affiliation(s)
| | - Thelma Beatriz González-Castro
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Jalpa de Méndez, Jalpa de Méndez, Tabasco, Mexico
| | - Carlos Alfonso Tovilla-Zárate
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Comalcalco, Comalcalco, Tabasco, Mexico.
| | - Isela E Juárez-Rojop
- Universidad Juárez Autónoma de Tabasco, División Académica de Ciencias de la Salud, Villahermosa, Tabasco, Mexico
| | | | - Ana Frésan
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Yazmin Hernández-Díaz
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Jalpa de Méndez, Jalpa de Méndez, Tabasco, Mexico
| | | |
Collapse
|
17
|
Amoyaw JA, Luginaah I. Residential Spaces and Timing of First Sexual Intercourse Among Never-Married Youths in Nigeria. Arch Sex Behav 2017; 46:1939-1948. [PMID: 27457473 DOI: 10.1007/s10508-016-0803-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 05/26/2016] [Accepted: 06/28/2016] [Indexed: 06/06/2023]
Abstract
Youths in sub-Saharan Africa who initiate sex at an early age tend to be more vulnerable to HIV/AIDS and other sexually transmitted diseases because of the lack of accurate knowledge of preventive behaviors. Although sociocultural and economic factors associated with sexual initiation among youths have been studied extensively in Nigeria, little is known about the effect of place-based factors. Rural and urban disparities remain high in Nigeria, and these disparities are reinforced by stark regional inequalities between the north and south. Considering these underlying inequalities, we examined the extent to which rural and urban youths in northern and southern Nigeria differ with regard to the timing of sexual initiation using the 2013 Nigerian Demographic and Health Survey. Results from our event history analyses suggest that never-married male and female youths who lived in the urban north delayed their first sexual intercourse compared with their counterparts in the rural north, but those who lived in the rural south had their first sex earlier. Young males who lived in the urban south also experienced their first sex earlier than their counterparts in the rural north. Surprisingly, educated youths and those who had accurate knowledge about HIV/AIDS transmission experienced their first sex early. Clearly, the timing of sexual initiation among youths varies across different spatial and cultural contexts. Therefore, interventions aimed at discouraging early sexual initiation among young people in Nigeria may need to go beyond merely providing health information and services to addressing the livelihood needs of youths, especially those in rural settings.
Collapse
Affiliation(s)
- Jonathan Anim Amoyaw
- Department of Sociology, University of Western Ontario, Room 5333, Social Science Centre, London, ON, N6A 5C2, Canada.
| | - Isaac Luginaah
- Department of Geography, University of Western Ontario, Social Science Centre, London, ON, Canada
| |
Collapse
|
18
|
Haupert ML, Gesselman AN, Moors AC, Fisher HE, Garcia JR. Prevalence of Experiences With Consensual Nonmonogamous Relationships: Findings From Two National Samples of Single Americans. J Sex Marital Ther 2017; 43:424-440. [PMID: 27096488 DOI: 10.1080/0092623x.2016.1178675] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Although academic and popular interest in consensual nonmonogamy (CNM) is increasing, little is known about the prevalence of CNM. Using two separate U.S. Census based quota samples of single adults in the United States (Study 1: n = 3,905; Study 2: n = 4,813), the present studies show that more than one in five (21.9% in Study 1; 21.2% in Study 2) participants report engaging in CNM at some point in their lifetime. This proportion remained constant across age, education level, income, religion, region, political affiliation, and race, but varied with gender and sexual orientation. Specifically, men (compared to women) and people who identify as gay, lesbian, or bisexual (compared to those who identify as heterosexual) were more likely to report previous engagement in CNM. These findings suggest that a sizable and diverse proportion of U.S. adults have experienced CNM, highlighting the need to incorporate CNM into theoretical and empirical therapy and family science work.
Collapse
Affiliation(s)
- M L Haupert
- a Department of Psychological and Brain Sciences , Indiana University , Bloomington , Indiana , USA
- b The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University , Bloomington , Indiana , USA
| | - Amanda N Gesselman
- b The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University , Bloomington , Indiana , USA
| | - Amy C Moors
- c Department of Women's Studies and National Center for Institutional Diversity, University of Michigan , Ann Arbor , Michigan , USA
| | - Helen E Fisher
- b The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University , Bloomington , Indiana , USA
- d Department of Anthropology , Rutgers University , New Brunswick , New Jersey , USA
| | - Justin R Garcia
- b The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University , Bloomington , Indiana , USA
- e Department of Gender Studies , Indiana University , Bloomington , Indiana , USA
| |
Collapse
|
19
|
Abstract
The establishment of a legal father for children of unmarried parents reflects both high paternity confidence and male willingness to commit to paternal investment. Whether an unmarried man voluntarily acknowledges paternity after a child is born has important consequences for both the mother and child. This paper brings to bear a life history perspective on paternity establishment, noting that men face trade-offs between mating and parental effort and that women will adjust their investment in children based on expected male investment. I predict that paternity establishment will be more likely when the mother has high socioeconomic status, when maternal health is good, and when the child is male, low parity, or a singleton (versus multiple) birth. I further predict that establishment of paternity will be associated with increased maternal investment in offspring, resulting in healthier babies with higher birthweights who are more likely to be breastfed. These predictions are tested using data on 5.4 million births in the United States from 2009 through 2013. Overall the results are consistent with the hypothesis that the trade-offs men face between reproductive and parental investment influence whether men voluntarily acknowledge paternity when a child is born.
Collapse
Affiliation(s)
- Kermyt G Anderson
- Department of Anthropology, University of Oklahoma, 521 Dale Hall Tower, 455 West Lindsey, Norman, OK, 73131, USA.
| |
Collapse
|
20
|
Simpson JL, Cohen RA. The Association of Marital Status and Offers of Employer-based Health Insurance for Employed Women Aged 27-64: United States, 2014-2015. NCHS Data Brief 2017:1-8. [PMID: 28135187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Data from the National Health Interview Survey •Among employed women aged 27-64, unmarried women (72.2%) were more likely than married women (69.3%) to have been offered health insurance by their employer. •Among employed married women aged 27-64, 16.8% were offered health insurance only through their spouse's employer. •Considering all offers of health insurance (through a woman's employer or her spouse's employer), employed married women aged 27-64 (86.1%) were more likely than employed unmarried women (72.2%) to have had an employer offer of health insurance. •Regardless of educational attainment, and for most income and racial groups, employed married women aged 27-64 were more likely than employed unmarried women to have been offered health insurance by their employer or their spouse's employer. In 2015, women were less likely than men to have been insured through their own employer and more likely to have been covered as a dependent (1). This report describes the association of marital status and the presence of employer-based health insurance offers among employed women in the United States. Analyses are limited to women aged 27-64 to exclude offers associated with parental employment for those under age 27. An offer of employer-based health insurance includes offers by the woman's employer or her spouse's employer. The presence of an offer does not indicate offer take up.
Collapse
|
21
|
Abstract
We consider the intersection between two striking U.S. trends: dramatic increases in the imprisonment of fathers and increases in the proportion of mothers who have children with more than one partner (multiple-partner fertility, or MPF). Using matched longitudinal administrative data that provide unusually comprehensive and accurate information about the occurrence and timing of imprisonment, fertility, and MPF for the population of the state of Wisconsin, we consider the relationship between paternal imprisonment and MPF among unwed mothers. Employing discrete-time event history analysis with multinomial logistic regression, we model the occurrence and timing of the mother's second birth, distinguishing between a birth with the same father and a birth with a different father, and distinguishing between current imprisonment and a history of imprisonment. We find that current imprisonment is associated with an increased likelihood of MPF and a decreased likelihood of fertility with the same father (compared with no additional birth) and that a history of imprisonment is associated with increased MPF in some models but not in our preferred model. To control for unobserved heterogeneity among mothers and assess the evidence of a causal effect of fathers' imprisonment, we also employ the case-time-control method, a fixed-effects method for the analysis of nonrepeated events. Results suggest that fathers' current imprisonment may increase mothers' MPF. Policy implications are discussed.
Collapse
Affiliation(s)
- Maria Cancian
- Institute for Research on Poverty, La Follette School of Public Affairs, and School of Social Work, University of Wisconsin–Madison, 1180 Observatory Drive, Madison, WI 53706 USA
| | - Yiyoon Chung
- Department of Public Administration and Management, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029 South Korea
| | - Daniel R. Meyer
- Institute for Research on Poverty and School of Social Work, University of Wisconsin–Madison, 1180 Observatory Drive, Madison, WI 53706 USA
| |
Collapse
|
22
|
Mard S, Nielsen FE. Single living predicts a higher mortality in both women and men with chronic heart failure. Dan Med J 2016; 63:A5268. [PMID: 27585529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION We examined the impact of single living on all-cause mortality in patients with chronic heart failure and determined if this association was modified by gender. METHODS This historical cohort study included 637 patients who were admitted to the Department of Cardiology, Herlev Hospital, Denmark, between 1 July 2005 and 30 June 2007. Baseline clinical data were obtained from patient records. Data on survival rates were obtained from the Danish Civil Registration System. Cox proportional hazard analysis was used to compute the hazard ratio (HR) of all-cause mortality, controlling for confounding factors. RESULTS The median follow-up time was 2.8 years. A total of 323 (50.7%) patients died during the follow-up period. After adjustment for confounding factors, risk of death was associated with being single (HR = 1.53 (95% confidence interval: 1.19-1.96)). In a gender-stratified analysis, the risk of death did not differ among single-living women and men. CONCLUSION Single living is a prognostic determinant of all-cause mortality in men and women with chronic heart failure. FUNDING none. TRIAL REGISTRATION not relevant.
Collapse
|
23
|
Aubry T, Duhoux A, Klodawsky F, Ecker J, Hay E. A Longitudinal Study of Predictors of Housing Stability, Housing Quality, and Mental Health Functioning Among Single Homeless Individuals Staying in Emergency Shelters. Am J Community Psychol 2016; 58:123-135. [PMID: 27473922 DOI: 10.1002/ajcp.12067] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The current study examined risk and resilience factors at multiple levels that affect homeless individuals' ability to exit homelessness and achieve housing stability. It also examined the relationship between housing status, housing quality and mental health functioning. The methodology is a longitudinal study of single homeless individuals staying in emergency shelters in a medium-sized Canadian city who were followed for a 2 year period. Data were collected from participants at a baseline interview when they were homeless and at a 2-year follow-up. There were 329 participants interviewed at baseline and 197 (59.9%) participants interviewed at follow-up. Results from a structural equation modelling analysis found that having interpersonal and community resources were predictive of achieving housing stability. Specifically, having a larger social support network, access to subsidized housing, and greater income was related to achieving housing stability. On the other hand, having a substance use problem was a risk factor associated with a failure to achieving housing stability. Being female, feeling personally empowered, having housing that is perceived of being of higher quality were directly predictive of mental health functioning at follow-up. Findings are discussed in the context of previous research and their policy implications.
Collapse
Affiliation(s)
- Tim Aubry
- School of Psychology, Centre for Research on Educational and Community Services, University of Ottawa, Ottawa, ON, Canada.
| | - Arnaud Duhoux
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - Fran Klodawsky
- Department of Geography and Environmental Studies, Carleton University, Ottawa, ON, Canada
| | - John Ecker
- School of Psychology, Centre for Research on Educational and Community Services, University of Ottawa, Ottawa, ON, Canada
| | - Elizabeth Hay
- School of Psychology, Centre for Research on Educational and Community Services, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
24
|
Abstract
This analysis examined suicide rates by age, sex, and marital status in England and Wales for the period 1982–1996. Never married, widowed, and divorced people had higher rates of suicide than those who were married, for both sexes. Among the widowed ages 20–39 years, both sexes had the highest rate, and the rate decreased with age. The suicide rate for divorced people was similar to those who had never married, except for the younger group ages 20–29 years. The male:female ratios for the relative suicide risk for never married, widowed, and divorced to married for both sexes were statistically significantly different for older adults. The decrease in suicide rates observed for the period 1982–1996 in England and Wales was mainly attributable to the reduction of suicide rates among the widowed and divorced.
Collapse
Affiliation(s)
- Paul S Yip
- Hong Kong Jockey Club, Centre for Suicide Research and Prevention, University of Hong Kong, Pokfulam Road, Hong Kong, SAR.
| | | |
Collapse
|
25
|
Cavanagh B, Ibrahim S, Roscoe A, Bickley H, While D, Windfuhr K, Appleby L, Kapur N. The timing of general population and patient suicide in England, 1997-2012. J Affect Disord 2016; 197:175-81. [PMID: 26994435 DOI: 10.1016/j.jad.2016.02.055] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/29/2016] [Accepted: 02/26/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND There have been conflicting findings on temporal variation in suicide risk and few have examined the phenomenon in clinical populations. The study investigated seasonal and other temporal patterns using national data. METHODS Data on 73,591 general population and 19,318 patient suicide deaths in England between 1997 and 2012 were collected through the National Confidential Inquiry into Suicide examining suicide rates in relation to month of the year, day of the week, and individual days of national or religious significance. RESULTS Suicide incidence fell over successive months of the year and there was evidence of an overall spring peak. Monday was associated with the highest suicide rates and in the patient population this effect appeared to be more pronounced in those aged over 50 or those who lived alone. Suicide risk was significantly lower during Christmas, particularly for women. There was a peak in suicide on New Year's Day in the general population. Other 'special days' were not associated with a change in suicide incidence. LIMITATIONS We were limited to identifying associations between the variables investigated and were unable to explore causal mechanisms. We did not carry out comprehensive multi-variable adjustment in our regression models. CONCLUSIONS There is substantial seasonal and temporal variation in suicide deaths, and there appears to be some evidence in the clinical as well as the general population in England. Clinical services should be aware of the risk of suicide just after the weekend, especially in people who live alone, and the potential need for closer supervision during this period.
Collapse
Affiliation(s)
| | - Saied Ibrahim
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK.
| | - Alison Roscoe
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK
| | - Harriet Bickley
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK
| | - David While
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK
| | - Kirsten Windfuhr
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK
| | - Louis Appleby
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK
| | - Nav Kapur
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK; Manchester Mental Health and Social Care Trust, Manchester, UK
| |
Collapse
|
26
|
Turner AJ, Nikolova S, Sutton M. The effect of living alone on the costs and benefits of surgery amongst older people. Soc Sci Med 2015; 150:95-103. [PMID: 26741271 DOI: 10.1016/j.socscimed.2015.11.053] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 11/26/2015] [Accepted: 11/27/2015] [Indexed: 11/18/2022]
Abstract
Older people who live alone are a growing, high-cost group for health and social services. The literature on how living alone affects health and the costs and benefits of healthcare has focused on crude measures of health and utilisation and gives little consideration to other cost determinants and aspects of patient experience. We study the effect of living alone at each stage along an entire treatment pathway using a large dataset which provides information on pre-treatment experience, treatment benefits and costs of surgery for 105,843 patients receiving elective hip and knee replacements in England in 2009 and 2010. We find that patients who live alone are healthier prior to treatment and experience the same gains from treatment. However, living alone is associated with a 9.2% longer length of in-hospital stay and increased probabilities of readmission and discharge to expensive destinations. These increase the costs per patient by £179.88 (3.12%) and amount to an additional £4.9 million per annum. A lack of post-discharge support for those living alone is likely to be a key driver of these additional costs.
Collapse
Affiliation(s)
- Alex J Turner
- Manchester Centre for Health Economics, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
| | - Silviya Nikolova
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, Charles Thackrah Building, 101 Clarendon Road, Leeds, LS2 9LJ, UK.
| | - Matt Sutton
- Manchester Centre for Health Economics, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
| |
Collapse
|
27
|
Abstract
BACKGROUND Environmental factors such as urban birth and ethnic minority position have been related to risk for psychotic disorders. There is some evidence that not only individual, but also neighborhood characteristics influence this risk. The aim of this study was to investigate social disorganization of neighborhoods and incidence of psychotic disorders. METHOD The research was a 7-year first-contact incidence study of psychotic disorders in The Hague. Neighborhood characteristics included continuous, dichotomous and cumulative measures of socio-economic level, residential mobility, ethnic diversity, proportion of single person households, voter turnout, population density and crime level. Using multilevel Poisson regression analysis, incidence rate ratios (IRRs) and 95% confidence intervals (CIs) of psychotic disorders were calculated for the indicators of neighborhood social disorganization. RESULTS A total of 618 incident cases were identified. Neighborhood socio-economic level and residential mobility had the strongest association with incidence of psychotic disorders [individual-level adjusted Wald χ2 1 = 13.03 (p = 0.0003) and 5.51 (p = 0.02), respectively]. All but one (proportion of single person households) of the dichotomous neighborhood indicators were significantly associated with a higher IRR. The cumulative degree of neighborhood social disorganization was strongly and linearly associated with the incidence of psychotic disorders (trend test, Wald χ2 5 = 25.76, p = 0.0001). The IRR in neighborhoods with the highest degree of social disorganization was 1.95 (95% CI 1.38-2.75) compared with the lowest disorganization category. CONCLUSIONS The findings suggest that the risk for developing a psychotic disorder is higher for people living in socially disorganized environments. Longitudinal studies are needed to investigate causality.
Collapse
Affiliation(s)
- W Veling
- Parnassia Psychiatric Institute,The Hague,The Netherlands
| | - E Susser
- Department of Epidemiology,Mailman School of Public Health, Columbia University,New York,NY,USA
| | - J-P Selten
- Department of Psychiatry and Neuropsychology,Maastricht University,Maastricht,The Netherlands
| | - H W Hoek
- Parnassia Psychiatric Institute,The Hague,The Netherlands
| |
Collapse
|
28
|
Okigbo CC, Speizer IS. Determinants of Sexual Activity and Pregnancy among Unmarried Young Women in Urban Kenya: A Cross-Sectional Study. PLoS One 2015; 10:e0129286. [PMID: 26047505 PMCID: PMC4457813 DOI: 10.1371/journal.pone.0129286] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 05/06/2015] [Indexed: 12/01/2022] Open
Abstract
Objectives With age of marriage rising in Kenya, the period between onset of puberty and first marriage has increased, resulting in higher rates of premarital sexual activity and pregnancy. We assessed the determinants of sexual activity and pregnancy among young unmarried women in urban Kenya. Methods Baseline data from five urban areas in Kenya (Nairobi, Mombasa, Kisumu, Machakos, and Kakamega) collected in 2010 by the Measurement, Learning & Evaluation project were used. Women aged 15-24 years, who had never been married, and were not living with a male partner at the time of survey (weighted n=2020) were included. Using weighted, multivariate Cox proportional hazard regression and logistic regression analyses, we assessed factors associated with three outcome measures: time to first sex, time to first pregnancy, and teenage pregnancy. Results One-half of our sample had ever had sex; the mean age at first sex among the sexually-experienced was 17.7 (± 2.6) years. About 15% had ever been pregnant; mean age at first pregnancy was 18.3 (±2.2) years. Approximately 11% had a teenage pregnancy. Three-quarters (76%) of those who had ever been pregnant (weighted n=306) reported the pregnancy was unwanted at the time. Having secondary education was associated with a later time to first sex and first pregnancy. In addition, religion, religiosity, and employment status were associated with time to first sex while city of residence, household size, characteristics of household head, family planning knowledge and misconceptions, and early sexual debut were significantly associated with time to first pregnancy. Education, city of residence, household wealth, early sexual debut, and contraceptive use at sexual debut were associated with teenage pregnancy for those 20-24 years. Conclusion Understanding risk and protective factors of youth sexual and reproductive health can inform programs to improve young people’s long-term potential by avoiding early and unintended pregnancies.
Collapse
Affiliation(s)
- Chinelo C. Okigbo
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Measurement, Learning, and Evaluation Project, Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, United States of America
- * E-mail:
| | - Ilene S. Speizer
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Measurement, Learning, and Evaluation Project, Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, United States of America
| |
Collapse
|
29
|
Zain NM, Low WY, Othman S. FACTORS ASSOCIATED WITH PREGNANCY AMONG UNMARRIED WOMEN IN MALAYSIA. Southeast Asian J Trop Med Public Health 2015; 46:526-538. [PMID: 26521527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Pregnancy among unmarried women may have negative social and health implications in Malaysia. The number of pregnancies among unmarried women has increased in Malaysia, but the socio-demographic profile of these women is unclear. This study aims to evaluate the characteristics of unmarried pregnant women and the factors associated with unmarried pregnancies among young women in Malaysia. We conducted a cross sectional study at six hospitals and six women's shelters in Peninsular Malaysia during 2011-2012. Unmarried pregnant women were compared with married pregnant women. Participants were interviewed using a structured questionnaire asking for socio-demographic data, family background, risky sexual behavior, social support and pregnancy details. A total of 484 women (239 unmarried and 245 married) were included in the study. Most unmarried subjects were adolescents, from urban areas, from a low socioeconomic group, and lived with parents prior to pregnancy. Age (OR=0.67; 95% CI: 0.61-0.74), studying status (OR=17.33; 95% CI: 2.65-113.19), alcohol use (OR=40.46; 95% CI: 2.51-652.38) exposure to pornographic material (OR=13.48; 95% CI: 3.24-56.01), contraceptive use (OR=0.20; 95% CI: 0.08-0.51), and social support (OR=0.90; 95% CI: 0.86-0.94) were all associated with unmarried pregnancy. These factors need to be considered when.designing an intervention program.
Collapse
|
30
|
Levitz NR, Haji-Jama S, Munro T, Gorey KM, Luginaah IN, Bartfay E, Zou G, Wright FC, Kanjeekal SM, Hamm C, Balagurusamy MK, Holowaty EJ. Multiplicative disadvantage of being an unmarried and inadequately insured woman living in poverty with colon cancer: historical cohort exploration in California. BMC Womens Health 2015; 15:8. [PMID: 25783640 PMCID: PMC4333264 DOI: 10.1186/s12905-015-0166-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 01/20/2015] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Many Americans diagnosed with colon cancer do not receive indicated chemotherapy. Certain unmarried women may be particularly disadvantaged. A 3-way interaction of the multiplicative disadvantages of being an unmarried and inadequately insured woman living in poverty was explored. METHODS California registry data were analyzed for 2,319 women diagnosed with stage II to IV colon cancer between 1996 and 2000 and followed until 2014. Socioeconomic data from the 2000 census classified neighborhoods as high poverty (≥30% of households poor), middle (5-29%) or low poverty (<5% poor). Primary health insurance was private, Medicare, Medicaid or none. Comparisons of chemotherapy rates used standardized rate ratios (RR). We respectively used logistic and Cox regression models to assess chemotherapy and survival. RESULTS A statistically significant 3-way marital status by health insurance by poverty interaction effect on chemotherapy receipt was observed. Chemotherapy rates did not differ between unmarried (39.0%) and married (39.7%) women who lived in lower poverty neighborhoods and were privately insured. But unmarried women (27.3%) were 26% less likely to receive chemotherapy than were married women (37.1%, RR = 0.74, 95% CI 0.58, 0.95) who lived in high poverty neighborhoods and were publicly insured or uninsured. When this interaction and the main effects of health insurance, poverty and chemotherapy were accounted for, survival did not differ by marital status. CONCLUSIONS The multiplicative barrier to colon cancer care that results from being inadequately insured and living in poverty is worse for unmarried than married women. Poverty is more prevalent among unmarried women and they have fewer assets so they are probably less able to absorb the indirect and direct, but uncovered, costs of colon cancer care. There seem to be structural inequities related to the institutions of marriage, work and health care that particularly disadvantage unmarried women that policy makers ought to be cognizant of as future reforms of the American health care system are considered.
Collapse
Affiliation(s)
- Naomi R Levitz
- />School of Social Work, University of Windsor, Windsor, Ontario Canada
| | - Sundus Haji-Jama
- />Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| | - Tonya Munro
- />School of Social Work, University of Windsor, Windsor, Canada
| | - Kevin M Gorey
- />School of Social Work, University of Windsor, Windsor, Canada
| | - Isaac N Luginaah
- />Department of Geography, Western University, London, Ontario Canada
| | - Emma Bartfay
- />Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario Canada
| | - Guangyong Zou
- />Department of Epidemiology and Biostatistics, and Robarts Research Institute, Western University, London, Ontario Canada
| | - Frances C Wright
- />Division of General Surgery, Sunnybrook Health Sciences Center and Departments of Surgery and Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario Canada
| | - Sindu M Kanjeekal
- />Medical Oncology Department, Windsor Regional Cancer Center, Windsor, Ontario Canada
| | - Caroline Hamm
- />Medical Oncology Department, Windsor Regional Cancer Center and School of Medicine and Dentistry, Department of Oncology, Western University, London, Canada
| | | | - Eric J Holowaty
- />Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| |
Collapse
|
31
|
Greiner MA, Qualls LG, Iwata I, White HK, Molony SL, Sullivan MT, Burke B, Schulman KA, Setoguchi S. Predicting nursing home placement among home- and community-based services program participants. Am J Manag Care 2014; 20:e535-e536. [PMID: 25741870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Several states offer publicly funded-care management programs to prevent long-term care placement of high-risk Medicaid beneficiaries. Understanding participant risk factors and services that may prevent long-term care placement can facilitate efficient allocation of program resources. OBJECTIVES To develop a practical prediction model to identify participants in a home- and community-based services program who are at highest risk for long-term nursing home placement, and to examine participant-level and program-level predictors of nursing home placement. STUDY DESIGN In a retrospective observational study, we used deidentified data for participants in the Connecticut Home Care Program for Elders who completed an annual assessment survey between 2005 and 2010. METHODS We analyzed data on patient characteristics, use of program services, and short-term facility admissions in the previous year. We used logistic regression models with random effects to predict nursing home placement. The main outcome measures were long-term nursing home placement within 180 days or 1 year of assessment. RESULTS Among 10,975 study participants, 1249 (11.4%) had nursing home placement within 1 year of annual assessment. Risk factors included Alzheimer's disease (odds ratio [OR], 1.30; 95% CI, 1.18-1.43), money management dependency (OR, 1.33; 95% CI, 1.18-1.51), living alone (OR, 1.53; 95% CI, 1.31-1.80), and number of prior short-term skilled nursing facility stays (OR, 1.46; 95% CI, 1.31-1.62). Use of a personal care assistance service was associated with 46% lower odds of nursing home placement. The model C statistic was 0.76 in the validation cohort. CONCLUSIONS A model using information from a home- and community-based service program had strong discrimination to predict risk of long-term nursing home placement and can be used to identify high-risk participants for targeted interventions.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Soko Setoguchi
- Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715. E-mail:
| |
Collapse
|
32
|
Sagtani RA, Bhattarai S, Adhikari BR, Baral DD, Yadav DK, Pokharel PK. Understanding socio economic contexts of female sex workers in eastern Nepal. Nepal Med Coll J 2014; 16:119-124. [PMID: 26930727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The present focus is mostly laid on high risk behavior of commercial sex workers without any consideration of their location, educational status and other socio-cultural norms. Thus, we designed a study to understand socio demographic characteristics, lifestyle of female sex workers and search for driving factors for prostitution in eastern Nepal. A descriptive study was conducted in three districts of Eastern Nepal in 2012 over the period of six months. The data regarding their socio demographic characteristics, income, reason for joining sex trade and future choice regarding the profession were recorded from 210 female sex workers through face-to-face interviews. Majority (53.3%) of respondents belonged to the productive age group of 20-29 years, more than one thirds (43.3%) had not received any form of formal education and were unmarried. More than half (53.80%) were presently living alone and about one thirds of the women (31.90%) were minors when they joined this profession. Major portion of the sample (94.80%) worked more than three days a week with median income of 15 thousand per month and 41 percent had sex with more than or equal to ten clients per week. Poor economic condition was the most frequent (47.6%) factor leading to joining of sex trade however, more than two thirds, (72.80%) wanted to quit the profession. Given low level of education, relatively low income, and young age among this population, empowerment and alternative employment/education opportunities should be created to develop this part of Nepalese society.
Collapse
|
33
|
Wong LP, Atefi N, Majid HA, Su TT. Prevalence of pregnancy experiences and contraceptive knowledge among single adults in a low socio-economic suburban community in Kuala Lumpur, Malaysia. BMC Public Health 2014; 14 Suppl 3:S1. [PMID: 25438066 PMCID: PMC4251125 DOI: 10.1186/1471-2458-14-s3-s1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to investigate the prevalence of pregnancy experience and its association with contraceptive knowledge among single adults in a low socio-economic suburban community in Kuala Lumpur, Malaysia. METHODS A cross-sectional survey was conducted in 2012 among the Kerinchi suburban community. Of the total 3,716 individuals surveyed, young single adults between 18 and 35 years old were questioned with regard to their experience with unplanned pregnancy before marriage. Contraceptive knowledge was assessed by a series of questions on identification of method types and the affectivity of condoms for the prevention of sexually transmitted diseases. RESULTS A total of 226 female and 257 male participants completed the survey. In total, eight female (3.5%) participants reported experience with an unplanned pregnancy before marriage, and five male (1.9 %) participants had the experience of impregnating their partners. The participants had a mean total score of 3.15 (SD = 1.55) for contraceptive knowledge out of a possible maximum score of five. Female participants who had experienced an unplanned pregnancy had a significantly lower contraceptive knowledge score (2.10 ± 1.48) than who had never experienced pregnancy (3.30 ± 1.35), p<0.05. Likewise, male participants who had experienced impregnating their partners had a significantly lower contraceptive knowledge score (1.60 ± 1.50) than those who did not have such experience (3.02 ± 1.59), p<0.05. CONCLUSION The results showed evidence of premarital unplanned pregnancy among this suburban community. The low level of contraceptive knowledge found in this study indicates the need for educational strategies designed to improve contraceptive knowledge.
Collapse
Affiliation(s)
- Li Ping Wong
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Narges Atefi
- Department of Nursing, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hazreen Abd Majid
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Tin Tin Su
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
34
|
Abstract
INTRODUCTION Despite recent advances in understanding orgasm variation, little is known about ways in which sexual orientation is associated with men's and women's orgasm occurrence. AIM To assess orgasm occurrence during sexual activity across sexual orientation categories. METHODS Data were collected by Internet questionnaire from 6,151 men and women (ages 21-65+ years) as part of a nationally representative sample of single individuals in the United States. Analyses were restricted to a subsample of 2,850 singles (1,497 men, 1,353 women) who had experienced sexual activity in the past 12 months. MAIN OUTCOME MEASURES Participants reported their sex/gender, self-identified sexual orientation (heterosexual, gay/lesbian, bisexual), and what percentage of the time they experience orgasm when having sex with a familiar partner. RESULTS Mean occurrence rate for experiencing orgasm during sexual activity with a familiar partner was 62.9% among single women and 85.1% among single men, which was significantly different (F1,2848 = 370.6, P < 0.001, η(2) = 0.12). For men, mean occurrence rate of orgasm did not vary by sexual orientation: heterosexual men 85.5%, gay men 84.7%, bisexual men 77.6% (F2,1494 = 2.67, P = 0.07, η(2) = 0.004). For women, however, mean occurrence rate of orgasm varied significantly by sexual orientation: heterosexual women 61.6%, lesbian women 74.7%, bisexual women 58.0% (F2,1350 = 10.95, P < 0.001, η(2) = 0.02). Lesbian women had a significantly higher probability of orgasm than did either heterosexual or bisexual women (P < 0.05). CONCLUSIONS Findings from this large dataset of U.S. singles suggest that women, regardless of sexual orientation, have less predictable, more varied orgasm experiences than do men and that for women, but not men, the likelihood of orgasm varies with sexual orientation. These findings demonstrate the need for further investigations into the comparative sexual experiences and sexual health outcomes of sexual minorities.
Collapse
Affiliation(s)
- Justin R. Garcia
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA
- Department of Gender Studies, Indiana University, Bloomington, IN, USA
| | - Elisabeth A. Lloyd
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA
- Department of History and Philosophy of Science, Indiana University, Bloomington, IN, USA
| | - Kim Wallen
- Department of Psychology and Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
| | - Helen E. Fisher
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA
- Department of Anthropology, Rutgers University, New Brunswick, NJ, USA
| |
Collapse
|
35
|
Abstract
The goal of this study was to explore associations between short- and long-term self-regulation and dimensions of oral and coital sexual risk-taking in emerging adulthood. A total of 287 unmarried heterosexual young adults ages 18 to 26 years (62% female; 87% European American; 81% enrolled in college) provided study data via Internet surveys. High levels of long-term self-regulation predicted later initiation of oral sex and coitus, fewer lifetime coital partners, increased likelihood of condom and other contraceptive use at last intercourse, and low composite levels of coital risk. High levels of short-term self-regulation predicted reduced likelihood of condom use and high overall coital risk. The discussion focuses on the interpretation of these effects and potential directions for future research.
Collapse
Affiliation(s)
- Kristin L Moilanen
- a Department of Learning Sciences and Human Development , West Virginia University
| |
Collapse
|
36
|
Chen Y, Hicks A, While AE. Loneliness and social support of older people living alone in a county of Shanghai, China. Health Soc Care Community 2014; 22:429-438. [PMID: 24621394 DOI: 10.1111/hsc.12099] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/05/2013] [Indexed: 06/03/2023]
Abstract
China has an ageing population with the number of older people living alone increasing. Living alone may increase the risk of loneliness of older people, especially for those in China where collectivism and filial piety are emphasised. Social support may fill the need for social contacts, thereby alleviating loneliness. However, little is known about loneliness and social support of older people living alone in China. This study investigated loneliness and social support of older people living alone, by conducting a cross-sectional questionnaire survey with a stratified random cluster sample of 521 community-dwelling older people living alone in a county of Shanghai. Data were collected from November 2011 to March 2012. The instruments used included the UCLA Loneliness Scale version 3 and the Social Support Rate Scale. The participants reported a moderate level of loneliness. Their overall social support level was low compared with the Chinese norm. Children were the major source of objective and subjective support. Of the participants, 53.9% (n = 281) and 47.6% (n = 248) asked for help and confided when they were in trouble, but 84.1% (n = 438) never or rarely attended social activities. The level of loneliness and social support differed among the participants with different sociodemographic characteristics. There were negative correlations between loneliness and overall social support and its three dimensions. The findings suggest that there is a need to provide more social support to older people living alone to decrease their feelings of loneliness. Potential interventions include encouraging more frequent contacts from children, the development of one-to-one 'befriending' and group activity programmes together with identification of vulnerable subgroups.
Collapse
Affiliation(s)
- Yu Chen
- School of Nursing, Fudan University, Shanghai, China
| | | | | |
Collapse
|
37
|
Kohn JL, Averett SL. The effect of relationship status on health with dynamic health and persistent relationships. J Health Econ 2014; 36:69-83. [PMID: 24769050 DOI: 10.1016/j.jhealeco.2014.03.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 01/28/2014] [Accepted: 03/27/2014] [Indexed: 06/03/2023]
Abstract
The dynamic evolution of health and persistent relationship status pose econometric challenges to disentangling the causal effect of relationships on health from the selection effect of health on relationship choice. Using a new econometric strategy we find that marriage is not universally better for health. Rather, cohabitation benefits the health of men and women over 45, being never married is no worse for health, and only divorce marginally harms the health of younger men. We find strong evidence that unobservable health-related factors can confound estimates. Our method can be applied to other research questions with dynamic dependent and multivariate endogenous variables.
Collapse
Affiliation(s)
- Jennifer L Kohn
- Department of Economics and Business Studies, Drew University, 301 Lewis House, Madison, NJ 07940, United States.
| | - Susan L Averett
- Department of Economics, Lafayette College, Easton, PA 18042, United States.
| |
Collapse
|
38
|
Burdette AM, Haynes SH, Hill TD, Bartkowski JP. Religious variations in perceived infertility and inconsistent contraceptive use among unmarried young adults in the United States. J Adolesc Health 2014; 54:704-9. [PMID: 24388112 DOI: 10.1016/j.jadohealth.2013.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 11/01/2013] [Accepted: 11/04/2013] [Indexed: 11/17/2022]
Abstract
PURPOSE In this paper, we examine associations among personal religiosity, perceived infertility, and inconsistent contraceptive use among unmarried young adults (ages 18-29). METHODS The data for this investigation came from the National Survey of Reproductive and Contraceptive Knowledge (n = 1,695). We used multinomial logistic regression to model perceived infertility, adjusted probabilities to model rationales for perceived infertility, and binary logistic regression to model inconsistent contraceptive use. RESULTS Evangelical Protestants were more likely than non-affiliates to believe that they were infertile. Among the young women who indicated some likelihood of infertility, evangelical Protestants were also more likely than their other Protestant or non-Christian faith counterparts to believe that they were infertile because they had unprotected sex without becoming pregnant. Although evangelical Protestants were more likely to exhibit inconsistent contraception use than non-affiliates, we were unable to attribute any portion of this difference to infertility perceptions. CONCLUSIONS Whereas most studies of religion and health emphasize the salubrious role of personal religiosity, our results suggest that evangelical Protestants may be especially likely to hold misconceptions about their fertility. Because these misconceptions fail to explain higher rates of inconsistent contraception use among evangelical Protestants, additional research is needed to understand the principles and motives of this unique religious community.
Collapse
Affiliation(s)
- Amy M Burdette
- Department of Sociology and Center for Demography & Population Health, Florida State University, Tallahassee, Florida.
| | - Stacy H Haynes
- Department of Sociology, Mississippi State University, Starkville, Mississippi
| | - Terrence D Hill
- Department of Sociology, University of Utah, Salt Lake City, Utah
| | - John P Bartkowski
- Department of Sociology, University of Texas-San Antonio, San Antonio, Texas
| |
Collapse
|
39
|
Rosen G. Determinants of employment: impact of Medicaid and CHIP among unmarried female heads of household with young children. Soc Work Public Health 2014; 29:491-502. [PMID: 25068614 DOI: 10.1080/19371918.2014.884959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This research explores whether participation in Medicaid is a determinant of hours of employment among unmarried parenting female heads of households with at least one child younger than age 6. The measures include Medicaid participation, Children's Health Insurance Program participation, health status, and Medicaid generosity. A multilevel regression was conducted using data from the Current Population Survey 2011 Annual Social and Economic (ASEC) Supplement. The findings indicate that Medicaid participation, health status, and Medicaid generosity all have a significant negative effect on labor force participation when measured by hours of employment per week.
Collapse
Affiliation(s)
- Gina Rosen
- a Luskin School of Public Affairs, University of California-Los Angeles , Los Angeles , California , USA
| |
Collapse
|
40
|
Heianza Y, Arase Y, Kodama S, Hsieh SD, Tsuji H, Saito K, Shimano H, Hara S, Sone H. Association of living alone with the presence of undiagnosed diabetes in Japanese men: the role of modifiable risk factors for diabetes: Toranomon Hospital Health Management Center Study 13 (TOPICS 13). Diabet Med 2013; 30:1355-9. [PMID: 23756249 DOI: 10.1111/dme.12255] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/06/2013] [Indexed: 11/28/2022]
Abstract
AIMS To investigate whether living alone was associated with the presence of undiagnosed diabetes and whether this association could be attenuated by modifiable lifestyle habits. METHODS This cross-sectional study included 6400 Japanese men without a history of diagnosed diabetes. Individuals with currently undiagnosed diabetes were identified through fasting glucose concentration ≥7.0 mmol/l or HbA1c concentration ≥ 48 mmol⁄mol (≥ 6.5%). Effect modification was examined using body mass index, hypertension, history of dyslipidaemia, drinking habits, smoking habits, physical activity, vegetable intake, emotional stress and depressed mood. RESULTS Men who lived alone (n = 1098) had a significantly elevated odds ratio for having undiagnosed diabetes in an age-adjusted model (odds ratio 1.45, 95% CI 1.07, 1.96; P = 0.018). After adjustment for lifestyle factors, the association was slightly attenuated (odds ratio 1.40, 95% CI 1.02, 1.91; P = 0.036). After further adjustment for all factors mentioned above, living alone was still marginally significantly associated with the presence of undiagnosed diabetes (odds ratio 1.38, 95% CI 1.003, 1.90; P = 0.048). A significant association of living alone with the presence of undetected diabetes was particularly observed among men who were overweight, currently smoked and were physically inactive, or had any one of those three factors. CONCLUSIONS The association between undiagnosed diabetes and living alone can be partially influenced by modifiable lifestyle factors. Men who lived alone, especially those who did not engage in favourable lifestyle habits, were more likely to have undiagnosed diabetes. Such individuals have a higher probability of having undetected diabetic hyperglycaemia and would need to undergo glucose tests to identify the disease.
Collapse
Affiliation(s)
- Y Heianza
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata; Health Management Center, Toranomon Hospital, Tokyo; Department of Internal Medicine, University of Tsukuba Institute of Clinical Medicine, Ibaraki
| | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Sakelliadis EI, Vlachodimitropoulos DG, Goutas ND, Panousi PI, Logiopoulou API, Delicha EM, Spiliopoulou CA. Forensic investigation of suicide cases in major Greek correctional facilities. J Forensic Leg Med 2013; 20:953-8. [PMID: 24237797 DOI: 10.1016/j.jflm.2013.08.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 08/20/2013] [Indexed: 11/18/2022]
Abstract
INTRODUCTION According to Greek legislation the medico-legal investigation of deaths occurring in prisons is mandatory. Furthermore, in cases of suicide or of suspected suicide the contribution of medico-legal investigation is of grave importance. The current paper addresses the medico-legal investigation of suicide cases in Greek correctional facilities and aims to describe the current situation. MATERIALS & METHODS Our study consists of the meticulous research in the data records of major Greek correctional facilities, for the time period 1999-2010. Official permission was obtained by the Hellenic Ministry of Justice, which provided us the access to the records. Data was also collected from the Piraeus Forensic Service, from the Department of Pathological Anatomy of the University of Athens and finally from our own records. Measures were taken to respect the anonymity of the cases. Data was collected for the social, penal, medical history as well as for the medico-legal investigation. RESULTS-CONCLUSIONS It appears that 85.7% of suicide cases were transferred to the Prisoner's Hospital (p < 0.0001), the forensic pathologist who conducted the PME did not perform scene investigation in none of the 70 suicide cases. In a total of 70 cases, histopathological examination, was requested only in 30 cases (42.9%). Hanging was the preferred method for those who committed suicide, followed by the poisoning due to psychoactive substances. Understanding the mistakes made during the forensic investigation of suicide cases inside correctional facilities is necessary, in order to prevent them from occurring again in the future, by implementing appropriate new policies and guidelines.
Collapse
Affiliation(s)
- E I Sakelliadis
- Department of Forensic Medicine & Toxicology, Medical Faculty, National & Kapodistrian University of Athens, Mikras Asias 75, Goudi, 11527 Athens, Greece.
| | | | | | | | | | | | | |
Collapse
|
42
|
Abstract
Despite the dramatic rise in U.S. nonmarital childbearing in recent decades, limited attention has been paid to factors affecting nonmarital fatherhood (beyond studies of young fathers). In this article, we use data from the 2002 National Survey of Family Growth and the National Longitudinal Survey of Youth 1979 cohort to examine the antecedents of nonmarital fatherhood, as compared to marital fatherhood. Overall, we find the strongest support across both data sets for education and race/ethnicity as key predictors of having a nonmarital first birth, consistent with prior literature about women's nonmarital childbearing and about men's early/teenage fatherhood. Education is inversely related to the risk of nonmarital fatherhood, and minority (especially black) men are much more likely to have a child outside of marriage than white men. We find little evidence that employment predicts nonmarital fertility, although it does strongly (and positively) predict marital fertility. High predicted earnings are also associated with a greater likelihood of marital childbearing but with a lower likelihood of nonmarital childbearing. Given the socioeconomic disadvantage associated with nonmarital fatherhood, this research suggests that nonmarital fatherhood may be an important aspect of growing U.S. inequality and stratification both within and across generations.
Collapse
Affiliation(s)
- Marcia J. Carlson
- Department of Sociology, Center for Demography and Ecology, and Institute for Research on Poverty, University of Wisconsin–Madison, 1180 Observatory Drive, Madison, WI 53706,
| | - Alicia G. VanOrman
- Department of Sociology and Center for Demography and Ecology, University of Wisconsin–Madison,
| | | |
Collapse
|
43
|
|
44
|
Mkandawire P, Luginaah I, Dixon J, Armah F, Arku G. Circumcision status and time to first sex among never-married young men in Malawi: evidence from the demographic and health survey. AIDS Behav 2013; 17:2123-35. [PMID: 23474595 DOI: 10.1007/s10461-013-0444-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This study examines the association between circumcision status and the timing of first sexual intercourse among adolescents in Malawi. Results of survival models applied to nationally representative sample of never-married young men aged between 15 and 24 obtained from the Demographic and Health Survey data show that being circumcised is associated with earlier initiation of sexual activity in Malawi. Young men who reported being circumcised experienced their first sexual intercourse earlier in life than their uncircumcised counterparts. Although the introduction of theoretically relevant knowledge, socio-cultural, demographic, and socioeconomic variables in the multivariate models attenuated the association between circumcision and earlier sexual initiation, the relationship nonetheless remained robust. The study concludes by discussing the implications of these findings and suggests relevant policy recommendations.
Collapse
Affiliation(s)
- Paul Mkandawire
- Institute of Interdisciplinary Studies, Carleton University, 1125 Colonel By Drive, Ottawa, ON K1S 5B6, Canada.
| | | | | | | | | |
Collapse
|
45
|
Copen CE, Daniels K, Mosher WD. First premarital cohabitation in the United States: 2006-2010 National Survey of Family Growth. Natl Health Stat Report 2013:1-15. [PMID: 24988817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
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.
Collapse
|
46
|
Mariño R, Au-Yeung W, Habibi E, Morgan M. Sociodemographic profile and career decisions of Australian oral health profession students. J Dent Educ 2012; 76:1241-1249. [PMID: 22942421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This study collected and analyzed recent information regarding the sociodemographic profile and career decisions of Australian oral health profession students (earning B.D.Sc. and B.O.H. degrees) and the reasons for their career choice. Data were collected during the 2009-10 academic year via a web-based survey. A total of 829 students participated; the response rates for each oral health course at the seven participating universities ranged from 15.0 percent to 88.7 percent. The respondents had an average age of 21.4 years, ranging from eighteen to fifty-one. The majority of the respondents were female (61.4 percent), single (91.0 percent), and of Asian ethnicity (65.0 percent), and almost half had attended a public secondary school (49.7 percent). Most of the responding students either lived in rented accommodation (44.0 percent) or with their parents (28.6 percent), and 41.5 percent reported having an urban address. Most respondents' fathers (67.2 percent) and mothers (54.8 percent) had completed undergraduate or postgraduate education and were employed in managerial or professional occupations (68.5 percent and 54.9 percent, respectively). Most of the students said they had selected their course in high school (66.8 percent) and were most influenced in their career choice by self-motivation (85.3 percent) and caring for and helping other people (86.6 percent). The majority of the respondents reported wishing to work in a city (51.5 percent), practicing general dentistry (31.8 percent) in either the public or private sector (40.2 percent each). This article provides a preliminary look at the future dental workforce of Australia, identifying issues for further analysis and assisting each university to address current inequalities and challenges.
Collapse
Affiliation(s)
- Rodrigo Mariño
- Melbourne Dental School, University of Melbourne, 720 Swanston St., Parkville, Victoria 3010, Australia.
| | | | | | | |
Collapse
|
47
|
Dempsey AR, Billingsley CC, Savage AH, Korte JE. Predictors of long-acting reversible contraception use among unmarried young adults. Am J Obstet Gynecol 2012; 206:526.e1-5. [PMID: 22425402 DOI: 10.1016/j.ajog.2012.02.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 02/02/2012] [Accepted: 02/21/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The objective of the study was to improve the understanding of long-acting reversible contraception (LARC) use patterns among unmarried, young adults at risk of unintended pregnancy. STUDY DESIGN We performed a secondary data analysis of a national survey conducted by Guttmacher Institute of unmarried women and men aged 18-29 years. LARC is defined as an intrauterine device (IUD) or implant. Predictors of LARC use and IUD knowledge among those at risk for unintended pregnancy (n = 1222) were assessed using χ(2) analysis and logistic regression models. RESULTS LARC use was associated with older age, high IUD knowledge, and earlier onset of sexual activity. Respondents with high IUD knowledge were 6 times more likely to be current LARC users (odds ratio [OR], 6.3; 95% confidence interval [CI], 1.4-28.8). Sociodemographic variables did not predict use. Respondents with lower education (OR, 1.76; 95% CI, 1.0-3.0), an external locus of control (OR, 1.6; 95% CI, 1.1-2.3), male sex (OR, 2.8; 95% CI, 1.9-4.1), and foreign language had less knowledge of IUD. CONCLUSION Increasing knowledge of IUD among certain groups may improve LARC use among young, unmarried adults and in turn decrease unintended pregnancy.
Collapse
Affiliation(s)
- Angela R Dempsey
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC 29425, USA.
| | | | | | | |
Collapse
|
48
|
Abstract
Researchers continue to question fathers' willingness to report their biological children in surveys and the ability of surveys to adequately represent fathers. To address these concerns, this study evaluates the quality of men's fertility data in the 1979 and 1997 cohorts of the National Longitudinal Survey of Youth (NLSY79 and NLSY97) and in the 2002 National Survey of Family Growth (NSFG). Comparing fertility rates in each survey with population rates based on data from Vital Statistics and the U.S. Census Bureau, we document how the incomplete reporting of births in different surveys varies according to men's characteristics, including their age, race, marital status, and birth cohort. In addition, we use Monte Carlo simulations based on the NSFG data to demonstrate how birth underreporting biases associations between early parenthood and its antecedents. We find that in the NSFG, roughly four out of five early births were reported; but in the NLSY79 and NLSY97, almost nine-tenths of early births were reported. In all three surveys, incomplete reporting was especially pronounced for nonmarital births. Our results suggest that the quality of male fertility data is strongly linked to survey design and that it has implications for models of early male fertility.
Collapse
Affiliation(s)
- Kara Joyner
- Department of Sociology, Bowling Green State University, Bowling Green, OH 43403, USA.
| | | | | | | | | | | |
Collapse
|
49
|
Abstract
Never-married persons (singles) constitute a growing demographic group; yet, the magnitude of the all-cause relative mortality risk for nonelderly singles is not known and important moderating factors have not been explored. The authors used meta-analysis to examine 641 risk estimates from 95 publications that provided data on more than 500 million persons. The comparison group consisted of currently married individuals. The mean hazard ratio for mortality was 1.24 (95% confidence interval: 1.19, 1.30) among multivariate-adjusted hazard ratios with a high subjective quality rating. Meta-regressions showed that hazard ratios have been modestly increasing over time for both genders, but have done so somewhat more rapidly for women. The results also showed that the hazard ratio decreased with age and that study quality has an important relation to hazard ratio magnitude.
Collapse
Affiliation(s)
- David J Roelfs
- Department of Sociology, Stony Brook University, New York, USA.
| | | | | | | |
Collapse
|
50
|
Gheorghe A, Banner J, Hansen SH, Stolborg U, Lynnerup N. Abandonment of newborn infants: a Danish forensic medical survey 1997-2008. Forensic Sci Med Pathol 2011; 7:317-21. [PMID: 21706371 DOI: 10.1007/s12024-011-9253-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2011] [Indexed: 11/24/2022]
Abstract
Concealment of pregnancy and newborn infant abandonment are closely associated with neonaticide, the killing of an infant within the first 24 h of life or less than 28-30 days depending on the jurisdiction. Abandonment of newborn infants occurs throughout the world and often the outcome for the infant is death. Together with neonaticide it is felt to be one of the least preventable crimes. In this retrospective study we present all forensically known Danish cases of abandoned newborn infant corpses, covering the period from 1997 to 2008. Eleven newborn infant corpses were found; we registered characteristics of the newborn infants and the circumstances of the cases based on autopsy reports. One further newborn infant was included, dating back to 1992, as it was found to be connected with one of the later cases. The mean age of the women who abandoned their newborn infants was 22 years, and five of the autopsied newborn infants were probably alive when abandoned. In two cases the newborn infants were half siblings and abandoned by the same mother. The time span from abandonment to when the newborn infant was found ranged from hours to 7 years. Two-thirds of the newborn infants were girls (66.6%). The most common means of disposal was in a plastic bag (~60%); only one newborn infant was wearing clothes when found. Causes of death were usually given as asphyxia, brain injury or simply undetermined. Two-thirds of the newborn infants showed signs of violence. None of the newborn infants had congenital malformations.
Collapse
|