Even though South Korea’s universal health care system was established in 1989, many South Koreans continue to encounter obstacles in their attempts to access health care. Previous studies have not investigated the relationship between health care access and utilization and perceived health in the context of a universal health care system that implements a mandatory social health insurance policy. The objective of this study was to evaluate the influence of health care access and use of preventive health care services on self-rated health among young and middle-aged adults in Korea. The sample consisted of 1242 young adults aged 20–39 years and 2389 middle-aged adults aged 40–64 years who had participated in the cross-sectional 2015 Korea National Health and Nutrition Examination Survey. Using multiple logistic regression analysis, the association between health care access and use of preventive health care services and perceived poor health among young adults and middle-aged adults was assessed. The main finding was that a history of unmet health care requirements during the past 12 months was strongly associated with fair and poor self-rated health, especially among young adults. Additionally, middle-aged adults who had attended medical check-ups during the preceding 2 years reported poorer self-rated health. This study’s findings suggest that, despite South Korea’s universal public insurance system, there remains the need to improve access to health care services, especially among young adults. As a health improvement strategy, it is imperative that measures be taken to promote the availability of health care services when they are required and to solve any of the various individual accessibility problems, such as cost, particularly with young adults in mind.

Unintended pregnancy and sexually transmitted infections (STIs) pose a huge public health problem in the United States. Efforts towards reducing unintended pregnancies have previously focused on women, but the role of men in family planning and preventing unwanted pregnancy is becoming clearer. The primary objective of the study was to fully examine the utilization of family planning services by men in the US, and to determine whether factors such as race, health insurance type and number of sexual partners influenced their utilization and receipt of family planning services and STI-related health services. Data were from the 2006–2010 National Survey on Family Growth (NSFG) study conducted in the US. The study sample comprised 7686 men aged 14–44 who ever had sex with women, and who had had at least one sexual partner in the 12 months before the survey. The receipt of family planning and STI-related health services by this group of men was estimated. The results showed that non-Hispanic Black men were more likely to receive family planning and STI-related services than Hispanic and non-Hispanic White males. Given that non-Hispanic Black men are disproportionately affected by STIs and are a high-risk group, the finding that this group received more family planning and STI services is a positive step towards reducing the disproportionately high prevalence of STIs in men in this under-privileged population.

Despite an overall downward trend in child sex ratios in India, some of the most imbalanced districts in 2001 (fewer girls than boys) showed signs of becoming more balanced in 2011. This analysis looked in depth at these districts to better understand the nature of the improvement in the child sex ratio using two rounds of data from the Census of India from 2001 and 2011. Data were used from the 153 districts that showed improvement in their child sex ratio between 2001 and 2011. The improvement was decomposed into: (1) less sex-selective abortion and (2) improved girl compared with boy mortality. Most of the improvement in child sex ratios were shown to be due to reductions in sex-selective abortion, although this still made up the majority of the cause of imbalanced sex ratios in 2011. Child sex ratio improvement has been happening in both rural and urban areas of India, and there is evidence of stagnation in mortality decline for urban girls.

The Trivers–Willard Hypothesis (TWH) states that parents in good conditions bias the sex ratio towards sons and parents in poor conditions bias the sex ratio towards daughters. This study used data from a large nationwide population dataset (N=1,401,851) from the Czech Republic – a modern contemporary society. The study included air pollution and property prices in the TWH estimation, and had a more detailed focus on stillbirths than previous studies. Using official natality microdata from the Czech Statistical Office for years between 1992 and 2010 and data on levels of air pollution in the country over the same period, the study assessed whether the biological and socioeconomic status of mothers and environmental factors affected the sex of children. The results were largely insignificant and not robust across specifications. The presented epidemiological evidence suggests that stillbirths are randomly distributed in the Czech Republic and that the sex ratio is not affected by the socioeconomic status of mothers or by environmental characteristics.

Maternal education plays a central role in children’s health, but there has been little research comparing the role of maternal education across health outcomes. It is important to distinguish child health outcomes from medical care outcomes. Health outcomes such as short-term morbidity and stunting are multifactorial in origin and determined by a range of factors not necessarily under a mother’s control. Mother’s education, given the necessary structural factors such as medical centres, is likely to lead to increased access to, and uptake of, medical services. Using data from the 2004–05 India Human Development Survey, eight separate logistic regressions were carried out on 11,026 women of reproductive age and their last-born child under five years of age. The results showed that maternal education had the strongest association with medical care, immunization (except polio) and iron supplementation for pregnant mothers, moderate association with underweight and weak association with short-term diseases and stunting. In addition, the study investigated whether maternal education impacts child health and medical care outcomes through the intervening roles of empowerment and human, social and cultural capital. These intervening linkages were found to be missing for short-term diseases and stunting, bolstering the argument that the influence of maternal education is limited for these outcomes.

From an evolutionary perspective, childlessness may be considered a failure, as it implies that there will be no direct transmission of one’s genetic material to later generations. It is also a pressing social issue, because in many contemporary advanced societies, levels of childlessness have increased, and particularly so among men. The absence of a partner is naturally a fundamental determinant of childlessness. Empirical evidence on how childlessness relates to individuals’ partnership histories is nevertheless limited. This issue was analysed with Finnish population register data, which allow the complete cohabitation and marriage histories of individuals from age 18 years to be observed. For women and men born between 1969 and 1971, logistic regression models were estimated for childlessness at age 40 by partnership histories in terms of various stages in the process of union formation and dissolution, and accounting for several socioeconomic variables. A strong link between union histories and childlessness was found, with short partnership spells raising the risk of not becoming a parent. Later age when leaving the parental home raised female childlessness, while a short first-union duration related more strongly to male childlessness. These findings may be considered as providing insights into how specific life-history strategies affect reproductive outcomes, and highlight the need to develop new approaches to understand this feature of social inequality.

India is the highest contributor to child anaemia among developing countries. To see the latest picture of child anaemia in India, data for 6- to 59-month-old children were taken from the fourth round of the National Family Health Survey conducted in 2015–16 (NFHS-4). The study sample consisted of 1,37,347 children. The dependent variable was the anaemia status of the child. The objectives of the study were to assess (i) the distribution of anaemia prevalence by child age group, (ii) the prevalence of child anaemia by zone and state and (iii) the relation of child anaemia prevalence with social, demographic and economic variables, including maternal nutritional status and low birth weight. The study found that in India in 2015–16, 56% of 6- to 59-month-old children were anaemic – a decrease of only 13.5 percentage points since the NFHS-3 study conducted in 2005–06. It is well known that iron supplementation is necessary for child growth and brain development. This study suggests that, in addition, the socioeconomic conditions of households in India need to be improved to prevent child anaemia. Low birth weight and low maternal nutritional status are also responsible for the high prevalence of anaemia among children in India.

Associations have been shown between father’s absence and menarcheal age, but most studies have focused on absence resulting from divorce, abandonment or death. Little research has been conducted to evaluate the effect on menarcheal age of paternal absence through migrant work. In a sample of 400 middle school students, this study examined the association between paternal migrant work and menarcheal age against a backdrop of extensive rural-to-urban migration in China. Data were collected through a self-reported questionnaire, including social-demographic characteristics, aspects of family relationships, information about father’s migrant work and age at menarche. After adjusting for BMI, parent marital status and perceived relationship with mother, lower self-perceived quality of father–daughter relationship (both ‘father present, relationship poor’ and ‘father absent, relationship poor’) and lower frequency of contact with the father were associated with higher odds for early menarche. These findings suggest that the assumption that father’s absence for work influences the timing of menarche needs to be examined in the context of the quality of the father–daughter relationship and paternal care, which appear to play a critical role in the timing of menarche. These findings also emphasize the importance of enhancing paternal involvement and improving father–daughter relationships in the development of appropriate reproductive strategy in daughters.

Fertility in West Bengal is one of the lowest in India, and this relies heavily on the use of traditional methods of contraception. Social scientists and demographers have pointed to the historical role of the diffusion process of adhering to a small family size. The Total Fertility Rate (TFR) in Kolkata district, the state capital, is the lowest in the country, and has been a centre of low fertility historically. However, stark differences in rural–urban fertility rates have existed over the last few decades in West Bengal, but these have now started to narrow. This study aimed to capture the macro-level rural–urban differences in fertility levels and preferences in the West Bengal, and understand how socioeconomic factors affect these. Data were drawn from the Census of India (2011) and NFHS-4 (2015–16). Using census data and the Reverse-Surviving Method, the TFR of West Bengal was estimated to be 1.9, varying between 2.1 and 1.7 in rural and urban areas. The rural–urban gap in the district-level fertility rates was prominent, specifically in districts with higher levels of fertility. Kolkata, Hugli and North Twenty-Four Parganas had the lowest-low fertility (TFR = <1.5). Fewer than half of women with only one living child wanted further children, and this was somewhat higher in rural areas. Around 40% of women had achieved their desired number of children. However, a substantial proportion (43.1%) had a lower number of children than desired, varying between 45.9% and 41.7% in urban and rural areas, respectively. Contraception use, female education and age at marriage, along with the other socioeconomic factors, had a greater influence on rural fertility rates than on urban counterparts in the districts of West Bengal. Further research should be directed at understanding the contemporary fertility decline as well as the gap between ideal and desired number of children, specifically in those districts with very low fertility rates.

Age, as a variable, represents a critical basis for demographic classification; thus, its misrepresentations or misreporting alter the accuracy of demographic estimates. This paper examines the extent and pattern of age heaping in the age data for adults, collected in the Nigerian Demographic Health Survey (NDHS). The study used the NDHS data for 2003, 2008, and 2013 to compute a Whipple’s and Meyers’ blended index for each survey year, by gender, geopolitical zones, states and place of residence. The analysis shows that age heaping was higher than the acceptable levels in all three data sets. The Whipple’s index puts the rate of age heaping in the 2003 dataset at 271.3, whilst the rates declined slightly in the 2008 and 2013 datasets to reach 204.2 and 202.5 respectively. Similarly, the Myers’ blended index portrayed that age heaping in the 2003 data was highest at 47.0 while the subsequent years were lower at 38.60 and 38.66, respectively. Digits ending in 0 and 5 were mostly reported in all three surveys and higher rates of age heaping were observed among males, the uneducated and rural dwellers. Age heaping was prominent in all three surveys, thus affecting the data quality gathered at these surveys. Thus, future studies should assess the extent to which age misreporting could bias the estimate of fertility rate.

In Afghanistan, acute respiratory infection (ARI) is a leading cause of under-five mortality. Previous studies on the effects of cooking fuel on ARI have only looked at the types of cooking fuel, and not the effects of the location of the cooking place. The present study aimed to assess the effects of fuel type and place of cooking on the prevalence of ARI among under-five children in Afghanistan. Descriptive statistics and multilevel logistic regression analysis were performed for 31,063 children using data from the first round of the Afghanistan Demographic and Health Survey conducted in 2015. Overall, 13% of the children suffered from ARI symptoms in the 2 weeks before the survey, but this varied widely across the country. The multilevel analysis showed that, compared with households using clean cooking fuel in a separate building or outside, households using clean cooking fuel within the house and without a separate kitchen had a 32% lower risk [95% confidence interval (CI)=0.51–0.91] of having under-five children with ARI, and those using clean fuel in a separate kitchen in the house had a 17% lower risk (95% CI=0.67–1.03). On the other hand, households using polluting cooking fuel in the house without a kitchen had a 14% (95% CI=0.91–1.44) higher risk of having under-five children with ARI, and those using polluting cooking fuel in the house with a separate kitchen had a 5% (95% CI=0.85–1.30) higher risk, after adjusting for other covariates. The findings indicate that type of cooking fuel is not the only issue affecting ARI in children. Place of cooking (in a house with or without a separate kitchen versus outside) also affects the risk of ARI among under-five children. The study also found that mother’s education and occupational status, community poverty and ethnicity are other important factors affecting the prevalence of ARI in under-five children in Afghanistan.

This study sought to establish whether recent changes in discontinuation of contractive use and switching in Egypt can be considered an important cause of the unexpected increase in overall fertility and slight fall in contraceptive prevalence in the country. The analysis was based on calendar data from the 2008 and 2014 Egyptian DHS. Single/multiple decrement life tables were built to calculate contraceptive discontinuation rates and examine these by reasons for discontinuation focusing on three methods: IUDs, pills and injectables. The unit of the analysis was ‘segment of use’, defined as a continuous period of use/non-use of a contraceptive method (in months). It was found that over the period 2008–2014 the rise in the ‘all method’ discontinuation rate was mainly due to the shift away from IUDs to hormonal methods, which have higher discontinuation rates. Segments of use were more likely to be discontinued for ‘method/service-related’ reasons than for ‘reduced need’ reasons. This was due to an increase in contraceptive failure and side-effect/health concerns. Also, ‘the desire to get pregnant’ increased to become the second highest reason-specific discontinuation rate. This has coincided with a recent increase in ideal family size in Egypt. About half of the women who reported discontinuing for reasons related to method/services switched to another method, while the rest became subject to the risk of an unintended pregnancy. The rate of switching, rather than stopping use, increased for IUDs, remained the same for pills and increased slightly for injectables, indicating an improvement in switching behaviour. However, a marked high percentage of switchers moved to less-effective methods. If these issues are not addressed, many women in Egypt have an unmet need for contraception, leading to an increase in unintended pregnancies. Specific interventions that would greatly benefit the family planning programme in Egypt include improvement in counselling at the time of IUD insertion and removal and the reduction in failure rates for hormonal methods.