Social stratification is an important mechanism of human organization that helps to explain health differences between demographic groups commonly associated with socioeconomic gradients. Individuals, or group of individuals, with similar health profiles may have had different stratification experiences. This is particularly true as social stratification is a significant non-measurable source of systematic unobservable differences in both SES indicators and health statuses of disadvantage. The goal of the present study was to expand the bulk of research that has traditionally treated socioeconomic and demographic characteristics as independent, additive influences on health by examining data from the United States. It is hypothesized that variation in an index of multi-system physiological dysregulation – allostatic load – is associated with social differentiation factors, sorting individuals with similar demographic and socioeconomic characteristics into mutually exclusive econo-demographic classes. The data were from the Longitudinal and Biomarker samples of the national Study of Midlife Development in the US (MIDUS) conducted in 1995 and 2004/2006. Latent class analyses and regression analyses revealed that physiological dysregulation linked to socioeconomic variation among black people, females and older adults are associated with forces of stratification that confound socioeconomic and demographic indicators. In the United States, racial stratification of health is intrinsically related to the degree to which black people in general, and black females in particular, as a group, share an isolated status in society. Findings present evidence that disparities in health emerge from group-differentiation processes to the degree that individuals are distinctly exposed to the ecological, political, social, economic and historical contexts in which social stratification is ingrained. Given that health policies and programmes emanate from said legal and political environments, interventions should target the structural conditions that expose different subgroups to different stress risks in the first place.

Female genital mutilation (FGM) has persisted in Nigeria despite the very harmful effects on its victims. Massive inequality in the demographic and socioeconomic status of the Nigerian populace, coupled with marked differences in cultural values, have led to lopsided patterns of most health indicators based on the geographical location. The risk factors of health indicators are equally expected to vary according to location. This study aimed to explain the spatial variations in the risk factors for female cutting in Nigeria. Data were from the geo-referenced 2013 Nigeria Demographic and Health Survey. The objective was to estimate the spatially varying relationships of the factors influencing women’s attitude towards female cutting in Nigeria and to identify how the variables exact influence across the states using geographically weighted logistic regression analysis – a technique that allows for spatially varying relationships among variables to be established. The results showed that women’s higher educational level and higher household wealth lowered the desire for continuation of FGM everywhere in the country, but the effects of most other variables varied in direction, strength and magnitude. The findings suggest the use of local approaches to address the factors that encourage the continuation of female cutting in Nigeria.

The latest National Family Health Survey conducted in 2015–16 (NFHS-4) showed that malnutrition and anaemia still pose huge health challenges in India. Data on 651,642 adult non-pregnant women aged 15–49 years were taken from the survey to study the nutritional and anaemia statuses of adult women by Indian zone and state. The relationships of these two variables with the women’s urban/rural place of residence, education level, religion and eating habits, and wealth index of the family, were assessed. Body Mass Index (BMI) and haemoglobin level were used to assess nutritional status and level of anaemia, respectively. The results show that in 2015–16 in India the percentages of underweight and obese/overweight people were 22.4% and 18.4%, respectively. The percentages of undernutrition and overnutrition were more or less same. The percentage of underweight people was higher in the middle belt region of India. Zones with high levels of overweight or obesity were concentrated in the West, North and South zones. A comparison of the two national-level data sets, i.e. NFHS-4 and NFHS-3, showed that the prevalences of undernutrition and anaemia reduced by 13 and 5 percentage points, respectively, from NFHS-3 to NFHS 4, i.e. over the 10-year period from 2004–05 to 2015–16, whereas overnutrition increased by 4 percentage points during this period. Analysis of possible socio-demographic factors and eating habits thought to influence underweight, obesity and anaemia revealed substantive causal relations. More specifically, education and eating habit were found to influence underweight, overweight or obesity and anaemia significantly. The nutritional status of a woman was also found to depend on household income.

The aim of this study was to examine the effect of economic changes in the Polish territories under Austrian partition at the end of the 19th and the beginning of the 20th centuries on the trend in adult body height, and to examine the effect of number of children in a family, as a socioeconomic factor, on the differences in heights of males and females. Data collected in a 1939 survey for a group of 350 Lemkos living in Polish lands under the Austrian partition were obtained from archive material. Individual data were obtained for body height and number of siblings, to calculate family size. Linear regression analysis confirmed an increase in body height in males by about 1.2 cm per decade over the period 1860 to 1922. The number of children in a family did not appear to influence the mean body height of men and women. The observed positive mean body height trend probably resulted from the improvement in the economic conditions in the Austrian sector over the survey period.

The aim of this cross-sectional study was to investigate beliefs, attitudes and reproductive behaviours in relation to consanguinity in a population living in the backlands of north-eastern Brazil. Data were collected by face-to-face interview from 147 high school students aged 13–20 years and from 532 elderly individuals aged 60 years and over from Brejo dos Santos in the state of Paraíba in 2017. The frequency of consanguineous marriage was found to have increased over the generations, being 15.9% in the parents of the elderly participants, 17.1% in the elderly participants themselves and 20.5% in their descendants. Although 258 (50.9%) of the elderly interviewees opposed consanguineous union, 341 (65.3%) would approve of the marriage of their children with relatives. Both the young (n=108 or 78.3%) and elderly (n=398 or 80.4%) interviewees believed that consanguineous marriages were no more durable than non-consanguineous marriages (p=0.578). Additionally, 408 (82.4%) of the elderly individuals and 108 (80.6%) of the students recognized that spouses in consanguineous unions experience conflicts, just like other couples do (p=0.625). In both groups, the majority of the participants did not believe that consanguinity increased the risk of having children with disabilities. The regression of the two continuous variables ‘age’ and ‘positive attitudes score’ showed a significant correlation, suggesting that younger individuals are more susceptible to the influence of cultural factors contributing to consanguinity, such as the opinions of their parents and grandparents. The belief that consanguineous unions are more durable showed a significant difference between elderly individuals in consanguineous and non-consanguineous unions (p=0.001); the former were 2.42 more likely to believe that marriages between relatives contributes to marriage durability.

In 1893, Frederick Jackson Turner proposed that America’s Western frontier was an economic ‘safety-valve’ – a place where settlers could migrate when conditions in eastern states and Europe crystallized against their upward economic mobility. However, recent studies suggest the Western frontier’s material conditions may not have been as advantageous as Jackson proposed because settlers lacked the knowledge and human capital to succeed on the Plains and Far Western frontier. Using stature, BMI and weight from five late 19th and early 20th century prisons, this study uses 61,276 observations for men between ages 15 and 79 to illustrate that current and cumulative net nutrition on the Great Plains did not deteriorate during the late 19th and early 20th centuries, indicating that recent challenges to the Turner Hypothesis are not well supported by net nutrition studies.

Age at sexual debut is known to have implications for future sexual behaviours and health outcomes, including HIV infection, early pregnancy and maternal mortality, but may also influence educational outcomes. Longitudinal data on schooling and sexual behaviour from a demographic surveillance site in Karonga district, northern Malawi, were analysed for 3153 respondents between the ages of 12 and 25 years to examine the association between sexual debut and primary school dropout, and the role of prior school performance. Time to dropout was modelled using the Fine and Gray survival model to account for the competing event of primary school completion. To deal with the time-varying nature of age at sexual debut and school performance, models were fitted using landmark analyses. Sexual debut was found to be associated with a five-fold increase in rate of subsequent dropout for girls and a two-fold increase in dropout rate for boys (adjusted hazard ratio [aHR] of 5.27, CI 4.22–6.57, and 2.19, CI 1.77–2.7, respectively). For girls who were sexually active by age 16, only 16% ultimately completed primary schooling, compared with 70% aged 18 or older at sexual debut. Prior to sexual debut, girls had primary completion levels similar to those of boys. The association between sexual debut and school dropout could not be explained by prior poor school performance: the effect of sexual debut on dropout was as strong among those who were not behind in school as among those who were overage for their school grade. Girls who were sexually active were more likely to repeat a grade, with no effect being seen for boys. Pathways to dropout are complex and may differ for boys and girls. Interventions are needed to improve school progression so children complete primary school before sexual debut, and to improve sex education and contraception provision.

Worldwide data indicate a growing number of energy homeostasis disorders, which are especially dangerous in childhood. The distribution and growing trends of overweight and obesity in children have been widely investigated, unlike the prevalence of too-low body weight and its determinants. This study aimed to estimate the frequency of body mass deficiency in Polish rural girls and differences among four Polish regions – Choszczno and Leszno in the north-west, and Ostrów Mazowiecka and Suwałki in the north-east. Data were taken from 7764 rural girls aged 9–18 years examined in 1987, when the country was in economic crisis, and 9431 such girls examined in 2001, when the country was undergoing political transformation. The frequency of weight deficiency was estimated based on BMI by applying the international standards of Cole. An Extent of Overweight (EOW) index was used to create an Extent of Thinness (EOT) index. A significant increase in weight deficiency was found in the rural girls – from 7.5% in 1987 to 8.9% in 2001 – and an increase in the EOT index from 0.37 in 1987 to 0.43 in 2001. Analysis by area of residence demonstrated significant differentiation. In the regions in north-west Poland, mainly inhabited by non-farming families, the prevalence of weight deficiency in girls almost doubled from 1987 to 2001, probably because of the mass and long-term unemployment that resulted from the closure of state farms in 1992. In contrast, in the north-east regions, the prevalence of weight deficiency remained almost unchanged over this period, with only a slight decrease, probably because the inhabitants were mainly farm and farm/working families with better living conditions. Despite the overall increase in thinness prevalence in rural girls in Poland, different living conditions have had different biological effects.

India has gradually progressed into fertility transition over the last few decades. However, the timing and pace of this transition has varied notably in terms of both its geography and the demographic groups most affected by it. While much literature exists on the relationships between fertility level and its influence on demographic, economic, socio-cultural and policy-related factors, the potential spatial variations in the effects of these factors on the fertility level remain unaddressed. Using the most recent district-level census data (of 2011) for India, this nationwide study has identified plausible spatial dependencies and heterogeneities in the relationships between the district-wise Total Fertility Rates (TFRs) and their respective demographic, socioeconomic and cultural factors. After developing a geocoded database for 621 districts of India, spatial regression and Geographically Weighted Regression (GWR) models were used to decipher location-based relationships between the district-level TFR and its driving forces. The results revealed that the relationships between the district-level TFR and the considered selected predictors (percentage of Muslims, urbanization, caste group, female mean age at marriage, female education, females in the labour force, net migration, sex ratio at birth and exposure to mass media) were not spatially invariant in terms of their respective strength, magnitude and direction, and furthermore, these relationships were conspicuously place- and context-specific. This study suggests that such locality-based variations and their complexities cannot be explained simply by a single narrative of either socioeconomic advancement or government policy interventions. It therefore contributes to the ongoing debate on fertility research in India by highlighting the spatial dependence and heterogeneity of the impacts made by demographic, socioeconomic and cultural factors on local fertility levels. From a methodological perspective, the study also discerns that the GWR local model performs better, in terms of both model performance and prediction accuracy, compared with the conventional global model estimates.

The aim of this study was to analyse the relationship between childhood socioeconomic conditions and body asymmetry in young Polish women. The study measured fluctuating asymmetry (FA), which refers to small random deviations from perfect symmetry in bilaterally paired body structures. Data were obtained from 620 female students aged from 19 to 25 years recruited from Jagiellonian University in Cracow, Poland. The research was carried out in the period from January 2016 to May 2017. A composite fluctuating asymmetry (cFA) of the women was calculated using five bilateral body traits. The lengths and widths of the women’s ears, lengths of their 2nd and 4th digits and wrist widths of the right and left sides of the body were measured twice using standard methodology. The following data were collected in a questionnaire: degree of urbanization of the woman’s place of residence during childhood, number of older siblings, parental education and woman’s dominant hand. The results showed a tendency for FA to fall with an increase in parental education, and to rise with an increase in number of older siblings. The level of FA was significantly lower in women from rural areas than in those from cities. The results of the study show that FA in early adulthood is significantly associated with socioeconomic status during childhood, and confirm that the level of FA in adulthood may be a good indicator of stress factors in the early stages of development.