Final body height is achieved as the result of a combination of genetic and environmental factors. The aim of this article is to review past studies on body height that have followed different scientific traditions. In modern Western societies, about 20% of variation in body height is due to environmental variation. In poorer environments, this proportion is probably larger, with lower heritability of body height as well as larger socioeconomic body height differences. The role of childhood environment is seen in the increase in body height during the 20th century simultaneously with the increase in the standard of living. The most important non-genetic factors affecting growth and adult body height are nutrition and diseases. Short stature is associated with poorer education and lower social position in adulthood. This is mainly due to family background, but other environmental factors in childhood also contribute to this association. Body height is a good indicator of childhood living conditions, not only in developing countries but also in modern Western societies. Future studies combining different scientific traditions in auxology are needed to create a more holistic view of body height.

In 1968, a prospective study was started in collaboration with the Family Planning Association to try to provide a balanced view of the beneficial and harmful effects of different methods of contraception. This investigation is now in progress at seventeen clinics and over 17,000 women are under observation. At the time of recruitment, all these women were married white British subjects, aged 25–39 years, who voluntarily agreed to participate. Fifty-six per cent were using oral contraceptives, 25% were using a diaphragm and 19% were using an intrauterine device (IUD). During follow-up each woman is questioned at return visits to the clinic and a record of pregnancies and their outcome, hospital referrals (inpatient or outpatient), changes in contraceptive methods and the results of cervical smears, is accumulated. Women who default are sent a postal questionnaire and, if this is not returned, are telephoned or visited in their homes to collect the necessary information.

So far, data obtained during 56,000 woman-years of observation are available for analysis. Follow-up has been maintained with an annual lapse rate of about 0.3%due to withdrawal of co-operation or loss of contact; adherence to the method of contraception in use at recruitment has been reasonably good, and the reporting of pregnancies and hospital admissions appears to have been both reliable and unbiased.

The present data include only 24 deaths, so the mortality associated with different contraceptive methods cannot yet be estimated. With regard to morbidity, however, our preliminary results closely resemble those obtained in the prospective study carried out by the Royal College of General Practitioners (1974) and in the principal retrospective studies carried out in Britain and the United States. Women who used oral contraceptives at the start of the study experienced a deficiency of hospital referrals for cancer, benign lesions of the breast, menstrual disorders other than amenorrhoea, duodenal ulcer, and retention cysts of the ovary; they showed an excess of referrals for cerebrovascular disease, cervical erosion, skin disorders, self-poisoning, migraine, venous thrombosis and embolism, hayfever, gallbladder disease, amenorrhoea, and sterility. Women who used a diaphragm showed a deficiency of hospital referrals for carcinoma-in-situ and dysplastic lesions of the cervix uteri and accidental injury; and an excess of referrals for haemorrhoids and cystitis. Women who used an IUD experienced an excess of hospital referrals for anaemia, varicose veins and salpingitis. About half of these differences (12 out of 23) were predicted from other studies while some suggestive evidence already existed for a further five. Of the remaining six, some probably reflect the influence of selective factors or chance.

Multiple pregnancies, stillbirths, malformations, the sex ratio and birthweight showed no consistent relationship to method of contraception. The outcome of unplanned pregnancies occurring in women using an IUD, however, was remarkably unfavourable both in terms of ectopic gestation and miscarriage.

Clear evidence was found of impairment of fertility after discontinuation of oral contraceptives. Whether this is likely to lead to permanent sterility in some women is uncertain.

The study has provided data on the efficacy of a wide variety of contraceptive methods. In general the failure rates are in keeping with those obtained in other large-scale studies, save that those for the diaphragm and the sheath are much lower than those usually quoted.

The available evidence does not yet allow a final balance to be struck between the benefits and risks associated with the new methods of contraception that have become widely used during the last two decades. It seems clear, however, that there are no material risks associated with the use of the diaphragm apart from the risk of pregnancy and that there may be some unintended benefits.

It is hypothesized that recent trends in US and worldwide obesity are, in part, related to an increase in the marginal rate of time preference, where time preference refers to the rate at which people are willing to trade current benefit for future benefit. The higher the rate of time preference, the larger is the factor by which individuals discount the future health risks associated with current consumption. Data from the United States, as well as international evidence, suggest that a relationship between these two variables is plausible. The authors encourage researchers to explore the possible link between obesity and time preference, as important insights are likely to result.

Most women in Western society seem to reach the menopause in their early fifties; the median age in this Aberdeen series being 50.1 years. As far as symptoms were concerned, only the vasomotor disorders, flushing and night sweats, were definitely correlated with the menopause.

The agreement between zygosity diagnosis in twins by reference to the twins' own answers to written questions and diagnosis based on an objective assessment of zygosity by blood-typing is studied for 178 pairs of same sex twins. Seventy-two female and 106 male twin pairs answered two questions concerning their similarity in appearance and frequency of confusion in childhood, and were blood-grouped using up to 23 different antisera. Of those pairs concordant for all markers and diagnosed as MZ, 98% agreed that they were confused in childhood and that they are alike in physical appearance. Only 55% of those pairs discordant for at least one marker and classified as DZ agreed that they were never confused and are not alike in appearance. The replies of the remaining 45% are spread over all the other combinations of responses. If all twins who agree that they were confused in childhood and are alike in appearance were to be classified as MZ on the basis of the questionnaire alone, and all others as DZ, the diagnoses of only seven pairs out of the total 178 (3–9%) would disagree with those based on blood group data.

Data from a representative sample of 736 women aged 45–54 living in or near London in 1965 were analysed with respect to menopausal status and median and mean age at menopause (final menses). The median age at the natural menopause was 50·78 years. The validity of the measures used and the reliability of the data in this and previous studies are discussed. The conclusions are reached that median age of menopause is a more valid measurement than mean age and that there is no conclusive evidence of an increase in the age at menopause over the last century. The data also indicate understatement of the age at the last menstrual period (LMP) by women, with increasing lapse of time.

The menopause was found to occur markedly later in currently married women than in unmarried or previously married women. When marital status was controlled by considering currently married women only, increased parity was shown to be related to a late menopause among women of higher socio-economic status, but not among those of lower socio-economic status. There was no notable association between the menopause and early or late menarche and socio-economic status.

Lack of social integration predicts coronary heart disease mortality in prospective studies; however, the biological pathways that may be responsible are poorly understood. The specific aims of this study were to examine whether social networks are associated with serum concentrations of the inflammatory markers interleukin-6 (IL-6), C-reactive protein (CRP), soluble intercellular adhesion molecule-1 (sICAM-1) and monocyte chemoattractant protein-1 (MCP-1). Participants in the Framingham Study attending examinations from 1998 to 2001 (n=3267) were eligible for inclusion in the study. Social networks were assessed using the Berkman–Syme Social Network Index (SNI). Concentrations of IL-6, CRP, sICAM-1 and MCP-1 were measured in fasting serum samples. Multivariable linear regression analyses were used to assess the association of social networks with inflammatory markers adjusting for potential confounders including age, smoking, blood pressure, total:HDL cholesterol ratio, body mass index, lipid-lowering and antihypertensive medication, diabetes, cardiovascular disease, depression and socioeconomic status. Results found that the SNI was significantly inversely associated with IL-6 in men (p=0·03) after adjusting for potential confounders. In age-adjusted analyses, social networks also were significantly inversely associated with IL-6 for women (p=0·03) and were marginally to modestly associated with CRP and sICAM-1 for men (p=0·08 and 0·02, respectively), but these associations were not significant in the multivariate analyses. In conclusion, social networks were found to be inversely associated with interleukin-6 levels in men. The possibility that inflammatory markers may be potential mediators between social integration and coronary heart disease merits further investigation.

Consanguineous marriages are strongly preferred in much of West and South Asia. This paper examines the prevalence and sociodemographic correlates of consanguineous unions in Pakistan using local and national data. Information from 1011 ever-married women living in four multi-ethnic and multi-lingual squatter settlements of Karachi, the main commercial centre of the country, are compared with data from the national 1990/91 Pakistan Demographic and Health Survey (PDHS), based on information provided by 6611 women. Both sets of results indicate that approximately 60% of marriages were consanguineous, over 80% of which were between first cousins. The mean coefficients of inbreeding (F) in the present generation were 0·0316 and 0·0331 for the Karachi and PDHS data respectively. In both surveys the prevalence of consanguineous unions appeared to be unchanged over the past three to four decades. Consanguineous unions were more common among women who were illiterate or had only primary level education, were first or second generation migrants from rural areas of Pakistan or, in the PDHS, lived in rural areas, and whose parents were also consanguineously married.

This study examines the frequency of consanguineous marriage and the coefficient of inbreeding in the United Arab Emirates (UAE). The study was conducted in Al Ain and Dubai cities between October 1994 and March 1995. A sample of 2033 married UAE females aged 15 years and over participated. The degree of consanguinity between each female and her spouse, and the degree of consanguinity between their parents were recorded. The rate of consanguinity in the present generation was high (50·5%) with a coefficient of inbreeding of 0·0222. The commonest type of consanguineous marriage was between first cousins (26·2%). Double first cousin marriages were common (3·5%) compared to other populations. The consanguinity rate in the UAE has increased from 39% to 50·5% in one generation. The level of consanguinity was higher in Al Ain (54·2%) than in Dubai (40%).

Domestic spousal violence against women in developing countries like India, is now beginning to be recognized as a widespread health problem impeding development. This study aimed to explore the risk and protective factors for lifetime spousal physical violence. A cross-sectional household survey was carried out in rural, urban and urban-slum areas across seven sites in India, among women aged 15–49 years, living with a child less than 18 years of age. The sample was selected using the probability proportionate to size method. Trained field workers administered a structured questionnaire to elicit information on spousal physical violence. The main hypothesized variables were social support, witnessed father beating mother and experience of harsh physical violence during childhood, alcohol abuse by spouse and socioeconomic variables. The outcome variables included three physical violence behaviours of hit, kick and beat. Odds ratios were calculated for risk and protective factors of violence using logistic regression. Of 9938 women surveyed, 26% reported experiencing spousal physical violence during the lifetime of their marriage. Adjusted odds ratios calculated using multiple logistic regression analysis suggest that women whose husbands regularly consumed alcohol (OR 5·6; 95% CI 4·7–6·6); who experienced dowry harassment (OR 3·2; 95% CI 2·7–3·8); had reported experiencing harsh physical punishment during childhood (OR 1·6; 95% CI 1·4–1·8) and had witnessed their fathers beat their mothers (OR 1·9; 95% CI 1·6–2·1), were at increased risk of spousal physical violence (beat, hit and kick). Higher socioeconomic status and good social support acted as protective buffers against spousal physical violence. The findings provide compelling evidence of the potential risk factors for spousal physical violence, which in turn could help in planning interventions.

The Food Choice Questionnaire (FCQ), which measures the reported importance to a given individual of nine factors underlying food choice, and a food frequency questionnaire, were administered to 241 participants, who were also required to classify their diet as either 'standard', 'low in red meat' or 'vegetarian'. Respondents describing their diet as low in red meat attributed greater importance to health, natural content, weight control and ethical concern in their food choice than did those who described their diets as standard, whereas vegetarians differed significantly from those with a standard diet only on the score for ethical concern. Differences between men and women and between students and non-students in the frequency of consumption of a number of foods were shown to be mediated by differences in the importance attached to FCQ factors. Thus the generally healthier diets of women compared to men appeared to be accounted for by the greater importance attributed by women to weight control, natural content and ethical concerns.

Information on reproductive attitudes is now routinely collected in fertility surveys in developing countries, and has become very important for understanding fertility behaviour. The quality of this information, however, is rarely assessed, partly due to lack of necessary data. In this paper, the recently completed panel survey in Morocco by the Demographic and Health Surveys (DHS) was used to investigate the consistency of reporting of ideal number of children, reproductive intentions and the planning status of the last birth. The validity of reproductive intentions for subsequent fertility behaviour was also examined. The findings indicate that the three measures of reproductive attitudes are subject to different degrees of measurement error. The measure of reproductive intentions is the most consistent of the three, followed by ideal number of children. The latter is much more consistent at the aggregate level than at the individual level. The reliability of the planning status of the last birth is marred, mainly by an unwanted child being reclassified as 'wanted' with time since the birth of the child. The reproductive intentions of women were also found to be positively related to their subsequent fertility.

This paper reviews the literature examining the relationship between women’s empowerment and contraceptive use, unmet need for contraception and related family planning topics in developing countries. Searches were conducted using PubMed, Popline and Web of Science search engines in May 2013 to examine literature published between January 1990 and December 2012. Among the 46 articles included in the review, the majority were conducted in South Asia (n=24). Household decision-making (n=21) and mobility (n=17) were the most commonly examined domains of women’s empowerment. Findings show that the relationship between empowerment and family planning is complex, with mixed positive and null associations. Consistently positive associations between empowerment and family planning outcomes were found for most family planning outcomes but those investigations represented fewer than two-fifths of the analyses. Current use of contraception was the most commonly studied family planning outcome, examined in more than half the analyses, but reviewed articles showed inconsistent findings. This review provides the first critical synthesis of the literature and assesses existing evidence between women’s empowerment and family planning use.

Although the recent Pakistan Demographic and Health Survey (DHS) show that two-thirds of marriages in Pakistan are consanguineous, the sociocultural determinants of such marriages remain largely unexplored. This paper examines the relative importance of the three commonly perceived reasons for such marriages: religious, economic and cultural. The analysis is based on qualitative data collected in 1995 from multi-ethnic and multi-religious communities in Karachi, the largest city of Pakistan. Results show that consanguineous marriages are preferred across all ethnic and religious groups to a varying degree, and that parents continue to be the prime decision-makers for marriages of both sons and daughters. The major reasons for a preference for consanguineous marriages are sociocultural rather than any perceived economic benefits, either in the form of consolidation of family property or smaller and less expensive dowries. Among Muslims, following religious traditions is the least commonly cited reason for such marriages. Despite the reported sociocultural advantages of consanguineous marriages, such unions are perceived to be exploitative as they perpetuate the existing power structures within the family.

This is a critical, systematic review of the relationship between socioeconomic status (SES) and HIV infection in women in Southern, Central and Eastern Africa. In light of the interest in micro-credit programmes and other HIV prevention interventions structured to empower women through increasing women’s access to funds and education, this review examines the epidemiological and public health literature, which ascertains the association between low SES using different measurements of SES and risk of HIV infection in women. Also, given the focus on structural violence and poverty as factors driving the HIV epidemic at a structural/ecological level, as advocated by Paul Farmer and others, this study examines the extent to which differences in SES between individuals in areas with generalized poverty affect risk for SES. Out of 71 studies retrieved, 36 studies met the inclusion criteria including 30 cross-sectional, one case-control and five prospective cohort or nested case-control studies. Thirty-five studies used at least one measurement of female’s SES and fourteen also included a measurement of partner’s SES. Studies used variables measuring educational level, household income and occupation or employment status at the individual and neighbourhood level to ascertain SES. Of the 36 studies, fifteen found no association between SES and HIV infection, twelve found an association between high SES and HIV infection, eight found an association between low SES and HIV infection and one was mixed. In interpreting these results, this review examines the role of potential confounders and effect modifiers such as history of STDs, number of partners, living in urban or rural areas and time and location of study in sub-Saharan Africa. It is argued that STDs and number of partners are on the causal pathway under investigation between HIV and SES and should not be adjusted as confounders in any analysis. In conclusion, it is argued that in low-income sub-Saharan Africans countries, where poverty is widespread, increasing access to resources for women may initially increase risk of HIV or have no effect on risk-taking behaviours. In some parts of Southern Africa where per capita income is higher and within-country inequalities in wealth are greater, studies suggest that increasing SES may decrease risk. This review concludes that increased SES may have differential effects on married and unmarried women and further studies should use multiple measures of SES. Lastly, it is suggested that the partner’s SES (measured by education or income/employment) may be a stronger predictor of female HIV serostatus than measures of female SES.

The association between perception of risk of HIV infection and sexual behaviour remains poorly understood, although perception of risk is considered to be the first stage towards behavioural change from risk-taking to safer behaviour. Using data from the 1998 Kenya Demographic and Health Survey, logistic regression models were fitted to examine the direction and the strength of the association between perceived risk of HIV/AIDS and risky sexual behaviour in the last 12 months before the survey. The findings indicate a strong positive association between perceived risk of HIV/AIDS and risky sexual behaviour for both women and men. Controlling for sociodemographic, sexual exposure and knowledge factors such as age, marital status, education, work status, residence, ethnicity, source of AIDS information, specific knowledge of AIDS, and condom use to avoid AIDS did not change the direction of the association, but altered its strength slightly. Young and unmarried women and men were more likely than older and married ones to report risky sexual behaviour. Ethnicity was significantly associated with risky sexual behaviour, suggesting a need to identify the contextual and social factors that influence behaviour among Kenyan people.

This study investigated the impact of some socioeconomic, demographic and health and community factors on chronic malnutrition or stunting in Bangladeshi children aged less than 5 years. The analysis revealed that the overall prevalence of stunting was 44%, of which 18% of children were severely stunted, and the demographic characteristics appeared to be the most significant factors for chronic malnutrition. Multinomial logistic regression analysis showed that parents’ education, household economic status, media exposure, number of under-5 children, place of delivery, child’s age, birth order, months of breast-feeding, birth size, mother’s BMI, mother’s height, age of household head, measles vaccine, supplementation of diet with liquids and regional differentials were significantly associated with severe as well as moderate stunting.

Using data from the first wave of the Netherlands Kinship Panel Study (NKPS) for 2867 women and 2195 men aged 40 to 79, this study examines to what extent educational, employment and marital pathways shape the likelihood of remaining childless, and whether these pathways are gendered. The findings indicate that women and men have distinctive pathways into childlessness. Educational attainment increases the likelihood of remaining childless among women only. A stable career increases the likelihood of remaining childless among women, but it increases the likelihood of entering fatherhood. Years without a partner is positively associated with childlessness among both women and men. Not having had a partnership and having had multiple partnerships are strong determinants of childlessness, especially among men.

This paper uses data collected using in-depth, semi-structured interviews to examine utilization of maternal health care services among two rural and urban populations of Pune and Mumbai in Maharashtra, India. The study aims to identify key social, economic and cultural factors influencing women’s decisions to use maternal health care and the places used for child delivery, whilst considering the accessibility of facilities available in the local area. Socioeconomic status was not found to be a barrier to service use when women perceived the benefits of the service to outweigh the cost, and when the service was within reasonable distance of the respondent’s place of residence. A large number of women perceived private services to be superior to those provided by the government, although cost often meant they were unable to use them. The provision of services did not ensure that women used them; they had to first perceive them to be beneficial to their health and that of their unborn child. Respondents identified the poor quality of services offered at government institutions to be a motivating factor for delivering at home. Thus further investigation is needed into the quality of services provided by government facilities in the area. A number of respondents who had received antenatal care went on to deliver in the home environment without a trained birth attendant. Further research is needed to establish the types of care provided during an antenatal consultation to establish the feasibility of using these visits to encourage women, particularly those with high-risk pregnancies, to be linked to a trained attendant for delivery.