This study confirms an association between survival probability of becoming a centenarian (SPBC) for those aged 65 to 69 and country-level socioeconomic indicators in Europe: the gender inequality index (GII), male labour force participation (MLP) rates and proportions of seats held by women in national parliaments (PWP). The analysis was based on SPBC data from 34 countries obtained from the United Nations (UN). Country-level socioeconomic indicator data were obtained from the UN and World Bank databases. The associations between socioeconomic indicators and SPBC were assessed using correlation coefficients and multivariate regression models. The findings show significant correlations between the SPBC for women and men aged 65 to 69 and country-level socioeconomic indicators: GII (r=−0.674, p=0.001), MLP (r=0.514, p=0.002) and PWP (r=0.498, p=0.003). The SPBC predictors for women and men were lower GIIs and higher MLP and PWP (R 2=0.508, p=0.001). Country-level socioeconomic indicators appear to have an important effect on the probability of becoming a centenarian in European adults aged 65 to 69. Country-level gender equality policies in European counties may decrease the risk of unhealthy old age and increase longevity in elders through greater national gender equality; disparities in GII and other country-level socioeconomic indicators impact longevity probability. National longevity strategies should target country-level gender inequality.

Very little is known, at national and state levels, about how much information women in India are receiving about the method of contraception they are using. The purpose of this study was to fill this gap in knowledge. A Method Information Index (MII) was calculated from the responses of women who started using a modern contraceptive method five years prior to interview, and who were still using it at the time of interview, in the third National Family Health Survey conducted in India in 2005–06. The women were asked whether at the time they initiated contraceptive use they were told about other methods they could use, the side-effects of their selected method and what to do if they experienced these side-effects. The MII values (percentages of women who responded ‘yes’ to all three questions) were calculated for each category of women’s characteristics to show the relationship between MII and each characteristic. Mixed-effect logistic regression models were used to assess the independent effect of each variable after controlling for the effects of other variables on MII. The results indicate that contraceptive users in India in 2005–06 were receiving very little information about the method they were using: only 15.6% of contraceptive users reported receiving information on all three items. This low level was prevalent across different socioeconomic strata and across all the major states. There were a few exceptions, but the level was still quite low. Clearly, there is plenty of scope to improve the content of information exchanged between service providers and clients in order to ensure the rights of women to receive services of good quality, as well as improve informed choice and continuity of contraceptive use. Such a focus on improving quality of services is likely to help the Ministry of Health and Family Welfare in making its stated transition from a ‘population control centric’ to a ‘reproductive rights based’ approach to family planning in India.

The aim of this study was to assess the impact of social and occupational status on the BMI of the gentry and peasantry in the Kingdom of Poland at the turn of 19th and early 20th centuries. Use was made of data on the height and weight of 304 men, including 200 peasants and 104 gentlemen, and 275 women, including 200 from the peasantry and 75 from the gentry. Gentlemen were characterized by a greater body height than peasants (169.40 cm and 166.96 cm, respectively), a greater body weight (67.09 kg and 60.99 kg, respectively) and a higher BMI (23.33 kg/m2 and 21.83 kg/m2, respectively). Landowners and intelligentsia had a greater BMI than peasants (23.12 kg/m2 and 24.20 kg/m2 vs 21.83 kg/m2, respectively). In the case of women, there were no statistically significant differences in mean height, weight and BMI by their social position, and in BMI by occupational status. Underweight occurred less frequently in the gentry and more frequently in the peasantry (0.97% and 2.04%, respectively). Overweight was five times more common in gentlemen than in peasants (26.21% and 5.10%, respectively). Differences in the BMI of gentlefolk and peasants resulted from differences in diet and lifestyle related to socioeconomic status.

There is contradictory evidence of having fewer live births and higher embryonic mortality among high-altitude populations than their counterparts at lower altitude. This study explores the geospatial differences in selection intensities among human populations living in different ecological settings. Reproductive data from post-menopausal women were collected from 75 women from near Shimla, Himachal Pradesh, at an altitude of 2150 m above sea level and 100 women from Jind, Haryana, at an altitude of 227 m. Secondary data were taken from 85 women from the Kinnaur district of Himachal Pradesh at an average altitude of 3420 m. A comparison of the study data was made with similar data from different populations living in the western and eastern Himalayas. The total selection intensity index based on Johnston and Kensinger’s index was highest in Shimla and lowest in Kinnaur. The fertility selection component was highest in Shimla and lowest in Kinnaur. The prenatal mortality contribution to the total selection was highest in Shimla (30.76%) and lowest in Kinnaur (2.14%), while the contributions of normalized postnatal mortality were 16.39% and 57.80% in Shimla and Kinnaur, respectively. The fertility component of selection was higher than the mortality component in Shimla, while in the other two places the reverse was observed. Hypoxic conditions at high altitude seem to have little effect on the fertility and embryonic mortality rates of indigenous people. The geospatial differences in the selection intensities may be due to differences in ethnic, behavioural ecology, environmental, cultural and socioeconomic factors.

This study examines the consequences of the universalization of small family norms in Indonesia for family well-being over the past decade (2006–2014) using contrasting views of Malthusian theory. Data came from Indonesia’s 2006–2014 Socio-Economic Survey (Susenas) conducted by Indonesia’s Bureau of Statistics and from official statistics. The survey covered 2.3 million households in 483 districts of the country. The findings show a steady small family ratio and an increase in family well-being over this period. A small family was found to be positively associated with high family well-being. The benefits of a small family for family well-being were found to vary between different sub-groups and sub-national levels. The data reveal that improving human capital and increasing access to formal jobs may be among the channels by which small family norms have increased family well-being in Indonesia.

The aim of the study was to determine the associations of the self-perceptions of health and social support among Kuwaitis who were 60 years old and older, who either were or were not currently living with a spouse. A sample of 1427 was selected (472 men and 955 women). Social Affairs nurses completed all interviews in the participants’ homes. A single questionnaire was designed; SPSS (version 21) was used for data entry and analysis. Participants living with their spouse reported significantly greater social support, more frequent contact with others and greater strength of social relationships than those without a spouse. Significant differences between those with and without a spouse were observed for all physically assessed and self-reported aspects of health. Of 60 items included in the somatic symptoms, participants with a spouse reported fewer poor health symptoms than those without a spouse. More children living in the same household, along with greater frequency of contact, strength of contact and social support significantly and independently predicted positive somatic symptoms in the total sample as well as in both sexes. Participants with a spouse reported fewer poor health symptoms than did those without a spouse. Having a spouse is a significant benefit to many aspects of elder Kuwaitis’ daily lives, including their health and well-being.

This cross-sectional study was carried out to capture possible maternal factors affecting newborns’ anthropometric measurements. Data were collected from eight public health centres and referral university hospital records in Tabriz and Heriss districts, north-west Iran, for 807 mother–neonate pairs delivering live singleton births and their offspring during the two years up to August 2014. The incidence of low birth weight (LBW) was 5.1%. A close correlation was found between maternal anthropometry and birth order with neonatal anthropometric data. Birth order and maternal height and body mass index (BMI) positively affected neonates’ birth size (weight, length and head circumference). The rate of LBW was significantly higher for older (≥35 years), taller (≥170 cm), underweight (BMI<18.5) and non-iron-taking women and in the first-born babies. The odds of having LBW newborns in older, taller, underweight, obese and irregular iron-taking women were 3.82, 4.00, 9.07, 3.50 and 2.50 times those of mid-age group, middle-height, overweight and regular iron-taking women, respectively. First-born newborns were 5.97 times more likely to be LBW compared with second-birth neonates. The results indicate that maternal anthropometric indices, age, iron intake and birth order influence the risk of LBW in newborns.

This study aimed to identify the levels of, and socioeconomic variations in, income-related inequality in induced abortion among Turkish women. The study included 15,480 ever-married women of reproductive age (15–49) from the 2003 and 2008 waves of the Turkish Demographic and Health Survey. The measured inequalities in abortion levels and their changes over time were decomposed into the percentage contributions of selected socioeconomic factors using ordinary least square analysis and concentration indices were calculated. The inequalities and their first difference (difference in inequalities between 2003 and 2008) were decomposed using the approaches of Wagstaff et al. (2003). Higher socioeconomic characteristics (such as higher levels of wealth and education and better neighbourhood) were found to be associated with higher rates of abortion. Inequality analyses indicated that although deprived women become more familiar with abortion over time, abortion was still more concentrated among affluent women in the 2008 survey. The decomposition analyses suggested that wealth, age, education and level of regional development were the most important contributors to income-related inequality in abortion. Therefore policies that (i) increase the level of wealth and education of deprived women, (ii) develop deprived regions of Turkey, (iii) improve knowledge about family planning and, especially (iv) enhance the accessibility of family planning services for deprived and/or rural women, may be beneficial for reducing socioeconomic variations in abortion in the country.

This article analyses male contraceptive use, both globally and for developing countries. Shares of all contraceptive use due to males are examined, in the context of female use and all use. Patterns according to wealth quintiles are analysed, as well as time trends and geographic variations. Data are drawn primarily from compilations by the UN Population Division and from the Demographic and Health Series and subjected to relatively simple statistical methods including correlation/regression applications. Contraceptive methods that men use directly, or that require their co-operation to use, including condoms, withdrawal, rhythm and male sterilization, account for one-quarter of all contraceptive use worldwide. This represents 13% of married/in-union women. Both the share and the prevalence of male methods vary widely by geography and by the four methods, as well as by quintile wealth groups. With greater wealth there is an unbroken rise for total use; among the male methods, the shares of condom use and rhythm rise by wealth quintiles, while the share of withdrawal drops. The share for male sterilization is highest in the lowest and highest wealth quintiles and dips for the middle quintiles. The overall time trend since the 1980s has been steady at one-quarter of all use involving men; moreover, the share is about the same at all levels of total use. The female-only methods continue to dominate: female sterilization, IUD, pill, injectable and implant, again with great diversity geographically. In surveys men report less total use but more condom use, while females report more injectable use. For the future the male share of one-quarter of use seems secure, with little prospect of an increase unless concerted programmatic efforts are made to expand access to male methods and promote their use as part of a broadened contraceptive method mix.

Since 2001 a decentralization policy has increased the responsibility placed on local government for improving child health in Indonesia. This paper explores local government and community leaders’ perspectives on child health in a rural district in Indonesia, using a qualitative approach. Focus group discussions were held in May 2013. The issues probed relate to health personnel skills and motivation, service availability, the influence of traditional beliefs, and health care and gender inequity. The participants identify weak leadership, inefficient health management and inadequate child health budgets as important issues. The lack of health staff in rural areas is seen as the reason for promoting the use of traditional birth attendants. Midwifery graduates and village midwives are perceived as lacking motivation to work in rural areas. Some local traditions are seen as detrimental to child health. Husbands provide little support to their wives. These results highlight the need for a harmonization and alignment of the efforts of local government agencies and local community leaders to address child health care and gender inequity issues.

A majority of Zambian children live in impoverished communities that lack safe water and proper sanitation, exposing them to urogenital and intestinal helminths. Efforts to mitigate this plight have been implemented through mass drug administration aimed at deworming school-age and under-five children against schistosomiasis and soil-transmitted helminths. However, the disease status of adults living in the same communities as the treated children remains unknown. The aim of this study was to describe the potential contribution of infected adult populations to the transmission of these infections in southern Zambia. A cross-sectional study was conducted in April and May 2013 as part of baseline survey for a larger study in Mazabuka and Siavonga Districts. Stool and urine samples of 2829 adults from five catchment areas were collected and processed using Kato-Katz and urine filtration methods, respectively. Adults from Siavonga had a 13.9% combined prevalence of Schistosoma haematobium and S. mansoni, and 12.1% combined prevalence of Ascaris lumbricoides and hookworm. There was no S. mansoni in Mazabuka, and only a 5.3% prevalence of S. haematobium and 7.4% combined prevalence of A. lumbricoides and hookworm. Additionally, no Trichuris trichiura infections were observed in the two districts. Despite most of these infections being categorized as light intensity, heavy infection intensities were also found for all four parasite species. If this infected adult population is left untreated, the possibility of it acting as a reservoir of infections and ultimately transmitting the infections to treated children remains. Therefore, there is need to consider alternative treatment strategies that incorporate adults, thereby reducing the risk of contaminating the environment and perpetuating transmission to children.

Previous research has indicated that biological older brothers increase the odds of androphilia in males. This finding has been termed the fraternal birth order effect. The maternal immune hypothesis suggests that this effect reflects the progressive immunization of some mothers to male-specific antigens involved in fetal male brain masculinization. Exposure to these antigens, as a result of carrying earlier-born sons, is hypothesized to produce maternal immune responses towards later-born sons, thus leading to female-typical neural development of brain regions underlying sexual orientation. Because this hypothesis posits mechanisms that have the potential to be active in any situation where a mother gestates repeated male fetuses, a key prediction is that the fraternal birth order effect should be observable in diverse populations. The present study assessed the association between sexual orientation and birth order in androphilic male-to-female transsexuals in Brazil, a previously unexamined population. Male-to-female transsexuals who reported attraction to males were recruited from a specialty gender identity service in southern Brazil (n=118) and a comparison group of gynephilic non-transsexual men (n=143) was recruited at the same hospital. Logistic regression showed that the transsexual group had significantly more older brothers and other siblings. These effects were independent of one another and consistent with previous studies of birth order and male sexual orientation. The presence of the fraternal birth order effect in the present sample provides further evidence of the ubiquity of this effect and, therefore, lends support to the maternal immune hypothesis as an explanation of androphilic sexual orientation in some male-to-female transsexuals.

Changing socioeconomic conditions over the last century have left their mark on neonatal size and final body size of individuals born in those days. The main aim of this study was to investigate how the historical, political and economic changes occurring from the late 19th century to the 2000s have affected the birth weight of newborns. Additionally, changes in weight and body height in the case of young women (potential mothers) were analysed. Data were from two cities in Poland (Kraków and Poznań) covering 15,884 newborns and 3612 women aged 18 years, derived from 1900 to 2010. Despite short-term fluctuations, the results showed significant increasing trends in all studied features. Changes in birth weight were similar in both cities: in Kraków it increased by 184 g (males) and 206 g (females), and in Poznań by 216 g (males) and 120 g (females). Changes in women’s body size were also significant, but the level was different depending on place of residence. In the last century, women’s body height increased by 8.2 cm in Kraków and by 10.2 cm in Poznań, and their body weight increased by 1 kg and 5 kg respectively. The considered period covered the years of socioeconomic change that occurred as a result of the political system transformation. Crises, periods of prosperity and other factors that determine standard of living and health care have influenced the development of the Polish population’s physical features.

Males are usually born in excess of females. The sex ratio at birth (SR) is often expressed as the ratio of male to total births. A wide variety of factors have been shown to influence SR, including terrorist attacks, which have been shown to reduce SR. This paper reviews the effects on SR outcomes of the stressful events in France in 1968 (in association with the student and worker riots) and in Japan following the Aum Shinrikyo religious cult’s attack on the Tokyo subway using sarin nerve gas in 1995. Both countries displayed seasonal variation in SR. France exhibited a decline in SR in 1968 (p=0.042), with a particularly strong dip in May of that year (p=0.015). For Japan, there was no statistically significant dip for 1995 but there was a significant dip in June of that year (p=0.026). The SR dips follow catastrophic or tragic events if these are perceived to be momentous enough by a given populace. It is believed that SR slumps may be caused by population stress, which is known to lead to the culling of frail/small male fetuses. It has been observed that these fluctuations are comparable in intensity to a substantial proportion of quoted values for perinatal mortality, potentially making this a public health issue.

The long-term high sex ratio at birth (SRB) is a serious issue in China. In this study, changes in SRB were decomposed into variations in SRB by birth order and compositional changes in female births by birth order. With SRB data from China’s surveys and censuses, and SRB data from South Korea’s vital registration and censuses from 1980–2015, the trend and decomposition results in SRB were compared between China and South Korea, and the decomposition results for urban and rural SRBs, and for provinces, are presented. In both China and South Korea the rise in the SRB was driven by a rise in the SRB at all birth orders, which was only partly counteracted by the change in the distribution of births by order. The overall rise in the SRB ended when there was a decline in the SRB at second birth or above in South Korea. In China the total effect of variations in SRB of all birth orders increased more for the rural population than for the urban population before 2000, resulting in a higher total SRB for rural than urban population. After 2000, the total effect of variations in SRB of all birth orders lowered the total SRB for the rural population, whereas the effect of compositional change increased the total SRB, leading to a very slight rise in the total SRB for the rural population. At the province level, there was no spatial autocorrelation for the changes in total SRB by province, the total effect of variations in SRB of all birth orders or the effect of compositional change. The effect of variations in SRB by birth order accounted for the majority of changes in total SRB in most provinces.

This paper examines the fertility transition and its recent dynamics in Sri Lanka using data from Demographic and Health Surveys and Population Censuses. Fertility trends and patterns were analysed for two periods: 1953–2000 and 2000–2012. The findings revealed that Sri Lanka’s fertility transition has been relatively rapid and has taken place over a period of about four decades to reach replacement level. Social and health-related factors, including decline in maternal and infant mortality, increase in women’s education, changes in institutions, reproductive values and behaviour, and increased contraceptive use all contributed to bringing down the fertility level by 2000. However, in the 2006/07 Sri Lankan DHS and 2012 Population Census, a slight increase in Total Fertility Rate (TFR) to 2.3 and 2.4, respectively, was observed. Binary logistic regression estimates based on 2006/2007 DHS data were used to identify the significant predictors of fertility preferences of ever-married women. The analysis of factors affecting the likelihood of having a larger family (more than 2 children) revealed that lower educated women were more likely to have a higher number of children than their counterparts with a higher level of education. Women who lived in rural and estate (commercial area of 20 acres or more employing 10 or more labourers) sectors were 1.4 and 1.2 times, respectively, more likely to prefer more children compared with urban women. In terms of ethnic groups, Moor and Tamil women were 4.5 and 1.4 times, respectively, more likely to prefer more children than Sinhalese women. When the economic status of women was considered, the poorer women were 1.4 times more likely to desire a higher number of children compared with rich women, while women in the middle wealth quintile were 1.2 times more likely to desire more children. The findings suggest that the Sri Lankan government should re-visit population and reproductive health policy and family planning programmes to see how it can better manage fertility among the different population groups in Sri Lanka.

This study sought to characterize sexual behaviour, contraceptive use and contributory upbringing factors among young people who had dropped out of school or college in a Nigerian setting. A community-based, cross-sectional sexual survey of 161 young people aged between 15 and 35 who had dropped out of school or college was performed in Ado-Ekiti, south-west Nigeria, in April 2015. One hundred and nineteen of the respondents (73.9%) had had sexual intercourse. Mean age at sexual debut was 19.08±3.5 years. Of those with sexual experience, 79 (66.4%) had their sexual debut with a previous boy/girlfriend and 33 (27.7%) had it in their current relationship. Three (2.5%) respondents had first sex with a stranger. About 90% were still having sexual intercourse within 12 months of the survey; more males had had sex than females (81.1% versus 67.8%). Around 80% of those with sexual exposure practised a form of contraception, mainly use of the male condom, but fewer than 25% were all-time contraceptive users. Coming from a single-parent family (p=0.04) or from a family of poor economic status (AOR: 7.41; 95% CI: 0.69–0.83) were found to be associated with sexual debut by the age of 19 and premarital sex, respectively, in these young people. Unprotected sexual intimacy was found to be high among young school/college drop-outs in this region of Nigeria. This group of young people need targeted reproductive health intervention as they represent a potent route for HIV transmission in the region.

An increasing number of developing countries are experiencing below replacement fertility rates. Although the factors associated with low fertility in developed countries have been widely explored in the literature, studies of low fertility in middle- and low-income countries continue to be rare. To help fill this gap, Brazil was used as a case study to assess whether human development, gender equality and the ability of mothers with young children to work are associated with the likelihood of married or cohabiting women to have a child. For this purpose, multilevel logistic regressions were estimated using the 1991, 2000 and 2010 Brazilian Demographic Censuses. It was found that human development was negatively associated with fertility in the three periods analysed. Gender equality and the ability of mothers with young children to work were positively associated with the odds of having higher order births in Brazil in 2000 and 2010. In 1991, these variables were not associated with higher order births, and gender equality was negatively associated with first births. The positive association found in 2000 and 2010 may constitute a reversal of the relationship that in all likelihood prevailed earlier in the demographic transition when gender equality was most likely negatively correlated with fertility levels.

Turkey has high levels of infant mortality and consanguineous marriages. It has had a high level of infant mortality for its economic level for many years. Over recent decades, although adult mortality rates have not been very different from those of other countries with similar socioeconomic structures, its life expectancy at birth has remained low due to its high infant mortality rate. This has been called the Turkish Puzzle. According to the Turkey Family Structure and Population Issues Survey, 27% of women had a consanguineous marriage in 1968. Subsequent Turkish Demographic and Health Surveys (TDHSs) found the rate of consanguineous marriages to be stagnated at 22–24%, with a resistance to reduction. According to the TDHS-2008, 24% of women had a consanguineous marriage. Numerous studies in various countries of the world have indicated that consanguineous marriages, particularly of first-degree, have the effect of increasing infant mortality. The main aim of this study was to assess the causal impact of consanguineous, particularly first-degree consanguineous, marriages on infant mortality, controlling for individual, cultural, bio-demographic and environmental factors. Data were merged from four Turkish DHS data sets (1993, 1998, 2003 and 2008). Multivariate analysis revealed that first-degree consanguineous marriages have increased infant mortality by 45% in Turkey: 57% in urban areas and 39% in rural areas. The results indicate that there is a causal relationship between consanguineous marriages and infant mortality. This finding should be taken into account when planning policies to reduce infant mortality in Turkey, and in other countries with high rates of consanguineous marriage and infant mortality.

The impact of maternal height, pre-pregnancy weight status and gestational weight gain on fetal growth patterns and newborn size was analysed using a dataset of 4261 singleton term births taking place at the Viennese Danube Hospital between 2005 and 2013. Fetal growth patterns were reconstructed from three ultrasound examinations carried out at the 11th/12th, 20th/21th and 32th/33th weeks of gestation. Crown–rump length, biparietal diameter, fronto-occipital diameter, head circumference, abdominal transverse diameter, abdominal anterior–posterior diameter, abdominal circumference and femur length were determined. Birth weight, birth length and head circumference were measured immediately after birth. The vast majority of newborns were of normal weight, i.e. between 2500 and 4000 g. Maternal height showed a just-significant but weak positive association (r=0.03: p=0.039) with crown–rump length at the first trimester and with the majority of fetal parameters at the second trimester (r>0.06; p<0.001) and third trimester (r>0.09; p<0.001). Pre-pregnancy weight status was significantly positively associated with nearly all fetal dimensions at the third trimester (r>0.08; p<0.001). Maternal height (r>0.17; p<0.001) and pre-pregnancy weight status (r>0.13; p<0.001), but also gestational weight gain (r>0.13; p<0.001), were significantly positively associated with newborn size. Some of these associations were quite weak and the statistical significance was mainly due to the large sample size. The association patterns between maternal height and pre-pregnancy weight status with fetal growth patterns (p<0.001), as well as newborn size (p<0.001), were independent of maternal age, nicotine consumption and fetal sex. In general, taller and heavier women gave birth to larger infants. This association between maternal size and fetal growth patterns was detectable from the first trimester onwards.