Causes and consequences of increase in child survival rates: ethnoepidemiology among the Hmong of Thailand.

The Hmong "hill tribe" minority in Thailand has much higher exposure to factors usually associated with risk of child mortality (high fertility, low status of women, low education, less use of modern medical care for births, exposure to warfare, economic and physical disruption, and poor hygienic conditions) than the rural ethnic Thai population. Nonetheless, infant mortality has declined from over 120 per 1000 to under 50 per 1000 live births among both these populations in the past 30 years. The reason for the rapid increase in child survival among the Hmong appears to be better access to and more use of modern curative and preventive medical care associated with road construction rather than major changes in social or hygienic conditions. Conventional wisdom suggests that high fertility is both a cause and a consequence of high infant and child mortality and that parents will not reduce fertility until they see that mortality has declined. Most Hmong parents recognize the decline in child mortality and attribute it to better access to modern medical care. Most Hmong parents also say that, if they were starting to have children now, they would want to have fewer children. Fear of child death is infrequently mentioned as a motive for having more children, and the perceived decline in child mortality is rarely mentioned as a reason for reduced fertility. Most Hmong parents explain their desired family size in terms of economic conditions rather than perceived risk of child mortality. Results of this study suggest that fertility and child mortality can vary independently of one another and that major reductions in child mortality can be accomplished without waiting for major social changes (e.g., improved education or status of women) or major reductions in fertility.     

Why do women live longer than men?

In the contemporary United States, males have 60 percent higher mortality than females. In Part I, published in the previous issue, we showed that 40 percent of this sex differential in mortality is due to a twofold elevation of arteriosclerotic heart disease among men. Major causes of higher rates of arteriosclerotic heart disease in men include greater cigarette smoking among men; probably a greater prevalence of the competitive, aggressive Coronary Prone Behavior Pattern among men; and possibly a protective role of female hormones. In addition, men have higher death rates for lung cancer and emphysema, primarily because more men smoke cigarettes. In Part II we analyze the other major causes of men's higher death rates: accidents, suicide, and cirrhosis of the liver. Each of these is related to behaviors which are encouraged or accepted more in men than in women in our society--for example, using guns, being adventurous and acting unafraid, working at hazardous jobs and drinking alcohol. We conclude with suggestions for reducing male mortality; for example, by changing the social conditions which foster in men the behaviors that elevate their mortality.     

Disease resistance in Arabidopsisthaliana increases the competitive ability and the predicted probability of long‐term ecological success under disease pressure

Evidence is mounting that flowering by the mast-fruiting Dipterocarpaceae in Southeast Asia is triggered by ENSO events such that seeds are dispersed at the end of ENSO droughts. These droughts induce substantial defoliation and mortality of canopy trees, producing a favorable environment for seedling recruitment in the forest understory. Therefore, seedling release following droughts may have selected for synchronized, supra-annual fruiting in these rain forests. Currently, mast fruiting in Southeast Asia is generally regarded as an evolutionary response to seed predation by nomadic vertebrates. Separating the two causes for mast fruiting, seedling release and predator satiation, may be difficult if they are coupled in nature by ENSO droughts. Nevertheless, if the cue for masting is environmental, then the post-ENSO seedling environment should be considered a potential cause for masting, and if it operates in conjunction with predator satiation, then it may have provided the initial stimulus for supra-annual synchrony in fruiting.     

Morphological aspects of the science of human ecology

Human ecology is the science on interaction of the man with the environment including the social surrounding. In the human ecological morphology biogenic and sociogenic peculiarities are distinguished; they are formed in the phylo- or ontogenesis. Peculiarities of the body integument, proportions, development of the fat component of the body mass etc. are related with the biogenic signs of the phylogenic origin, since they are connected with life in certain climato-natural conditions. These signs have certain analogues among Mammalia. The sociogenic signs of the phylogenic origin include complexes of bepedality, labour and informative-speech activity. They are characteristic for the human being only. The sociogenic peculiarities of the ontogenic origin include certain changes of the organism connected with professional and sporting activities. According to the human organism state, observed in dynamics, it is possible to judge on biogenic and sociogenic consequences of the environmental influences. For this purpose the data of anthropometric observations in newborn are considered to be important. The role of the biogenic changes is followed in the example of shifts of the body dimensions in time, connected with the solar activity cycles; the sociogenic changes are considered in an example of growth processes under conditions of different gas-pollution of the atmosphere with industrial waste.     

Developmental psychopathology: recent advances and future challenges

The integrative field of developmental psychopathology is having a huge impact on our understanding of human health and behavior. In this paper, I use the example of children's early stress exposure to illustrate how developmental psychopathologists now tend to deemphasize diagnostic categories and, instead, emphasize the social and biological contexts, events and circumstances that have created opportunities for maladaptive responses and health problems in youth. This example shows that developmental psychopathology is increasing understanding of how children develop the abilities that allow them to cope effectively with challenges and what leads to failures in development of these abilities. Integrating research about the neurobiology of learning may prove to be a powerful future direction to understand how the environment regulates behavior. Learning processes become increasingly intricate and fine‐tuned as relevant neuroanatomical systems develop, and as the range, complexity and amount of environmental information increases for the developing child. A focus on these processes allows psychopathologists to formulate questions about which neural mechanisms children use to process information, how these mechanisms are themselves shaped by social context, why adverse social environments confer risk for children, and, perhaps, what sorts of neutrally informed interventions might remediate the deficits in self‐regulation that underlie common psychopathologies.     

Racial/Ethnic Differences in Early-Life Mortality in the United States

U.S. early-life (ages 1–24) deaths are tragic, far too common, and largely preventable. Yet demographers have focused scant attention on U.S. early-life mortality patterns, particularly as they vary across racial and ethnic groups. We employed the restricted-use 1999–2011 National Health Interview Survey–Linked Mortality Files and hazard models to examine racial/ethnic differences in early-life mortality. Our results reveal that these disparities are large, strongly related to differences in parental socioeconomic status, and expressed through different causes of death. Compared to non-Hispanic whites, non-Hispanic blacks experience 60 percent and Mexican Americans 32 percent higher risk of death over the follow-up period, with demographic controls. Our finding that Mexican Americans experience higher early-life mortality risk than non-Hispanic whites differs from much of the literature on adult mortality. We also show that these racial/ethnic differences attenuate with controls for family structure and especially with measures of socioeconomic status. For example, higher mortality risk among Mexican Americans than among non-Hispanic whites is no longer significant once we controlled for mother’s education or family income. Our results strongly suggest that eliminating socioeconomic gaps across groups is the key to enhanced survival for children and adolescents in racial/ethnic minority groups.     

Through the Eyes of Children: Perceptions of Environmental Change in Tropical Forests

This study seeks to understand children''s perceptions of their present and future environments in the highly biodiverse and rapidly changing landscapes of Kalimantan, Indonesian Borneo. We analyzed drawings by children (target age 10–15 years) from 22 villages, which show how children perceive the present conditions of forests and wildlife surrounding their villages and how they expect conditions to change over the next 15 years. Analyses of picture elements and their relationships to current landscape variables indicate that children have a sophisticated understanding of their environment and how different environmental factors interact, either positively or negatively. Children appear to have landscape-dependent environmental perceptions, showing awareness of past environmental conditions and many aspects of recent trends, and translating these into predictions for future environmental conditions. The further removed their present landscape is from the originally forested one, the more environmental change they expect in the future, particularly declines in forest cover, rivers, animal diversity and increases in temperature and natural disasters. This suggests that loss of past perceptions and associated “shifting environmental baselines” do not feature strongly among children on Borneo, at least not for the perceptions we investigated here. Our findings that children have negative expectations of their future environmental conditions have important political implications. More than other generations, children have a stake in ensuring that future environmental conditions support their long-term well-being. Understanding what drives environmental views among children, and how they consider trade-offs between economic development and social and environmental change, should inform optimal policies on land use. Our study illuminates part of the complex interplay between perceptions of land cover and land use change. Capturing the views of children through artistic expressions provides a potentially powerful tool to influence public and political opinions, as well as a valuable approach for developing localized education and nature conservation programs.     

Causes of death which contribute to the mortality crossover effect

Abstract

Death rates vary over the life cycle in a standard fashion, with mortality probabilities being highest at infant and older ages. Nevertheless, when age curves of mortality are compared for different populations, they sometimes can be seen to intersect so that one population has higher death rates at younger and middle ages and lower rates at older ages. Past research has shown that this phenomenon is not due to erroneous data and is probably a result of some type of selection in survival patterns. A sample of pairs of mortality curves, 31 of which cross over and 31 of which do not, for combinations of countries and dates are analyzed to discover which causes of death are associated with the crossover phenomenon at the older ages. Cardiovascular and “other and unknown” diseases appear to contribute strongly to the crossover effect. Further research should deal with other comparisons and explore the underlying social and environmental factors.     

Bioethics,children, and the environment

Queer perspectives have typically emerged from sexual minorities as a way of repudiating flawed views of sexuality, mischaracterized relationships, and objectionable social treatment of people with atypical sexuality or gender expression. In this vein, one commentator offers a queer critique of the conceptualization of children in regard to their value for people's identities and relationships. According to this account, children are morally problematic given the values that make them desirable, their displacement of other beings and things entitled to moral protection, not to mention the damaging environmental effects that follow in the wake of population growth. Objectionable views of children are said even to have colonized the view of lesbian, gay, bisexual, and trans (LGBT) people who – with the enthusiastic endorsement of bioethics – increasingly turn to assisted reproductive treatments to have children. In the face of these outcomes, it is better – according to this account – that people reconsider their interest in children. This account is not, however, ultimately strong enough to override people's interest in having children, relative to the benefits they confer and relative to the benefits conferred on children themselves. It is certainly not strong enough to justify differential treatment of LGBT people in matters of assisted reproductive treatments. Environmental threats in the wake of population growth might be managed in ways other than devaluing children as such. Moreover, this account ultimately damages the interests of LGBT people in matters of access, equity, and children, which outcome is paradoxical, given the origins of queer perspectives as efforts to assert and defend the social interests of sexual and gender minorities.     

Understanding the Social Meaning of Infertility and Childbearing: A Qualitative Study of the Perception of Childbearing and Childlessness in Northern Ghana

Background

Infertility is a major medical condition that affects many married couples in sub-Saharan African and as such associated with several social meanings. This study therefore explored community''s perception of childbearing and childlessness in Northern Ghana using the Upper West Region as a case study.

Methods

The study was exploratory and qualitative using in-depth and key informant interviews and focus group discussions. Fifteen marriage unions with infertility (childless), forty-five couples with children, and eight key informants were purposively sampled and interviewed using a semi-structured interview guides. Three focus group discussions were also carried out, one for childless women, one for women with children and one with men with children. The data collected were transcribed, coded, arranged, and analyzed for categories and themes and finally triangulated.

Results

The study revealed that infertility was caused by both social and biological factors. Socially couples could become infertile through supernatural causes such as bewitchment, and disobediences of social norms. Abortion, masturbation and use of contraceptives were also identified as causes of infertility. Most childless couples seek treatment from spiritualist, traditional healers and hospital. These sources of treatment are used simultaneously.

Conclusion

Childbearing is highly valued in the community and Childlessness is highly engendered, and stigmatised in this community with manifold social consequences. In such a community therefore, the concept of reproductive choice must encompass policies that make it possible for couples to aspire to have the number of children they wish.     

Epidemiology of childhood leukemia in the presence and absence of Down syndrome

Down syndrome (DS) is a common congenital anomaly, and children with DS have a substantially higher risk of leukemia. Although understanding of genetic and epigenetic changes of childhood leukemia has improved, the causes of childhood leukemia and the potential role of environmental exposures in leukemogenesis remain largely unknown. Although many epidemiologic studies have examined a variety of environmental exposures, ionizing radiation remains the only generally accepted environmental risk factor for childhood leukemia. Among suspected risk factors, infections, exposure to pesticides, and extremely low frequency magnetic fields are notable. While there are well-defined differences between leukemia in children with and without DS, studies of risk factors for leukemia among DS children are generally consistent with trends seen among non-DS (NDS) children.We provide background on DS epidemiology and review the similarities and differences in biological and epidemiologic features of leukemia in children with and without DS. We propose that both acute lymphoblastic and acute myeloblastic leukemia among DS children can serve as an informative model for development of childhood leukemia. Further, the high rates of leukemia among DS children make it possible to study this disease using a cohort approach, a powerful method that is unfeasible in the general population due to the rarity of childhood leukemia.     

The companion dog as a model for human aging and mortality

Around the world, human populations have experienced large increases in average lifespan over the last 150 years, and while individuals are living longer, they are spending more years of life with multiple chronic morbidities. Researchers have used numerous laboratory animal models to understand the biological and environmental factors that influence aging, morbidity, and longevity. However, the most commonly studied animal species, laboratory mice and rats, do not experience environmental conditions similar to those to which humans are exposed, nor do we often diagnose them with many of the naturally occurring pathologies seen in humans. Recently, the companion dog has been proposed as a powerful model to better understand the genetic and environmental determinants of morbidity and mortality in humans. However, it is not known to what extent the age‐related dynamics of morbidity, comorbidity, and mortality are shared between humans and dogs. Here, we present the first large‐scale comparison of human and canine patterns of age‐specific morbidity and mortality. We find that many chronic conditions that commonly occur in human populations (obesity, arthritis, hypothyroidism, and diabetes), and which are associated with comorbidities, are also associated with similarly high levels of comorbidity in companion dogs. We also find significant similarities in the effect of age on disease risk in humans and dogs, with neoplastic, congenital, and metabolic causes of death showing similar age trajectories between the two species. Overall, our study suggests that the companion dog may be an ideal translational model to study the many complex facets of human morbidity and mortality.     

The natural regulation of buffalo populations in East Africa: III. Population trends and mortality*

Analysis is carried out on the population data obtained from censuses and estimates of fertility and recruitment for the years 1965–1972, From the analysis, adult mortality is the only detectable reduction which acts as a negative feedback on the population, and is the only one needed to regulate the population in a way similar to the observed population trends. From a frequency distribution of ages at death, an approximate composite life table is constructed. This shows that males and females have similar age-specific mortalities until old age, but then males survive relatively better. Information on the causes of mortality indicate that the regulating adult mortality is caused in part by undernutrition, which in turn is due to food limitation rather than to social and physiological factors. Predation causes only a small part of the annual adult mortality, and its effect is swamped by other factors. Diseases play an important part as a primary factor in juvenile mortality but not in adult mortality because of the development of immunity. However, both disease and predation are important as secondary agents killing adults already weakened by moderate undernutrition. It is suggested that they play an essential role by hastening the population's response to changes in the food supply, and hence dampening oscillations that might develop in population and resource.     

A working-class profession: opportunism and diversity in U.S. law

Experts of capitalist labor and economy have called white-collar professionals a “re-embedded market” inasmuch as they defy expectations that free-market economic life should be liberated from social and moral constraints. In the USA, lawyers, a historically middle-class community, have re-embedded their profession through robust ethics rules that prohibit opportunistic behavior. But, in recent years, they have seen increased opportunism by legal academics toward aspiring students eager for a chance at professional upward mobility. This shift has manifested in the increased recruitment of working-class students into low-value law schools struggling to fill their seats after the global economic downturn. As legal education grew more accessible to the working class, it grew increasingly detached from the morally grounded economic judgment that once characterized professionalism. From this example, I argue that the embeddedness of professional labor may be tied to socioeconomic class relations more than advanced knowledge and the informational asymmetries that entails.     

Health inequalities: new concerns about the children of single mothers.

OBJECTIVES--To show that the exclusion from conventional class based analyses of child mortality of children whose parents are classified as "unoccupied" produces a misleading picture of health inequalities. DESIGN--Reanalysis of data published in the childhood supplement of the registrar general''s decennial supplement on occupational mortality in England and Wales, which compares numerator data for registrations of deaths in children over the age of 1 but below their 16th birthday in 1979, 1980, 1982, and 1983 with data about children aged 1-15 who were enumerated at the 1981 census. RESULTS--Parents who are classified as "unoccupied" largely consist of economically inactive single mothers. Their children are estimated to represent 89% of the 614,000 aged 1-15 classified as "unoccupied" in the childhood supplement. They have the worst mortality record of all social groups--an age specific death rate of 68.8/100,000 a year, 42% worse than in social class V (48.4/100,000) and worse than that of social class I (22.8) by a factor of 3. At older ages (10-15 years) these children have a relative risk of death of 4.14 relative to classes I and II; the risk is 2.58 in children 0-4 and 2.56 in those 5-9. Relative risks of child mortality in social classes I and II in comparison to classes IV and V suggests a progressive shallowing from 2.08 at ages 1-4 to 1.37 at ages 10-15. When unoccupied parents were combined with classes IV and V and compared with classes I and II, however, inequalities seemed to be pervasive throughout childhood; the relative risks were 2.21 for those aged 1-4 and 1.98 for those aged 10-15. CONCLUSION--Children classified as unoccupied are almost certainly living in poverty as well as experiencing relatively high risks of mortality. Class based analyses which exclude them therefore produce a misleading picture of inequalities in child health. The implications for health policy are profound. Strategies to promote the nation''s health should acknowledge the importance of material and social deprivation more explicitly.     

Skin and environment

The human skin is one of the major human organs in perpetual interaction with environmental factors. Permanent micro-aggressions by light, mechanical factors or chemical factors are useful for the maintenance of healthy skin. For example light is necessary for vitamin D synthesis and for the control of skin inflammation. If the aggression is too strong, repair mechanisms are involved such as wound healing or DNA repair. Accumulation of aggressions could induce acute or chronic diseases such as sunburn, photoageing or skin carcinoma. On specific individuals with genetic predisposition environmental aggressions can induce frequent diseases such as atopic dermatitis, present in 20% of children or psoriasis, present in 2-3% of the European population. Chemical aggressions are responsible for irritant dermatitis or allergic dermatitis, which are among the most frequent professional diseases. Aggression by UV light is one of the best examples of the interaction between environment and health. At a low dose UV light is very good for the health. At a high dose it is responsible for photoageing and skin carcinoma. To improve the control of environmental factors important for health, two approaches are essential: 1) research into epidemiology to discover the causal relationships and into biology to discover the mechanisms involved; 2) education from childhood to explain the results of research and to propose effective behaviours. For each aggression individuals at risk have to be identified.     

The price of play: self-organized infant mortality cycles in chimpanzees

Chimpanzees have been used extensively as a model system for laboratory research on infectious diseases. Ironically, we know next to nothing about disease dynamics in wild chimpanzee populations. Here, we analyze long-term demographic and behavioral data from two habituated chimpanzee communities in Ta? National Park, C?te d'Ivoire, where previous work has shown respiratory pathogens to be an important source of infant mortality. In this paper we trace the effect of social connectivity on infant mortality dynamics. We focus on social play which, as the primary context of contact between young chimpanzees, may serve as a key venue for pathogen transmission. Infant abundance and mortality rates at Ta? cycled regularly and in a way that was not well explained in terms of environmental forcing. Rather, infant mortality cycles appeared to self-organize in response to the ontogeny of social play. Each cycle started when the death of multiple infants in an outbreak synchronized the reproductive cycles of their mothers. A pulse of births predictably arrived about twelve months later, with social connectivity increasing over the following two years as the large birth cohort approached the peak of social play. The high social connectivity at this play peak then appeared to facilitate further outbreaks. Our results provide the first evidence that social play has a strong role in determining chimpanzee disease transmission risk and the first record of chimpanzee disease cycles similar to those seen in human children. They also lend more support to the view that infectious diseases are a major threat to the survival of remaining chimpanzee populations.     

Social class differences in infant mortality: the problem of competing hypotheses

The authors acknowledge there is no agreed upon explanation of the social class gradient in infant mortality. Some individuals favor explanations based on natural or social selection; some stress the influence of environmental circumstances. Often, theories are presented in articles in such a way that implies an absolute choice is needed. The authors critically examine such a controversial article to point out that erroneous conclusions may be reached and attention may be diverted away from the basic concern of improving infant survival. The controversial article argues that maternal competence is responsible for infant survival. This competence comes from the attributes of intelligence, education, and initiative, which are genetically determined. The attributes are distributed differently between social classes, as evidenced by the social mobility of women in marriage. Class differences in genetically determined maternal competence, therefore, explain the social class gradient in infant mortality. The authors argue that the article is based on the assumption that the issues can be analyzed as mutually exclusive alternatives. For example, the 1st dichotomy is that socially mobile women are either swamped or uplifted by their new environment, or that the women are stratified socially through marriage, on the basis of certain personal attributes such as intelligence, education, health, and height. The 1st option is ignored on the basis that evidence is cited to support the 2nd option, and no allowance is made for the possibility that both explanations may play a part. The differences in opinions about the hypotheses reflect varying political implications. Much well-founded evidence about environmental health risks, for example, are dangerously ignored, such as poor housing or inadequate housing.     

An alternative method for assessing early mortality in contemporary populations

Biological anthropologists are interested in a population's early mortality rates for a variety of reasons. Early mortality (infant or juvenile) is of obvious importance to those interested in demography, but early mortality statistics are useful for life history analysis, paleodemography, and human adaptability studies, among others. In general, the form of mortality statistics is derived from demography, where chronological age is the gold standard for statistical calculation and comparison. However, there are numerous problems associated with the collection, analysis, and interpretation of early mortality statistics based on age, particularly for anthropological research, which is often conducted in small or non-calendrical-age numerate populations. The infant mortality rate (IMR), for example, is notoriously difficult to determine in populations where accurate accounting of age is not routine, and yet it is widely used in demography, public health, medicine, and social science research. Here we offer an alternative to age-based early mortality statistics that makes use of human biologists' interest in, and skill at, assessing human growth and development. Our proposal is to use developmental stages of juveniles instead of relying exclusively on age as the basis for mortality statistics. Death or survival according to a developmental stage (such as crawling or weaning) may provide more accurate data that are also more closely related to the cause of death. Developmental stages have the added advantage of putting infants and children back at the center of the discussion of early mortality by focusing on their activities in relation to their environment. A case study from the Turkana population of Kenya illustrates the use of developmental stages in describing early mortality. Am J Phys Anthropol 107:315–330, 1998. © 1998 Wiley-Liss, Inc.     

How Do Hunter-Gatherer Children Learn Subsistence Skills?

Hunting and gathering is, evolutionarily, the defining subsistence strategy of our species. Studying how children learn foraging skills can, therefore, provide us with key data to test theories about the evolution of human life history, cognition, and social behavior. Modern foragers, with their vast cultural and environmental diversity, have mostly been studied individually. However, cross-cultural studies allow us to extrapolate forager-wide trends in how, when, and from whom hunter-gatherer children learn their subsistence skills. We perform a meta-ethnography, which allows us to systematically extract, summarize, and compare both quantitative and qualitative literature. We found 58 publications focusing on learning subsistence skills. Learning begins early in infancy, when parents take children on foraging expeditions and give them toy versions of tools. In early and middle childhood, children transition into the multi-age playgroup, where they learn skills through play, observation, and participation. By the end of middle childhood, most children are proficient food collectors. However, it is not until adolescence that adults (not necessarily parents) begin directly teaching children complex skills such as hunting and complex tool manufacture. Adolescents seek to learn innovations from adults, but they themselves do not innovate. These findings support predictive models that find social learning should occur before individual learning. Furthermore, these results show that teaching does indeed exist in hunter-gatherer societies. And, finally, though children are competent foragers by late childhood, learning to extract more complex resources, such as hunting large game, takes a lifetime.