The main trends in the palaeodemography of the 7th-18th century population of Latvia

The study represents palaeodemographic research of osteological material of 3304 individuals from the funds of the Anthropological Laboratory of the Institute of History of the University of Latvia in Riga, dating from the 7th to the 18th century AD. Compensated life expectancy at birth is varying between 20.3 and 22.2 years during the research period. Crude mortality has changed between 49.3 and 45% per hundred. In the early period (7th-13th century) there is a significant male prevalence (2.2-1.4); female life expectancy at the age of 20 is on average 6.6 years less than for males. This difference decreases to 5.4 years in the 13th-18th century. According to historical demography, female life span exceeded male only in the 2nd half of 19th century. The palaeodemographic data indicate that in the 7th-18th century, women in Latvia gave birth to a mean of 4-5 children (the figure includes childless women), of whom half, at most 2-2.5, reached reproductive age, on account of high child mortality. The net reproductive rate R0 (the number of descendants per individual of the parents' generation) varies between 1 and 1.25 in the study period. Concerning the completely excavated cemeteries of Lejasbiteni (7th-10h century) and Daudziesi (16th-17th century), it was possible to calculate the size and structure of the populations that had used these cemeteries. They were similar, having 45.3-49.9% of children up to an age of 14 and 24-28% individuals over the age of 30. According to historical demography, radical improvement of the demographic situation in Latvia began in the second half of the 19th century, when the process of demographic transition in Latvia started.     

Mortality and age differences in marriage.

Data from the 1971 census population were used to evaluate the effects of age differences of married partners on mortality rates. Different age groups were isolated to highlight the association between mortality and age of spouse for specific ages of married men and women. Men married to much younger or to older women exhibited a higher mortality rate than men married to women who were only a few years younger than themselves. A similar trend was observed among women married to much younger or much older men compared with those whose spouses were a few years older or of similar ages as themselves. Trends for other age groups (women aged 60-69 years, men below 40, and women below 30) did not exhibit a clear pattern. Although statistical biases within age groups may in part account for the differences in the findings, the trend which emerged from the analysis suggests that lower morbidity is associated with the most common age combinations (husbands same age or slightly older than wives). Other factors could also account for the differences (e.g., selection of healthy partners in 1st marriages, differences in lifestyles between married and single).     

Long-term trends in marital status mortality differences in The Netherlands 1850-1970

This article describes the long-term trends in marital status mortality differences in the Netherlands using a unique dataset relating to the period 1850-1970. Poisson regression analysis was applied to calculate relative mortality risks by marital status. For two periods, cause-of-death by marital status could be used. Clear differences in mortality by marital status were observed, with strongly increasing advantages for married men and women and a relative increase in the mortality of widowed compared with non-married people. Excess mortality among single and formerly married men and women was visible in many cause-of-death categories, and this became more widespread during the last decades of the nineteenth century. Hypotheses are formulated that might explain why married men and women underwent a stronger decrease in mortality up until the end of World War II.     

Survey of 3,000 Unwanted Pregnancies

A survey of 3,000 unwanted pregnancies disclosed two main populations differing in age, marital status, and contraceptive practice. Failure to use contraception accounted for two-thirds of the pregnancies. More than half of the patients were married women or single women in stable relationships, but many single women faced their predicament alone, without help from partner or parent.Some evidence is given of valid needs which could not be met by existing N.H.S. facilities.     

Assessing the utilization of maternal and child health care among married adolescent women: evidence from India

This study explores the prevalence and factors associated with the utilization of maternal and child health care services among married adolescent women in India using the third round of the National Family Health Survey (2005-06). The findings suggest that the utilization of maternal and child health care services among adolescent women is far from satisfactory in India. A little over 10% of adolescent women utilized antenatal care, about 50% utilized safe delivery services and about 41% of the children of adolescent women received full immunization. Large differences by urban-rural residence, educational attainment, religion, economic status and region were evident. Both gross effect and fixed effect binary logit models yielded statistically significant socioeconomic and demographic factors. Women's education, wealth quintile and region are the most important determinants for the utilization of maternal and child health care services. Health care programmes should focus more on educating adolescents, providing financial support, creating awareness and counselling households with married adolescent women. Moreover, there should be substantial financial assistance for the provision of delivery and child care for married women below the age of 19 years.     

Alcohol Consumption Practices among Married Women of Reproductive Age in Nepal: A Population Based Household Survey

BackgroundAlcohol chemically known as ethanol, causes several health, economic and social consequences across the world. Literatures suggest potential harm of alcohol drinking by pregnant women especially to the fetus and the mother. Despite anumber of significant public health problems related to alcohol consumption, this area has been ignored in Nepal and information at the national level is limited. Thus this study aimed at finding the prevalence of alcohol consumption among married women of reproductive age.MethodsA nationally representative household survey was carried out from April to August 2013 by taking 16 districts across all 15 eco administrative regions. From the selected districts, 86 village development committees and 14 municipalities were selected as primary sampling units using probability proportionate to size, followed by random selection of 3 wards from each primary sampling unit. Finally, 30 households within each ward were selected using systematic random sampling, and one married women of reproductive age from each household. A total of 9000 married women of reproductive age were interviewed using a semi-structured questionnaire, on alcohol consumption practices including environmental factors and socio demographic characteristics and were included in the analysis.ResultsNational prevalence of alcohol consumption ever among married women of reproductive age was 24.7% (95% CI:21.7–28.0), last 12 months 17.9% (95% CI:15.3–20.7) and last 30 days (current drinking) 11.8% (95% CI:9.8–14.1). There was substantial variation among the districts ranging from 2% to 60%. Multivariable analysis suggests women with no education or within formal education, dalit and janajatis ethnicity, whose husbands drink alcohol, who brew alcohol at home and women from mountains were significantly at higher risk of consuming alcohol. Among the women who drank alcohol in last 12 months, a substantial proportion of them drank home brewed alcoholic beverages (95.9%, 95% CI:94.3–97.4).ConclusionAlcohol consumption was common practice among married women of reproductive age in Nepal with variation among the subgroups of population. Thus, further investigation and behavior change communication interventions to reduce alcohol consumption especially among the women with higher risk of drinking is essential.     

Effects of oral contraceptive use on body mass index and blood pressure among female villagers in north-east Thailand

The use of contraceptives has become prevalent among females in Thailand in the past 20 years, and oral contraceptive use has been suggested to trigger changes in fat intake, energy expenditure, fat metabolism and blood pressure. Based on field investigations of 391 married women aged 20 years or over in Yasothon Province, North-east Thailand, this study aims to elucidate the effects of oral contraceptive use on body mass index (BMI: kg/m2) and blood pressure, taking into account reproductive histories and socioeconomic conditions. The proportion of obese (BMI > or = 25) subjects was high in the age groups 30-39, 40-49 and 50-59, accounting for, respectively, 39.4%, 51.1% and 48.5% of these populations. The proportion of women with hypertension (90/140 mmHg) was 23.7%, 18.5% and 26.2% in the 40-49, 50-59 and 60-69 age groups. Current contraceptive practices in the studied population included sterilization by operation, oral contraception and injection. These methods accounted for 43.0%, 12.8% and 8.2% of the population, respectively. Sociodemographic factors such as reproductive history, years of education and household income were not significantly related to BMI or to blood pressure (ANOVA with age adjustment). In contrast, oral contraceptive users had significantly higher BMIs and diastolic blood pressures (p<0.01, ANOVA with age adjustment). Multiple regression analysis also revealed that oral contraceptive use was a weak but significant contributing factor to both high BMI and blood pressure when sociodemographic factors were taken into account and controlled for statistically. It can thus be concluded that the use of contraceptive pills, which contain oestrogen and progestin and are provided free of charge to Thai women, tend to increase BMI and to elevate blood pressure.     

Therapeutic abortion and its psychological implications: the Canadian experience.

Approximately 9 months after a legal therapeutic abortion, 188 Canadian women were interviewed. One half were single and the rest were married, separated or divorced. They were matched closely for a number of demographic variables with control women who had not had abortions. Neurotic disturbance in several areas of personality functioning was assessed from questionnaire responses. Out of 27 psychological scales, differences between the abortion and control groups were found on only 3: in general, women who had had abortions were more rebellious than control women, abortion tended to be associated with somewhat greater depression in married women, and single women who had had abortions scored higher on the shallow-affect scale. However, all the personality scores were well within the normal range. Perceived social support was strongly associated with favourable psychological reactions after abortion. Use of contraceptives improved greatly after the abortion, when over 90% of women reported using contraceptives regularly.     

Contraception after childbirth in Thailand

Data from the Third Contraceptive Prevalence Study conducted in 1984 in Thailand were analyzed to learn the extent of contraceptive practice after childbirth. Focusing on those women who had a birth within a given period prior to the survey, for some purposes the analysis was limited to those women whose most recent birth occurred within 1 year of interview, while for others it was extended to women whose most recent birth occurred within the last 2-4 years. The number of women in 4 years following childbirth in the Contraceptive Prevalence Survey 3 sample were 3442 in the unweighted ever married group and 3342 in the unweighted currently married group; the figures were 3447 for the weighted ever married group and 3342 for the weighted currently married group. Thai couples adopted contraception in very substantial proportions and very soon following the birth of a child. Based on women interviewed within 1 year of most recent birth, over half started some contraception by the end of the 6th month and almost 4/5 by the end of the 1st year. The timing of female sterilization was quite different from initiation of all other methods. Female sterilization in Thailand occurred primarily during the immediate postpartum period, while women are still in the hospital after delivery. Relatively few women sterilized in the 2 years following the 1st postpartum month. Of women in their first 2 years following childbirth, 17% were sterilized by the end of the 1st postpartum month and only an additional 3% by the end of the 2nd year. Initiation of temporary methods was not linked to the immediate postpartum period but occurred throughout the 1st year following birth. Contraceptive use during the 1st year following childbirth was more likely among menstruating women than among women who were still amenorrheic. Methods other than female sterilization predominated among women who already experienced the return of menses, suggesting that the return of menses was an important stimulus to their adoption. The data suggest that the proportion of Thai women exposed to risk of unwanted pregnancies for any extended period of time following childbirth is quite modest.     

The effect of marriage on utilization of colorectal endoscopy exam in the United States

Purpose: This study examines the association between marriage and colorectal endoscopy exam, and whether this association varies by gender and financial benefits of marriage including improved access to health insurance and pooled family income. Methods: Representative survey data of the non-institutionalized United States population were used from the 2000, 2005, and 2008 National Health Interview Survey. Analyses targeted persons 50-85 years of age without a personal history of cancer and with complete information on all study variables (n=21,760). Multivariate logistic regression was used to model marital status differences in the probability of undergoing a colorectal endoscopy exam with interaction effects used to model variation over time by gender, health insurance, and poverty level. Results: Married persons were more likely than unmarried persons to report ever having undergone a colorectal endoscopy exam (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.12-1.29), and the difference between married and unmarried persons in the probability of undergoing a colorectal endoscopy exam remained stable over time. Married persons were more likely than unmarried persons to report having undergone a colorectal endoscopy exam within the past 10 years (OR, 1.49; 95% CI, 1.15-1.95). For each survey year, married men were significantly more likely than women and unmarried men to report having undergone a colorectal endoscopy exam. For example, in 2008, 56% of married men reported having undergone a colorectal endoscopy exam, compared to 49% of unmarried men, 52% of married women, and 50% of unmarried women. Among persons with health insurance, married persons were significantly more likely than unmarried persons to have undergone a colorectal endoscopy exam. Among persons who were poor, there was no difference by marital status in the likelihood of having undergone a colorectal endoscopy exam. However, among persons who were not poor, married persons were more likely than unmarried persons to have undergone a colorectal endoscopy exam. Conclusion: Given that colorectal endoscopy exams are a potentially life-saving procedure, persistently higher uptake of colorectal endoscopy for married persons over time may be an important health promoting benefit of marriage. Therefore, clinicians and policy makers should focus on improving the use of cancer prevention services among unmarried persons.     

Cessation of childbearing in the absence of contraception in Sri Lanka

In data from the Sri Lanka Fertility Survey, 1975, the cessation of childbearing is examined among women who have never used contraception. The sample consisted of 6810 currently or previously married women, 57% of whom reported that they had never used contraception. Cessation of childbearing is studied according to age and marriage duration. The variables analyzed are age at last birth, proportions infertile during the last 5 or 7 years, and the infertile open interval. The duration of breastfeeding is taken into account where necessary, and the contraceptive users and nonusers are compared where appropriate. Non-users tend to cease childbearing early, and therefore are infertile for longer periods during their marriages. It is probably age of the 1st child that influences decisions on future fertility. Among women aged 45-49 who married before age 20 and continued in their 1st marriage, mean age at last live birth in non-users, was 34.5 years, about 2 years earlier than in those who had used contraception. Non-users who married at any age below 30 years cease childbearing well below age 40. The proportion not currently pregnant and infertile over the past 5 years increases with marriage duration among the fertile non-users in each age group. When age at last birth and the duration of breastfeeding in the open interval are taken into account and the reference period is increased to 7 years, the period of infertility increases with marriage duration among nonpregnant non-users below age 45. The proportion of women who were currently not pregnant and had remained infertile over the past 7 years is higher among the older non-users whose 1st child was born more than 10 years ago.     

How does marriage affect length of life? Analysis of a French historical dataset from an evolutionary perspective

There are broadly two explanations for why human longevity appears to be extended by marriage. First, there is the social explanation, whereby the companionship, division of labour and the economic support that marriage offers is thought to extend life. Second, there is a selective explanation, whereby those individuals with high potential longevity are more attractive to the opposite sex and therefore more likely to get married. Here we analyse the “TRA” dataset from 19th century France, using an evolutionary approach to address the question of why marriage is linked to longevity, focussing particularly on sex differences. The dataset is based on death and marriage records from all of France between 1798 and 1901 and includes information on age at death, marriage and wealth for individuals whose surnames began with the letters TRA. We find that marriage is positively associated with longevity, particularly for men. In part, this is related to the higher rate of deaths for single males during marriageable age, as compared to a higher rate of deaths for females during marriage. There is a positive association between wealth (at death) and longevity for individuals who were single or married at death, with a stronger effect for singles. Analysis of the effect of spousal age gap on duration of survival after first marriage indicates that men who were married to younger women lived longer, whereas the longevity of women was not associated with the spousal age gap. We put forward an evolutionary perspective on marriage and longevity, hypothesizing that there is an important role for sexual selection in the association between marriage and longevity, with women selecting on characteristics associated with longevity, whilst men select on characteristics associated with reproductive potential.     

Does early age at marriage influence gynaecological morbidities among Pakistani women?

This paper presents the prevalence of and investigates predictors for specific perceived gynaecological morbidities in Pakistani women. A total of 717 women were identified from eight squatter settlements in Karachi, Pakistan. Detailed information on demographics, contraceptive use and gynaecological morbidities was elicited. The perceived prevalence of uterine prolapse was 19.1% and that of pelvic inflammatory disease 12.8%. The prevalence of uterine prolapse (adjusted odds ratio 1.8; 95% confidence interval 1.0-3.0) was significantly higher among women who married at younger ages (< or = 16 years), independent of education, socioeconomic status and parity. That of pelvic inflammatory disease was significantly higher among those under 21 years of age (adjusted odds ratio 2.3; 95% confidence interval 1.1-4.8), independent of education, socioeconomic status and parity. Young Pakistani women report an immense burden of reproductive ill health, especially those who began sexual activity at an early age.     

Health checks in general practice: another example of inverse care?

OBJECTIVE--To assess attendance at and the characteristics of patients attending health checks for cardiovascular disease offered in a general practice over a period of five years (1984-9). DESIGN--Medical record audit and postal questionnaire survey. SETTING--One general practice in Oxfordshire with a socially diverse population. PARTICIPANTS--1101 Men and 1110 women aged 35-64 registered with the practice. MAIN OUTCOME MEASURES--Age, sex, marital state, social class, smoking habits, alcohol consumption, and diet. RESULTS--Of the 2211 men and women in the target age group (35-64) in 1989, 1458 (65.9%) had been offered screening and 963 (43.6%) had attended for a health check. Attenders were more likely to be women, aged greater than or equal to 45, married, non-smokers, and of higher social class than patients who did not respond to the invitation. The relative likelihood of non-attendance was 1.24 for smokers, 1.20 for the overweight, 1.16 for heavy drinkers, and 1.28 for those with a less healthy diet, even after adjustment for age, sex, marital state, and social class. CONCLUSIONS--After five years of offering health checks, opportunistically (to men) and in the context of cervical smear tests (to women), less than half of the eligible patients had attended. The likelihood of acceptance of an invitation to attend was inversely related to the patient''s cardiovascular risk for all factors measured except age. A coherent strategy to reduce cardiovascular disease depends on more careful targeting of scarce health service resources and more emphasis on public health measures (such as dietary regulation and tobacco taxation). Doctors should be careful not to absolve the government of its public health obligations by substituting unproved preventive interventions aimed at the individual patient.     

Inequalities in women's health: looking at mortality differentials using an alternative approach

Data obtained from follow up of the 1971 census sample in the Office of Population Censuses and Surveys longitudinal study of England and Wales were used to look at women''s mortality differentials at ages 15-59. Women were grouped by combining information on marital state, own occupation, husband''s occupation (if married), economic activity, and indicators of household wealth (housing tenure and access to a car). Large groups were found with considerable differences in mortality. High mortality was associated with working in manual occupations and living in rented housing with no car in the household. In contrast, low mortality was associated with non-manual occupations and living in owner occupied housing with a car. Among married housewives and single women these extreme groups contributed 44% of expected deaths, the disadvantaged group experiencing death rates two and a half times that of the advantaged group. Smaller differences were found among married women with an occupational class.These findings are further evidence of the “health divide” in England and Wales and show that accurately to reflect the relation between a woman''s life circumstances and mortality it is necessary to utilise other measures than those based solely on occupation.     

Decline of Supportive Attitudes among Husbands toward Female Genital Mutilation and Its Association to Those Practices in Yemen

Objectives

To elucidate the attitudes of women and their husband’s towards female genital mutilation (FGM) and their associations with the continuation of FGM upon their daughters.

Methods

Subjects were 10,345 (in 1997) and 11,252 (in 2003) ever married women aged 15 to 49 years from the Yemen Demographic Health Surveys. Performances of FGM on the most-recently-born daughters were investigated. Attitudes of women and their husbands were assessed by their opinions on the continuation of FGM. The association between the attitudes of women and their husbands and performance of FGM on the most-recently-born daughters were investigated after adjusting for age and education of the women.

Findings

The percentage among the most-recently-born daughters who received FGM of women who had undergone FGM declined from 61.9% in 1997 to 56.5% in 2003 (p<0.001). The percentages of women who had undergone FGM and who supported the continuation of FGM and of husbands who also supported its continuation decreased from 78.2% and 60.1% in 1997 to 70.9% and 49.5% in 2003, respectively (both p<0.001). When the women or the husbands did not agree with FGM, it was less likely to be performed on their daughter than when the women or the husbands agreed in 1997 (odds ratio=0.11, 95% confidence interval 0.07-0.16 and odds ratio=0.07, 95% confidence interval 0.04-0.12, respectively) and in 2003 (odds ratio=0.12, 95% confidence interval 0.09-0.16 and odds ratio=0.11, 95% confidence interval 0.07-0.16, respectively).

Conclusion

Non-supportive attitudes of women and their husbands towards the continuation of FGM have become common and were associated with their decision not to perform FGM upon their daughters.     

Differentials of fertility between polygynous and monogamous marriages in rural Bangladesh

This paper discusses polygynous marriages in rural Bangladesh, using marital status and birth registration data from the Demographic Surveillance System (DSS) of the International Center for Diarrheal Disease Research, for the period 1975-79. Of all the marriages recorded during this period about 5% were polygynous. To identify the women polygynously married, 1974 census data of the DSS area were used. The difference in age at marriage between the polygynous groom and his subsequent wife was 15 years on average. The socioeconomic indicators studied were education, occupation and area of dwelling space. In general, these indicators between women in monogamous marriages were significantly higher than between the women in polygynous unions. During the period 1976-79, 863 polygynous marriages were recorded (4.9% of all marriages in the study area). Polygynous marriages were found to be less frequent among men with 2ndary and higher levels of education. The highest proportion of polygynous marriages occurred among husbands with no schooling or Koranic education. The general fertility rate of women in monogamous marriages was significantly higher than for women in polygynous marriages, overall and in all age groups except 20-24. During the period 1975-79, the mean number of liveborn children for monogamous women was higher than that of polygynous women.     

Deliveries in teenagers at a Newfoundland general hospital.

A study of deliveries in teenagers was undertaken for the year 1975 in a hospital that had recorded 2797 births, 371 (13%) of which were to women under 20 years of age. Conception had occurred out of wedlock in 314 (85%) of the 371 pregnancies; 124 of the 314 women had married during the pregnancy, most often in the 3rd or 4th month of gestation. The peak months for conception out of wedlock were June and December. This was not the first pregnancy for 65 women (18%), 21 of whom had married during a previous pregnancy. Of the "heads of the households" 36% were labourers and 27% were unemployed. Cesarean section was the method of delivery for 51 (14%) of the women, and 63 (17%) were reported as having had toxemia. There were seven perinatal deaths and seven infants had severe congenital abnormalities. The frequency of low birth weight was 6% overall but 13% for the infants of single women. Five women underwent tubal ligation post partum.     

Snoring in adults: some epidemiologic aspects.

Although snoring is a common problem it has received little attention in the medical literature. Therefore, a study was undertaken to determine the prevalence and epidemiologic aspects of snoring. The results showed that it is much more common than previously thought--86% of the married men and 57% of the married women were reported to snore. Overall, snoring was found to be more frequent in adult men than women, and its prevalence in adults was not related to age. It was found that 15% of the husbands and 52% of the wives were bothered by their spouse''s snoring. Physicians must be made more aware of this problem and its potential effects on patients.     

The Spanish woman and birth control

The author presents in this article just a small part of the results obtained in national survey of 1.902 married women, carried out in 1972, on "fertility and family planning in Spain". More specifically, attitudes of this sample of Spanish married women towards family planning are explained. It is pointed out, in the first place, that eight out of every ten interviewed women say that all married couples who can have children ought to have them. Younger women and those with a higher socio-econimic status, however, are less in favor of that statement. Trough several questions it is also evident that the number of interviewees who think that other women control their fertility is higher the more distant from the respondent is the social circle about which the question is formulated. In other words, interviewees resist to admit that persons with whom they are more intimately related control their fertility. Approximately half the women in the sample say that married couples should have as many children as may come, but the other half say that couples should decide the number of children they want to have and when they want to have them. This last opinion is relatively more important among younger and higher status women. Along with the previous finding, almost half of the interviewees are very much in favor or rather in favor of family planning, that proportion being even higher among younger and higher status women. Finally, seven ou of every ten respondents say that there should be wide and complete information about all family planning methods, leaving it up to each individual to use or not to use them according to its own conscience. This opinion, of course, is also more common among younger and higher status women.