Ethnic fertility differentials in Peninsular Malaysia and Singapore

Differences in fertility between the three major ethnic groups (Malays, Chinese and Indians) in Peninsular Malaysia and Singapore have existed since before the onset of fertility decline in the late 1950s and remain today, although the relative positions and the actual differences have changed due to the varying rates of decline. By 1987, the Malays experienced the highest fertility and the Chinese the lowest in both countries but in Singapore the Malay fertility was lower than the Chinese fertility in Peninsular Malaysia. The fertility differentials will lead to changes in the ethnic composition in both countries but more so in Peninsular Malaysia.     

Stable aggregate fertility in a time of family change: a decomposition of trends in American fertility, 1970-1999

Population-level birth rates in the United States were largely stable between 1970 and 1999. This stability contrasts with rapid change in marriage rates and fertility timing during the same period. In this article, I use decomposition techniques to analyze this seeming paradox. I decompose the general fertility rate into four components: age distribution, marital status, age-specific nonmarital fertility, and age-specific marital fertility. Absent other changes, declining time spent married would have led to substantial decline in fertility. Several factors combined to counterbalance these changes in marital behavior. Among white women in the 1970s and 1980s, marital fertility rates increased at older ages, consistent with a scenario in which women postponed both marriage and childbearing; increased nonmarital birth rates during this period were not a driving factor in overall fertility trends. Increased nonmarital fertility was more important in compensating for declining time spent married among African American women and among white women in the 1990s.     

Seasonality of births for West Malaysia's two main racial groups.

Patterns of Malay and Chinese births occurring from January 1964 through December 1969 as registered by Malaysia's Department of Statistics were analyzed by comparing them with charts of major religious and secular holidays and with the marriage distributions (by month) of the 2 ethnic groups. For Malays there was a reduction in conc eptions associated with the Moslem month of Ramadan, a period of fasting. For the Chinese, number of conceptions peaked around the Chinese New Year, the main Chinese festival. For both groups the months of high marriage rates corresponded to months of high conception rates. Seasonal fluctuations in birthrates were higher for Malays than for the Chinese, which appeared to be due to the more pervasive effect of Islamic beliefs and practices on the Malay way of life. As the Malays constitute a more rural population, climate-related factors were considered as a possible explanation of their more extreme seasonal fluctuations, but the influence of climate could not be demonstrated for either the Malays or the Chinese.     

Seasonality of births: stability and change in a developing country

A marked seasonality of births for the two main ethnic groups of peninsular Malaysia, far exceeding the cyclic fluctuations in births in the United States and Canada, was reported for the 1960s. A 36% excess of births over the average monthly number was observed among Malays each January. Among the ethnic Chinese in Malaysia a regular periodicity in the numbers of births was also found, but it was far less marked and the peak occurred in October or November. The peaks in both groups were due in large measure to conceptions that correlate with religious observances or holidays. Here I report on cyclic birth patterns in peninsular Malaysia for the period 1970-1985. Rapid economic development has occurred during this time and has brought with it demographic changes, such as a massive rise in contraceptive use and a decline in birth rates. These demographic changes have been accompanied by the loss of the pronounced seasonal pattern of births among the Malays. The seasonality of Malay births is now of roughly the same magnitude as the seasonality in the United States and Canada, whereas seasonality of births among the Chinese in Malaysia remains essentially unchanged.     

Fertility levels, trends and differentials in Kuwait

Data used in this study come from the published reports of the censuses and vital registration systems. The crude birth rate in Kuwait is very high, although an apparent decline seems to have started in the period 1975-80. There are considerable differences between the Kuwaiti and non-Kuwaiti populations. The former had a relatively stable high rate around 50 until 1975 and then fell to 47 in 1980. The total fertility rate was 6.8 per woman. The rate for the non-Kuwaitis rose in 1965-70 and then fell sharply throughout 1970-1980, from 44 to 30. Non-Kuwaiti fertility is consistently lower than Kuwaiti fertility at all ages, the differences being relatively greater after age 35. The peak ages of fertility are 25-29 years for Kuwaitis and 20-29 years for non-Kuwaitis. For Kuwaitis, there is clear evidence of declining fertility in the younger age groups but not in the older, largely reflecting the trend towards later marriage among the younger Kuwaitis. As expected, there is a diminishing trend in completed family size from the least to the most educated women in both Kuwaiti and non-Kuwaiti women in all age groups. The illiterate women at marriage are younger than the university educated women by about 5 years. Results further show that women who are economically active have lower fertility than those who are not, both in Kuwaiti and non-Kuwaiti groups. The differences in each group are significant, as are differences in the fertility level by husband's occupation. High fertility in Kuwait, as well as in other oil-exporting Arab countries, is a result of a variety of factors including the generally pronatalist sentiment of the Arab population, improved health facilities, rising wealth, the youthful age structure, the young age at marriage and the substantial incentives in the different governmental schemes to promote native high fertility and keep a balance between the native and immigrant populations.     

Probabilities of marriage in two outer Hebridean islands, 1861-1990.

A study has been made of the probabilities of marriage of females and males aged 15-49 (either as a whole or in 5-year age groups) in two Outer Hebridean islands, Harris and Barra. The results were compared with ages of marriage and with the frequencies of permanent celibacy. The marriages took place between 1861 and 1990. Median ages of marriage rose to maxima in the 1930s and 1940s, then fell steeply, levelling out latterly. Permanent celibacy was consistently high among females, but rose from much lower levels in males to maxima in the 1970s and 1980s. It is concluded that in these populations age at marriage and the extent of permanent celibacy are largely independent of one another. In both islands the overall probabilities of females marrying fell until the 1920s, and then rose. The last decades showed stability (Barra) and a fall (Harris). Males showed only slight falls to about 1910; data were absent for between 1911 and 1960, but subsequently there was little rise in probability. These overall changes seemed to be associated with reciprocal variations in probabilities in the younger and older age groups. Declining overall probabilities were associated with declines in younger and increases in older age-group probabilities, and vice versa. Non-parametric correlations between median ages of marriage and probability of marriage were negative and generally significant for the 15-19 age group. Among the older age groups coefficients were generally positive. There was some evidence of an association between probability of marriage and sex ratio in any group of potential mates. The effect appeared more marked among 15- to 19-year-old females. Local factors which might explain at least part of the decline in nuptiality for the greater part of the period under study include the decline in the fishing industry and the 'land hunger' which existed until the late 1920s. This decline is interpreted as a 'Malthusian' response to economic and social conditions, but it coexisted with a 'neo-Malthusian' strategy, in the shape of declining marital fertility. The 'Malthusian' strategy seems to have been largely abandoned around the 1950s, but it may have reappeared during the 1980s.     

The Changing Timing of Births in Iran: An Explanation of the Rise and Fall in Fertility After the 1979 Islamic Revolution

Studies exploring the course of period fertility in Iran after the 1979 Islamic Revolution have not examined systematically the role played by changes in the timing of births. Using retrospective data from the 2000 Iran Demographic and Health Survey and frailty hazard models, this study finds that the rise in fertility in the early 1980s was due to faster transitions to the first birth among all social groups of women and to the fourth birth largely among illiterate and less educated women. In contrast, the rapid fertility decline after 1985 is attributed to slower transition to successive births, especially to the second, third, and fourth births. These findings point to the importance of education and contraceptive use (measured by length of previous birth interval) as key determinants of birth timing in Iran. Interaction between age at marriage and education positively influenced the timing of births, with stronger effects among highly educated women, suggesting that the onset of rapid fertility decline was likely driven by these highly educated women. Another interaction between the gender of prior children and education shows that birth timing, even among highly educated women, appears to have been influenced by son preference in Iran.     

Acid alpha-glucosidase in Malaysians. Population studies and the occurrence of a new variant.

Acid alpha-glucosidase from the placenta was electrophoretically surveyed in a total of 633 Malaysians, 236 of Malay, 261 of Chinese and 136 of Indian ancestries. A new variant, alpha-glucosidase 3-1 was observed in 1 Malay and 3 Indians. A polymorphism for this enzyme was observed among Indians, but in Chinese and Malays variants are rare. Phenotype 2-1 was observed once in a Chinese and once in a Malay.     

Ethnic differences in survival after breast cancer in South East Asia

Background

The burden of breast cancer in Asia is escalating. We evaluated the impact of ethnicity on survival after breast cancer in the multi-ethnic region of South East Asia.

Methodology/Principal Findings

Using the Singapore-Malaysia hospital-based breast cancer registry, we analyzed the association between ethnicity and mortality following breast cancer in 5,264 patients diagnosed between 1990 and 2007 (Chinese: 71.6%, Malay: 18.4%, Indian: 10.0%). We compared survival rates between ethnic groups and calculated adjusted hazard ratios (HR) to estimate the independent effect of ethnicity on survival. Malays (n = 968) presented at a significantly younger age, with larger tumors, and at later stages than the Chinese and Indians. Malays were also more likely to have axillary lymph node metastasis at similar tumor sizes and to have hormone receptor negative and poorly differentiated tumors. Five year overall survival was highest in the Chinese women (75.8%; 95%CI: 74.4%–77.3%) followed by Indians (68.0%; 95%CI: 63.8%–72.2%), and Malays (58.5%; 95%CI: 55.2%–61.7%). Compared to the Chinese, Malay ethnicity was associated with significantly higher risk of all-cause mortality (HR: 1.34; 95%CI: 1.19–1.51), independent of age, stage, tumor characteristics and treatment. Indian ethnicity was not significantly associated with risk of mortality after breast cancer compared to the Chinese (HR: 1.14; 95%CI: 0.98–1.34).

Conclusion

In South East Asia, Malay ethnicity is independently associated with poorer survival after breast cancer. Research into underlying reasons, potentially including variations in tumor biology, psychosocial factors, treatment responsiveness and lifestyle after diagnosis, is warranted.     

<Emphasis Type="Italic">ABCA1</Emphasis> gene polymorphisms and their associations with coronary artery disease and plasma lipids in males from three ethnic populations in Singapore

Mutations in the ATP-binding cassette transporter ABCA1 underlie Tangier disease and familial hypoalphaliproteinemia (FHA), disorders that are characterised by reduced high-density lipoprotein-cholesterol (HDL-C) concentration and cholesterol efflux, and increased coronary artery disease (CAD). We explored if polymorphisms in the ABCA1 gene are associated with CAD and variations in plasma lipid levels, especially HDL-C, and whether the associations may depend on ethnicity. Male cases and controls from the Singapore Chinese, Malay and Indian populations were genotyped for five ABCA1 single nucleotide polymorphisms. Various single-locus frequency distribution differences between cases and controls were detected in different ethnic groups: the promoter -14C>T in Indians, exon 18 M883I in Malays, and 3'-untranslated (UTR) region 8994A>G in Chinese. For the Malay population, certain haplotypes carrying the I825- A (exon 17) and M883- G alleles were more frequent among cases than controls, whereas the converse was true for the alternative configuration of V825- G and I883- A, and this association was reinforced in multi-locus disequilibrium analysis that utilized genotypic data. In the healthy controls, associations were found for -14C>T genotypes with HDL-C in Chinese; 237indelG (5'UTR) with apolipoprotein A1 (apoA1) in Malays and total cholesterol (TC) in Indians; M883I with lipoprotein(a) [Lp(a)] in Malays and apolipoprotein B (apoB) in Chinese; and 8994A>G with Lp(a) in Malays, and TC, low-density lipoprotein-cholesterol (LDL-C) as well as apoB in Indians. While genotype-phenotype associations were not reproduced across populations and loci, V825I and M883I were clearly associated with CAD status in Malays with no effects on HDL-C or apoA1.     

Erythrocyte adenosine deaminase in Malaysians.

944 adenosine deaminase phenotypings of Malay, Chinese, and Indian blood donors and newborns at Kuala Lumpur, Malaysia, yielded ADA1 gene frequency estimates of 0.885 for the Malays, 0.939 for the Chinese, and 0.853 for the Indians.     

Salivary proline-rich protein polymorphisms in Chinese, Malays and Indians in Singapore

Salivary proline-rich protein (PRP) polymorphism, PRH1, PRH2, Ps, Pm (PmF), PmS and Gl, were investigated in three ethnic groups in Singapore: Chinese, Malays and Indians. The phenotype and gene frequencies were presented and comparison with other ethnic groups was made. The As protein, which was recently found in Japanese but not in Caucasians as a new allelic product of the PRH1 locus, was also observed in Chinese and Malays but not in Indians. Another allelic product (Ps4) of Ps protein polymorphism was found in Malays but not in Chinese and Indians. The results indicate the usefulness of salivary PRP polymorphism as markers in population genetic studies.     

Ethnic Variation in the Correlation Between Fasting Glucose Concentration and Glycated Hemoglobin (HbA1C)

ObjectiveWe aimed to determine the relationship between fasting serum glucose (FSG) concentration and glycated hemoglobin-Alc (HbAlc) in the 3 ethnicities in Singapore after adjustment for demographic and therapeutic variables.MethodsFasting serum glucose (FSG), HbAlc, and serum creatinine levels were simultaneously sampled from 575 patients with diabetes (389 Chinese, 97 Indians, 89 Malays) in this cross-sectional study between January and May 2008, and the results were subjected to multivariate linear regression analysis.ResultsWe found a significant interaction between FSG and ethnicity on HbAlc. The correlation between FSG and HbAlc among Chinese subjects was 0.25 (95% confidence interval [CI]:0.2-0.3) relative to the Malays (0.38, 95% CI: 0.30-0.45) after adjustment for age; gender; serum creatinine concentrations; body mass index (BMI); duration of diabetes; use of sulfonylureas, metformin, and insulin; and hemoglobin (Hb) and red cell indices (P = .005). Hence, for a given FSG, the predicted HbAlc will be higher in Malays compared to Chinese subjects.We did not observe a statistically significant difference between Indians and Malays with respect to the correlation between FSG and HbAlc.ConclusionWe showed a higher correlation between HbAlc and FSG in Malay subjects relative to the Chinese in this cohort. The ethnic variation in the HbAlc-FSG relationship may be related to differences in percentage contribution by the FSG to overall HbAlc among ethnic groups. Future studies using continuous glucose monitoring (CGM) to elucidate the relative contributions by FSG and postprandial glucose (PPG) to the daily blood glucose profile and the overall HbA1c by ethnicity are required. (Endocr Pract. 2013;19:812-817)     

Social-demographic influence on first birth interval in China, 1980-1992

This study examines the delay between first marriage and first live birth in China among a sample of women who married between 1980 and 1992. Most couples in China only use contraception after the first child is born. Most sample women had their first child within 2 years of marriage. However, there are significant rural-urban differences in the first birth interval, indicating that there was most probably deliberate fertility regulation after marriage among many urban couples. Survival analysis shows that place of residence, level of education, age at first marriage and marriage cohort affect the first birth interval.     

Biological and behavioral determinants of fertility in Tierra del Fuego

The reproductive history of 182 women in postreproductive life or near menopause from the Chilean part of Tierra del Fuego was traced back by means of familial interviews. These postmenopausal women represent the population since almost the beginning of the settlement, and their reproductive years were spent on the island. Path analysis was applied to analyze fertility determinants of these women and to propose a complex model of interconnections among factors. The reproductive history of these women is characterized by a long fertile span, a short childbearing period, and low fertility. Age at menarche is relatively late, and the age of the women at first birth is mainly determined by their late age at marriage. The use of contraception is related to both spacing and stopping behaviors. The late age of women at marriage, the rhythm of conception, and practices of contraception are proposed as the main determinants of fertility in Tierra del Fuego.     

Fertility preferences among Malaysian women: an analysis of responses to the new population policy

About 10% of 3887 ever-married women included in the 1984-85 Malaysian Population and Family Survey revealed that they were influenced by the new population policy to desire more children than they had originally wanted. These women were more likely to be rural Malays from the lower socioeconomic class. Ideal family size was more than four children. Children are desired for economic benefits and emotional support. The natality of the Malays has risen since 1980: their total fertility rate has increased while their contraceptive prevalence rate has dropped sharply. Coupled with a decline in the crude death rate, the present fertility preferences and behaviour of the Malays will render the target of the population policy more attainable than is reflected by the survey data.     

Apolipoprotein A-IV polymorphism in Singapore ethnic groups

A total of 627 subjects comprising 455 Chinese, 127 Dravidian Indians and 45 Malays were investigated for serum Apo A-IV polymorphism. The frequency of Apo A-IV*2 was found to be significantly higher (p less than 0.001) in Indians (0.043) compared to that in the Chinese (0.010) and Malays (0.011). The frequency of A-IV*3 was found to be around 0.02 in all the ethnic groups. A low frequency of A-IV*4 (less than 0.01) was observed in the Chinese and Indians. The phenotypic distribution of Apo A-IV was at Hardy-Weinberg equilibrium in the three ethnic groups.     

Fertility Changes in Rural Moroccan Berbers during the 20th Century

Morocco’s fertility pattern evolved in the 20th century from a traditional model close to ‘natural fertility’ to a modern pattern incorporating contraception. The very high fertility rate of nearly 7 offspring per woman observed in the 1960s was still at a level of 5.5 offspring per woman in the early 1980s. The total fertility rate subsequently declined to 2.5 by 2003. This decline was apparently, principally, the result of two factors in the urban context: the relative increase in women’s age at marriage and the use of contraception to regulate and to close reproduction. This research studied a group of Berber agriculturists in the region of Marrakech to better understand the extension and modalities of fertility changes in a rural environment. Though delayed, the changes observed in rural Berbers paralleled the general trends seen at the national level. As in the urban environment, the changes affecting reproductive patterns resulted from an increase in the age at marriage of women and the introduction of contraception. However, these changes were apparently minor adaptations to the traditional pattern, in that the progressive increase in mean age at marriage was obtained by the decrease in the frequency of pre-nubile unions (<15 years old) and not from the upward shift of the modal age. On the other hand, contraception apparently was employed to stop childbearing after the expected family size was already attained.     

Social,biological, and political considerations on fertility in Arab populations

In analyzing fertility in the Arab countries, crude birth rate, total fecundity rate, and age specific fertility rates were measured. The data was obtained from United Nations, UNICEF, and the World Bank. In the early 1980's 13 of the countries had birth rates 40/1000. The majority of countries showed a decline in their crude birth rate (CBR) between 1960-83, except Somalia, which increased. The United Arab Emirates (UAE), Tunisia, Lebanon, and Kuwait, had the largest CBR decreases, followed by Morocco, Egypt, and Saudi Arabia. The global fecundity rate (GFR) shows the number of expected births a woman lives through her reproductive period, having children at the prevailing rate for each age. The GFR in these countries is much higher than those of non Moslem countries in the area. Results show that the fertility of Arab countries are in a gradual decline, but remain high, and many have a CBR over 40/1000. In the last 20 years Saudi Arabia, with the largest population of oil producing countries, has had a decreasing CBR. It is not in agreement with its high GFR, but this can be attributed to the large number of immigration workers in the country. The UAE showed a decrease in CBR from 46/1000 to 27/1000, the largest decrease in these countries. This decline coincided with the economic development due to oil production. Kuwait had a 25.5% decrease in CBR but less than Tunisia and Lebanon. The fertility decline in Kuwait intensified in the middle 1970's; the decline in northern Africa began in the late 1960's. There were declines in birth rates in the North African countries in the early 1970's except for Tunisia. The rapid declines in fertility can be attributed to the countries' socioeconomic and political situations.     

Kin influences on fertility in Thailand: Effects and mechanisms

It has been suggested that human mothers are cooperative breeders, as they need help from others to successfully raise offspring. Studies working under this framework have found correlations between the presence of kin and both child survival and female fertility rates. This study seeks to understand the proximate mechanisms by which kin influence fertility using data from the 1987 Thailand Demographic and Health Survey (DHS), a nationally representative sample of 6775 women. Kin influence is measured by the length of time couples live with the husband's or wife's parents after marriage. Event history analysis, multilevel modeling and structural equation modeling are used to investigate both fertility outcomes and potential pathways through which postnuptial residence may influence fertility outcomes, including employment status, maternal and child outcomes, contraceptive use, breastfeeding duration, and age at marriage. We show that living virilocally (with husband's kin after marriage) increases total fertility by shortening time from marriage to first birth, and increasing the likelihood of progression to each subsequent birth. These effects are mediated through correlations between virilocal residence and earlier age at marriage as well as delayed initiation of contraceptive use. We find no influence of husband's kin on maternal or child outcomes. Living uxorilocally (with wife's kin after marriage) also reduces age at marriage, shortens time from marriage to first birth and (marginally) improves child survivorship, but has no effect on other child and maternal outcomes or progression to subsequent births and results in a similar number of living children as women living neolocally.