Andrew Hinde

Perception of risk of HIV / AIDS and sexual behaviour in Kenya.

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

Gender, family, and the nutritional status of children in three culturally contrasting states of India

This paper has three main aims: to measure the clustering of children with low weight for age z-scores within families, to establish whether significant differences exist by gender in weight for age z-scores, and to demonstrate whether the presence of a mother-in-law in the household has any significant impact on the nutritional status of young children. Regression modelling is used to examine the weight for age z-scores of children under the age of four years in Maharashtra, Tamil Nadu and Uttar Pradesh using the 1992-93 Indian National Family Health Survey data. Random effects models measure the clustering of children with low weight for age z-scores in families, controlling for a number of other family factors. Our findings do not reveal significant gender differences in weight for age z-scores. Although little variation was found between family structures in the nutritional status of children, there were significant differences between families after controlling for family type. This suggests that there are differences between families that cannot be explained by a cross-sectional demographic survey. The evidence from this work suggests that nutrition programs need to adopt community nutrition interventions that aim resources at young children from families where children with low weight for age z-scores are found to cluster. However, there is a need for further inter-disciplinary research to collect data from families on behavioural factors and resource allocation in order that we might better understand why some families are more prone to having children with low weight for age z-scores. The diversity in the significant covariates between the three states in the models has shown the need for Indian nutrition programs to adopt state-specific approaches to tackling malnutrition.

INFANT AND CHILD MORTALITY IN THREE CULTURALLY CONTRASTING STATES OF INDIA

Using cross-sectional, individual-level survey data from Maharashtra, Tamil Nadu and Uttar Pradesh collected under the Indian National Family Health Survey programme of 1992-93, statistical modelling was used to analyse the impact of a range of variables on the survival status of children during their first 2 years of life. Attention was focused on the potential impact of the mothers autonomy. The strongest predictors of mortality were demographic and biological factors, breast-feeding behaviour, and use and knowledge of health services. Variables that can be interpreted as being related to maternal autonomy, such as the presence of a mother-in-law in the household, did not have a significant direct effect on child survival at the individual level, and their indirect effects were very limited.

Factors associated with contraceptive approval among religious leaders in Pakistan.

Research is needed to understand the role of religion in family planning dynamics, particularly in societies where the views of religious leaders can be an important influence on the reproductive decisions of individuals. This paper attempts to describe the factors associated with approval of contraception among religious leaders in Pakistan. The data are taken from the 1999-2000 Survey of Perception of Religious Leaders about Population Welfare. Regression modelling shows that whether or not religious leaders approve of family planning is associated with their views on the ideal family size, their level of religious education, the specific religious sect to which they belong, their own knowledge and use of family planning, their exposure to television and the region of the country in which they live.

Estimating fertility rates using the ONS Longitudinal Study - what difference does the inclusion of non-continually resident members make?

Among datasets available for fertility research in England and Wales, the Office for National Statistics (ONS) Longitudinal Study (LS) is unique in its construction and scale. The large number of individuals who are part of the study means that it is an important dataset for estimating fertility trends in England and Wales by age and parity. This article uses the LS to estimate age‐specific fertility rates (ASFRs) for England and Wales between 1991 and 2001. This necessitates great care to ensure that the exposure to risk of birth for female LS members is fully understood. To achieve this, two forms of residential history are defined – consistent cases where the residential information for the LS member is potentially complete for the whole decade and inconsistent cases where there is certainly some form of incompleteness in the residence information. By considering ‘all consistent cases’, that is both the continuously resident plus those who are not continuously resident but appear to have a complete residential history, we obtain ASFRs which are slightly lower than official statistics figures, but closer to these official figures than ASFRs produced when restricting the sample to LS members who remain continuously resident between 1991 and 2001. The fertility of those consistent cases who are not continuously resident is substantially higher than the rates of continuously resident cases.

Heights Across the Last 2000 Years in England

Abstract This paper uses a dataset of heights calculated from the femurs of skeletal remains to explore the development of stature in England across the last two millennia. We find that heights increased during the Roman period and then steadily fell during the ‘Dark Ages’ in the early medieval period. At the turn of the first millennium heights grew rapidly, but after 1200 they started to decline coinciding with the agricultural depression, the Great Famine and the Black Death. Then they recovered to reach a plateau which they maintained for almost 300 years, before falling on the eve of industrialisation. The data show that average heights in England in the early nineteenth century were shorter than those in Roman times, and that average heights reported between 1400 and 1700 were similar to those of the twentieth century. The paper also discusses the ssociation of heights across time with some potential determinants and correlates (real wages, inequality, food supply, climate change and expectation of life), showing that in the long run heights change with these variables, and that in certain periods, notably the thirteenth and fourteenth centuries, the associations are observable over the shorter run as well. We also examine potential biases surrounding the use of skeletal remains.

Combining work and child care: The experiences of mothers in Accra, Ghana

ABSTRACT Work–family research has focused predominantly on western women. Yet the forms of economic labour in which women are typically involved and the meaning of motherhood are context specific. This article aims to explore the experience of combining economic activity and child care of mothers with young children using urban Ghana as a case study. Semi-structured interviews (n = 24) were conducted in three locations in the Accra Metropolitan Area. Transcripts were analysed using the general inductive approach. The results found women’s experience of role conflict to be bi-directional. With regard to role enhancement, economic activity allowed women to provide materially for their children. The combination of work and child care had negative consequences for women’s well-being. This research questions policy-makers’ strategy of frequently targeting women in their roles either as generators of income or as the primary care-takers of children by highlighting the reality of women’s simultaneous performance of these roles.

Sex differentials in phthisis mortality in England and Wales, 1861–1870

In the mid-nineteenth century phthisis, or pulmonary tuberculosis, was the single most important cause of death in England and Wales. It was widely distributed geographically though some areas were worse affected than others. This paper explores aspects of the geography of phthisis mortality in England in the second half of the nineteenth century, with particular attention to the sex differential in mortality from this cause. Phthisis is often thought of as a disease of young women, and throughout much of England and Wales, especially in agricultural areas, women aged between 15 and 40 years were especially vulnerable. However the sex ratio of deaths from phthisis varied greatly from place to place and, in some places where phthisis was prevalent, men rather than young women were at the greatest risk of death. Phthisis mortality was sufficiently important that the geography of the overall sex differential in mortality was to a considerable extent determined by the geography of the sex differential in phthisis mortality. Where phthisis mortality disadvantaged females, the overall sex differential between male and female mortality was small or even negative; where phthisis mortality disadvantaged males, the overall sex differential was large. The paper then considers explanations of geographical variations in the sex differential in phthisis mortality. It is not clear that these are best explained by a ‘bargaining-nutrition’ account which holds that young women in poor households were especially vulnerable to mortality from phthisis because their weak intra-household bargaining position compromised their nutritional status. Other factors, such as the return migration to their native areas of out-migrants who became sick with the disease, and working conditions, especially for females, may have been more important. The final part of the paper considers the implications of the results for explanations of the decline of phthisis mortality between 1860 and 1900.

Demographic dividend and literate life expectancy: The case of Pakistan

During the demographic transition from high mortality and fertility to low mortality and fertility, the age structure of a country changes, so that for a period the proportion of the population (which is of working ages) rises and then falls. This period during which the working-age population is relatively large is often termed the ‘demographic dividend’, a phenomenon which may be exploited by a country to accelerate economic development. The effectiveness with which a country may make use of the demographic dividend in this way, however, depends on the level of human capital of the working population, which determines its productivity. One way of measuring human capital is to use the socalled literate life expectancy, which is an estimate of the average number of years a member of the population spends in the literate state. This paper describes the calculation of the literate life expectancy for Pakistan, and compares the situation of Pakistan with that of other countries.

Accessing genitourinary medicine clinics: does it matter where you live?

Objectives To determine whether genitourinary medicine (GUM) clinics in England are located conveniently for potential users and to assess whether there are any regional variations in accessibility. Methods A surface model was created in ArcGIS to estimate driving times to the nearest GUM clinic and to identify the proportion of the population living more than 30 minutes drive from their nearest clinic. Results Overall, 3.0% of the population live further than 30 minutes from their nearest clinic. However, this average figure disguises considerable regional variation. While access in London and the South East was excellent, with less than 1% of the population living more than 30 minutes from the nearest clinic, in the South West and the East of England, these percentages rose to 7.7% and 9.2%, respectively. Conclusions In some regions of England it is important to consider the physical barriers to clinic access, as inability or unwillingness to undertake a long journey to a GUM clinic may increase the workload in other clinical settings.