Kathryn M. Yount

Impacts of domestic violence on child growth and nutrition: a conceptual review of the pathways of influence.

Domestic violence against women is a global problem, and young children are disproportionate witnesses. Childrens exposure to domestic violence (CEDV) predicts poorer health and development, but its effects on nutrition and growth are understudied. We propose a conceptual framework for the pathways by which domestic violence against mothers may impair child growth and nutrition, prenatally and during the first 36 months of life. We synthesize literatures from multiple disciplines and critically review the evidence for each pathway. Our review exposes gaps in knowledge and opportunities for research. The framework also identifies interim strategies to mitigate the effects of CEDV on child growth and nutrition. Given the global burden of child malnutrition and its long-term effects on human-capital formation, improving child growth and nutrition may be another reason to prevent domestic violence and its cascading after-effects.

Nutritional Supplementation in Early Childhood, Schooling, and Intellectual Functioning in Adulthood: A Prospective Study in Guatemala

OBJECTIVE To estimate the association of improved nutrition in early life with adult intellectual functioning, controlling for years of schooling. DESIGN Prospective cohort study. SETTING Four villages in Guatemala, as well as locations within Guatemala to which cohort members migrated. PARTICIPANTS Individuals who had participated as children in a nutrition supplementation intervention trial from March 1, 1969, through February 28, 1977 (N = 2392). From May 1, 2002, through April 30, 2004, adequate information for analysis was obtained from 1448 of 2118 individuals (68.4%) not known to have died. INTERVENTIONS Individuals exposed to atole (a protein-rich enhanced nutrition supplement) at birth through age 24 months were compared with those exposed to the supplement at other ages or to fresco, a sugar-sweetened beverage. We measured years of schooling by interview. MAIN OUTCOME MEASURES Scores on the Serie Interamericana (InterAmerican Series) tests of reading comprehension and the Raven Progressive Matrices, obtained from May 1, 2002, through April 30, 2004. RESULTS In models controlling for years of schooling and other predictors of intellectual functioning, exposure to atole at birth to age 24 months was associated with an increase of 3.46 points (95% confidence interval, -1.26 to 8.18) and 1.74 points (95% confidence interval, 0.53-2.95) on the InterAmerican Series and Raven Progressive Matrices tests, respectively. There was no statistical interaction between exposure to atole at birth to age 24 months and years of schooling on either outcome (P = .24 and P = .60, respectively). CONCLUSION Improved early-life nutrition is associated with increased intellectual functioning in adulthood after taking into account the effect of schooling.

Community-level correlates of intimate partner violence against women globally: A systematic review

Intimate partner violence (IPV) against women is a problem facing women around the world, one that has implications for womens health and well-being. The relationship between communities and the occurrence of IPV is an expanding area of research. Although a large number of community characteristics have been examined in relation to IPV, the research as a whole lacks a coherent theoretical focus or perspective. In this systematic review, we provide a comprehensive synthesis of the evidence regarding the community-level correlates of IPV against women. In our review of peer-reviewed research published between January 1, 1990 and January 31, 2011, we identify key community-level correlates, detect gaps, and offer recommendations for future research. Recognizing a difference in approach between U.S. and non-U.S. based research and an over-reliance on a primarily urban, U.S.-based perspective on communities and IPV, we advocate for a global perspective that better reflects the social and economic fabric of communities around the world. Specifically, future research should focus on the most promising, but currently under-studied, community-level correlates of IPV against women, namely gender inequality, gender norms, and adapted measures of collective efficacy/social cohesion.

Research Note: A Socioeconomic Index for the INCAP Longitudinal Study 1969–77

In this note, we calculate and describe proxy measures that account for variation in standard of living across subjects in the Institute of Nutrition of Central America and Panama (INCAP) Longitudinal Study (1969–77), at the time of the original intervention. Using principal components analysis, we construct two linear indices from an array of household consumer durable goods and housing characteristics, measured at the nuclear family level in the 1975 cross-sectional census. The two indices perform well on three dimensions. First, they are internally coherent in that average ownership and quality of housing characteristics increase with the principal component score. Second, they are robust in that the different approaches yield similar results, for example, in classifying nuclear families into tertiles. And third, they are consistent in that they yield results similar to scores constructed by previous researchers. The indices can be used as background controls in analyses of the INCAP Longitudinal Study (1969–77) data and subsequent follow-up studies, including the Human Capital Study 2002–04. Several articles presented in this supplement to the Food and Nutrition Bulletin used the 1975 index.

Informal and Formal Long-term Care for Frail Older Adults in Cairo, Egypt: Family Caregiving Decisions in a Context of Social Change

This paper explores the factors that lead family caregivers to place their frail older relatives into long-term care centers in Cairo, Egypt despite norms of family care. Semi-structured interviews were conducted with 18 “case” caregivers who placed their older relatives into long-term care and 17 “control” caregivers who provided for their older relatives at home. Cases and controls differed in their relationship to the older adult, number and proximity of supportive siblings, and perceived health status of the older adult. Caregivers who used long-term care justified their decision by stressing the need for relief from the burden of caregiving, and by conceiving long-term care as part of a broadened definition of family care. Egyptians are devising new strategies of care despite persistent norms of reciprocity among kin. As demographic, epidemiologic, and socioeconomic changes continue, families may adopt new combinations of care to support their frail older relatives. Findings underscore the need for population-based research about strategies of caring for frail older relatives in this context.

Gender, resources across the life course, and cognitive functioning in Egypt

In this article, I evaluate the life-course determinants of cognitive functioning among 1,003 women and men aged 50 and older in Ismailia, Egypt. Three questions motivate this analysis: (1) Do older women have poorer cognitive functioning than do older men?; (2) Do cognitive resources accrued in childhood and adulthood have net positive associations with later-life cognitive functioning for women and men?; and (3) To what extent do differences in the amounts and effects of women’s and men’s cognitive resources account for gaps in their cognitive functioning? Compared with men, women have lower Modified-Mini Mental Status Exam (M-MMSE) scores for overall cognitive functioning. Cognitive resources in childhood and adulthood are jointly associated with the M-MMSE score. About 83% of the gender gap in mean M-MMSE scores is attributable to gaps in men’s and women’s attributes across the life course. Gender gaps in childhood cognitive resources—and especially schooling attainment—account for the largest share (18%) of the residual gender gap in cognitive functioning.

Social and Economic Development and Change in four Guatemalan Villages: Demographics, Schooling, Occupation, and Assets

This article uses census data and village histories to examine changes over the last 35 years in the four villages where the Institute of Nutrition of Central America and Panama (INCAP) Longitudinal Study (1969–77) was conducted and offers a rare picture of development and change in rural localities over a long period of time. In addition, by characterizing the environment in which the subjects of this study were raised, we provide context for and inputs into quantitative analyses of data collected at various points in time on these subjects. The villages have undergone massive demographic, social, and economic change. Initial differences have conditioned many of these changes, especially differences associated with agricultural potential and location. Originally these villages were rather isolated, but road and transportation access has improved substantially. The populations in the villages have more than doubled and also have aged. While marriage patterns have held steady, religious practice has changed a great deal. After many years of steady out-migration, three of the four villages are more recently experiencing net in-migration, a pattern associated with ease of access. Schooling access and outcomes also have improved, with average grades of schooling nearly tripling and literacy doubling to levels currently above national averages. Although agriculture remains an important component of individual livelihood strategies, non-agricultural sources of employment have become more important. Much of this change is associated with declining agricultural markets and increased access to non-agricultural jobs near the villages and in the capital. Accompanying these changes has been an improvement in living standards as measured by a number of indicators of household living conditions and consumer durable goods.

Socioeconomic resources and living arrangements of older adults in Lebanon: who chooses to live alone?

ABSTRACT During recent decades, Lebanon has experienced demographic and social changes which, coupled with political instability, have led to waves of youth migration and a higher proportion of older adults living alone. This paper uses the 2004 data of the ‘Pan Arab Project for Family Health’ to assess the levels of various living arrangements and to examine the correlates of living alone, with a focus on economic resources. The findings reveal that 12 per cent of older adults in Lebanon lived alone (17.3 per cent of women and 6.2 per cent of men). Financially better-off older adults and those who reported being satisfied with their income were, respectively, 4.4 and 1.7 times significantly more likely to live alone than their counterparts. The incomes of Lebanese older adults were mainly provided by their children (74.8%) and a relatively small share derived from pension schemes. Contrary to findings from other Arab countries, variations in living arrangements among Lebanese older adults seem to follow the western model whereby wealthier older individuals are more likely to live alone and to be residentially independent. Further studies are warranted to examine to what extent this trend is the result of past migration of adult children who are now established elsewhere and sending remittances home.

They "miss more than anything their normal life back home": masculinity and extramarital sex among Mexican migrants in Atlanta.

CONTEXT: Gender has been recognized as a significant influence on sexual health behaviors. Labor migration presents an important context of vulnerability for sexual health. To understand how the context of migration affects risk-related practices, both cultural and social aspects of gender need to be explored. METHODS: In the quantitative part of a mixed-methods study conducted in 1999 in Atlanta, 187 Mexican migrant men were asked about their demographic characteristics; sexual history; migration motivations; substance use; social support; leisure-time activities; and ideas about masculinity, sexuality and marriage. Multivariate regression analyses were conducted to test the association between these domains and mens number of partners since their arrival in Atlanta. RESULTS: Number of partners was positively associated with owning a home in Mexico; number of trips back to Mexico; social network size; having had a sex worker as a partner; and going out dancing and to strip clubs on weekends (coefficients, 0.3–4.1). It was negatively associated with age, education, contact with social network members and feeling that sex is tied to emotional intimacy (–0.4 to –1.0). CONCLUSIONS: Programs must acknowledge and target migrant mens social networks and the spaces in which they may encounter risky sexual situations. Multilevel strategies, such as the development of more health-enhancing community spaces and the promotion of safer sexual practices should form part of comprehensive efforts to reduce sexual risk among migrant men.

Gender Differences in Physical Disability Among Older Adults in Underprivileged Communities in Lebanon

Objective: To examine the role of health conditions, socioeconomic, and socioenvironmental factors in explaining gender differences in physical disability among older adults. Method: We compared 412 women and 328 men residing in underprivileged communities in Lebanon on their activities of daily living (ADL), instrumental activities of daily living (IADL), and physical tasks (PT). Binary logistic regression analyses adjusting for possible explanatory covariates were conducted sequentially. Results: Women showed higher prevalence rates of ADL, IADL, and PT compared to men. Gender disparities in ADL disability were explained by chronic-disease risk factors and health conditions (OR = 1.46; 95% CI = 0.94-2.25). The odds of disability in IADL and PT remained significantly higher for women compared to men after accounting for all available covariates. Discussion: These results suggest underlying differences in functional status between women and men, yet, may have been influenced by the sensitivity of the measures to the social context and gendered environment surrounding daily activities.