Lynda Clarke

Incomplete reporting of men’s fertility in the united states and britain: A research note

We evaluate men;s retrospective fertility histories from the British Household Panel Survey and the U.S. Panel Study of Income Dynamics (PSID). Further, we analyze the PSID men’s panel-updated fertility histories for their possible superiority over retrospective collection. One third to one half of men’s nonmarital births and births within previous marriages are missed in estimates from retrospective histories. Differential survey underrepresentation of previously married men compared with previously married women accounts for a substantial proportion of the deficits in previous-marriage fertility. More recent retrospective histories and panel-updated fertility histories improve reporting completeness, primarily by reducing the proportion of marital births from unions that are no longer intact at the survey date.

Women's health: Dimensions and differentials

This paper is concerned with the social patterning of ill-health amongst women in Britain. It uses the various health measures available in the Health and Lifestyle Survey (self-assessed health, disease/disability, illness, psycho-social well-being and fitness) to explore whether there are particular aspects of health systematically associated with social advantage and disadvantage, as measured by current or last occupation, employment status, household composition and household income. Among women aged 18-59, after controlling for age, number of psychological symptoms experienced in the past month showed the greatest social variation. Number of physical illness symptoms in the last month showed the least. Lone mothers with dependent children were found to have particularly poor psycho-social health, although this was confined to those in full-time employment. The presence of a long-standing disease/disability proved useful as a control for the influence of health selection in to and out of both employment and motherhood.

Ambivalence and the paradoxes of grandparenting

This paper focuses on ‘normative talk’ about grandparenting. It is based on a secondary analysis of a study involving 46 interviews with grandparents. It identifies two main cultural norms of grandparenting that emerged from the data – ‘being there’ and ‘not interfering’. There were very high levels of consensus in the study that these constituted what grandparents ‘should and should not’ do. However, these two norms can be contradictory, and are not easy to reconcile with the everyday realities of grandparenting. The study found that norms of parenting and also of self determination were also very important for the grandparents in the study. They had a keen sense of what being a ‘good parent’ (to their own adult children) should mean – especially in terms of allowing them to be independent – but this could sometimes conflict with their sense of responsibility to descendant generations of grandchildren. Using the concept of ambivalence and drawing on the accounts of grandparents in the study, the paper explores and offers an explanation for both the coexistence and conflict between different sets of norms, as well as for the remarkably high levels of consensus about ‘being there’ and ‘not interfering’. The paper concludes with a discussion of some of the limitations of the data and the analysis, and with suggestions for the development of further work in this area.

Fathers and absent fathers: Sociodemographic similarities in britain and the united states

Using data from the British Household Panel Survey and the National Survey of Families and Households in the United States, we present a sociodemographic profile of fathers and compare the determinants of absent fatherhood in each country. Although fatherhood has a younger profile in the United States, especially for blacks, predictors of fathers’ residency with their children are remarkably similar in the two countries. In both countries, the strongest predictor of a father’s absence is the parents’ relationship to each other at the time of the child’s birth. Policy implications of this finding are discussed.

Evaluating youth-friendly health services: young people's perspectives from a simulated client study in urban South Africa.

Background Few youth-friendly health services worldwide have been scaled up or evaluated from young peoples perspectives. South Africas Youth Friendly Services (YFS) programme is one of the few to have been scaled up. This study investigated young peoples experiences of using sexual and reproductive health services at clinics providing the YFS programme, compared to those that did not, using the simulated client method. Design Fifteen primary healthcare clinics in Soweto were randomly sampled: seven provided the YFS programme. Simulated clients conducted 58 visits; young men requested information on condom reliability and young women on contraceptive methods. There were two outcome measures: a single measure of the overall clinic experience (clinic visit score) and whether or not simulated clients would recommend a clinic to their peers. The clinic visit score was based on variables relating to the simulated clients’ interactions with staff, details of their consultation, privacy, confidentiality, the healthcare workers’ characteristics, and the clinic environment. A larger score corresponds to a worse experience than a smaller one. Multilevel regression models and framework analysis were used to investigate young peoples experiences. Results Health facilities providing the YFS programme did not deliver a more positive experience to young people than those not providing the programme (mean difference in clinic visit score: −0.18, 95% CI: −0.95, 0.60, p=0.656). They were also no more likely to be recommended by simulated clients to their peers (odds ratio: 0.48, 95% CI: 0.11, 2.10, p=0.331). More positive experiences were characterised by young people as those where healthcare workers were friendly, respectful, knew how to talk to young people, and appeared to value them seeking health information. Less positive experiences were characterised by having to show soiled sanitary products to obtain contraceptives, healthcare workers expressing negative opinions about young people seeking information, lack of privacy, and inadequate information. Conclusions The provision and impact of the YFS programme are limited. Future research should explore implementation. Regular training and monitoring could enable healthcare workers to address young peoples needs.

Staying Out of Trouble: Intentions of Young Male Offenders

During the fall of 2005, we interviewed a sample of 103 young men aged 18 to 21 imprisoned at a young offender’s prison in England. Drawing on the theory of planned behavior, as well as the theory of cognitive transformation, our purpose was to investigate prisoners’ reports of their likelihood of reoffending following release from prison. Primary explanatory factors included measures of attitudes, behavioral control, and subjective norms. Attitudes measured inmates’ plans of what they would do following release. Behavioral control variables included indicators of life control and self-efficacy. Subjective norms measured the number of peers inmates reported ever being imprisoned. Prison activities and background characteristics were also modeled. The data were analyzed using regression techniques and structural equation modeling. Intentions to stay out of trouble were most strongly associated with self-efficacy and the number of imprisoned friends reported. Intentions were also associated with the specificity of postrelease plans and life control. Offenders’ feelings of life control were stronger among those who had more frequent contact with family members and friends while in prison. Employment prior to prison and family relationships were predictive of contacts with family and friends in prison. Specific policies consistent with our findings include encouragement of contact with family members and friends. In addition, interventions that help offenders make specific plans and increase feelings of control and self-efficacy have promise in helping released offenders successfully complete the transition from prison to the community.

Children's risk of parental break-up - Norway and England/Wales compared

Higher proportions of births outside marriage and more family breakdown indicate that children experience increased diversity of family circumstances at birth and during childhood. While England/Wales and Norway have many similar features, there are distinct differences in social and welfare policies. This article compares children’s experiences in the two countries in relation to these policies. Emphasis is put particularly on the impact of consensual unions. Children are the statistical unit and data from surveys and national statistics are compared. In both countries there is considerable risk of family dissolution in the case of children born into consensual unions, but the more so in England/Wales than in Norway. Even though the rate of extramarital births is much higher in Norway than in England/Wales, the corresponding rate of family change is lower. The article suggests that behind parental break-up lies an old pattern of social stratification masked as family change.

Trends in catastrophic health expenditure in India: 1993 to 2014.

Abstract Objective To investigate trends in out-of-pocket health-care payments and catastrophic health expenditure in India by household age composition. Methods We obtained data from four national consumer expenditure surveys and three health-care utilization surveys conducted between 1993 and 2014. Households were divided into five groups by age composition. We defined catastrophic health expenditure as out-of-pocket payments equalling or exceeding 10% of household expenditure. Factors associated with catastrophic expenditure were identified by multivariable analysis. Findings Overall, the proportion of catastrophic health expenditure increased 1.47-fold between the 1993–1994 expenditure survey (12.4%) and the 2011–2012 expenditure survey (18.2%) and 2.24-fold between the 1995–1996 utilization survey (11.1%) and the 2014 utilization survey (24.9%). The proportion increased more in the poorest than the richest quintile: 3.00-fold versus 1.74-fold, respectively, across the utilization surveys. Catastrophic expenditure was commonest among households comprising only people aged 60 years or older: the adjusted odds ratio (aOR) was 3.26 (95% confidence interval, CI: 2.76–3.84) compared with households with no older people or children younger than 5 years. The risk was also increased among households with both older people and children (aOR: 2.58; 95% CI: 2.31–2.89), with a female head (aOR: 1.32; 95% CI: 1.19–1.47) and with a rural location (aOR: 1.27; 95% CI: 1.20–1.35). Conclusion The proportion of households experiencing catastrophic health expenditure in India increased over the past two decades. Such expenditure was highest among households with older people. Financial protection mechanisms are needed for population groups at risk for catastrophic health expenditure.

Is “Sexual Competence” at First Heterosexual Intercourse Associated With Subsequent Sexual Health Status?

The timing of first sexual intercourse is often defined in terms of chronological age, with particular focus on “early” first sex. Arguments can be made for a more nuanced concept of readiness and appropriateness of timing of first intercourse. Using data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), conducted in 2010–2012, this study examined whether a context-based measure of first intercourse—termed sexual competence—was associated with subsequent sexual health in a population-based sample of 17-to 24-year-olds residing in Britain (n = 2,784). Participants were classified as “sexually competent” at first intercourse if they reported the following four criteria: contraceptive protection, autonomy of decision (not due to external influences), that both partners were “equally willing,” and that it happened at the “right time.” A lack of sexual competence at first intercourse was independently associated with testing positive for human papillomavirus (HPV) at interview; low sexual function in the past year; and among women only, reported sexually transmitted infection (STI) diagnosis ever; unplanned pregnancy in the past year; and having ever experienced nonvolitional sex. These findings provide empirical support for defining the nature of first intercourse with reference to contextual aspects of the experience, as opposed to a sole focus on chronological age at occurrence.

Horizontal inequity in outpatient care use and untreated morbidity: evidence from nationwide surveys in India between 1995 and 2014.

Abstract Equity in healthcare has been a long‐term guiding principle of health policy in India. We estimate the change in horizontal inequities in healthcare use over two decades comparing the older population (60 years or more) with the younger population (under 60 years). We used data from the nationwide healthcare surveys conducted in India by the National Sample Survey Organization in 1995‐96 and 2014 with sample sizes 633 405 and 335 499, respectively. Bivariate and multivariate logit regression analyses were used to study the socioeconomic differentials in self‐reported morbidity (SRM), outpatient care and untreated morbidity. Deviations in the degree to which healthcare was distributed according to need were measured by horizontal inequity index (HI). In each consumption quintile the older population had four times higher SRM and outpatient care rate than the younger population in 2014. In 1995‐96, the pro‐rich inequity in outpatient care was higher for the older (HI: 0.085; 95% CI: 0.066, 0.103) than the younger population (0.039; 0.034, 0.043), but by 2014 this inequity became similar. Untreated morbidity was concentrated among the poor; more so for the older (−0.320; −0.391, −0.249) than the younger (−0.176; −0.211, −0.141) population in 2014. The use of public facilities increased most in the poorest and poor quintiles; the increase was higher for the older than the younger population in the poorest (1.19 times) and poor (1.71 times) quintiles. The use of public facilities was disproportionately higher for the poor in 2014 than in 1995‐96 for the older (−0.189; −0.234, −0.145 vs − 0.065; −0.129, −0.001) and the younger (−0.145; −0.175, −0.115 vs − 0.056; −0.086, −0.026) population. The older population has much higher morbidity and is often more disadvantaged in obtaining treatment. Health policy in India should pay special attention to equity in access to healthcare for the older population.