Øystein Kravdal

Education and Fertility in Sub-Saharan Africa: Individual And Community Effects

Using data from Demographic and Health Surveys for 22 countries in sub-Saharan Africa, I show that the average educational level in a village or a community of a similar size has a significant depressing effect on a woman’s birth rates, net of urbanization and her own education. According to simulations, average fertility for these countries would be 1.00 lower if education were expanded from the current level in the region to the relatively high level in Kenya. The exclusion of aggregate education from the model leaves a response of only 0.52. A considerable aggregate contribution is estimated even when several potential determinants of education are included. This finding illustrates the need to consider aggregate education in future assessments of the total impact of education.

The impact of marital status on cancer survival

Marital differentials in survival from 12 common types of cancer are assessed by estimating a mixed additive multiplicative hazard regression model on the basis of individual register and census data for the whole Norwegian population. These data cover the period 1960-91 and include more than 100,000 cancer deaths. The data and method make it possible to take into account the marital mortality differentialsin the absence of cancer. The excess all-cause mortality among cancer patients compared with similar persons without a cancer diagnosis is, on the whole, more than 15% higher for never-married men, never-married women and divorced men, than for the married of the same sex. Other previously married have an excess mortality elevated by about 7%. This protective effect of marriage is not due to stage, which is controlled for. The possible importance of treatment and host factors is discussed.

Child mortality in India: The community-level effect of education

When assessing the health benefits of increased education in less developed countries, many researchers have been concerned about the omission of important determinants of an individual’s education from the models. The study presented here shows that one should also be concerned about the limitations of the individual-level perspective. According to a multilevel discrete-time hazard model estimated with data from the National Family Health Survey II, the average education of women in a census enumeration area has a strong impact on child mortality, in addition to the effect of the mother’s own education. The lower child mortality associated with women’s autonomy is taken into account in this estimation. Results from similar models for various health and health-care variables suggest that the effect of community education, like that of individual education, operates through the use of maternity services and other preventive health services, the child’s nutrition, and the mother’s care for a sick child.

CHILD CARE AVAILABILITY AND FIRST-BIRTH TIMING IN NORWAY

Both sociological and economic theories posit that widely available, high-quality, and affordable child care should have pronatalist effects. Yet to date, the empirical evidence has not consistently supported this hypothesis. We argue that this previous empirical work has been plagued by the inability to control for endogenous placement of day care centers and the possibility that people migrate to take advantage of the availability of child care facilities. Using Norwegian register data and a statistically defensible fixed-effects model, we find strong positive effects of day care availability on the transition to motherhood.

Individual and community effects of women's education and autonomy on contraceptive use in India.

This study makes use of the National Family Health Survey of 1998‐99 to investigate whether differences in womens autonomy can explain much of the relationship between education and contraceptive use among married Indian women with at least one child. The analyses show that a womans education does not influence her contraceptive use through a strengthening of her position in relation to that of men, but that the inclusion of a simple indicator of her general knowledge reduces education effects appreciably. Further, the average educational level of other women in the census‐enumeration area has an effect on a womans contraceptive use above and beyond that of her own education. This effect cannot be explained by the specific indicators of autonomy, but can to some extent be explained by the son preference of the community. The latter is a more general autonomy indicator that may also pick up other contextual factors.

Consequences of Family Disruption on Children's Educational Outcomes in Norway

Using high-quality data from Norwegian population registers, we examine the relationship between family disruption and children’s educational outcomes. We distinguish between disruptions caused by parental divorce and paternal death and, using a simultaneous equation model, pay particular attention to selection bias in the effect of divorce. We also allow for the possibility that disruption may have different effects at different stages of a child’s educational career. Our results suggest that selection on time-invariant maternal characteristics is important and works to overstate the effects of divorce on a child’s chances of continuing in education. Nevertheless, the experience of marital breakdown during childhood is associated with lower levels of education, and the effect weakens with the child’s age at disruption. The effects of divorce are most pronounced for the transitions during or just beyond the high school level. In models that do not allow for selection, children who experienced a father’s death appear less disadvantaged than children whose parents divorced. After we control for selection, however, differences in the educational qualifications of children from divorced and bereaved families narrow substantially and, at mean ages of divorce, are almost non-existent.

Increasing absolute mortality disparities by education in Finland, Norway and Sweden, 1971–2000

Background and objectives Studies on socioeconomic health disparities often suffer from a lack of uniform data and methodology. Using high quality, census-linked data and sensible inequality measures, this study documents the changes in absolute and relative mortality differences by education in Finland, Norway and Sweden over the period 1971 to 2000. Methods The age-standardised mortality rates and the population exposures for three educational categories were computed from detailed data provided by the national statistical offices. Mortality disparities by education were assessed using two range measures (rate differences and rate ratios), and two Gini-like measures (the average inter-group difference (AID) and the Gini coefficient (G)). The formulae for the decomposition of the change in the AID into (1) the contribution of change in population composition by education, and (2) the contribution of mortality change were introduced. Results Mortality decreases were often greater for high than for medium and low education. Both relative and absolute mortality disparities tend to increase over time. The magnitude and timing of the increases in absolute disparities vary by country. Both the rate differences and the AIDs have increased since the 1970s in Norway and Sweden, and since the 1980s in Finland. The contributions of the changes in population composition to the total AID increase were substantial in all countries, and for both sexes. The mortality contributions were substantial for males in Norway and Sweden. Conclusions The study reports increases in absolute mortality disparity, and its components. This trend needs to be further studied and addressed by policies.

Fertility history and cause-specific mortality: A register-based analysis of complete cohorts of Norwegian women and men

The relationship between womens reproductive histories and later all-cause mortality has been investigated in several studies, with mixed results. Some studies have also considered cause-specific mortality and some have included men, but none has done both. We analyse associations between parity and age of first birth for women and men across 11 cause-of-death groupings using Norwegian register data for complete cohorts born 1935-1968 whose mortality was observed 1980-2003 (i.e. at ages 45-68). Age, period, educational level, marital status, region of residence and population size of municipality were included as co-variates. In total, there were 63,000 deaths. Results showed that relative to parents of two children, childless men and women and those with one child had higher mortality risks for nearly all cause of death groupings. High parity (4+ children) was associated with raised male mortality from accidents and violence and higher mortality from cancer of the cervix among women. For other cause and gender groupings there was either little difference between those with two children and those of higher parities or an overall negative association between parity and mortality. Among men with the lowest level of education, however, high parity was positively associated with mortality from circulatory diseases. For all causes except female breast cancer, there was an inverse association between age at first birth and mortality risk. Similarities observed across cause groups and for women and men suggest that much of the fertility-mortality relationship is a result of selection or effects of reproductive behaviour on lifestyle. The latter may include both beneficial effects and harmful stress responses. However, physiological mechanisms are most probably important for some causes of death for women. Research on associations between parenting histories, health related behaviours, social support exchanges and reported or measured stress is needed to clarify mechanisms underlying the associations reported here.

Childbearing impeded education more than education impeded childbearing among Norwegian women

In most societies, women at age 39 with higher levels of education have fewer children. To understand this association, we investigated the effects of childbearing on educational attainment and the effects of education on fertility in the 1964 birth cohort of Norwegian women. Using detailed annual data from ages 17 to 39, we estimated the probabilities of an additional birth, a change in educational level, and enrollment in the coming year, conditional on fertility history, educational level, and enrollment history at the beginning of each year. A simple model reproduced a declining gradient of children ever born with increasing educational level at age 39. When a counterfactual simulation assumed no effects of childbearing on educational progression or enrollment (without changing the estimated effects of education on childbearing), the simulated number of children ever born decreased very little with increasing completed educational level, contrary to data. However, when another counterfactual simulation assumed no effects of current educational level and enrollment on childbearing (without changing the estimated effects of childbearing on education), the simulated number of children ever born decreased with increasing completed educational level nearly as much as the decrease in the data. In summary, in these Norwegian data, childbearing impeded education much more than education impeded childbearing. These results suggest that women with advanced degrees have lower completed fertility on the average principally because women who have one or more children early are more likely to leave or not enter long educational tracks and never attain a high educational level.

CHILDREN, FAMILY AND CANCER SURVIVAL IN NORWAY

Models for all‐cause mortality among 45,000 men and women with cancer in 12 different sites were estimated, using register and census data for complete Norwegian birth cohorts. This observed‐survival method appeared to be an adequate approach. The results support the idea that women who were pregnant shortly before a breast cancer diagnosis may have a poorer prognosis than others. In principle, such an effect may also reflect that these women have a young child during the follow‐up period and are burdened by that. However, this social explanation can hardly be very important, given the absence of a corresponding significant effect in men and for other cancer sites in women. Breast cancer is different from other malignancies also with respect to the effect of parenthood more generally, regardless of the timing of the pregnancies. On the whole, male and female cancer patients with children experience lower mortality than the childless, though without a special advantage associated with adult children. This suggests a social effect, perhaps operating through a link between parenthood, lifestyle and general health. No parity effect was seen for breast cancer, however, which may signal that the social effect is set off against an adverse physiologic effect of motherhood for this particular cancer. Among men, both marriage and parenthood were associated with a good prognosis. Married male cancer patients with children had mortality one‐third lower than that among the childless and never‐married. Women who had never married did not have the same disadvantage.