CAUSES AND CONSEQUENCES OF THE WORLD POPULATION EVOLUTION

This study intends to realize a critical debate on the content and the dynamics of the theoretical concepts connected to the world population growth, trying to explain the origin and sense of the expression demographic explosion and other expressions that completed, detailed or disproved this syntagm. The research is founded on the idea that the debate on the terminology used in present to define the demographic evolution, the presentation of the global and the differential components of the population increase, the main factors and evolutive scenarios of the world population, throw light correctly on the dimension of the phenomenon and represent a guide for the demographic present time. Based on these relevant aspects, the study leads to the idea that our planet is structured in two diverging worlds: a poor one, still in a demographic expansion and a rich one, in a demographic stagnation, even in a virtual decline.demographic explosion, overpopulation, regional disparities

Using mobile technology to engage sexual and gender minorities in clinical research.

IntroductionHistorical and current stigmatizing and discriminatory experiences drive sexual and gender minority (SGM) people away from health care and clinical research. Being medically underserved, they face numerous disparities that make them vulnerable to poor health outcomes. Effective methods to engage and recruit SGM people into clinical research studies are needed.ObjectivesTo promote health equity and understand SGM health needs, we sought to design an online, national, longitudinal cohort study entitled The PRIDE (Population Research in Identity and Disparities for Equality) Study that enabled SGM people to safely participate, provide demographic and health data, and generate SGM health-related research ideas.MethodsWe developed an iPhone mobile application ("app") to engage and recruit SGM people to The PRIDE Study-Phase 1. Participants completed demographic and health surveys and joined in asynchronous discussions about SGM health-related topics important to them for future study.ResultsThe PRIDE Study-Phase 1 consented 18,099 participants. Of them, 16,394 provided data. More than 98% identified as a sexual minority, and more than 15% identified as a gender minority. The sample was diverse in terms of sexual orientation, gender identity, age, race, ethnicity, geographic location, education, and individual income. Participants completed 24,022 surveys, provided 3,544 health topics important to them, and cast 60,522 votes indicating their opinion of a particular health topic.ConclusionsWe developed an iPhone app that recruited SGM adults and collected demographic and health data for a new national online cohort study. Digital engagement features empowered participants to become committed stakeholders in the research development process. We believe this is the first time that a mobile app has been used to specifically engage and recruit large numbers of an underrepresented population for clinical research. Similar approaches may be successful, convenient, and cost-effective at engaging and recruiting other vulnerable populations into clinical research studies

Rural-Urban Economic Disparities among China’s Elderly

Some of the most controversial effects of China's post-1978 economic reforms have been on regional income disparities and on the divide between urban and rural development. How important are those income disparities? And how do they affect the elderly, who are perhaps the most vulnerable to the changes brought by China’s transition? What is the government’s role in providing income support? This paper examines the rural-urban disparities in income, expenditures, and government support among the elderly in China. We test for significant differences in levels and sources of income and in types of expenditures using a nationwide survey on rural and urban elderly conducted by China’s Elderly Scientific Research Center in 1992. This survey consists of two separate sets of responses, one for urban areas (9,889 respondents) and the other for rural areas (10,194 respondents), and provides demographic, socioeconomic, and health characteristics of the elderly. In addition, we propose to investigate the type and level of government income support programs at the local and state level. The findings are evaluated and policy implications discussed in the context of China’s transition to a market economy and choice of development strategies.

Sexual HIV Risk Among Male Parolees and Their Female Partners: The Relate Project

Background: The massively disproportionate impact of America’s prison boom on communities of color has raised questions about how incarceration may affect health disparities, including disparities in HIV. Primary partners are an important source of influence on sexual health. In this paper, we investigate sexual HIV risk among male-female couples following a man’s release from prison. Methods: We draw upon data from the Relate Project, a novel cross-sectional survey of recently released men and their female partners in Oakland and San Francisco, California (N=344). Inferential analyses use the actor-partner model to explore actor and partner effects on sexual HIV risk outcomes. Results: Dyadic analyses of sexual HIV risk among male parolees and their female partners paint a complex portrait of couples affected by incarceration and of partners’ influences on each other. Findings indicate that demographic factors such as education level and employment status, individual psycho-social factors such as perception of risk, and relationship factors such as commitment and power affect sexual HIV risk outcomes. Conclusion: The Relate Project provides a novel dataset for the dyadic analysis of sexual risk among male parolees and their female partners, and results highlight the importance of focusing on the couple as a unit when assessing HIV risk and protective behaviors. Results also indicate potentially fruitful avenues for population-specific interventions that may help to reduce sexual health disparities among couples affected by incarceration

Explaining Ethnic Disparities in School Enrollment in Turkey

There exist remarkable differences in educational outcomes across ethnic groups in Turkey. Moreover, almost a quarter of the population of 8- to 15-year-old children belong to ethnic minority groups. Yet, there exists no study that examines the ethnic disparities in educational outcomes in Turkey. This study presents these disparities and uncovers the factors that bring about these disparities using a rich micro-level dataset (Turkish Demographic and Health Survey). In doing so, this paper examines the differences not only in the levels of enrollment but also in the timing of drop-out across ethnic groups. The multivariate analysis accounts for a rich set of regional and socioeconomic factors, which also display striking differences across ethnic groups. The results show that regional and family level characteristics can fully account for the differences in the levels of enrollment across ethnic groups for male children, but not fully for female children. In other words, ethnicity has a direct impact on girls' school enrollment but not on boys'. There exists a gender gap among ethnic Turkish children as well as ethnic Arabic and Kurdish children. However, the gender gap among ethnic Kurdish children is wider than that among ethnic Turkish children.Education; Ethnicity; Gender; Human Capital

Measuring & Mapping Mortality in the Elm City: Identifying and Addressing Health Inequities in New Haven with Years of Potential Life Lost (YPLL) and Other Health Determinants

Population health in the City of New Haven, including health care access, health outcomes, and mortality, is influenced by socioeconomic disparities. These disparities exist on both the individual and neighborhood scale, and across demographics such as age, sex, race, and ethnicity. Continued analyses to understand these disparities is imperative to elucidate public health concerns and to design and to implement appropriate initiatives and interventions. The objectives of this study were as follows: To measure the leading causes of death, average life expectancy, and premature death in New Haven using mortality data and stratifying by key variables including age, sex, race, and ethnicity, and to characterize the relationships between mortality, geographic location, and other demographic variables.https://elischolar.library.yale.edu/ysph_pbchrr/1019/thumbnail.jp

Demographic differences and annual trends in childhood and adolescent cancer incidence and mortality in Michigan during the period 1999-2012

Background. Michigan has declining economic conditions and factories that release pollutants. During the period 1999-2012, only 10 out of 50 states had an overall cancer incidence rate that was higher than that in Michigan. It is not known how children’s cancer rates in Michigan vary by age, gender, race/ethnicity, and year as well as how these rates compare to those in the U.S. Method: The Center for Disease Control and Prevention WONDER database obtained cancer incidence and mortality data from cancer registries and death certificates. We compared age-adjusted incidence and mortality cancer rates by gender, race/ethnicity, and year for children and adolescents aged 0 to 19 years in Michigan and the U.S. for the period 1999-2012. Results. Males in Michigan had higher incidence rates of cancer than females in both Michigan and the U.S. Non-Hispanic Whites had higher cancer incidence rates than people of all other races/ethnicities in Michigan. The childhood cancer incidence rates increased for all racial/ethnic groups except for Hispanic Whites in Michigan during the period 1999-2012. Incidence rates increased more so in Michigan compared to the U.S. for some racial/ethnic groups such as non-Hispanic Whites during the period 1999-2012. Hispanic Whites in all age categories had higher cancer mortality rates than people of all other races/ethnicities in Michigan. Mortality rates for both males and females exhibited a downward trend from 1999 to 2002 in both Michigan and the U.S. Conclusions. Males, non-Hispanic Whites, and Hispanic Whites tended to be disproportionately affected by cancer in Michigan. Future research should investigate the relationship of genetic determinants, socio-economic factors, prenatal behaviors, and air pollution with cancer rates among racial/ethnic groups in Michigan

Not Always Black and White: Racial Bias for Birth Disparities from Excluding Hispanic Identification

Despite gains in prenatal care (PNC) usage and birth outcomes for minority women during the past few decades, observed disparities between non-Hispanic Whites, Blacks, and Hispanics persist. Using the National Center for Health Statistics’ (NCHS) natality files from 1981 through 1998, Alexander, Kogan, & Nabukera (2002) examined live births of U.S. residents by trimester in which PNC was initiated and the appropriateness of that care based on the Adequacy of Prenatal Care Utilization Index (APNCU) (Kotelchuck, 1994). They found racial disparities between White and Black women in both the trimester of PNC initiation and the number of PNC visits made. Alexander et al.(2002) noted reductions in racial disparities in PNC; specifically, Blacks were steadily increasing in the number of prenatal visits and in first trimester initiation of PNC. However, a weakness of their study was the exclusivity of racial categories; only White and Black racial groups were analyzed based on the mother’s self reported race. Other racial groups were not included because Hispanic data were not identifiable for some states during part of the study period, and other racial groups lacked sufficient numbers to establish trending in the categories of interest (Alexander et al., 2002). Thus Hispanics identified their race as White and their ethnicity as Hispanic. Alexander et al. counted both non-Hispanic Whites and Hispanics as ‘Whites’ regardless of ethnicity or the availability of ethnicity in their analysis. This created a potential source of bias, as one could speculate that the reported narrowing of racial disparities in the number of PNC visits and earlier initiation of care between Whites and Blacks could be the result of increasing births to Hispanic women included in the ‘White’ birth group. The reported narrowing of disparities could simply be the result of failing to separate Hispanic women in the analysis, a potentially significant portion of the ‘White’ group given their high fertility rates and increased percentage of the total U.S. population. While the expansion of Medicaid-sponsored funding for pregnant women likely contributed to some of the reported increases in earlier PNC initiation and the number of prenatal visits in the late 1980s and early 1990s (Hessol, Vittingoff, & Fuentes-Afflick, 2004; Hueston, Geesey, & Diaz, 2008), it is not clear if this expansion benefited one racial group over another, particularly when Hispanic ethnicity is taken into account. Therefore, the purpose of this study was to evaluate differentials in birth outcomes for singletons by race for Whites, Blacks, and Hispanics beginning in 1979 (the year when Hispanic identifiers became available in the natality files) through 2006. Specifically, we examined trends the trimester that PNC was initiated, the number of PNC visits, and birth weight by race and ethnicity. While previous studies have evaluated pregnancy outcomes based on race, the exclusion of Hispanic identifiers in the analysis (Alexander, Kogan, Himes, Mor, & Goldenberg, 1999; Alexander et al., 2002; Alexander, Wingate, Bader, & Kogan, 2008; Cox, Zhang, & Zotti, 2009; Hunsley, Levkoff, Alexander, & Tompkins, 1991) potentially introduced a bias in results reported. We estimated racial disparities between Blacks and Whites with and without Hispanic identification. Hence, we quantified the bias created due to Hispanics being identified as Whites. Although Gavin et al. (Gavin, Adams, Hartmann, Benedict, & Chireau, 2004) attempted to address this gap by including Hispanics in their analysis, only pregnancy-related care among Medicaid recipients in four states (Florida, Georgia, New Jersey, and Texas) was examined, therefore omitting a significant portion of the childbearing population. In this current study, the addition of Hispanics as a separate racial group and the extension of analysis back to 1979 through 2006 provide an additional decade of observations over previous reports. Hence this analysis is unique and more comprehensive than previous reports

Elevated Depressive Symptoms In A Community Sample Of African-Americans And Whites

This study examined demographic and psychosocial correlates of elevated depressive symptoms among African-Americans and Whites from comparable socioeconomic and neighborhood backgrounds. 851 African-Americans and 597 Whites from adjacent census tracts were interviewed using previously validated indicators of depressive symptoms, social support, religious practices and various demographic characteristics. More Whites than African-Americans reported elevated depressive symptoms and the groups also differed on several demographic variables and psychosocial variables. Employment, marital status and age were salient demographic covariates for African Americans, while income was for Whites. For both groups, social support and church attendance were inversely associated with depressive symptoms. Prayer was positively associated with depressive symptoms. Future research should explore within racial/ethnic group variations in depressive symptoms. Insights also are needed into possible changes over time in the relationship between religious variables and depressive symptoms, and how social support limits depressive symptoms in diverse populations

Equity in the Digital Age: How Health Information Technology Can Reduce Disparities

While enormous medical and technological advancements have been made over the last century, it is only very recently that there have been similar rates of development in the field of health information technology (HIT).This report examines some of the advancements in HIT and its potential to shape the future health care experiences of consumers. Combined with better data collection, HIT offers signi?cant opportunities to improve access to care, enhance health care quality, and create targeted strategies that help promote health equity. We must also keep in mind that technology gaps exist, particularly among communities of color, immigrants, and people who do not speak English well. HIT implementation must be done in a manner that responds to the needs of all populations to make sure that it enhances access, facilitates enrollment, and improves quality in a way that does not exacerbate existing health disparities for the most marginalized and underserved