DEMOGRAPHIC RESEARCH

Background: Mexican women in the United States (US) have higher rates of fertility compared to other ethnic groups and women in Mexico. Whether variation in women’s access to family planning services or patterns of contraceptive use contributes to this higher fertility has received little attention. Objective: We explore Mexican women’s contraceptive use, taking into account women’s place in the reproductive life course. Methods: Using nationally representative samples from the US (National Survey of Family Growth) and Mexico (Encuesta National de la Dinámica Demográfica), we compared the parity-specific frequency of contraceptive use and fertility intentions for non-migrant women, foreign-born Mexicans in the US, US-born Mexicans, and whites. Results: Mexican women in the US were less likely to use IUDs and more likely to use hormonal contraception than women in Mexico. Female sterilization was the most common method among higher parity women in both the US and Mexico, however, foreign-born Mexicans were less likely to be sterilized, and the least likely to use any permanent contraceptive method. Although foreign-born Mexicans were slightly less likely to report that they did not want more children, differences in method use remained after controlling for women’s fertility intentionsPopulation Research Cente

Medicaid Policy on Sterilization — Anachronistic or Still Relevant?

Female sterilization, typically accomplished by means of tubal ligation, is a widely used method of contraception that is highly effective at preventing unintended pregnancy. Yet there appears to be unmet demand for the procedure in certain segments of the U.S. population. Specifically, low-income women and women from minority racial and ethnic groups may face substantial system-level barriers to obtaining a desired sterilization procedure. One such barrier is the federal policy regarding Medicaid-funded sterilizations. Although this policy was designed to protect vulnerable populations, we believe that it does not effectively fulfill that intention — in fact, it restricts the reproductive autonomy of the women it intends to serve. With the upcoming Medicaid expansions, the number of women affected by these barriers could increase substantially.Population Research Cente

Barriers to Offering Vasectomy at Publicly Funded Family Planning Organizations in Texas

Few publicly funded family planning clinics in the United States offer vasectomy, but little is known about the reasons this method is not more widely available at these sources of care. Between February 2012 and February 2015, three waves of in-depth interviews were conducted with program administrators at 54 family planning organizations in Texas. Participants described their organization’s vasectomy service model and factors that influenced how frequently vasectomy was provided. Interview transcripts were coded and analyzed using a theme-based approach. Service models and barriers to providing vasectomy were compared by organization type (e.g., women’s health center, public health clinic) and receipt of Title X funding. Two thirds of organizations did not offer vasectomy on-site or pay for referrals with family planning funding; nine organizations frequently provided vasectomy. Organizations did not widely offer vasectomy because they could not find providers that would accept the low reimbursement for the procedure or because they lacked funding for men’s reproductive health care. Respondents often did not perceive men’s reproductive health care as a service priority and commented that men, especially Latinos, had limited interest in vasectomy. Although organizations of all types reported barriers, women’s health centers and Title X-funded organizations more frequently offered vasectomy by conducting tailored outreach to men and vasectomy providers. A combination of factors operating at the health systems and provider level influence the availability of vasectomy at publicly funded family planning organizations in Texas. Multilevel approaches that address key barriers to vasectomy provision would help organizations offer comprehensive contraceptive services.Population Research Cente

Hypertension among Oral Contraceptive Users in El Paso, Texas

On the U.S.-Mexico border, residents frequently cross into Mexico to obtain medications or medical care. We previously reported relatively high prevalence of hypertension among Latina oral contraceptive users in El Paso, particularly those obtaining pills over the counter (OTC) in Mexico. Here, we examine factors associated with having hypertension among 411 OTC users and 399 clinic users. We also assess hypertension awareness and interest in using blood pressure kiosks. Women age 35 to 44 and who had BMI ≥ 30 kg/m2 had higher odds of having hypertension. 59% of hypertensive women had unrecognized hypertension, and 77% of all participants would use a blood pressure kiosk; there were no significant differences between clinic and OTC users. Alternative approaches to increase access to health screenings are needed in this setting, where OTC pill use among women with unrecognized hypertension confers unique health risksPopulation Research Cente

The Impact of Information about Abortion Safety on Texas Voters’ Opinions about Restrictive Laws

A substantial gap exists between the scientific evidence demonstrating the safety of abortion in the United States and public opinion about abortion safety. But recent studies suggest that it may be possible to change perceptions about health issues that are based on misinformation. This brief, by researchers from the Texas Policy Evaluation Project, demonstrates that informational statements about the safety of office-based abortion care as currently practiced in Texas significantly reduced perceptions that ambulatory surgical center and admitting privileges requirements would make abortion safer and reduced support for these requirements.Population Research Cente

Demographic Change and the Structure of Wages: A Demand-Theoretic Analysis for Brazil

With rapidly declining fertility and increased longevity the age structure of the labor force in developing countries has changed rapidly. Changing relative supply of workers by age group, and by educational attainment, can have profound effects on labor costs. Their impacts on earnings have been heavily studied in the United States but have received little attention in Asia and Latin America, where supply shocks are at least as large and have often proceeded less evenly across the economy. We use data on 502 local Brazilian labor markets from Censuses 1970-2000 to examine the extent of substitution among demographic groups as relative supply has changed. The results suggest that age-education groups are imperfect substitutes, so that larger age-education cohorts see depressed wage rates, particularly among more-educated groups. The extent of substitution has increased over time, so that the decreasing size of the least-skilled labor force today is barely raising its remaining members' wages.

Is Brazil really a catholic country? What opinions about abortion, sex between individuals who are not married to each other, and homosexuality say about the meaning of catholicism in three Brazilian cities

The idea of being a Catholic country is quite widespread throughout the nation. What does it mean to be Catholic in Brazil? Do Catholics follow the Catholic Doctrine? The objective of this paper is to investigate the relationship between religion and religious involvement (measured by religious affiliation and service attendance) and opinions about abortion, sex between individuals who are not married to each other, and homosexuality in São Paulo, Porto Alegre, and Recife. Data come from the survey “Spirit and Power: A 10-Country Survey of Pentecostals,” carried out in 2006. Results suggest that Brazilian Catholics are a very heterogeneous group with respect to opinions about abortion and sex between individuals who are not married to each other. In addition, service attendance among Catholics and those opinions are strongly correlated, except for the case of homosexuality, a topic which Catholics tend to have the same opinions about, irrespective of their religious involvement. Committed Protestants are, by far and away, the most conservative group.Brazil

Fecundidade no Rio Grande do Sul entre 1946 e 1960: uma análise utilizando o método dos filhos próprios

Using the own-children methodology and data from the 1960 Brazilian census, the objective of this work is to examine the onset of fertility decline in Brazil through estimative of the Total Fertility Rate (TFR) between 1946 and 1960. This study employs micro-regions from Rio Grande do Sul as unit of analysis, which allows considering demographic and socioeconomic differentials within the state. Rio Grande do Sul was chosen because it was a pioneer in terms of fertility decline in Brazil. Results show that although fertility varies substantially by micro-regions, there was a high-fertility concentration in the north and low-fertility setting in the south (particularly in two micro-regions close to Uruguay) as well as in the micro-regions of Porto Alegre and Santa Cruz do Sul. Results show that fertility was already low in the Porto Alegre micro-region between 1946 and 1960, dropping from 3.6 to 3.2 between 1946-1950 and 1956-1960. It is remarkable that rates were lower than those from Rio de Janeiro city in 1964 (CELADE/CSFC, 1972). Some explanations suggested for such early onset of fertility decline are based on the higher proportion of single and high-educated women, who participated in the labor market, and the low child mortality already observed in 1960 in Porto Alegre. However, our results also reveal that the Porto Alegre micro-region was unable to diffuse its reproductive behavior to Rio Grande Sul and hence, its fertility decline, at least before 1955.Utilizando o Método dos Filhos Próprios e dados do Censo Brasileiro de 1960, o objetivo deste artigo é examinar o início do declínio da fecundidade no Brasil a partir do cálculo das Taxas de Fecundidade Total (TFT) entre 1946 e 1960. Uma contribuição deste trabalho é o uso de microrregiões do Rio Grande do Sul como unidade de análise, o que permite considerar diferenciais demográficos e socioeconômicos dentro do estado. O Rio Grande do Sul foi escolhido porque foi um dos pioneiros no declínio da fecundidade no Brasil. Os resultados mostram que embora a fecundidade varie substancialmente por microrregião, existia uma concentração de altas TFT em microrregiões no norte do estado, e de baixas TFT no sul (particularmente em duas microrregiões que fazem divisa com o Uruguai) e nas microrregiões de Porto Alegre e Santa Cruz do Sul. Os resultados evidenciam que a fecundidade já era baixa na microrregião de Porto Alegre entre 1946 e 1960, declinando de 3,6 para 3,2 entre 1946-1950 e 1956-1960. Estes valores já eram inferiores aos da TFT da cidade do Rio de Janeiro em 1964 (CELADE/CSFC, 1972). Algumas explicações sugeridas para a precoce diminuição da fecundidade na microrregião de Porto Alegre são baseadas na alta proporção de mulheres solteiras, com maior escolaridade e participação no mercado de trabalho, e a baixa mortalidade infanto-juvenil, observadas em 1960. Contudo, nossos achados fornecem evidências de que a microrregião de Porto Alegre não foi capaz de difundir para o restante do estado o seu comportamento reprodutivo diferenciado, e assim o declínio da fecundidade, pelo menos até 1955