Anemia among Adolescent and Young Women in Low-and-Middle-Income Countries

Objective: Anemia is a global public health problem that affects maternal and infant mortality as well as human capital  development.  Yet  there  is  not  much  research  on  anemia  among  young  women  in  low-and-middle-income  countries with nationally representative samples. The aim of the current research is to assess the extent of anemia in a critical age group: adolescents and young adults ages 15 to 24. Methods: The data are from 34 Demographic and Health Surveys and are used to describe the prevalence of anemia among pregnant and non-pregnant women by age, rural/urban residence, and household wealth. Anemia was assessed using the HemoCue® blood hemoglobin testing system.   Findings: The  prevalence  of  anemia  among  young  women  ranges  from  15%  to  over  50%.  This  is  substantially  higher  than 5%, which is the cutoff to identify a population where anemia is a public health problem. African countries show the highest prevalence of anemia; Benin, Ghana and Mali have over 60% anemia prevalence. Moreover, the prevalence of moderate to severe anemia is particularly high in African countries, over 20% in Ghana and Guinea. Our results show that anemia is a public health concern for adolescents and young adult females in all 34 countries we analyzed. Conclusion: The high prevalence of anemia among youth is alarming. Considering the importance of the adolescent and young adult years, when human capital development is consolidated and family formation begins, these findings call for interventions to redress the problem of anemia

Pathways of Early Fatherhood, Marriage, and Employment: A Latent Class Growth Analysis

http://dx.doi.org/10.1007/s13524-011-0022-

Racial, ethnic, and gender differences in smoking cessation associated with employment and joblessness through young adulthood in the US

The dynamics of labor force participation and joblessness during young adulthood influence access to social and material resources and shape exposure to different sources of psychosocial strain. Differences in these dynamics by race, ethnicity, and gender are related to changes in a behavioral determinant of poor health (tobacco use) for young adults aging into midlife. Using discrete-time hazards models, we estimate the relationship between labor force participation in the past year and smoking cessation for US adults (ages 14-21 years in 1979) followed in a population-representative sample until 1998 (i.e. the National Longitudinal Survey of Youth). We assess the unique role of racial, ethnic and gender differences in exposure, vulnerability, and reactivity to employment and joblessness by controlling for social and economic resources obtained through working and by controlling for early life factors that select individuals into certain labor force and smoking trajectories. There are three main findings: (1) joblessness is more strongly associated with persistent daily smoking among women than among men; (2) fewer social and economic resources for women out of the labor force compared to employed women explains their lower cessation rates; and (3) lower cessation among unemployed women compared to employed women can only partially be explained by these resources. These findings illustrate how differential access to work-related social and economic resources is an important mediator of poor health trajectories. Contextual factors such as social norms and psychosocial strains at work and at home may play a unique role among European American men and women in explaining gender differences in smoking.USA Gender inequality Racial and ethnic differences Labor force participation Smoking cessation

Why Do Americans Want Children?

Data from the 1987-88 US National Survey of Families and Households are used to test four hypotheses about fertility intentions. Fertility intentions are examined as a function of the importance of the social resource value of children, economic costs, women's career impact, and childlessness. The study sample includes 4691 non-Hispanic White or Black women who are aged 16-39 years. The authors analyze subgroups stratified by race, gender, union, and parity. Findings indicate that fertility intentions declined with increased parity. Parity differences varied by race and union status. Multivariate logistic regression results confirm the impact of parity on fertility intentions. The social resource variable was positively related to fertility intentions for men and for women. The odds ratio was larger among persons with a high degree of agreement with attitudes valuing children as a resource. The 'economic cost of children' variable was only weakly and insignificantly related to fertility intentions. The 'career impact' variable was significant and positive for parity 0 White women. Both married and unmarried women with careers were less inclined to desire a child. The 'career impact' variable was significant but weak for married White women at parity 1 and 2 plus. The 'career impact' variable was only significant for White men at parity 1, and these men were less likely to desire another child. Childless men and women, married and unmarried, who supported childlessness, were less likely to desire a child. Married women at parity 1 and married men at parity 2 plus, who supported parenthood over childlessness, had lower fertility intentions. The analysis of Black men and women was hampered by small sample sizes, but race was not directly associated with fertility intentions at any parity. The most important predictor was actual fertility. A "primary motivator" of childbearing among low fertility populations is the social resource value of children.This work was supported by grant R01 HD33240 from the Center for Population Research (NICHD). It benefitted from the research assistance of Emma Larkin and from support provided to the Hopkins Population Center by NICHD grant P30 HD06268

Why Do Americans Want Children?

Data from the 1987-88 US National Survey of Families and Households are used to test four hypotheses about fertility intentions. Fertility intentions are examined as a function of the importance of the social resource value of children, economic costs, women's career impact, and childlessness. The study sample includes 4691 non-Hispanic White or Black women who are aged 16-39 years. The authors analyze subgroups stratified by race, gender, union, and parity. Findings indicate that fertility intentions declined with increased parity. Parity differences varied by race and union status. Multivariate logistic regression results confirm the impact of parity on fertility intentions. The social resource variable was positively related to fertility intentions for men and for women. The odds ratio was larger among persons with a high degree of agreement with attitudes valuing children as a resource. The 'economic cost of children' variable was only weakly and insignificantly related to fertility intentions. The 'career impact' variable was significant and positive for parity 0 White women. Both married and unmarried women with careers were less inclined to desire a child. The 'career impact' variable was significant but weak for married White women at parity 1 and 2 plus. The 'career impact' variable was only significant for White men at parity 1, and these men were less likely to desire another child. Childless men and women, married and unmarried, who supported childlessness, were less likely to desire a child. Married women at parity 1 and married men at parity 2 plus, who supported parenthood over childlessness, had lower fertility intentions. The analysis of Black men and women was hampered by small sample sizes, but race was not directly associated with fertility intentions at any parity. The most important predictor was actual fertility. A "primary motivator" of childbearing among low fertility populations is the social resource value of children.This work was supported by grant R01 HD33240 from the Center for Population Research (NICHD). It benefitted from the research assistance of Emma Larkin and from support provided to the Hopkins Population Center by NICHD grant P30 HD06268

Anemia among Adolescent and Young Women in Low-and-MiddleIncome Countries

Objective: Anemia is a global public health problem that affects maternal and infant mortality as well as human capital development. Yet there is not much research on anemia among young women in low-and-middle-income countries with nationally representative samples. The aim of the current research is to assess the extent of anemia in a critical age group: adolescents and young adults ages 15 to 24. Methods: The data are from 34 Demographic and Health Surveys and are used to describe the prevalence of anemia among pregnant and non-pregnant women by age, rural/urban residence, and household wealth. Anemia was assessed using the HemoCue® blood hemoglobin testing system. Findings: The prevalence of anemia among young women ranges from 15% to over 50%. This is substantially higher than 5%, which is the cutoff to identify a population where anemia is a public health problem. African countries show the highest prevalence of anemia; Benin, Ghana and Mali have over 60% anemia prevalence. Moreover, the prevalence of moderate to severe anemia is particularly high in African countries, over 20% in Ghana and Guinea. Our results show that anemia is a public health concern for adolescents and young adult females in all 34 countries we analyzed. Conclusion: The high prevalence of anemia among youth is alarming. Considering the importance of the adolescent and young adult years, when human capital development is consolidated and family formation begins, these findings call for interventions to redress the problem of anemia

Health of the world’s adolescents: a synthesis of internationally comparable data.

Adolescence and young adulthood off er opportunities for health gains both through prevention and early clinical intervention. Yet development of health information systems to support this work has been weak and so far lagged behind those for early childhood and adulthood. With falls in the number of deaths in earlier childhood in many countries and a shifting emphasis to non-communicable disease risks, injuries, and mental health, there are good reasons to assess the present sources of health information for young people. We derive indicators from the conceptual framework for the Series on adolescent health and assess the available data to describe them. We selected indicators for their public health importance and their coverage of major health outcomes in young people, health risk behaviours and states, risk and protective factors, social role transitions relevant to health, and health service inputs. We then specify defi nitions that maximise international comparability. Even with this optimisation of data usage, only seven of the 25 indicators, covered at least 50% of the world’s adolescents. The worst adolescent health profi les are in sub-Saharan Africa, with persisting high mortality from maternal and infectious causes. Risks for non-communicable diseases are spreading rapidly, with the highest rates of tobacco use and overweight, and lowest rates of physical activity, predominantly in adolescents living in low-income and middle-income countries. Even for present global health agendas, such as HIV infection and maternal mortality, data sources are incomplete for adolescents. We propose a series of steps that include better coordination and use of data collected across countries, greater harmonisation of school-based surveys, further development of strategies for socially marginalised youth, targeted research into the validity and use of these health indicators, advocating for adolescent-health information within new global health initiatives, and a recommendation that every country produce a regular report on the health of its adolescents