Social inequality and children's growth in Guatemala

This paper is an investigation of the effects of social inequality in Guatemala on children’s health and nutritional status as measured by attained height. Guatemala remains a highly stratified and poor society. We examine the association of land distribution, land tenure, occupation, and other aspects of family social and economic status with children’s height between the ages of three months and 36 months, using data from a cross-sectional survey. An important consequence of the poverty and poor living conditions of the majority of the Guatemalan population is substantial deficits in children’s growth. Our results suggest that children’s growth is affected by ethnicity, their father’s occupation, land distribution in the area where they live, and maternal education. Substantial growth deficits are observed among children living at altitudes above 1500 metres; we hypothesize that this is because, in Guatemala, higher altitude is associated with land scarcity, poorer agricultural conditions, and greater remoteness from transport networks and other public services

Childhood immunization and pregnancy-related services in Guatemala

In this paper we examine the experience of one poor country, Guatemala, that provided childhood immunization partly through a major national campaign, and provided pregnancyrelated services through government health facilities, during the 1980s. Specifically, we compare the breadth of coverage of these two types of services using national sample survey data collected in 1987. We then draw upon results of previous qualitative studies to explore the social, cultural, and organizational factors that may account for differences between the use of immunization and the use of pregnancy-related health services

New Insights into the Far Eastern Pattern of Mortality

The Far Eastern pattern of mortality, first identified in 1980, is characterized by some of the largest sex differentials at adult ages to be found anywhere in the world. These atypically high levels of excess male mortality were present in several Far Eastern populations during the 1960s and 1970s and have progressively disappeared since that time. This study uses cause of death data to determine the diseases responsible for the existence and attenuation of these sex differences in Hong Kong, Singapore and Taiwan. The analysis focuses primarily on two hypotheses – regarding the roles of respiratory tuberculosis and liver diseases associated with hepatitis B infection – which were proposed to explain the Far Eastern pattern but were never tested. The results of our analysis indicate that respiratory tuberculosis is the single most important cause underlying the existence and attenuation of the Far Eastern pattern, that the role of liver diseases is far from clear cut, and that other causes (such as cardiovascular diseases) are important as well. Some of the risk factors which may underlie these exceptional mortality patterns are identified

Life expectancy loss among Native Americans during the COVID-19 pandemic

Background: There has been little systematic research on the mortality impact of COVID-19 in the Native American population. Objective: We provide estimates of loss of life expectancy in 2020 and 2021 relative to 2019 for the Native American population. Methods: We use data on age-specific all-cause mortality rates from CDC WONDER and the 2019 life table recently released by the National Vital Statistics System for Native Americans to calculate life tables for the Native American population in 2020 and 2021 and to obtain estimates of life expectancy reductions during the COVID-19 pandemic. Results: The pandemic has set Native Americans further behind other major racial/ethnic groups in terms of life expectancy. The estimated loss in life expectancy at birth for Native Americans is 4.5 years in 2020 and 6.4 years in 2021 relative to 2019. Conclusions: These results underscore the disproportionate share of deaths experienced by Native Americans: a loss in life expectancy at birth in 2020 that is more than three years above that for Whites and about 1.5 years above the losses for the Black and Latino populations. Despite a successful vaccination campaign among Native Americans, the estimated loss in life expectancy at birth in 2021 unexpectedly exceeds that in 2020. Contribution: The increased loss in life expectancy in 2021, despite higher vaccination rates than in other racial/ethnic groups, highlights the huge challenges faced by Native Americans in their efforts to control the deleterious consequences of the pandemic

Refining Estimates of Marital Status Differences in Mortality at Older Ages

The main objective of this analysis is to demonstrate that some of the limitations that have characterized recent studies of the relationship between marital status and health outcomes may result in biased estimates of marital status differences in mortality among the elderly. A secondary goal is to evaluate the strength of evidence in support of the excess risks of mortality associated with widowhood, once we are able to eliminate or mitigate many of the limitations experienced by other studies. Our results, based on the 1984-1990 Longitudinal Study of Aging, demonstrate that the estimated marital status effects in logit and hazard models of survival are very sensitive to whether and how marital status information is updated after the baseline interview. Refined measures of marital status that capture prospectively transitions from the married to the widowhood state result in substantially increased estimates of the relative risk of dying in the early durations of widowhood (bereavement).

COVID-19 risk factors and mortality among Native Americans

Background: Academic research on the disproportionate impact of COVID-19 among Native Americans has largely been restricted to particular indigenous groups or reservations. Objective: We estimate COVID-19 mortality for Native Americans relative to other racial/ethnic groups and explore how state-level mortality is associated with known risk factors. Methods: We use the standardized mortality ratio (SMR), adjusted for age, to estimate COVID-19 mortality by racial/ethnic groups for the United States and 16 selected states that account for three-quarters of the Native American population. The prevalence of risk factors is derived from the American Community Survey and the Behavioral Risk Factor Surveillance System. Results: The SMR for Native Americans greatly exceeds those for Black and Latino populations and varies enormously across states. There is a strong positive correlation across states between the share of Native Americans living on a reservation and the SMR. The SMR for Native Americans is highly correlated with the income-poverty ratio, the prevalence of multigenerational families, and health insurance (excluding the Indian Health Service). Risk factors associated with socioeconomic status and comorbidities are generally more prevalent for Native Americans living on homelands, a proxy for reservation status, than for those living elsewhere. Conclusions: Most risk factors for COVID-19 are disproportionately high among Native Americans. Reservation life appears to increase the risk of COVID-19 mortality. Contribution: We assemble and analyze a broader set of COVID-19-related risk factors for Native Americans than previous studies, a critical step toward understanding the exceptionally high COVID-19 death rates in this population

Comparación entre las historias completas y truncadas de nacimientos para medir la fecundidad y la mortalidad de la niñez

Incluye BibliografíaComparación entre las técnicas de recopilación de datos de fecundidad a través de historias truncadas y de historias completas de nacimientos, en la experiencia en Perú, 1986

Working memory in older adults declines with age, but is modulated by sex and education

Working memory (WM), which underlies the temporary storage and manipulation of information, is critical for multiple aspects of cognition and everyday life. Nevertheless, research examining WM specifically in older adults remains limited, despite the global rapid increase in human life expectancy. We examined WM in a large sample (N=754) of healthy older adults (aged 58-89) in a non-Western population (Chinese speakers) in Taiwan, on a digit n-back task. We tested the influence not only of age itself and of load (1-back vs. 2-back), but also effects of both sex and education, which have been shown to modulate WM abilities. Mixed-effects regression revealed that, within older adulthood, age negatively impacted WM abilities (with linear, not nonlinear, effects), as did load (worse performance at 2-back). In contrast, education level was positively associated with WM. Moreover, both age and education interacted with sex. With increasing age, males showed a steeper WM decline than females; with increasing education, females showed greater WM gains than males. Together with other findings, the evidence suggests that age, sex, and education all impact WM in older adults, but interact in particular ways. The results have both basic research and translational implications, and are consistent with particular benefits from increased education for women