80 research outputs found

    Uncertainty and Narratives of the Future. A Theoretical Framework for Contemporary Fertility

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    Explanations for fertility decisions based on structural constraints—such as labor, housing condition, or income—do not account for the contemporary fertility downturn faced by many countries in Europe. In this paper, we posit that the rise of uncertainty is central for understanding contemporary fertility dynamics. We propose a theoretical framework (the Narrative Framework) for the study of fertility decisions under uncertain conditions based on expectations, imaginaries and narratives. Relying on the idea of future–oriented action, we argue that uncertainty needs to be conceptualized and operationalized taking into account that people use works of imagination, producing their own narrative of the future. Narratives of the future are potent driving forces helping people to act according to or despite uncertainty. We present the different elements of the Narrative Framework and address its causal validity. We conclude by highlighting the advantages of taking into account the narratives of the future in fertility research

    Disease load at conception predicts survival in later epidemics in a historical French-Canadian cohort, suggesting functional trans-generational effects in humans

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    Objective Functional trans-generational and parental effects are potentially important determinants of health in several mammals. For humans, the existing evidence is weak. We investigate whether disease exposure triggers functional trans-generational response effects among humans by analyzing siblings who were conceived under different disease loads, and comparing their mortality in later epidemics. Under functional trans-generational response mechanisms, we expect that those who were conceived under high pathogenic stress load will have relatively low mortality during a later epidemic. Methods We use data from the Registre de la Population du Québec Ancien, which covers the historical population living in St. Lawrence Valley, Québec, Canada. Children born in 1705–1724 were grouped according to their exposure during conception to the measles 1714–15 epidemic. The 1714–15 epidemic was followed by two mortality crises in 1729–1734. The cause of the first crises in 1729 is not exactly known. The second crisis in 1732 was caused by a smallpox epidemic. Using proportional hazard Cox regression models with multivariate adjustment and with fixed-effects approach that compare siblings, we analyze whether mortality in 1729–1734 is affected by exposure to the 1714–15 epidemic. Results Children who were conceived during the peak of the measles epidemic of 1714–15 exhibited significantly lower mortality during the 1729–1734 crisis than those who were born before the 1714–15 epidemic (mortality hazard ratio 0.106, p<.05 in multivariate adjusted models; 0.142 p<.1 in sibling comparison models). Conclusions The results are consistent with a trans-generational mechanism that functionally responds to pathogen stress and suggest that early disease exposure may be protective later in life. Alternative explanations for the mortality patterns are discussed and shown to be problemati

    The Impact of Mental Problems on Mortality and How It Is Moderated by Education

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    Mental disorders have a large impact on invalidity and mortality. Poor mental health is associated with low education, which is also associated with poor health and higher mortality. The association between mental health and mortality may, therefore, be partly explained by the increased incidence of mental problems of the low educated. An important issue is that mental health problems, education attainment and mortality may all depend on the same observed and unobserved individual factors. We account for both the selective incidence of mental health problems and selective educational attainment by using a correlated multistate model for the mental health (hospitalization) process (both admittance an discharge) and mortality with a re-weighting technique (inverse propensity weighting) based on the probability to attain higher education. We use Swedish Military Conscription Data (1951-1960), linked to the administrative Swedish death and National Hospital Discharge registers. We estimate the effect of mental hospitalization and education on the morality rate and how the effect of mental hospitalization is moderated by education. Our empirical results indicate a strong effect of both mental hospitalization and education on mortality. Mental hospitalization affects mortality due to external causes of death in particular. Only for the low educated improving education moderates the impact of mental hospitalization on mortality. We also found that ignoring onfounding would overestimate the impact of mental hospitalization on mortality. Accounting for confounding in mental hospitalization seems to be more important than accounting for selective educational attainment

    Working life and retirement expectancies at age 50 by social class: period and cohort trends and projections for Finland

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    Objectives: The balance between the amount of time spent in work and in retirement underlies the long-term sustainability of the social security system. We examined socioeconomic differences in how increasing longevity is distributed between labor market statuses in Finland. Method: We used register data and the Sullivan method to analyze life expectancy at age 50 spent in different labor market statuses over the period 1989&ndash;2012 and across cohorts born in 1938&ndash;1953. We projected the future mortality and labor market participation rates of partially observed cohorts. Results: Both working life expectancy at age 50 and the share of remaining life spent in work have increased across periods following the recession of the early 1990s, and across successive cohorts. The trends were similar across the social classes, but there were large differences in the numbers of years spent in various states: for the most recent period and the youngest cohort, we find that compared with upper non-manual employees, male and female manual workers were expected to spend 3.6&ndash;3.7 fewer years in work, 1.7&ndash;4.7 fewer years in statutory retirement, and 3.2&ndash;3.9 more years in other forms of nonemployment. Discussion: Our finding that the share of remaining life at age 50 spent in work is increasing implies that pressure on the welfare system is not as severe as is commonly thought.</p

    Changes in socioeconomic differences in hospital days with age: cumulative disadvantage, age-as-leveler, or both?

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    Objectives - Length of hospital stay is inversely associated with socioeconomic status (SES). It is less clear whether socioeconomic disparities in numbers of hospital days diverge or converge with age. Method - Longitudinal linked Finnish registry data (1988&ndash;2007) from 137,653 men and women aged 50&ndash;79 years at the end of 1987 were used. Trajectories of annual total hospital days by education, household income, and occupational class were estimated using negative binomial models. Results - Men and women with higher education, household income, and occupational class had fewer hospital days in 1988 than those with lower SES. Hospital days increased between 1988 and 2007. For some age groups, higher SES was associated with a faster annual rate of increase, resulting in narrowing rate ratios of hospital days between SES groups (relative differences); the rate ratios remained stable for other groups. Absolute SES differences in numbers of hospital days appeared to diverge with age among those aged 50&ndash;69 years at baseline, but converge among those aged 70&ndash;79 years at baseline. Discussion - The hypotheses that socioeconomic disparities in health diverge or converge with age may not be mutually exclusive; we demonstrated convergence/maintenance in relative differences for all age groups, but divergence or convergence in absolute differences depending on age.</p
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