Intergenerational support during the rise of mobile telecommunication in Indonesia

Background: In many Southeast Asian populations, urbanization and migration have increased the share of older adults supported by nonresident children. The expansion of mobile telephone infrastructure has emerged as a mechanism to bridge the spatial dispersion of families and to facilitate support for aging adults. Objective: We document two decades of change in the proximity of adult children of older people in Indonesia. We then ask how the arrival and expansion of mobile communication infrastructure changed key dimensions of intergenerational support: frequency of contact and material transfers. Methods: We combine data from a longitudinal, population-representative household survey with area-level information on mobile signal strength in Indonesia spanning the development of mobile telecommunication. We describe shifts in the family network available to older adults as well as changes in support between 1997 and 2014. We use fixed effect specifications to estimate the impact of the arrival of mobile telecommunication on intergenerational support. Results: For Indonesian older adults, the geographic dispersal of adult children increased over the two-decade period, but the proximate residence of at least one child remained stable. Weekly contact and the monetary value of material transfers to older people doubled. The arrival of mobile technology increased contact between aging parents and their adult children but had little impact on material transfers. Contribution: Despite the spatial dispersion of adult children, familial support for the Indonesian older-age population has increased substantially over the past two decades. Telecommunication has supported ongoing intrafamilial exchange, but the effects differ across dimensions of support

Impacts of the 1918 flu on survivors’ nutritional status: A double quasi-natural experiment

Three files needed to reproduce our work (data, code, results) are in https://gitlab.com/csic-echo/1918-flu-puerto-rico.Robust empirical evidence supports the idea that embryonic and, more generally, intrauterine disruptions induced by the 1918-flu pandemic had long-term consequences on adult health status and other conditions. In this paper we assess the 1918-flu long-term effects not just of in utero exposure but also during infancy and early childhood. A unique set of events that took place in Puerto Rico during 1918–1919 generated conditions of a “double quasi-natural experiment”. We exploit these conditions to empirically identify effects of exposure to the 1918 flu pandemic and those of the devastation left by an earthquake-tsunami that struck the island in 1918. Because the earthquake-tsunami affected mostly the Western coast of the island whereas early (in utero and postnatal) exposure to the flu was restricted to those born in the interval 1917–1920, we use geographic variation to identify the effects of the quake and timing of birth variation to identify those of the flu. We benefit from availability of information on markers of nutritional status in a nationally representative sample of individuals aged 75 and older in 2002. We make two contributions. First, unlike most fetal origins research that singles out early nutritional status as a determinant of adult health, we hypothesize that the 1918 flu damaged the nutritional status of adult survivors who, at the time of the flu, were in utero or infants. Second, we target markers of nutritional status largely set when the adult survivors were infants and young children. Estimates of effects of the pandemic are quite large mostly among females and those who were exposed to the earthquake-tsunami. Impacts of the flu in areas less affected by the earthquake are smaller but do vary by area flu severity. These findings constitute empirical evidence supporting the conjecture that effects of the 1918 flu and/or the earthquake are associated not just with disruption experienced during the fetal period but also postnatally.This work was supported by the National Institute on Aging (https://www.nia.nih.gov/), National Institute of Child Health and Development (https://www.nichd.nih.gov), Fogarty International Center Global Research Training in Population and Health (https://www.fic.nih.gov) and European Research Council (https://erc.europa.eu/) via the following project grants R01-AG016209 (AP), R03-AG015673(AP), R01-AG018016(AP), R37-AG025216 (AP), RO1-AG056608 (AP;HBS), RO1-AG052030(AP;HBS); D43-TW001586(AP), R24-HD047873(AP), P30-AG-017266(AP), R24 HD041022(UCLA:HBS); European Union Horizon 2020 Research and Innovation Programme, Project No 788582(AP).Peer reviewe

Population-level impact of adverse early life conditions on adult healthy life expectancy in low- and middle-income countries

Evidence from theories of Developmental Origins of Health and Disease (DOHaD) suggests that experiencing adverse early life conditions subsequently leads to detrimental adult health outcomes. The bulk of empirical DOHaD literature does not consider the nature and magnitude of the impact of adverse early life conditions at the population level. In particular, it ignores the distortion of age and cohort patterns of adult health and mortality and the increased load of chronic illness and disability that ensues. In this paper, we use a microsimulation model combined with empirical estimates of incidence and prevalence of obesity, type 2 diabetes, and associated disability in low- and middle-income countries to assess the magnitude of delayed effects on adult healthy life expectancy and on compression (or expansion) of morbidity at older ages. The main goal is to determine if, in what ways, and to what extent delayed effects due to early conditions can influence cohorts’ chronic illness and disability profilesBeltrán-Sánchez acknowledges support from grants by the National Institute on Aging (R01AG052030) and the National Institute of Child Health and Human Development (P2C-HD041022) to the California Center for Population Research at UCLA. Palloni acknowledges support from the National Institute on Aging, National Institute of Child Health and Development, Fogarty International Center (Global Research Training in Population and Health), and the European Research Council via the following project grants: R01-AG016209 (AP), R03-AG015673(AP), R01-AG018016(AP), R37-AG025216 (AP), RO1-AG056608 (AP;HBS), RO1-AG052030(AP;HBS), D43-TW001586(AP), R24 HD047873(AP), P30-AG-017266(AP), R24 HD-041022(UCLA:HBS), and the European Union Horizon 2020 Research and Innovation Programme, Project No 788582(AP)Peer reviewe

Population-level impact of adverse early life conditions on adult healthy life expectancy in low- and middle-income countries

Evidence from theories of Developmental Origins of Health and Disease (DOHaD) suggests that experiencing adverse early life conditions subsequently leads to detrimental adult health outcomes. The bulk of empirical DOHaD literature does not consider the nature and magnitude of the impact of adverse early life conditions at the population level. In particular, it ignores the distortion of age and cohort patterns of adult health and mortality and the increased load of chronic illness and disability that ensues. In this paper, we use a microsimulation model combined with empirical estimates of incidence and prevalence of obesity, type 2 diabetes, and associated disability in low- and middle-income countries to assess the magnitude of delayed effects on adult healthy life expectancy and on compression (or expansion) of morbidity at older ages. The main goal is to determine if, in what ways, and to what extent delayed effects due to early conditions can influence cohorts’ chronic illness and disability profiles.Beltrán-Sánchez acknowledges support from grants by the National Institute on Aging (R01AG052030) and the National Institute of Child Health and Human Development (P2C-HD041022) to the California Center for Population Research at UCLA. Palloni acknowledges support from the National Institute on Aging, National Institute of Child Health and Development, Fogarty International Center (Global Research Training in Population and Health), and the European Research Council via the following project grants: R01-AG016209 (AP), R03-AG015673(AP), R01-AG018016(AP), R37-AG025216 (AP), RO1-AG056608 (AP;HBS), RO1-AG052030 (AP;HBS), D43-TW001586(AP), R24 HD047873(AP), P30-AG-017266(AP), R24 HD-041022(UCLA:HBS), and the European Union Horizon 2020 Research and Innovation Programme, Project No 788582(AP).Peer reviewe