Neighbourhood effects and demographic outcomes

Many studies have focused on whether racism harms the health of targeted individuals. However less is known about whether and how racial prejudice harms the health of all community members including those who harbor such prejudice across time. The aim of this study is to examine racism as a risk factor harmful for the health of communities within which it occurs. We used data from the 1985-2002 General Social Survey (GSS), a representative sample of the U.S. non-institutionalized population that included questions about racist attitudes towards blacks. We prospectively linked the GSS data to mortality data through 2008 via the National Death Index (NDI) and assessed the effect of racial prejudice on all-cause mortality of individuals above age 18 nested within 384 U.S. Primary Sampling Units using multilevel models and age-period-cohort models. The study reveals that both black and white individuals living in communities with higher levels of racial prejudice had increased mortality rates compared to residents living in communities with less racial prejudice. This association was robust to controls for other individual- and community-level socio-economic characteristics.

More than half of the world’s population resides in urban areas. In developing countries, the vast majority of future population growth will be in cities. In order to address the health needs of this growing population, timely data on within-city differentials in morbidity and mortality is necessary. Mortality rates within cities are typically not available in standard data sources such as the DHS, and thus intra-urban differentials in child mortality are unknown. Using baseline data from the MLE project in urban sites of Kenya, Nigeria, Senegal and Uttar Pradesh, India, we estimate infant, child and under-five mortality rates for slum and non-slum populations in major cities. The representative household samples of the urban populations in 5-6 major cities in each country were drawn to represent slum and non-slum populations, or the urban poor in cities where slum designations were not available (Nigeria and Senegal). These age-specific mortality rates show that mortality is generally higher among the slum populations compared to the non-slum urban populations in all four countries. We then explore the individual, household, community and geographic factors which contribute to higher rates of child mortality among urban slum dwellers as compared to non-slum dwellers.

The aim of the communication is to analyse the onset of extra-marital births in each district of Switzerland between 1970 and 2000. The starting time of the spread of extra-marital birth differed according to regions. It has, for example, first increased in the French speaking area of Switzerland and in urbanized areas. We suspect a spatial diffusion process. Data we use is the level of out-of-wedlock births for each district of Switzerland at four moments, 1970, 1980, 1990 and 2000. We define the time of the onset of out-of-wedlock births for each district following a method suggested by Bocquet-Appel and Jakobi (1998). We then estimated an event history model of this time in which we introduce as a characteristic a social distance between districts which already experiment an increase of extra-marital births and those which did not. This social distance is considered as a proxy of the nearness between districts. Provisory results show a significant effect of this distance on the hazard rate. Lesser is the distance and higher is the probability of the onset. This result confirms our hypothesis of a diffusion process on the Swiss territory.

In this study we inquire upon certain pathways, i.e. material psychological and behavioral, which are known to have impact on health. The study is placed in an urban village of Varanasi, which historically suffers socio-spatial exclusion. This study is built upon sequential exploratory research design, a genre of mixed methodology of research. A total of 150 adult males participated in two phase of data collection, accomplished through various instruments like in-depth interviews, group discussion and questionnaire based survey. The data collected in different face were analyzed combinedly to get a complete picture. The inhabitants of the study area were segregated from urban surrounding socially and spatially. They have health problems originating from insanitation and poverty. Their perception was controlled by old rural values and experiences; and practices were curious mix of rurality and urbanism.

Sleep loss is becoming more prevalent in both developed and developing countries. Evidence accumulated over 40 years indicates a strong association between short and poor sleep and all-cause mortality. People with disadvantaged socioeconomic status present more stress and therefore serious sleep problems. Neighborhood disadvantage can double the health risks of poor sleep for low-income people who live in disadvantaged areas. This study examines the relative effect of individual economic hardship, psychological stress and neighborhood disadvantages on the chance of being poor sleep from 2001 to 2005. It also explores the geographical variations of neighborhood unemployment rate on average prevalence of poor sleep controlling for individual-level SES. Multilevel models and geographically weighted regression (GWR) are used. National representative data (SDTS, 2001 and 2005) is used. Poor sleep is defined by insomnia and restless sleep. Women reported more insomnia and more restless sleep than men. This study found double jeopardy of individual and neighborhood economic hardships on the risk of poor sleep. Certain area of Taiwan has more adverse consequences from neighborhood unemployment rate. As poor sleep increases from 2001 to 2005, it becomes more spatial clustering from 2001 to 2005.

Through exploratory spatial analysis, this paper found strong spatial dependence in levels of urbanization among 287 prefecture-level cities in China, and the high-high and low-low were the dominant spatial agglomeration types of the neighbor cities. The major socio-economic factors also showed obvious spatial dependence, which might contribute to the spatial aggregation of the urbanization level. Spatial error regression model further verified and controlled this kind of spatial dependence, and indicated that the degree of openness relatively more significantly increased the urbanization level than the degree of industrialization due to household registration system and strategy as well as process of industrialization in China.

Location has also manifestation on the morbidity pattern, knowledge and attitude for treatment seeking apart from socio-cultural, economic and demographic factors. The present paper aims to explore impact of neighbourhood effect on women’s reproductive morbidity and their treatment seeking behaviour using DLHS-3 data. Five regions were delineated on the basis of geographical proximity as districts bordering with Nepal (4), West Bengal (4), Jharkhand (6), Uttar Pradesh (6) and interior districts (17). There was high reporting of morbidity and low treatment seeking for the morbidities in the districts bordering with Nepal and West while the condition was vise-versa for districts near to the state capital and UP border. It is found that in addition to migration of husband and accessibility to the services, the ‘neighbourhood effect’ also plays significant role in regulating the health of women living in districts bordering with UP and Jharkhand.

Globally there has been an increase in the prevalence of obesity over the last two decades and low and middle-income countries in particular are being threatened with rising levels of obesity. Research on obesity in developing countries has focused mostly on rural urban differences without necessarily explaining the salient factors that account for these differences. This paper examines the likely regional socioeconomic and socio-cultural factors that explain the differences in obesity prevalence across Ghana. The study draws on data from two nationally representative surveys; the 2008 Ghana Demographic and Health and the 2005-2006 Ghana Living Standards Survey. The results show marked regional variations in socio-economic status and obesity levels. The Greater Accra region which had the most number of households (45.9%) belonging to the highest wealth quintile was also the most urbanized region (90% urban). Greater Accra also recorded the highest prevalence of obesity (19.3%) while the three northern regions which were the least urbanized and had the lowest number of households in the highest wealth quintile had obesity prevalence of less than 5%. These variations in socio-economic status and obesity levels demonstrate that there is more to the problem of obesity in Ghana than just rural urban differences.

Ouagadougou, the capital of Burkina Faso, is currently experiencing rapid population growth. Since 2008, the Ouagadougou Health and Demographic Surveillance System follows 80,000 people living in five neighborhoods on the periphery of the city, half of them living in poor, informal settlements. In this analysis, we study the social disparities characterizing the risk of dying before age five in these areas as well as the social differentials of associated risk factors. We find that children who are born to uneducated and poor parents are twice as likely to die as their counterparts, likely because they have worse access to both preventive and curative health care. Young children living in informal areas are also twice as likely to die compared to others because, everything else being equal, they are more often ill, more often malnourished, and less likely to receive medical care; these outcomes seem all related to the unsanitary environment.

The diffusion of contraceptive use, as a proxy for the spread of low fertility norms, has long been of interest to researchers wishing to understand the fundamental drivers of fertility decline. However, few studies have incorporated community level influences with work on social networks and individual factors. I examine the multilevel determinants of contraceptive use in 22 villages undergoing late-stage demographic transition in rural southern Poland. I test individual and community level hypotheses about the diffusion of contraceptive use to examine the extent to which it is individually strategic and/or culturally transmitted between kin and social networks. I find evidence consistent with Cultural Evolutionary hypotheses that individuals imitate the behaviour of easily observable social models, and that contraceptive uptake may exhibit positive frequency-dependence (aka conformity). The results support hypotheses about social influence in demography. The findings are also consistent with theoretical modelling showing that even when conformity to group norms is relatively high, average education in a group can increase the rates of transmission of low fertility norms, and thereby the rate of contraceptive uptake. However some methods of contraception are more sensitive to traditional norms than others.