Poster session on Health, mortality and longevity (1)

The present study examines urban-rural differentials in maternal health care services in the regions of Madhya Pradesh by demographic and socio-economic characteristics using third round of District Level Household and Facility Survey (2007-08). Bivariate and multivariate techniques have been used for analysis. Result shows wide gap between rural and urban areas in utilizing maternal health care services in the regions of Madhya Pradesh. Malwa and South Central Region are the best performing region while South Western and Northern Region are the worst performing regions. Full ANC is very low in Madhya Pradesh. But there is much variation among the regions and within the regions among rural and urban areas. Almost half of the women in Madhya Pradesh had safe delivery. There also prevails noticeable difference in safe delivery and PNC. Multivariate analysis shows that education is a key factor that influences the utilization of maternal health care services.

While the number of parents migrating to seek jobs elsewhere leaving young children in the care of others has been common, little is known about the positive or negative consequences for children. This study uses both bivariate and multivariate analyses to examine the impact of parental out-migration on the health of children left behind. Data were derived from “Migration and Health, Kanchanaburi Demographic Surveillance System (KDSS), 2007, Thailand”. A total of 11,241 children were the study population.

The study found that 14.5% of children had either one or both migrant parents in the Kanchanaburi study area. One out of four children (25%) had an incidence of illness. A significantly higher percentage of children whose mother, father or both had migrated had an illness compared to those whose parent(s) were not migrants. Several individual, household, and community factors were significantly associated with children’s health. Multivariate analysis suggests that parental out-migration in poor households is independently associated with a higher likelihood of an illness. The findings also suggest that strategies to alleviate the negative impact of parental migration as well as to maintain and enhance the well-being of families, especially among the children left behind in poor households, are warranted.

After having been a country of emigration for a long time, Italy has become one of the countries with the greatest foreign presence in Europe. The rapid increase in the number of foreign women – i.e. feminization process - and the fact that free health care is provided regardless of legal status, makes Italy an interesting case to study reproductive, maternal and perinatal health of foreign women. For our analyses we use Certificates of Healthcare at Delivery (CeDAPs), a nationwide system that cover births that have occurred in Italy since 2002. The data allowed us to identify differences between the various degrees of structural integration of foreign population. First results show that inequalities in perinatal outcomes between Italian and foreign women have persisted; especially for the less stable population.

Over the years there has always been an interest in the relationship between the two important variables for people: marital status and health. With the development of economic and the society, the nature of marriage and family has changed a lot nowadays. In the case that the value of marriage is coming under increased scrutiny and many aspects of marital roles are changing, it is necessary to find whether or not marriage is still associated with enhanced well-being.
Data for this analysis come from the EASS (East Asian Social Survey) Health Module conducted in 2010. Our study found that, there are almost no significant impact of marital status on people’s subjective health condition and physical health, but there are significant impacts on people’s mental health and health related habits. The married people always feel calm and energetic more frequently than the unmarried people significantly, and the married couples always feel less depressed and downhearted. The health related living habits are also different between the married and the unmarried. Married people smoke significantly more frequently than unmarried people in China, but significantly less frequently than unmarried people in Japan and South Korea. Married people drink alcohol significantly more frequently than unmarried people in Japan.

Recent demographic and health surveys have demonstrated massive declines in infant mortality in Kenya and Tanzania. This study employed survival analysis in order to demonstrate how various factors are related to infant mortality in Kenya and Tanzania. Level of education of the mother, occupation of the mother, region and birth order/preceding birth interval were found to be common factors explaining infant mortality in the duo. Unlike in Tanzania, old age at maternity was a significant determinant of infant mortality in Kenya. While the usage of well water was less likely to result to the death of a postneonate in Kenya, it was more likely to result to a postneonate death in Tanzania. The study backs up any health policy scheme that seeks to stimulate use of family planning methods to increase on birth spacing and reduce on higher order births that have been found to be significantly related to infant mortality at 0.01 significance levels.

China has experienced an extraordinary mortality transition over the last 60 years. However, mortality decline has not been consistent and uniform across all ages. Changes in health interventions and programs have particularly heavily affected health and mortality at old ages. This paper examines trends in China’s old-age mortality and its underlying determinants. Three stages of old-age mortality changes can be identified. Sharp fall in old-age mortality from the early 1950s to the early 1970s, stagnation in mortality improvement during the 1980s-1990s, and large decline again from 2000 to 2010. Life expectancy in China was rising overall, but perceived health expectancy at age 60 had stalled between 1992 to 2000. The last 10 years have seen marked improvement in both life expectancy and perceived health expectancy. Mortality change has been more evident for females than for males. There are reflections of social, economic and medical policy changes in each of the phases, which may have different impacts on different population subgroups. Deterioration in health at old ages was observed as a consequence of the economic and medical reform, while old-age mortality improvement is largely a result of government efforts in establishing urban and rural medical insurance systems.

A substantial number of epidemiological studies have discussed changes in mortality risk by life history exposures, and yet few have investigated the rate of aging. The rate of aging has been widely accepted as age-related mortality and the decline in physiological function. Hence, it has been assumed that smokers experience not only a higher mortality risk but also a higher rate of aging than never smokers. In this study, we address whether this assumption can be casually accepted by investigating the rate of aging in current and never smokers. Here, using a frailty-based Gompertz survival framework, we illustrate the force of mortality by smoking status and the rate of aging as the relative derivative in mortality with respect to increasing age. As expected, smokers experience a higher risk for mortality than never smokers. Interestingly, their relative risk converged with increasing age, a phenomenon due to unobserved heterogeneity. In this article, we report for the first time that long-term tobacco smokers do not experience a higher rate of aging than non-smokers, and that smokers do experience a 5-year decrement in life expectancy.

In South Africa, many circular migrants return to their places of origin when ill. To estimate the contribution the internal migrants have made to excess mortality in a rural sub-district population, we computed AIDS and TB cause-deleted life expectancy and crude death rates by gender and migration status between 1994 and 2006. The annualised crude death rate almost tripled from 5∙39 to 15∙10 per 1000 over the years 1994-2006. This reduced life expectancy from 67∙7 to 47∙0 years. AIDS and TB in returning migrants contributed to 44∙4% of the overall loss in life expectancy with a notable disparity by gender: 62∙3% for males and 34∙2% for females. The contribution of AIDS and TB in returned migrants to the increase in crude death rate was 78∙7% for males and 44∙4% for females. In a typical South African setting dependent on labour migration for rural livelihoods, the contribution of returned migrants, many infected with AIDS and TB, to the burden of disease is high. Returned male migrants are more affected by AIDS and TB than female migrants and non-migrant males and females. Care and referral systems must bridge long distances and span different settlement types to maintain continuity of health care.

This paper attempts a comparative analysis between disease and disability burden of elderly men and women in the context of relative deprivations of women in nutrition, health care, education etc. in childhood and adult ages, taking India as a case.

The data are culled out from Indian censuses and large scale surveys carried out during last three decades. The study variables are identified through a correlation analysis depicting linkage between disease and disability burden in old age and access to necessities of life in childhood and adult ages.

A time series analysis of prevalence of chronic diseases among elderly men and women at two points of time indicates that gender specific difference in the prevalence of chronic diseases in old age was quite minimal.

A multiple regression analysis between disease and disability burden of men and women and variables depicting deprivation to quality of life in childhood and adult ages did not show any significant effect of deprivation in childhood and adult ages on health status of women in old ages. Not only women are living longer, their health status is also at par with men.

Aim is to suggest a method to evaluate effectiveness of policy measures aimed at mortality reduction via specification of scale and models of life expectancy increase. Scale of growth (decline) of life expectancy is an informative indicator because amount of the growth (decline) corresponds to inputs by certain age groups. Since life expectancy in Russia depends upon mortality in the working ages, it is obvious that working population is one of priorities for policy measures in all regions regardless of their life expectancy levels. In favorable group of regions age profile of life expectancy growth is diffused among all age groups – from youth to elderly. That reflects a wide range of measures aimed at mortality reduction in such regions. The group with mortality level lower than Russia’s average is characterized by gender shift in age profile of life expectancy growth: in males growth of life expectancy became higher with faster decrease of mortality in middle ages and youth; in females – with faster decrease of mortality in middle ages and elderly. A peculiar characteristic of the unfavorable group is the direct relation between life expectancy growth and mortality reduction in working population.
Such approach appears to allow for unbiased evaluation the effectiveness of policy measures according to selected priorities.