Changes In Demographic Composition Research Articles

Projection of diabetes burden through 2050: impact of changing demography and disease prevalence in the U.S.

To project the number of people with diagnosed diabetes in the U.S. through 2050, accounting for changing demography and diabetes prevalence rates. We combined age-, sex-, and race-specific diagnosed diabetes prevalence rates-predicted from 1980-1998 trends in prevalence data from the National Health Interview Survey-with Bureau of Census population demographic projections. Sensitivity analyses were performed by varying both prevalence rate and population projections. The number of Americans with diagnosed diabetes is projected to increase 165%, from 11 million in 2000 (prevalence of 4.0%) to 29 million in 2050 (prevalence of 7.2%). The largest percent increase in diagnosed diabetes will be among those aged > or =75 years (+271% in women and +437% in men). The fastest growing ethnic group with diagnosed diabetes is expected to be black males (+363% from 2000-2050), with black females (+217%), white males (+148%), and white females (+107%) following. Of the projected 18 million increase in the number of cases of diabetes in 2050, 37% are due to changes in demographic composition, 27% are due to population growth, and 36% are due to increasing prevalence rates. If recent trends in diabetes prevalence rates continue linearly over the next 50 years, future changes in the size and demographic characteristics of the U.S. population will lead to dramatic increases in the number of Americans with diagnosed diabetes.

Beyond Cultural Competence: A Model for Individual and Institutional Cultural Development

Nursing's attention to cultural diversity has been influenced by the changing demographic composition of the U.S. population. Nursing must continue to increase awareness and promote attitudinal and behavioral changes that will result in the delivery of culturally appropriate nursing care. The nursing literature includes several models of cultural development to assist nurses and other health care professionals in conducting a cultural assessment and incorporating cultural data into nursing care plans. This article presents a synthesis model of cultural development that illustrates that cultural awareness, cultural sensitivity, and cultural competence do not achieve the level of cultural development necessary to meet the health care needs of a diverse population. Cultural proficiency is a concept that extends cultural competence into nursing practice, administration, education, and research. It is a philosophical and behavioral approach to cultural diversity that guides and prescribes individual and institutional behavior toward "cultural others."

Economic reform and household welfare in rural China: evidence from household survey data

Existing studies highlight the uncertainty about changes in living standards in China's transition to market economy. Using household data from Jiangsu and Sichuan provinces, we examine the significance of demographic characteristics on rural household welfare which has generally been overlooked in the existing literature. Three sets of results are reported here: (i) estimates of total land allocated per household suggests that household marginal share of land is higher for a resident adult compared to a child or an old and lower for non-resident members or members engaged in non-farm activities. (ii) Regular adjustment of land to changing demographic composition generates a lack of security of tenure in land as well as an impetus for the growth of rural non-farm activities as reflected in the estimates of household per capita income and expenditure: an additional resident or non-resident adult, engaged in non-farm activities enhances rural household welfare while an additional child or old member lowers it, which also reflects the deterioration in the provision of social services. (iii) Probit analysis of poverty status based on poverty-level income suggests that the poor are likely to be those households with more children or old members and also those primarily depending on farm activities. In a situation of changing demographic patterns and a changing balance between rural farm and non-farm employment prospects, there is a need to identify the poor and the vulnerable adequately so that the latter do not have to bear the brunt of the reform. Copyright (C) 2000 John Wiley and Sons, Ltd.

Trends in Substance Use among US Military Personnel: The Impact of Changing Demographic Composition

This paper examines the impact of the military population's changing demographic composition on observed changes in substance use by military personnel. Cross-sectional data are drawn from the six Department of Defense Worldwide Surveys of Substance Abuse and Health Behaviors Among Military Personnel conducted in 1980, 1982. 1985. 1988. 1992. and 1995. Using the method of direct standardization to adjust for changes in demographic composition, trends in substance use are examined. Changes in heavy alcohol use were more affected by demographic changes in the military population than were changes in illicit drug use or cigarette use. Findings indicate that changes in demographic composition may need to be controlled when assessing trends from cross-sectional surveys. [Translations are provided in the International s Section of this issue.]

Why Were Poverty Rates So High in the 1980s?

This paper explores the relationship between the macroeconomy and the poverty rate. The first section provides evidence that poverty was far less responsive to macroeconomic growth in the 1980s than it had been in earlier decades. The section explores and rejects four reasons for this: It is not due to the exclusion of in-kind income from the data, to the regional location of the poor, to the public assistance changes of the early 1980s, or to the changing demographic composition of the poor. Instead, it is almost entirely due to declines in real wages that occur among low-wage workers over the 1980s. In fact, employment and weeks of work per year within low-income households expands more rapidly in the 1980s than in the 1960s. This is almost entirely offset, however, by declines in weekly earnings at the bottom of the income distribution. The result is that economic growth has been a far less effective anti-poverty tool over the past decade.

The Changing Distributions of New Ph.D. Economists and Their Employment: Implications for the Future

This essay addressed the changing demographic composition of new Ph.D.s in economics and the changing distribution of the jobs that they are obtaining. It discusses how future trends may interact to influence the types of training that economists may provide their graduate students and the types of faculty positions that academic institutions may provide for new Ph.D. economists in the future.

Effects of managed care market penetration on physicians’ labor supply decisions

This paper examines data from a 1991 nationally representative survey of physicians under the age of 45 to evaluate the effects of HMO enrollment growth and the changing demographic composition of the physician work force on physicians’ choice of practice setting (employee versus self-employment) and annual hours of work. Our results indicate that HMO market penetration has a significant negative effect on the probability of self-employment for all physicians and the sub-samples of both specialists and generalists. Furthermore, increasing HMO market share has a significant negative effect on annual hours of work of all physicians and generalists but has only negligible effects on the work effort of specialists. Using these parameter estimates, we predict that a 100% increase in HMO market share decreases the probability of being self-employed by 23.5% for all physicians, 28% for specialists, and 21% among generalists. Controlling for self-employment, a doubling of the percentage of the population enrolled in HMOs reduces the annual hours of work by 4.9% for all physicians and by 6.8% among generalists. In contrast, HMO market penetration has only trivial effects on the work effort of specialists. We also find that the gender gap in hours between male and female physicians still persists. This gap is 17.7 to 19.6% for female physicians with young children, but is much smaller—5.5 to 8.5%—for women without young children.

From service to social control: Implications of welfare reform for professional practice in the United States

In response to the explosive growth and the changing demographic composition of public welfare recipients, this program has undergone four major reforms over the last three decades: the 1962 'Service' amendments, the 1967 Work Incentive program (WIN), the Family Support Act of 1988, and the 1996 program of Temporary Assistance to Needy Families (TANF). These reforms have had a profound impact not only on the scope and purpose of public assistance to needy families, but also on the nature of professional social work practice in this area of public social service. An analysis of the major welfare reforms over the last 35 years reveals how the national entitlement to income maintenance and social services has receded, local responsibility and private delivery of service have increased, and emphases on service functions have shifted from rehabilitative social casework/counselling to work-oriented training, job search activities, and local employment. The provision of public assistance has been transformed from a federal entitlement based on needs to a budget-driven-time-limited benefit enveloped by incentives and sanctions, with welfare clients increasingly subject to mandatory participation in work-related activities. This movement from welfare to workfare has infused the professional role of social workers with a steadily expanding function of social control, which is unlikely to encourage professional participation in the public social services.

Runaway Train? The Diffusion of State‐Level Reform in ADC/AFDC Eligibility Requirements, 1950–1967

Displeased with the increasing expenditures on ADC/AFDC and the changing demographic composition of the recipient population, state managers between 1950 and 1967 attempted to restrict the program. One way this was accomplished was through enacting work requirements as a condition of eligibility. Temporal variation in the enactment may be explained through a synthesis of two theoretical traditions on policy development: the intrastate and interstate approaches. The authors use diffusion models to examine how both sets of processes affected the rate of enactment of work requirements. States reformed AFDC programs in response to their own internal problem pressures. But this did not happen in a vacuum; work requirements diffused among states that were culturally and/ or institutionally linked.

A Microeconometric Analysis of Consumer Taste Determination and Taste Change for Beef

AbstractA new method for modeling determination of consumer taste and a test of the taste‐change hypothesis is presented. Taste varies across households because of differences in household characteristics. The method has a Multiple Indicator and Multiple Cause model interpretation, with taste as an unobserved variable. Taste indicators are residuals of regular household demand functions, the factors unexplained by prices and household expenditures. Taste‐cause variables are household characteristics and other variables. The proposed model is applied to U.S. beef demand using household data. Results show that structural taste changes, unexplained by changes in demographic composition, decreased 8% from 1977 to 1987.

Assessing the Potential Impact of the HIV-1 Epidemic on Orphanhood and the Demographic Structure of Populations in sub-Saharan Africa

infection attained,' which will, in turn, be primarily determined by current and future patterns of sexual behaviour, including rates of partner change, patterns of mixing between age and sexual-activity classes of the two sexes, the extent of condom use and. the control of other sexually transmitted diseases that appear to promote the likelihood of HIV transmission. However, irrespective of whether population growth rates become negative, the spread of HIV is likely to bring about significant changes in the demographic composition of populations; adult and infant mortality will rise steeply, as will the incidence of orphanhood. Significant changes in the age and sex structure of the adult population may also take place. Such changes have already been seen to be placing severe strains on the social and economic fabric of those areas worst affected in the early stages of the pandemic.2 In this paper, we investigate the nature and extent of likely changes in demographic composition and orphanhood by using a mathematical model which combines demographic and epidemiological processes to examine the effects of three alternative epidemics in which growth rates are and are not turned negative. These simulations are loosely based on the epidemiological and demographic profile of one of the more developed countries in sub-Saharan Africa (Zimbabwe), but are not regarded as representative of the situation in any particular country. Rather, by considering contrasting behavioural contexts, which give rise to significantly different degrees of

Caregiving system in transition: An illustration from Shanghai, China

Population aging, the diminution of family networks, and increasing demands for care create a substantial burden for the current family-based system of caregiving for the elderly in Shanghai. Using existing data, we explore recent and future changes in demographic composition, family structure, and elderly needs in Shanghai, and evaluate how these changes affect the care of the elderly. Within this context, we also describe the current caregiving system and discuss its limitations. Finally, we propose an improved caregiving system that features a greatly expanded role of the community, but maintains an integral role of the family as caregivers. We also outline two strategies that might be followed in the development of this new system.

What Was Driving the 1982–88 Boom In Temporary Employment?

Abstract. The level of temporary help employment rose two‐and‐a‐half fold between 1982 and 1988, was quite variable and had a disproportionately larger effect on employment flows. One conventional explanation suggests that changing demographic composition of the labor force in favor of groups preferring nontraditional employment arrangements fueled the temporary help boom. Demand‐side views emphasize the volatility in labor demand, intensified price competition and the absence of employee benefit contributions.Empirical estimation confirms that demand‐side forces predominate. Yet no labor supply variable is found to be positively associated with the extent of temporary employment. Cyclical fluctuation in output, intensified foreign competition and the magnitude of nonwage labor costs are all positively associated with temporary employment levels. The diminishing bargaining power of labor unions allows employers to exploit the labor cost savings of temporary hires, and the extent of paid time‐off and the lack of flexibility in weekly hours of work play a weak role. The findings suggest why temporary job growth accelerated in the 1980s, as more firms employed a “core‐periphery” human resource strategy. Public policy should adopt measures that attempt to limit the creation of temporary jobs to a level that accommodates the worker need for flexible annual work schedules.

EXPLAINING INCREASES IN PER CAPITA CONSUMPTION OF FRESH FRUITS

During the last two decades, per capita consumption of fresh fruit has increased markedly. Although many believe that this increase has been caused by a heightened concern in health and diet, economic analyses indicates that changes in retail prices and increasing per capita incomes adequately explain the increased consumption of fresh fruit. Also, with more single households and women entering the labor force, the convenience factor of focal preparation has likely caused an increase in the consumption of fresh fruit. Substantial substitution between fresh fruit products has occurred: grapes and strawberries have increasingly substituted for citrus fruit, particularly grapefruit. These results suggest that relative prices for fresh fruits, increasing disposable income, and the changing demographic composition of households have prompted observed increases in the per capita consumption of fresh fruit.

The demography of the unrelated individual: 1900–1950

This article is an analysis of the frequency and characteristics of unrelated individuals between 1900 and 1950. The much-heralded rise of the primary individual during the 20th century has been offset by a decline in the frequency of secondary individuals. The overall percentage of persons residing without family did not exceed turn-of-the-century levels until the 1970s. Using data from national microdata samples of the census for 1900, 1940, and 1950, the study applies decomposition techniques and life-course analysis to investigate these patterns. The results show that the decline of the secondary individual from 1900 to 1950 was largely a function of changing demographic composition, but the increase of primary individuals is linked to changing residential preferences.

Structural Unemployment, Demographic Change or Industrial Structure?

Changes in demographic composition and industrial structure have been used to explain rising natural unemployment rates in Canada. We find the change in industry mix accommodated concurrent changes in labour force structure, but the substitution within industries, rather than changes in the mix, was the principal adjustment mechanism. Hence, we find it implausible that structural changes in labour supply should have been merely a response to industrial demand(This abstract was borrowed from another version of this item.)

The effect of changing demographic composition on recent trends in underemployment

The effect of changing age-sex composition on trends in unemployment and underemployment from 1969 to 1980 is estimated. This effect is positive as anticipated, but negligible in both absolute and relative terms. For example, no more than .35 percent of the increase in unemployment between 1969 and 1980 can be attributed to compositional factors. The secular rise in unemployment and underemployment from the late 1960s into the 1980s simply cannot be attributed in any substantial way to the changing demographic composition of the labor force.