Household Demographic Structure Research Articles

Estimated Health Outcomes and Costs of COVID-19 Prophylaxis With Monoclonal Antibodies Among Unvaccinated Household Contacts in the US

The COVID-19 pandemic has led to more than 900 000 deaths in the US and continues to disrupt lives even as effective vaccines are available. To estimate the health outcomes and net cost of implementing postexposure prophylaxis (PEP) with monoclonal antibodies (mAbs) against household exposure to COVID-19. This study is a decision analytical model of results from a randomized clinical trial of casirivimab with imdevimab administered as subcutaneous injections to unvaccinated, SARS-CoV-2-negative household contacts of people with confirmed COVID-19 with complementary data on household demographic structure, vaccine coverage, and confirmed COVID-19 case counts. The study used US data from May 2021 for a simulated population of US individuals of all ages within low-transmission or high-transmission scenarios. Age, sex, race, ethnicity, and COVID-19 vaccination status. Symptomatic infection, hospitalization, death, and net payer cost of monoclonal antibody PEP for COVID-19. In a month of transmission intensity similar to that of May 2021, a mAb PEP program reaching 50% of exposed, unvaccinated household members aged 50 years and older was estimated to avert 1820 symptomatic infections (95% uncertainty interval [UI], 1220-2454 symptomatic infections), 528 hospitalizations (95% UI, 354-724 hospitalizations), and 84 deaths (95% UI, 55-116 deaths) in a low-transmission scenario and 4834 symptomatic infections (95% UI, 3375-6257 symptomatic infections), 1404 hospitalizations (95% UI, 974-1827 hospitalizations), and 223 deaths (95% UI, 152-299 deaths) in a high-transmission scenario. Without mAb PEP, the estimated cost of hospitalizations due to COVID-19 infections from household exposure in the lower transmission scenario was $149 million (95% UI, $115-$196 million), whereas the estimated hospitalization cost in the higher transmission scenario was $400 million (95% UI, $312-$508 million). In the lower transmission scenario, mAb PEP administered to 50% of eligible contacts aged 80 years and older was estimated to have 82% probability of saving costs, but was not associated with cost savings at age thresholds of 50 years and older or 20 years and older. In contrast, in the high-transmission scenario, mAb PEP administered to 50% of eligible household contacts had estimated cost savings in 100% of simulations at the 80-year age threshold, 96% of simulations at the 50-year threshold, and 2% of simulations at the 20-year thresholds. In this modeling study of a simulated US population, a mAb PEP for COVID-19 program was estimated to improve health outcomes and reduce costs. In the setting of a susceptible variant of SARS-CoV-2, health system and public health actors would have an opportunity to improve health and reduce net payer costs through COVID-19 PEP with mAbs.

Decline in alcohol consumption in Russia: Collectivity or polarisation?

Sales and survey data have shown a decline in alcohol consumption in Russia since 2007. This study examines whether this decline is consistent across lighter and heavier drinkers in line with the theory of the collectivity of drinking cultures. Data were collected through annual nationally representative surveys conducted between 2006 and 2018 of 33 109 individuals aged 18-85 years. We estimated generalised linear regression with Gamma distribution and used log alcohol volume consumed during the previous 30 days as the dependent variable for five percentile groups: heavy drinkers (95th), near heavy drinkers (90th), moderate drinkers (80th), light drinkers (60th for men and 70th for women) and non-drinkers. Dummy variables for years, percentile groups and their interactions were used as independent variables. The controls were age, education, income, body weight, marital status, household demographic structure, residence, ethnicity and regional climate. Reductions in alcohol consumption were observed in all percentiles, but the scale of change was proportionally smaller among heavier drinkers than among lighter drinkers. However, consumption fell by a smaller amount among lighter drinkers than among heavier drinkers. Results of the regression analysis fit with the descriptive statistics. Interactions between the time period and the percentile groups were significant after 2010. Trends were similar for both sexes. Downward trends across percentiles were in the same direction but the magnitude of change varied. Obtained evidence fails to support a polarisation and points towards soft collectivity hypothesis in the reduction in drinking in Russia.

District or distributed space heating in rural residential sector? Empirical evidence from a discrete choice experiment in South China

Rural residential space heating is strongly linked to policy considerations related to the clean energy supply and rural sustainable development. As there has been a hot debate on whether to promote district heating in South China, this paper aims to investigate household heating choices with a particular focus on rural residential sector, using the survey data from Sichuan Province. In order to investigate the main influencing factors of household decision-making behaviors, a multinomial logit (MNL) model with sample selection correction and an alternative-specific conditional logit (ASCL) model were used to respectively analyze the actual and stated choices. The estimation results show that energy-specific attributes such as safety level and smoky level have statistically significant effects on household stated preferences for heating systems. Households prefer to adopt lower-cost heating system with high quality energy sources. Among household-specific characteristics, income level, educational level of the decision-maker, household demographic structure, and household location are important determinants of heating fuel choices. These findings suggest that future energy policy should pay more attention to its combined effect on both cost and quality of heating system as well as its different regional effects. Besides, enhancing household socio-economic status should also be attached importance in policy design.

Do the Poor Really Feel Poor? Comparing Objective Poverty with Subjective Poverty in Pakistan

The current literature on poverty focuses intensively on objective poverty, which is based on household income, household consumption, basic needs, calorie intake or a multidimensional poverty approach. In contrast, this paper researches subjective poverty, which is compared with objective poverty measured by income in Pakistan. Using Pakistan Panel Household Survey 2010 data, where household heads classify themselves on a ten-point-scale from the poorest to the richest, we find that the determinants of subjective poverty (feeling poor) are not limited to household consumption, but include household size, household demographic structure, agriculture land ownership, sanitation facility, physical and food insecurity. In comparison with the overall non-poor, the objective poor and the subjective poor households are determined by different factors. Particularly, for households lying below the subjective poverty line, factors such as education, household size, own residence and physical security have a significant positive impact on the eradication of poverty relative to overall non-poor. In addition, the Spearman Rank test upholds that subjective poverty measure complements the conventional method. Thus, priority should be given to specific targeted determinants, which are more important in the alleviation of poverty, while making and implementing public policy given the limited available resources.

Household biomass energy choice and its policy implications on improving rural livelihoods in Sichuan, China

It is widely known that a switch from traditional biomass energy to modern clean, safe and efficient energy could improve local rural livelihoods by enhancing the access to ‘high quality’ energy and reducing the negative impacts of traditional biomass energy on health, environment and living standards. Hence, in this paper, we used alternative-specific conditional logit model (ASCLM) to examine the rural household energy choice behaviors in Sichuan Province of China from the perspective of revealed and stated preferences. The results show that the fuel switching in our study region is not a simple unidirectional process from traditional biomass energy to modern fuels as incomes improve. Household energy choice behaviors could be not only affected by energy-specific characteristics such as fuel price, smoky level and safety risk, but also influenced by household-specific factors such as income level, age and educational level of the decision maker, household demographic structure, number of people frequently eating at home, distance to the nearest biomass collecting spot and household location, suggesting that government should attach more importance to simultaneously improve energy quality, control energy price and enhance household socio-economic status.

Gender and migration from Albania

This article examines the dynamics and causes of the shift in the gender composition of migration, and more particularly, in women's access to migration opportunities and decision-making. Our analysis focuses on Albania, a natural laboratory for studying international migration where out-migration was essentially nonexistent from the end of World War II to the end of the 1980s. Interest in the Albanian case is heightened because of the complex layers of inequality existing at the time when migration began: relatively low levels of inequality within the labor market and educational system-a product of the Communist era-while household relations remained heavily steeped in tradition and patriarchy. We use micro-level data from the Albania 2005 Living Standards Measurement Study, including migration histories for family members since migration began. Based on discrete-time hazard models, the analysis shows a dramatic increase in male migration and a gradual and uneven expansion of the female proportion of this international migration. Female migration, which is shown to be strongly associated with education, wealth, and social capital, appears responsive to economic incentives and constraints. Using information on the dependency of female migration to the household demographic structure as well as the sensitivity of female migration to household-level shocks, we show how household-level constraints and incentives affect male and female migration differently. Throughout this period, however, women's migration behavior appears more directly aligned with household-level factors, and there is little evidence to suggest that increased female migration signals rising behavioral independence among Albanian women.

Inequality in Vietnamese Urban-Rural Living Standards, 1993-2006

Using data from five waves of the Vietnam Household Living Standard Survey, we find evidence of significant urban-rural expenditure inequality. Urban-rural inequality in Vietnam increased dramatically from 1993 to 1998, and peaked in 2002 before reducing slightly in 2004, and significantly in 2006. The urban-rural gap also monotonically increases across the expenditure distribution. We use a variant of the Oaxaca-Blinder decomposition method, applied to the unconditional quantile regression method of Firpo, Fortin and Lemieux (2009), to explain the components of the per capita expenditure differentials between urban and rural households at selected quantiles of the distribution. We also compare these estimates with those at mean obtained by OLS. Our results show a number of factors contributing significantly to the high urban-rural gap. These include inter-group differences in education, household demographic structure, industrial structure and their related returns. Adjusting the average characteristics of rural households to those of urban households will reduce about a half of the overall urban-rural expenditure gap. A significant part of the remaining unexplained component lies in the intercept differences; that is, the inter-group differences in other factors not captured in the model that favor urban households.

Gender and the Structure of Planter Households in the Eighteenth-Century Chesapeake: Harford County, Maryland, in 1776

This study analyzes gender and headship in the eighteenth-century Chesapeake using data from a unique census gathered in Maryland in 1776. The data are organized around individual planter-households and permit us to address important evidence related to female headship and the status of planter wives. In the eighteenth century, the household served as the center of production and reproduction. Control over household labor and resources translated into status and power or it signaled the very real risk of poverty. In this study, we examine four types of female headship and the economic status of their households in eighteenth-century Chesapeake. The first group is white adult women. Analyzing the household demographic structure of both white female and male headed-household provided clues to the circumstances surrounding their headship and the independence headship brought to a limited number of white females. Comparing patterns of wealth holding in the form of land and slaves helped to assess the extent to which white female heads faced a high risk of poverty. The second group of interest is free black female heads and their experience revealed the role that race played in eighteenth-century headship. To what extent did the experiences of free blacks mirror or differ from those of white householders? A further section discusses headship among never-married males and females who controlled twenty-two percent of the plantations in Harford County, Maryland. The final group that deserves our attention is the planter wives. Studying the productive and reproductive experiences of the planter wife will shed light on the extent they, as "co-heads," shared an informal equality with their husbands in plantation management.

School Choice and Quality

The 1993 Survey of Household Income and Wealth, a representative survey of the Italian population covering 24,000 individuals, reports detailed information on children attendance of public and private schools and parents' self-assessment of the quality of public schools in the city of residence. The survey also provides detailed information on the household demographic structure, income and parents' education. The empirical analysis indicates that the quality of schools is one of the driving factors in the choice between private and public schools. The results are robust with respect to the particular quality indicator used and the presence of provincial fixed effects.

Regional Disparity in Accessibility to Non‑Farm Economic Involvement among Rural Indonesian Households

Indonesia had achieved high economic growth in the late 1980s and the first half of the 1990s. Yet rural poverty is pervasive and widespread across the country. Recently, the significance of rural non-farm economic activities has received much attention for stabilizing household income of the rural poor. This paper focuses on factors that influence rural Indonesian households' accessibility to non-farm economic activities. It has tested the propensity of non farm economic engagement among rural households by incorporating community and household characteristics. A simple econometric analysis with the country-wide sample has found that household demographic structure, educational attainment, rural infrastructure, agricultural technology, local market and geographical factors are the major determinants. However, the econometric analysis with five regional-based sub-samples have shown that main determinants are not the same as those found in the country-wide sample, and they do vary across the different regions. This paper suggests that it is very important to understand region specific household and community characteristics in order to design effective development policy tools and to have more viable non-farm economic activities in rural Indonesia.

Why are boys so small? Child growth, diet and gender near Ranomafana, Madagascar

Dietary and anthropometric data are analyzed by age, sex and household demographic structure for cultivators' children near Ranomafana National Park in the southeastern rain forest of Madagascar. The 1989 dry season cross-sectional survey of 613 0–9 year olds in seven communities identifies chronic dietary and growth deficits. In the 1989 sample, 62.2% of the children are below −2 s.d. height/age, while 9.4% are below −2 s.d. weight/height of the NCHS international standard. The 1990–1991 dry and wet season study of 40 and 39 6–9 year olds and their households in two adjacent hamlets provides further detail about intrahousehold dietary practices. Overall, weight/height status is worse during the wet season. Male anthropometric status is worse than that of females during the dry season, but shows less seasonal variation. The male dietary intake is similar to or sometimes less adequate than female dietary intake in the different age cohorts. Data are also analyzed by single- and multiple-parent households where children make different contributions to the socioeconomic needs. Older girls in single-parent households have increased workloads and dietary intake compared with their siblings or age-mates.

Dynamic Hours of Work Functions for Husbands, Wives, and Single Females

Hours of work equations are derived from the constrained maximization of a utility function that is not separable over time and that varies with a household's demographic structure. These equations are fitted to observations on wage rates, nonlabor income, and other variables for husbands, wives, and unmarried women. The dependence of each household's current work and consumption behavior upon its work and consumption behavior in the past is examined closely and different interpretations of the relationship are confronted with the data.

Rural--urban differences in child care and breastfeeding behaviour in Southeastern Nigeria.

Abstract A model of household behaviour is used to test some postulates concerning the effects of market and non-market roles of urban and rural women on child care and breastfeeding. The paper analyses the determinants of total child care time for pre-school children and explores the allocative effects and intra-household substitutions which took place. This is used to explain casual relationships behind rural-urban variations in breastfeeding behaviour. The results suggest the significance of income, education, job compatibility, household demographic structure and point to human capital change as a relevant policy parameter.