Household-level Variation Research Articles

Dissecting the digital divide: A household fixed effects approach to estimating gender gaps in digital skills of youth in low- and middle-income economies

This study investigates gender gaps in digital skills among youth (15–24 years old) in 32 low- and middle-income economies using data from UNICEF-supported and internationally comparable Multiple Indicator Cluster Surveys (MICS). Utilizing a household fixed effects approach, we aim to isolate gender-based disparities from household-level variations. The intra-household analysis reveals significant inequalities, with biases against young women in possessing digital skills, including the very basic ones. Supplementary analysis using a mixed-effects model, which accounts separately for within- and between-household variation, highlights that wealthier households exhibit larger gender gaps in digital skills, disadvantaging young women primarily due to a floor effect in the poorest households. The paper concludes with policy implications aimed at reducing gender gaps in digital skills.

Income inequality and charitable giving to different causes in China: a distribution perspective

Abstract In contexts with high-income inequality, are people more or less inclined to support those in need through philanthropy? Using data from the 2016 wave of the China Labor-Force Dynamics Study, this study examines (i) how income inequality is associated with charitable giving to high-redistributive (e.g., poverty alleviation) and low-redistributive (e.g., arts and culture) causes and (ii) the household and contextual level variation for this relationship. We conduct this study in the unique context of China, where the Communist Party and Chinese government actively encourage charitable giving to play a role in diminishing income inequality. Empirical results show that in China, income inequality has no significant relationship with charitable giving to high-redistributive causes. We do find some support for a small moderating effect of education. Those with a higher level of education living in provinces with higher income inequality give more to high-distributive causes. We also find support for a small negative association with charitable giving to low-redistributive causes, which indicates that people in a context with higher income inequality are less inclined, although not substantially, to give to low-redistributive causes.

Multilevel analysis of risk factors associated with severe underweight among children under 5 years: evidence from the 2014 Ghana Demographic and Health Survey

Background: Undernutrition among children <5yr. is a global public health problem, especially in developing countries like Ghana. Undernutrition increases the risk of child morbidity and mortality. There is paucity of data on household-level effects on severe underweight and associated factors. Objective: The study investigated the risk factors associated with severe underweight among children < 5yr.in Ghana and examined unobserved differences across households based on the 2014 Ghana Demographic and Health surveys (GDHS) data. Methods: Data from a population-based cross-sectional study was obtained from the 2014 Ghana Demographic and Health Survey. Data on 2720 children nested within 1972 households was extracted for analysis. Our regression analysis used data on 2716 children with complete data on the outcome and risk factors. Children with weight-for-age Z-score below -3 standard deviations were classified as severely underweight based on the 2006 WHO child growth standards. We applied random intercept multilevel logistic regression to examine whether severe underweight status in children differ across households while simultaneously identifying potential risk factors. Results: A total of 2720 children had valid weight-for-age z-score and 53 (1.95%) of them were identified as severely underweight. In the univariate model, child level variables such as multiple birth [odds ratio (OR), 4.03;95%confidence interval (CI): 1.85-8.76]and child born average (OR, 2.17;95%CI: 1.09-4.32) or small (OR, 4.08; 95%CI: 2.01-8.28) in size at birth are associated with increased odds of severe underweight. Maternal/household level variables such as increase in number of children below 5 yr. (OR, 1.61; 95%CI: 1.28-2.04), poorest households (OR, 4.85; 95%CI: 1.14-20.59) and increase in number of births in last 5 yr. (OR, 1.80, 95%CI: 1.24-2.60) were associated with increased odds of severe underweight. Increase in maternal years of education (OR, 0.89; 95%CI: 0.83-0.95) was associated with reduced odds of severe underweight. In the multilevel logistic model, only type of birth (OR, 1.61;95%CI: 1.28-2.04), size of child (average: OR, 2.12;95%CI: 1.04-4.33; small: OR, 3.87;95%CI: 1.80-8.33) at birth, and maternal education (OR, 0.92;95%CI: 0.84-1.00) were independently associated with severe underweight. There were no significant residual household-level variations in severe underweight status. Conclusion: Our findings suggest that improving maternal education, socioeconomic conditions of families, and family planning are critical in addressing severe underweight

Prevalence, socio-demographic and environmental determinants of asthma in 4621 Ghanaian adults: Evidence from Wave 2 of the World Health Organization's study on global AGEing and adult health.

A previous multi-site study involving lower- and middle-income countries demonstrated that asthma in older adults is associated with long-term exposure to particulate matter, male gender and smoking. However, variations may occur within individual countries, which are relevant to inform health promoting policies as populations live longer. The present study estimates asthma prevalence and examines the sociodemographic characteristics and environmental determinants associated with asthma in older adults in Ghana. This study utilised data from the nationally representative World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 2. A final sample of 4621 individuals residing in 3970 households was used in analytical modelling. Factors associated with asthma were investigated using single level and multilevel binary logistic regression models. Asthma was reported by 102 (2.2%) respondents. Factors associated with asthma in the univariate model were: those aged 60-69 (OR = 5.22, 95% CI: 1.24, 21.95) and 70 or more (OR = 5.56, 95% CI: 1.33, 23.26) years, Ga-Adangbe dialect group (OR = 1.65, 95% CI: 1.01, 2.71), no religion (OR = 3.59, 95% CI: 1.77, 7.28), having moderate (OR = 1.76, 95% CI: 1.13, 2.75) and bad/very bad (OR = 2.75, 95% CI: 1.58, 4.80) health state, and severe/extreme difficulty with self-care (OR = 3.49, 95% CI: 1.23, 9.88) and non-flush toilet facility (OR = 0.62, 95% CI: 0.39, 0.99). Factors independently associated with asthma in the adjusted models were: those aged 60-69 (OR = 4.49, 95% CI: 1.03, 19.55) years, father with primary education or less (OR = 0.40, 95% CI: 0.17, 0.94), no religion (OR = 2.52, 95% CI: 1.18, 5.41), and households with non-flush toilet facility (OR = 0.58, 95% CI: 0.35, 0.96). Significant residual household-level variation in asthma was observed. Over 40% of variance in asthma episodes could be attributable to residual household-level variations. Individual as well as household factors were seen to influence the prevalence of asthma in this national survey. Clinical management of these patients in health facilities should consider household factors in addition to individual level factors.

Prevalence and risk factors associated with non-traffic related injury in the older population in Ghana: Wave 2 of the WHO Study on Global AGEing and adult health (SAGE).

Injuries are a significant cause of hospitalization in the older population, leading to a decline in physical activity and greater dependence on others. Compared to traffic related injury, relatively fewer studies have been conducted on non-traffic related injury in the older population in Ghana. This analysis provides a nationwide baseline prevalence and associated factors of non-traffic related injuries among older adults in Ghana. Data from the 2014–2015 nationally representative World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 2 was used. A final sample of 3461 older adults living in 2827 households was used in the statistical modelling. Predictors of injury were examined using both single-level and multilevel binary logistic regression models. The prevalence of non-traffic related injury found in this study was 3.74%. The odds of being injured decreased among females (OR = 0.66, 95% CI: 0.46, 0.95) compared to their male counterparts and those who rated their heath state as moderate (OR = 0.59, 95% CI: 0.38, 0.94). Depression was the only risk factor identified in the multivariable model (OR = 2.55, 95%CI: 1.38, 4.71). The study did not observe significant residual household-level variation in injury status. The role of depression as a risk factor suggests that interventions that aim to reduce non-traffic related injury in older adults should consider improving mental health.

Predictive model and determinants of under-five child mortality: evidence from the 2014 Ghana demographic and health survey

BackgroundGlobally, millions of children aged below 5 years die every year and some of these deaths could have been prevented. Though a global problem, under-five mortality is also a major public health problem in Ghana with a rate of 60 deaths per 1000 live births. Identification of drivers of mortality among children aged below 5 years is an important problem that needs to be addressed because it could help inform health policy and intervention strategies aimed at achieving the United Nations SDG Goal 3 target 2. The aim of this study is to develop a predictive model and to identify determinants of under-five mortality.MethodThe 2014 Ghana Demographic and Health Survey data was used in this study. Analyses were conducted on 5884 children. The outcome variable is child survival status (alive or dead). Single level binary logistic and multilevel logistic regression models were employed to investigate determinants of under-five mortality. The fit of the model was checked using Variance Inflation Factor and Likelihood Ratio tests. The Receiver Operating Characteristic curve was used to assess the predictive ability of the models. A p-value< 0.05 was used to declare statistical significance.ResultsThe study observed 289 (4.91%) deaths among children aged below 5 years. The study produced a good predictive model and identified increase in number of total children ever born, number of births in last 5 years, and mothers who did not intend to use contraceptive as critical risk factors that increase the odds of under-five mortality. Also, children who were born multiple and residing in certain geographical regions of Ghana is associated with increased odds of under-five mortality. Maternal education and being a female child decreased the odds of under-five mortality. No significant unobserved household-level variations in under-five mortality were found. The spatial map revealed regional differences in crude under-five mortality rate in the country.ConclusionThis study identified critical risk factors for under-five mortality and strongly highlights the need for family planning, improvement in maternal education and addressing regional disparities in child health which could help inform health policy and intervention strategies aimed at improving child survival.

Domestic Water Demand During Droughts in Temperate Climates: Synthesising Evidence for an Integrated Framework

In the upcoming years, as the population is growing and ageing, as lifestyle changes create the need for more water and as fewer people live in each household, the UK water sector will have to deal with challenges in the provision of adequate water services. Unless critical action is taken, every area in the UK may face a supply-demand gap by the 2080s. Extreme weather events and variations that alter drought and flood frequency add to these pressures and there is therefore a need to develop evidence-based drought scenarios models for water management purposes. However, little evidence is available about householders’ response to drought and there are few if any studies that have synthesised this evidence. In response, this paper discusses the current empirical literature on the factors driving domestic water consumption under both ‘normal’ and drought conditions. The paper identifies the limited availability of evidence on the many different and evolving factors affecting domestic consumption under both ‘normal’ and drought conditions and stresses the need for the inclusion of inter and intra household factors as well as water use practices in future demand forecasting models. The paper then presents ‘Water Cultures’ as an integrative modelling framework to combine the limited evidence that is available on the interactions of social norms, practices and material cultures. This enables the paper both to capture both the uncertainty and heterogeneity of individual and/or household level variation and also outline the research gaps that need to be addressed.

The Distributional Impact of VAT Reduction for Food in Hungary: Results from a Hungarian Microsimulation Model

In this paper we illustrate how the incorporation of behavioural responses and dynamic effects alters the conclusions of static household microsimulation models on the distributional impacts of economic policies. Based on Hungary's Household Budget and Living Conditions Survey, we model household consumption using the demand system approach of Creedy, 1998. This method makes it possible to obtain reasonable price elasticity estimates of consumption from cross-sectional data by combining them with Frisch-parameter values obtained from cross-country studies. With this consumption module, we simulate the distributional impacts of a hypothetical food VAT rate change in Hungary and show how the static and behavioural impact estimates differ according to income decile. We examine the sensitivity of our results to the choice of the country-level Frisch-parameter and to a realistic allowance for household-level variation in the Frisch-parameter.

Sustained usage of bioethanol cookstoves shown in an urban Nigerian city via new SUMs algorithm

An unbiased assessment of cooking patterns during a cookstove intervention can provide strong evidence for sustained usage of a cookstove among the target population. A bioethanol cookstove was used as an intervention within a randomized controlled trial being conducted in Ibadan, Nigeria to assess the ability of a clean stove to improve birth outcomes. Sustained usage of the intervention was quantified using a newly developed method of analyzing cooking patterns based on time integrated temperature data from Stove Use Monitors (SUMs) installed on household cookstoves. The method accounts for household level variations in ambient temperatures. We report a significant decline of traditional kerosene stove usage, 84% of women in the Bioethanol arm giving away their kerosene stove before the conclusion of the study (56% within the first month of enrollment), suggesting the bioethanol stove replaced the kerosene stove. This is the first study to objectively evaluate a liquid-to-liquid fuel substitution.

Mild Cognitive Impairment longitudinal Study in a Cuba population: 10 years later

An unbiased assessment of cooking patterns during a cookstove intervention can provide strong evidence for sustained usage of a cookstove among the target population. A bioethanol cookstove was used as an intervention within a randomized controlled trial being conducted in Ibadan, Nigeria to assess the ability of a clean stove to improve birth outcomes. Sustained usage of the intervention was quantified using a newly developed method of analyzing cooking patterns based on time integrated temperature data from Stove Use Monitors (SUMs) installed on household cookstoves. The method accounts for household level variations in ambient temperatures. We report a significant decline of traditional kerosene stove usage, 84% of women in the Bioethanol arm giving away their kerosene stove before the conclusion of the study (56% within the first month of enrollment), suggesting the bioethanol stove replaced the kerosene stove. This is the first study to objectively evaluate a liquid-to-liquid fuel substitution.

Risk Factors for Child Malnutrition in Bangladesh: A Multilevel Analysis of a Nationwide Population-Based Survey

To identify the prevalence and risk factors of child malnutrition in Bangladesh. Data was extracted from the Bangladesh Demographic Health Survey (2011). The outcome measures were stunting, wasting, and underweight. χ(2) analysis was performed to find the association of outcome variables with selected factors. Multilevel logistic regression models with a random intercept at each of the household and community levels were used to identify the risk factors of stunting, wasting, and underweight. From the 2011 survey, 7568 children less than 5years of age were included in the current analysis. The overall prevalence of stunting, wasting, and underweight was 41.3% (95% CI 39.0-42.9). The χ(2) test and multilevel logistic regression analysis showed that the variables age, sex, mother's body mass index, mother's educational status, father's educational status, place of residence, socioeconomic status, community status, religion, region of residence, and food security are significant factors of child malnutrition. Children with poor socioeconomic and community status were at higher risk of malnutrition. Children from food insecure families were more likely to be malnourished. Significant community- and household-level variations were found. The prevalence of child malnutrition is still high in Bangladesh, and the risk was assessed at several multilevel factors. Therefore, prevention of malnutrition should be given top priority as a major public health intervention.

Childhood Malnutrition and Its Determinants among Under-Five Children in Ghana.

Childhood malnutrition adversely affects short- and long-term health and economic well-being of children. Malnutrition is a global challenge and accounts for around 40% of under-five mortality in Ghana. Limited studies are available indicating determinants of malnutrition among children. This study investigates prevalence and determinants of malnutrition among children under-five with the aim of providing advice to policymakers and other stakeholders responsible for the health and nutrition of children. The study used data from the 2008 Ghana Demographic and Health Survey (GDHS). Analyses were conducted on 2083 children under 5 years old nested within 1641 households with eligible anthropometric measurements, using multilevel regression analysis. Results from the multilevel models were used to compute probabilities of malnutrition. This study observed that 588 (28%), 276 (13%), and 176 (8%) of the children were moderately 'stunted', moderately 'underweight', and moderately 'wasted' respectively. Older ages are associated with increased risk of stunting and underweight. Longer breast-feeding duration, multiple births, experience of diarrhoeal episodes, small size at birth, absence of toilet facilities in households, poor households, and mothers who are not covered by national health insurance are associated with increased risk of malnutrition. Increase in mother's years of education and body mass index are associated with decreased malnutrition. Strong residual household-level variations in childhood nutritional outcomes were found. Policies and intervention strategies aimed at improving childhood nutrition and health should address the risk factors identified and the need to search for additional risk factors that might account for the unexplained household-level variations.

Long-Run Discounting: Evidence from the UK Leasehold Valuation Tribunal

The United Kingdom's Leasehold Valuation Tribunal hears extension and enfranchisement cases between landlords (freeholders) and tenants (leaseholders). In these cases, the two parties argue about the terms of housing lease extensions of up to 90 years in length, and about enfranchisements to convert leasehold contracts of specific durations to perpetual ownership freeholds. The widely-followed decisions of the leasehold valuation tribunal provide a unique insight into household-level variation in expectations of long-run discount rates and cash-flows, and set bounds on the prices that market participants may be willing to pay for housing over long periods of time. We use the record of decisions since 1995 to extract information about long-run cash-flow and discount rate expectations in this unique setting, which requires no estimation, but has real stakes for the participants in these negotiations. We find evidence that the discount rate associated with these decisions causes values of properties discounted for long periods (above 90 years) to be close to zero.

Risk Factors for Anthroponotic Cutaneous Leishmaniasis at the Household Level in Kabul, Afghanistan

BackgroundKabul, Afghanistan, is the largest focus of anthroponotic cutaneous leishmaniasis (ACL) in the world. ACL is a protozoan disease transmitted to humans by the bite of phlebotomine sand flies. Although not fatal, ACL can lead to considerable stigmatization of affected populations.MethodsUsing data from a standardized survey of 872 households in 4 wards of Kabul, Afghanistan, univariate and multivariate logistic regression analyses tested associations between presence of active ACL and ACL scars with 15 household-level variables.FindingsUnivariate analyses showed that active ACL was positively associated with household member's age, ACL prevalence, and brick wall type, but negatively associated with household number of rooms, bednet use, and proportion of windows with screens. Multivariate analysis showed a positive association between active ACL and household member's age, ACL prevalence, and brick wall type, and a negative association with household proportion of windows with screens.ConclusionHousehold-level charateristics were shown to be risk factors for ACL. Monitoring a selected number of household characteristics could assist in rapid assessments of household-level variation in risk of ACL. ACL prevention and control programs should consider improving house construction, including smoothing of walls and screening of windows.

Child nutrition in the transition from nomadic pastoralism to settled lifestyles: individual, household, and community-level factors.

The research reported here examines child nutrition in a population that is currently experiencing a transition in subsistence, shifting from nomadic pastoralism to a variety of settled lifestyles. We investigate the range of nutritional consequences of settlement both within and between communities by examining individual, household, and community-level predictors of child nutritional status. Data are drawn from the Rendille Demographic and Health Survey, which contains anthropometric data from 1,088 children ages 6 months to 10 years, as well as socioeconomic data from 640 households drawn from one nomadic and four economically and ecologically diverse settled communities. Comparisons allow us to test the widely held assumption that settlement results in nutritional improvements. The examination of individual and household-level factors highlights several important influences on child nutrition. We find a complex interaction between gender and birthorder, whereby firstborn sons have significantly higher weight-for-height scores than other children, potentially reflecting preference under a system of primogeniture. We also find a complex interaction between defacto female-headed households, where males are absent for over half of the year, and economic status. Young children from poor female-headed households have significantly lower weight-for-height than other children, possibly due to the fact that these households are amongst the poorest in the entire community. However, young children from economically sufficient female-headed households actually fare better than their counterparts in male headed households, suggesting that in households with any discretionary resources, female heads prioritize food acquisition relative to other concerns. Finally, our comparison of child nutritional status across communities, while controlling for individual and household-level variation, does not support the contention that settlement is associated with nutritional improvements. Rather, the effect of community, and its associated changes in subsistence and lifestyle, results in either no nutritional changes, or in the case of young children in the lowland desert community of Korr, diminished nutritional status. Our results underscore the importance of considering variation in sample composition and socioeconomic status when performing community comparisons, and highlight the central role of women in influencing the nutritional welfare of their families.

Access to Subsistence Resources and the Sexual Division of Labor Among Potters

Research on the sexual division of labor among adults has exam ined its relationship to sexual dimorphism, labor-economizing strategies in production processes, and cultural complexity. The author argues that none of the studies has successfully explained the sexual allocation of labor in some of the crafts because re searchers have not examined the causal effect of the material and social conditions thatgive rise to household-level variation in access to subsistence resources. The author derives a theory from the work of ethnographers George Foster and Dean Arnold, introduces two codes for the Standard Cross-Cultural Sample, and tests the hy pothesis using logistic regression. The results indicate that the potters tend to be exclusively or primarily women in societies with relatively easy access to subsistence resources. Men tend to be the equal or principle potters in those societies where the potters'nuclear families have limited access to subsistence resources and instead rely on the exchange of manufactured pottery.