Nationally-representative Data Research Articles

Nationally Representative Evidence on the Association Between Preschool and School-Based Parental Involvement in Elementary School

Increasing school-based parental involvement—which has links to improved student outcomes like academic achievement—is a core area of focus in many preschool programs. Yet, little research to date has examined what the association is between attending preschool and school-based parental involvement in early elementary school. This study addresses this gap by drawing on nationally-representative data from the Early Childhood Longitudinal Study-Kindergarten Class of 2010 to 2011 ( N = 18,174) to examine the association between preschool attendance and measures of school-based parental involvement in early elementary school. The findings reveal consistent positive associations between preschool attendance and school-based parental involvement. There is little evidence of variation in associations based on the type (e.g., private and Head Start) or location (e.g., center-based and school-based) of the preschool program.

The causal effect of education on women’s empowerment: evidence from Kenya

ABSTRACT This paper investigated the impacts of education on women’s empowerment in Kenya using six waves of nationally-representative KDHS data. Our study utilizes the change in educational structure in 1985 as an instrument and finds that women under the new system enhanced their schooling by approximately two years. One year of education prolongs women’s timing of the first birth, decreases female genital mutilation for the first daughter, reduces intimate partner violence, and improves women’s household decision-making. Our findings are robust to several robustness checks. We examined different paths to explain these results, including information exposure, partner matching, and labor market engagement.

Trends and Patterns of Cancer Burdens by Region and Income Level in Korea: A National Representative Big Data Analysis.

This study aimed to elucidate the trends and characteristics of the cancer burden in Korea by cancer site, region, and income level. Korean National Burden of Disease research methodology was applied to measure the cancer burden in Korea from 2008 to 2018. The cause of death and national health insurance claims data were obtained from Statistics Korea and the National Health Insurance Service, respectively. An incidence-based approach was applied to calculate the disability-adjusted life-years, which is a summary measure of population health. In the past decade, the cancer burden in Korea increased from 2,088 to 2,457 person-years per 100,000 population. Among the cancer burden, the years of life lost decreased, and the years lived with disabilities increased. Cancers of the trachea, bronchus, and lung had the highest disease burden, followed by those of the stomach, colon and rectum, liver, and breast. The findings of this study can provide valuable quantitative data for prioritizing and evaluating cancer prevention strategies and implementing cancer policies. Estimating the difference in cancer burden according to region and income level within a country can yield useful data to understand the nature of the cancer burden and scale of the problem. In addition, the results of this study provide a better understanding of the causes of cancer patterns, thereby generating new hypotheses regarding its pathogenesis.

Structural transformation and the gender pay gap in Sub-Saharan Africa.

The focus of this study is the implications of structural transformation for gender equality, specifically equal pay, in Sub-Saharan Africa. While structural transformation affects key development outcomes, including growth, poverty, and access to decent work, its effect on the gender pay gap is not clear ex-ante. Evidence on the gender pay gap in sub-Saharan Africa is limited, and often excludes rural areas and informal (self-)employment. This paper provides evidence on the extent and drivers of the gender pay gap in non-farm wage- and self-employment activities across three countries at different stages of structural transformation (Malawi, Tanzania and Nigeria). The analysis leverages nationally-representative survey data and decomposition methods, and is conducted separately among individuals residing in rural versus urban areas in each country. The results show that women earn 40 to 46 percent less than men in urban areas, which is substantially less than in high-income countries. The gender pay gap in rural areas ranges from (a statistically insignificant) 12 percent in Tanzania to 77 percent in Nigeria. In all rural areas, a major share of the gender pay gap (81 percent in Malawi, 83 percent in Tanzania and 70 percent in Nigeria) is explained by differences in workers' characteristics, including education, occupation and sector. This suggests that if rural men and women had similar characteristics, most of the gender pay gap would disappear. Country-differences are larger across urban areas, where differences in characteristics account for only 32 percent of the pay gap in Tanzania, 50 percent in Malawi and 81 percent in Nigeria. Our detailed decomposition results suggest that structural transformation does not consistently help bridge the gender pay gap. Gender-sensitive policies are required to ensure equal pay for men and women.

Prevalence and Trends of Depression among Cyberbullied Adolescents - Youth Risk Behavior Survey, United States, 2011 – 2019 Jason Nicholson, University of West Georgia

The difference in depression between non-cyberbullied and cyberbullied youth is not well understood. To describe the prevalence and trends in depression among cyberbullied adolescents. Using cross-sectional, nationally-representative data from the YRBS 2011 - 2019, we estimated the prevalence and trends of depression across the total years and within cyberbullied groups that include biological sex and race and ethnicity among adolescents. The results indicated the prevalence of depression was higher among those that were cyberbullied. Within the cyberbullied groups the total trend was higher than the non-cyberbullied, females had a higher prevalence of depression than males, and Hispanics had a higher prevalence of depression than blacks. Further, the results showed the trends for cyberbullied, males, females, whites, and blacks had significant linear increases, but Hispanics remained stable. Further, the non-cyberbullied trend was quadratic where there was no change from 2011-2015, but an increase occurred between 2015-2019. Depression is high among adolescents. It appears to be increasing among individuals that are cyberbullied, with the exception of Hispanics. These results are discussed with programming recommendations.

Demand prediction of medical services in home and community-based services for older adults in China using machine learning.

Home and community-based services are considered an appropriate and crucial caring method for older adults in China. However, the research examining demand for medical services in HCBS through machine learning techniques and national representative data has not yet been carried out. This study aimed to address the absence of a complete and unified demand assessment system for home and community-based services. This was a cross-sectional study conducted on 15,312 older adults based on the Chinese Longitudinal Healthy Longevity Survey 2018. Models predicting demand were constructed using five machine-learning methods: Logistic regression, Logistic regression with LASSO regularization, Support Vector Machine, Random Forest, and Extreme Gradient Boosting (XGboost), and based on Andersen's behavioral model of health services use. Methods utilized 60% of older adults to develop the model, 20% of the samples to examine the performance of models, and the remaining 20% of cases to evaluate the robustness of the models. To investigate demand for medical services in HCBS, individual characteristics such as predisposing, enabling, need, and behavior factors constituted four combinations to determine the best model. Random Forest and XGboost models produced the best results, in which both models were over 80% at specificity and produced robust results in the validation set. Andersen's behavioral model allowed for combining odds ratio and estimating the contribution of each variable of Random Forest and XGboost models. The three most critical features that affected older adults required medical services in HCBS were self-rated health, exercise, and education. Andersen's behavioral model combined with machine learning techniques successfully constructed a model with reasonable predictors to predict older adults who may have a higher demand for medical services in HCBS. Furthermore, the model captured their critical characteristics. This method predicting demands could be valuable for the community and managers in arranging limited primary medical resources to promote healthy aging.

The role of non-cognitive skills in the adoption of information and communication technology in Indonesia

Non-cognitive skills play an essential role in economic development because they help determine the adoption of technological innovations, such as information and communication technology (ICT). However, evidence of the influence of non-cognitive abilities on ICT adoption in Indonesia is limited. Therefore, this study aims to analyze the role of non-cognitive skills in ICT adoption in Indonesia. This study employed the big five personality traits to measure individuals’ non-cognitive abilities. Using the national representative data from the Indonesian family life survey, the probit regression analysis was applied to analyze the role of non-cognitive skills on ICT adoption. The findings show that openness and extraversion can significantly increase ICT adoption. Meanwhile, conscientiousness, agreeableness, and neuroticism show a negative and significant influence. The disaggregate analysis based on gender and location shows different results. The findings in this study have shown that policymaking needs to consider the roles of non-cognitive skills. This finding implies that non-cognitive skills, such as the big five personality traits, should be considered in the formulation of the economic development policy.

한국 가계빈곤의 결정요인 분석

Purpose: As household characteristics are differently associated with poverty within population sub-groups, the present study examines the determinants of household poverty by gender and age of a household heads in Korea.
 Research design, data, and methodology: The present study examines the association between a vector of household demograpic and socioeconomic characteristics and poverty. Specifically, sample household survey is decomposed into male and female headed households, and elderly and non-elderly headed households to assess how attributes to poverty vary depending on population sub-goups. For empirical analysis, this study draws upon the recent national representative household data, survey of household finance and living conditions (SFLC) 2021 collected by Korea Statistical Office.
 Results: Three findings are highlighted; (1) household head’s age is prone to poverty for the non-elderly male-headed households but not for the non-elderly female headed households, partly reflecting relative weakness in earning power of female in labour market.; (2) the type of Job occupation of a household head has different effects on the elderly male and the elderly female households; (3) a hump-shape relationship between a household head’s age and poverty, partly capturing the life-cycle income hypothesis, is only observed from the non-elderly households whilst the relationship was linear for the elderly household. Finally we found that education played a role for the elderly household from anti-poverty perspective but not for the non-elderly household.
 Implications: Some findings suggests policy implication related to poverty relief. For example, the different age effect of poverty between the non-elderly male and the non-elderly female headed households for partly implies the weakness of earning power in income generating activities and suggests a government anti-poverty intervention should be taken into account wage differential stemming from gender discrimination in labour market.

Employment and mental health of youth in Egypt: Does job security matter?

Youth in Egypt face compounded difficulties from the widespread use of fixed-term and informal employment. However, the relationships between these jobs and mental health remain to be evaluated among employed youth. This paper investigates the effect of transitioning from non-employment into employment on the mental health of youth younger than 30 years old. I differentiate jobs based on security and formality, focusing on the variation between permanent, temporary, casual/seasonal, and informal employment. Using nationally-representative panel data, I estimate the impact of various employment transitions on mental health outcomes by applying a matched difference-in-differences design. Transitioning to temporary, seasonal, and casual jobs has no significant effect on mental health compared to staying in non-employment. The psychological benefits are gendered. The gain for women is on the prevalence of mental illness, while men see an improvement in the depth of mental illness. For women, transitioning to a formal job provides the highest mental health rewards, while for men, a transition to a permanent job yields the highest mental health rewards. More consideration for the various types of employment and mental illness is required when studying non-standard employment.

How Zambia reduced inequalities in under-five mortality rates over the last two decades: a mixed-methods study

BackgroundZambia experienced a major decline in under-five mortality rates (U5MR), with one of the fastest declines in socio-economic disparities in sub-Saharan Africa in the last two decades. We aimed to understand the extent to which, and how, Zambia has reduced socio-economic inequalities in U5MR since 2000.MethodsUsing nationally-representative data from Zambia Demographic Health Surveys (2001/2, 2007, 2013/14 and 2018), we examined trends and levels of inequalities in under-five mortality, intervention coverage, household water and sanitation, and fertility. This analysis was integrated with an in-depth review of key policy and program documents relevant to improving child survival in Zambia between 1990 and 2020.ResultsThe under-five mortality rate (U5MR) declined from 168 to 64 deaths per 1000 live births between 2001/2 and 2018 ZDHS rounds, particularly in the post-neonatal period. There were major reductions in U5MR inequalities between wealth, education and urban–rural residence groups. Yet reduced gaps between wealth groups in estimated absolute income or education levels did not simultaneously occur. Inequalities reduced markedly for coverage of reproductive, maternal, newborn and child health (RMNCH), malaria and human immunodeficiency virus interventions, but less so for water or sanitation and fertility levels.Several policy and health systems drivers were identified for reducing RMNCH inequalities: policy commitment to equity in RMNCH; financing with a focus on disadvantaged groups; multisectoral partnerships and horizontal programming; expansion of infrastructure and human resources for health; and involvement of community stakeholders and service providers.ConclusionZambia’s major progress in reducing inequalities in child survival between the poorest and richest people appeared to be notably driven by government policies and programs that centrally valued equity, despite ongoing gaps in absolute income and education levels. Future work should focus on sustaining these gains, while targeting families that have been left behind to achieve the sustainable development goal targets.

The Trend of Risk for Cardiovascular Diseases During the Past Decade in Iran, Applying No-Lab and Lab-Based Prediction Models.

As a surrogate for all relevant risk factors, it is preferable to show trends in the mean cardiovascular disease(CVD) risk rather than to examine each risk factor trend separately. Using national representative data, this study aimed to determine the changes in the World Health Organization (WHO) CVD risk during the last decade considering both laboratory and non-laboratory risk scoring. We used data from five rounds of the WHO STEPwise approach to surveillance surveys (2007-2016). In all, 62,076 (31,660 women) participants aged 40-65 years were included and their absolute CVD risk were calculated. The generalized linear model was performed to assess the trend of CVD risk in men and women, and also in diabetic and non-diabetic individuals. We showed significant declining trends in the mean CVD risk in the laboratory (from 10.5% to 8.8%) and non-laboratory (10.1% to 9.4%) models in men. In women, a significant reduction was observed in the laboratory-based model (from 8.4% to 7.8%). The laboratory model showed a greater decrease in men than women (P-for interaction < 0.001) and in diabetic patients (from 16.1% to 13.6%) than non-diabetic individuals (from 8.2% to 7%) (p-for interaction = 0.002). The proportion of high-risk individuals (risk ≥ 10%) decreased from 40% in 2007 to 31.5% in 2016 in men and from 29.8% to 26.1% in women based on the laboratory-model. During the last decade, CVD risk had a significant decrease in men and women. The reduction was more evident in men and diabetic population. However, still, one-third of our population is considered high-risk.

Mental health problems of black and white children in a nationally representative epidemiologic survey

Black children face more numerous socio-economic disadvantages than White children, but whether they have more adverse mental health problems remains understudied. Using nationally-representative data from the 2018–2019 National Survey of Children's Health, we examined differences in mental health problems between non-Hispanic Black (n = 2,890) and White (n = 30,015) children aged 6–17. Multivariate analyses were used to determine whether differences in mental health conditions could be accounted for by other factors. We found Black children were significantly less likely than White children to have clinically-identified internalizing conditions (especially anxiety) and more likely to be identified with conduct problems. Black children were also substantially more likely to have greater exposure to adverse childhood experiences (ACEs), to be uninsured, experience poverty, and less likely to receive needed mental health services. After adjusting for these potential confounders, Black children remained half as likely to have clinically-recognized internalizing conditions, but were no longer more likely to have clinically-identified conduct problems. Differences in ACEs alone fully accounted for the racial difference in conduct problems. These results point to the potential impact of assessment bias by clinicians and underscore the potential benefit of routine screening for depression/anxiety in racial/ethnic minority children, especially in light of rising suicide rates among Black youth.

The U-shaped association of non-high-density lipoprotein cholesterol with all-cause and cardiovascular mortality in general adult population.

Non-high-density lipoprotein cholesterol (non-HDL-C) has been associated with atherosclerosis. However, the association between non-HDL-C and mortality in adult population remains unclear. We intended to investigate the association of non-HDL-C with cardiovascular and all-cause mortality using national representative data. The study included 32,405 participants from the National Health and Nutrition Examination Survey (1999-2014). Mortality outcomes were ascertained by linkage to National Death Index records through December 31, 2015. Multivariable-adjusted Cox regression models were used to evaluate hazard ratio (HR) and 95% confidence interval (CI) of non-HDL-C concentrations in quintiles. Two-piecewise linear regression and restricted cubic spline analyzes were performed to test dose-response associations. After a median follow-up of 98.40 months, 2,859 (8.82%) all-cause and 551 (1.70%) cardiovascular deaths occurred. Compared with the highest group, the multivariable-adjusted hazard ratio (HR) of the first quintile for all-cause mortality was 1.53 (95%CI, 1.35-1.74). Higher non-HDL-C above a cutoff value of 4.9 mmol/L was related with cardiovascular mortality (HR = 1.33, 95%CI, 1.13-1.57). A U-shaped relationship between non-HDL-C and all-cause mortality was found in spline analysis with a cutoff value around 4 mmol/L. Similar results in subgroups analyzes were found among male, non-white population, participants who were not taking lipid-lowering drugs, and with body mass index (BMI) <25 kg/m2. Our findings suggest a U-shaped association between non-HDL-C and mortality among adult population.

Primary medical and health preparedness and people's life satisfaction in China: The mediating role of satisfaction with medical and health services.

To examine the association between primary medical and health preparedness (PMHP), satisfaction with medical and health services (SMHS), and life satisfaction (LS). Using the latest national representative data from the 2019 Chinese Social Survey and the 2018 Health Statistics Yearbook for each province in China, we conducted multi-level models to test the effect of three aspects of PMHP (the number of primary medical and health institutions (PMHIs), the number of beds in PMHIs, and the number of staff in PMHIs) on LS, and the mediation role of SMHS in this effect. The number of staff in PMHIs has a significant positive effect on people's LS. Besides, this effect is mediated completely by SMHS. However, the number of PMHIs and the number of beds in PMHIs do not affect LS significantly. PMHP has a positive impact on LS, but this impact is associated only with the number of staff in PMHIs. Therefore, governments should focus on optimizing human resources in PMHIs to meet the LS needs of individuals.

Livelihood Diversification and Household Vulnerability to Climate Shocks in Rural Kenya

This study tests the hypothesis that livelihood diversification mitigates vulnerability to climate shocks among rural households in Kenya. The study is based on two waves of nationally-representative household survey data collected in 2005/06 and 2015/16. A measure of livelihood diversification in the sampled households was computed using Simpson Diversity Index. Comparison of means and correlation analysis was used to test the study’s hypothesis on a sample of 8,483 and 12,217 rural households in 2005/06 and 2015/16 respectively. Consistent with the study’s hypothesis, results indicate lower mean values of livelihood diversification indices for rural households that reported loss in welfare due to climate shocks compared to those that reported no adverse effects in both 2005/06 and 2015/16. Correlation analysis results indicate an inverse relationship between livelihood diversification and vulnerability to climate shocks for all sampled households. Distinctive and nuanced differences in results were found when analysis was disaggregated along income classes and agro-ecological zones. Sensitivity analysis confirmed robustness of the results. Based on these results, it is recommended that rural households be supported to pursue a diverse portfolio of income generating activities and assets in order to build resilience against climate shocks.

The Association of Maternal BMI with Overweight among Children Aged 0-59 Months in Kenya: A Nationwide Cross-Sectional Study.

Childhood overweight is a growing global public health challenge and is prevalent in many countries. We aimed at exploring the prevalence of childhood overweight and the association of maternal body mass index (BMI), maternal demographic factors, and child-related factors with childhood overweight among Kenyan children aged 0-59 months. This study utilized Kenya's 2014 demographic and health survey, which was based on national representative cross-sectional data. A total of 8316 children and their mothers' data were analyzed. Overweight in children and maternal BMI were defined using WHO standard criteria. Multivariate logistics regression models were used to study the association of maternal BMI and childhood overweight. Nationally 5% of Kenyan children aged 0-59 months are overweight (5.5% male vs. 3.8% female). The highest prevalence in overweight among children was found in Central region (6.9%) and lowest in North Eastern (3.1%) which could be explained by the various economic disparities. Maternal BMI with underweight was associated with lower odds (OR 0.30, 95% CI 0.14-0.64) whereas, overweight and obesity were associated with higher odds of overweight (OR for overweight 1.64, 95% CI 1.28-2.11 and OR for obesity 1.74, 95% CI 1.22-2.47) among their children compared to normal weight mothers. Overweight among children is of great concern and therefore initiatives to tackle both child and maternal health are urgently needed.

Impact of the COVID-19 Pandemic on Gender Differences in Depression Based on National Representative Data.

Restrictions on daily life and changes in economic structure due to coronavirus disease 2019 (COVID-19) likely would have affected men and women differently. However, there is still a lack of research on the difference between men and women in the amount of change in depression during COVID-19 compared to before COVID-19. Therefore, the researchers investigated gender differences in the magnitude of increase in the prevalence of depression with its severity and individual symptoms during COVID-19 compared with pre-pandemic levels. The Korea National Health and Nutrition Examination Survey (KNHANES) 2016 and 2018 were used to assess depression levels pre-pandemic and the KNHANES 2020 for pandemic depression levels. Depression was evaluated using the Patient Health Questionnaire-9 (PHQ-9). To analyze the differences between men and women in the magnitude of the mental health impact of COVID-19, the researchers analyzed the weighted differences in depression prevalence, severity, and individual symptoms during the COVID-19 pandemic compared to before COVID-19 stratified by gender. In men, there were significant increases in weighted prevalence for depression (1.2% percentage point; 95% confidence interval [CI], 0.0-2.3) and severe symptoms of depression (2.6-fold; 95% CI, 1.2-5.7). Among the individual symptoms of depression, significant increases during the pandemic compared to before were: little interest or pleasure in doing things, 1.26-fold; feeling tired or having little energy, 2.2-fold; and suicidal thoughts, 1.7-fold. However, there was no significant difference in prevalence, symptoms severity, and any symptom before and during COVID-19 in women. Because the pandemic is likely to increase mental problems of the affected over time due to such problems as financial stress and joblessness or post-infection health issues, the researchers anticipate an increase in the prevalence of some mental illnesses. In particular, since the suicide rate of men is higher than that of women, from a public health perspective, active interventions are needed to prevent an increase in the suicide rate due to COVID-19. It is also necessary to establish national policies to overcome the psychological, social, and economic losses resulting from COVID-19.

Lopsided inclusion: The impact of multi‐employer bargaining and class‐based unionism on non‐regular employment in South Korea

AbstractThis study examines the impact of multi‐employer bargaining on non‐regular workers across different unions and types of non‐regular employment. Using national representative survey data from South Korea, I find that multi‐employer bargaining increases the likelihood that a workplace union would address a pay increase for non‐regular workers when the union was affiliated with a confederation espousing class‐based as opposed to business‐unionism. However, such a relationship was weaker for temporary agency workers and subcontractors than for direct‐hire fixed‐term workers. This mechanism is further illustrated through a second round of data collection and analysis, namely in‐depth interviews. I identify two factors that characterize the class‐based confederation: (1) centralized pressure from the union and (2) activists and their identity work. Altogether, these results further an understanding of how the identities of national union confederations can influence local representatives’ approach to representing non‐regular workers and how those influences are manifested through workplace‐level collective bargaining.

HEARING LOSS AND ITS CONSEQUENCES FOR SPOUSAL MENTAL HEALTH: EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY

Abstract Hearing loss (HL) is an increasingly prevalent chronic stressor among older adults and is associated with numerous adverse health outcomes. The life course perspective and stress process framework highlight that an individual’s stressors may have a short and/or long-term impact on the health of others. However, little is known about how HL influences the proliferation of stress within married couples. Drawing on nationally-representative data from 11 waves (1998-2018) of the Health and Retirement Study (n=9,000 individuals, 4,500 couples), we use age-based mixed models to examine how one’s own HL, spouse’s HL, or both spouses have HL shape the level and changes in depressive symptoms. For men, we find that their wives’ HL, their own HL, and both spouses having HL are each associated with an increase in depressive symptoms—and that the associations persist as spouses age. For women, we find that their own HL and both spouses having HL is associated with an increase in depressive symptoms. Furthermore, we find that the differences in women’s depressive symptoms between spouses who both have HL and those who do not have HL significantly declines with age. We also find no evidence to suggest that husbands’ HL is associated with wives’ depressive symptoms. Together, these findings suggest that the connections between spouses’ HL and their depressive symptoms are a dynamic process that unfolds differently by gender over time. Interventions that recognize the proliferation of stress associated with HL may help both individuals with HL and their spouses reduce their depressive symptoms.

LATER-LIFE TRAJECTORIES OF MARITAL QUALITY FOR WOMEN AND MEN

Abstract It is essential to better understand older adults’ marital dynamics, as marital quality is consequential for older adults’ physical and mental health, relationships with other social network members, and risk of divorce. Although numerous studies examine marital quality during the early life course, much less is known about later life trajectories. Earlier work suggested marital quality followed a U-shaped curve, characterized by a later-life upswing, but more recent research finds patterns of stability or decline over time. Gender differences in marital quality are well established, but it is less clear whether older men and women experience different marital quality trajectories during later life. We use nationally-representative data from a sample of continuously-married adults over age 50 in the Health and Retirement Study (n=2,175) with measures of both positive and negative marital quality at three time points (2006, 2010, and 2014). Latent growth mixture models in Mplus estimate trajectories of marital quality over the eight-year time period. Results show small declines in both positive (b = -0.016, p &amp;lt; 0.05) and negative (b = -0.028, p &amp;lt; 0.05) marital quality over the observation period, but the declines in positive marital quality are limited to those in remarriages. Women have lower initial positive marital quality and higher initial negative marital quality than men, but there are no significant gender differences in change over time. Results support the stability and continuous-decline patterns of marital quality over the life course rather than a U-shaped curve, and suggest persistence of gender differences over time.