Family Survey Research Articles

Child marriage as a risk factor for non-communicable diseases among women in India.

Child marriage, defined as marriage under the age of 18 years, remains pervasive in India. Global evidence documents a negative association between child marriage and women's reproductive and sexual health outcomes; however, its relationship with non-communicable diseases (NCDs) remains underexplored. We utilize biomarkers and self-reported data from the nationally representative National Family and Health Survey 4 (2015-2016) to examine the associations between child marriage and hypertension, diabetes, heart disease, asthma and thyroid disorder among currently married women (N = 421 107). We use regression models adjusted for a range of demographic and socio-economic controls to assess the association between child marriage and NCDs among women in India. We further assess whether and to what extent these relationships are mediated by early motherhood using the Karlson, Holm and Breen method of decomposition. Child marriage was associated with hypertension [adjusted odds ratio 1.20 (95% CI: 1.17-1.24)], diabetes [1.29 (1.22-1.37)], heart disease [1.27 (1.18-1.36)], asthma [1.19 (1.11-1.28)] and thyroid disorder [1.10 (1.02-1.18)]. Early motherhood also increased the risk of NCDs among women. Furthermore, it emerged as a pathway linking child marriage with hypertension, diabetes and heart disease; however, it provided a partial explanation for the disadvantage associated with child marriages. Child marriage emerges as a risk factor for NCDs among women in India. Health systems need to recognize the enduring influence of child marriages on women's health and ensure early detection and effective treatment of NCDs for this vulnerable group.

PO-04-124 ARRHYTHMIAS INCLUDING ATRIAL FIBRILLATION IN KLEEFSTRA SYNDROME: A POSSIBLE EPIGENETIC LINK

Kleefstra syndrome (KS), often diagnosed in early childhood, is a rare genetic disorder (EHMT1 gene: an important epigenetic modulator) that is characterized by hypotonia, developmental delay and distinct facial features. Although congenital heart disease (CHD) is frequently reported, there is a paucity of data on the prevalence of CHD subtypes and arrhythmias in KS; no known reports of Atrial Fibrillation (AF). To systematically assess the prevalence of CHD and arrhythmias in KS. Cross-sectional analysis of the two largest known KS registries: Radboudumc (50 patients, median/IQR age: 13.5/13 years) based on health record review at Radboud University Medical Center in Netherlands, and GenIDA (163 patients, median/IQR age: 10/12 years) based on surveys of patient families from around the world. Case series of 3 additional patients with KS and atrial tachyarrhythmias. Both registries independently report 40% (20 patients in Radboudumc and 65 in GenIDA) prevalence of a cardiovascular system abnormality and 2-8% prevalence of arrhythmias (4 in Radboudumc and 3 in GenIDA). Radboudumc registry included 14% patients with atrial septal defect (ASD), 12% with ventricular septal defect (VSD), 4% patients each with Tetralogy of Fallot and pulmonary valve stenosis, and none with left ventricular dysfunction. The 8% patients with arrhythmias in this registry did not report significant CHD and included one patient with AF, two with supraventricular tachycardias (SVTs), and one with ventricular tachycardia (VT). GenIDA registry reported 1% patients with cardiomyopathy, 10% with VSD, 13% with ASD, 16% with valvular disease, and 9% with vascular malformations. This registry also included one patient with AF and another with chronic ectopic atrial tachycardia with neither patient reporting CHD. A case series of 3 additional KS patients not included in these registries with atrial tachyarrhythmias reveals two patients with AF and one with atrial tachycardia, in the absence of CHD. One patient with symptomatic AF refractory to medications underwent successful pulmonary vein isolation (first known report) at age 23 without recurrence at 16 months. The largest database of KS patients compiled to-date reveals a high prevalence of CHD and early-onset atrial tachyarrhythmias including AF, even in the absence of structural heart disease. These findings suggest a role for regular electrocardiograms and ambulatory rhythm monitoring as well as a possible novel epigenetic mechanism for AF.

Changing socioeconomic and geographic gradients in cardiovascular disease risk factors among Indians aged 15-49 years - evidence from nationally representative household surveys.

Cardiovascular diseases (CVDs) are the leading cause of death in most low- and middle-income countries (LMICs). CVDs and their metabolic risk factors have historically been concentrated among urban residents with higher socioeconomic status (SES) in LMICs such as India. However, as India develops, it is unclear whether these socioeconomic and geographic gradients will persist or change. Understanding these social dynamics in CVD risk is essential for mitigating the rising burden of CVDs and to reach those with the greatest needs. Using nationally representative data with biomarker measurements from the fourth (2015-16) and fifth (2019-21) Indian National Family and Health Surveys, we investigated trends in the prevalence of four CVD risk factors: smoking (self-reported), unhealthy weight (BMI ≥25 ), diabetes (random plasma glucose concentration ≥200mg/dL or self-reported diabetes), and hypertension (one of: average systolic blood pressure ≥140mmHg, average diastolic blood pressure ≥90mmHg, self-reported past diagnosis, or self-reported current antihypertensive medication use) among adults aged 15-49 years. We first described changes at the national level and then trends stratified by place of residence (urban versus rural), geographic region (northern, northeastern, central, eastern, western, southern), regional level of development (Empowered Action Group member state or not), and two measures of socioeconomic status: level of education (no education, primary incomplete, primary complete, secondary incomplete, secondary complete, higher) and wealth (quintiles). Unhealthy weight increased among all social and geographic groups but both the absolute and the relative changes were substantially higher among people with low SES (as measured by education or wealth) and in rural areas. For diabetes and hypertension, the prevalence increased for those from disadvantaged groups while staying constant or even decreasing among the wealthier and more educated. In contrast, smoking consumption declined for all social and geographic groups. In 2015-16, CVD risk factors were higher among more advantaged subpopulations in India. However, between 2015-16 and 2019-21, the prevalence of these risk factors grew more rapidly for less wealthy and less educated subpopulations and those living in rural areas. These trends have resulted in CVD risk becoming far more widespread throughout the population; CVD can no longer be characterized as a wealthy urban phenomenon. This work was supported by the Alexander von Humboldt Foundation (grant received by NS); the Stanford Diabetes Research Center [grant received by PG] and the Chan Zuckerberg Biohub [grant received by PG].

Factors Affecting Married Women’s Intention to Have a Second Child: Focusing on Reproductive Health Factors

Purpose: This study analyzed factors that influence married women's intentions to have a second child from the perspective of reproductive health in Korea.Methods: The analysis included 332 married women whose first child birth was within the last 3 years from the 2021 National Family and Fertility Survey data. First, the general characteristics of married women was presented through frequency analysis. The differences in the characteristics of married women regarding their intention to have a second child were also analyzed using a chi-square test and independent samples t-test. Second, we analyzed the reproductive health characteristics of married women according to age using a chi-square test. Finally, logistic regression analysis was performed to investigate the effect of married women's reproductive health factors on their intention to have a second child.Results: With various variables controlled, age, infertility, and negative pregnancy experiences had a negative effect on the intention to have a second child, whereas child values and trust in the government had a positive effect. In addition, differences in the reproductive health of married women were found according to age, and the proportions of infertility, negative pregnancy experiences, and preterm birth or low birth weight of the first child were high in elderly married women.Conclusion: To alleviate the low fertility rate in terms of additional childbirth, it is necessary to combine and strengthen not only medical treatment related to women's reproductive health but also psychoemotional counseling as a non-medical treatment, with support from the government.

Domestic Violence and Its Impact on Abortion in Iran: Evidence From a Nationally Representative Survey.

The objective of this article is to assess the effect of domestic violence on abortion and investigate the mediating role of unwanted pregnancy. A secondary analysis was conducted on the National Family Survey data. This survey was a cross-sectional study conducted across Iran in 2018. The association between domestic violence and abortion was analyzed using the Partial Least Square-Structural Equation Model (PLS-SEM) with WarpPLS version 8.0. From among 1,544 married women (mean age 42.8 years) who participated in this survey, 27% (418 women) reported experiencing at-least one-lifetime of abortion. Overall, two in three women (67.3%) experienced at least one form of domestic violence. Almost half of the women with experience of abortion (49.3%) reported at least one unwanted pregnancy in their life course. The bivariate analysis showed a significant positive relationship between domestic violence and abortion, and there was a positive direct effect of domestic violence on unwanted pregnancy. Moreover, age had a negative direct and indirect effect on unwanted pregnancy and abortion. Although, the direct effect of domestic violence on abortion was not significant in the Structure Equation Model, a positive indirect effect of domestic violence on abortion through unwanted pregnancy was confirmed. The effect of unwanted pregnancy on abortion was particularly strong (β = .395, p < .01). These results have some implications for prevention of abortion through interventions against unwanted and unplanned pregnancy and domestic violence. This study makes a unique theoretical contribution to the literature through assessing the mediating role of unwanted pregnancy between domestic violence and abortion by using the SEM model.

Dietary diversity and association with non-communicable diseases (NCDs) among adult men (15-54 years): A cross-sectional study using National Family and Health Survey, India.

A healthy and diversified diet is essential for preventing several non-communicable diseases (NCDs). Given the increasing evidence of diet-related health burdens and the rising prevalence of NCDs among Indian adults, the present study aims to explore dietary diversity patterns among adult men in India and their association with non-communicable diseases (NCDs). For this purpose, the study used the fourth round of the National Family and Health Survey (NFHS-4) to analyze adult male samples (n = 1,12,122). Dietary Diversity Scores (DDS) were computed by the weighted sum of the number of different food groups consumed by an individual. The prevalence of diabetes, heart disease, and cancer among adult men is considered a non-communicable disease. Bivariate and logistic regression was carried out to examine the association between DDS and NCDs by estimating chi-squared tests (χ2-test), odds ratio (OR), and 95% confidence interval (CI). The prevalence of diabetes, heart disease, and cancer among adult men in India is 2.1 percent, 1.2 percent, and 0.3 percent, respectively. Results show a positive association between dietary diversity score and the prevalence of the non-communicable disease. High-level dietary diversity scores increase to two times the likelihood of diabetes (OR 2.15 with p<0.05) among adult men than to better-off counterparts while controlling all the covariates. However, a moderate dietary diversity score significantly decreases the likelihood of heart disease (OR 0.88 with p<0.10) and Cancer (OR 0.71 with p<0.05) for adult men compared to a lower score of dietary diversity. In addition, age, marital status, drinking and smoking habits, occupation, and wealth index are also significantly associated with the odds of non-communicable diseases among adult men.

Survei Kepuasan Masyarakat pada Program Satya Gawa dari PT. Indonesia Power Suralaya PGU

This article surveys the implementation of the Satya Gawa Program as part of the social responsibility of PT Indonesia Power Suralaya PGU. This program is intended for people with psychiatric problems, both patients and their families with the aim of improving mental health. The purpose of this study is to determine the success of the implementation of the Mental Disorder Service Center (Satya Gawa). The method used is a survey of patients and families of patients with mental disorders (ODGJ) on the aspect of existence of community development officers, community involvement in planning, implementation and evaluation, conformity with user needs, relevance to cultural, social and economic values, ability to improve knowledge, skills and improving the welfare of the target group. The results of the study show positive performance, meaning that it does not require major changes to the program, but requires minor changes in efforts to involve participation in planning and evaluation, use of opportunities to express opinions, increase income, and continue the Satya Gawa Program.

Characterization of Childhood Neurodegeneration and Associated Ataxia in UBTF-Related Disorder (P12-9.011)

<h3>Objective:</h3> To clarify the natural history of neurodegeneration related to a heterozygous missense de novo mutation in the upstream binding transcription factor (<i>UBTF</i>) gene and to understand the movement patterns extracted from continuous wrist and ankle accelerometer data. <h3>Background:</h3> <i>UBTF</i>-related childhood-onset neurodegeneration is characterized by a period of typical or mildly delayed development followed by regression. Affected individuals frequently experience movement disorders, including ataxia. <h3>Design/Methods:</h3> An online REDCap survey of families of patients with a pathogenic variant in <i>UBTF</i> was conducted. Between March 2021 and February 2022, 52 surveys were started. Duplicate and incomplete responses were excluded. Ten unique responses were fully submitted, and these were included for analysis. Patients with <i>UBTF</i>-related disorder evaluated in a neurogenetics clinic were enrolled for data collection using wearable wrist and ankle accelerometers. Longitudinal data during typical daily activities was collected remotely for continuous one-week periods. These findings were compared to similar data collected from patients with Ataxia-Telangiectasia (A-T) and control subjects. Motor activity was compared with clinical severity using the Brief Ataxia Rating Scale (BARS). <h3>Results:</h3> Median age of the survey subjects was 12.5 years (range 5–20 years), with symptom onset at a median of 2.5 years. All participants reported motor regression (median 3.75 years at onset), with 90% reporting ataxia. Motor activity data was collected from 5 participants (median age 12 years, range 8–12 years), with 3 time points included for one participant (2 with wrist data only) and 1 time point for the other 4 participants. Data from both sensors had high test-retest reliability. Motor activity showed similarities to A-T over controls across multiple measures and correlated with BARS scores. <h3>Conclusions:</h3> Ataxia is frequent in <i>UBTF-</i>related disorder. Motor activity data collected via wrist and ankle accelerometers is a highly reliable measure correlated to disease severity with results resembling other hereditary ataxias, indicating potential use as a motor biomarker. <b>Disclosure:</b> Dr. Nagy has nothing to disclose. Ms. Gupta has nothing to disclose. Ms. Molay has nothing to disclose. Miss De la Rosa Abreu has nothing to disclose. Catherine Becker has nothing to disclose. Dr. Gupta has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Biogen. The institution of Dr. Gupta has received research support from Biogen. An immediate family member of Dr. Eichler has received personal compensation for serving as an employee of UpToDate. Dr. Eichler has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for SwanBio Therapeutics. Dr. Eichler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alnylam. Dr. Eichler has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Origin Biosciences. Dr. Eichler has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Orchard Therapeutics. Dr. Eichler has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Autobahn Therapeutics. Dr. Eichler has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bluebird Bio. Dr. Eichler has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for UpToDate. Dr. Eichler has received stock or an ownership interest from SwanBio Therapeutics. The institution of Dr. Eichler has received research support from Bluebird Bio. The institution of Dr. Eichler has received research support from Minoryx Therpeutics. The institution of Dr. Eichler has received research support from Sio Therapeutics. Dr. Eichler has received intellectual property interests from a discovery or technology relating to health care.

Does having children matter? Associations between transitions in work-family role combinations and depressive symptoms among married women in Korea

Although having a variety of roles is generally beneficial for mental health, little is known about the relationships between work-family role combinations and depressive symptoms among married women in Korea, where child rearing is strongly considered a mother's responsibility. This study examines how the four types of work-family role combinations may be associated with depressive symptoms among married Korean women younger than 50 years old. Data were collected from 2012 through 2020 in five surveys by the Korean Longitudinal Survey of Women & Families. In total, 4811 married women (14,851 person-period observations) were analyzed using regression models with fixed effects. This enabled estimation of the within-person effects of transitions in work-family role combinations on depressive symptoms. Work-family role combinations were categorized as follows based on whether respondents had a job or at least one child: having both worker and mother roles, having a worker role only, having neither a worker nor a mother role, and having a mother role only. The findings indicate that married women who had only a mother role had more severe depressive symptoms than the other three groups. However, after controlling for whether respondents had a preschool-aged child, only those with both worker and mother roles had significantly lower levels of depressive symptoms compared with those with a mother role only. This study suggests that transitioning to being a working mother from a full-time mother may benefit the mental health of married Korean women. Furthermore, whether married women have a child critically impacts their mental health more than the number of roles. Raising a preschool-aged child seems to potentially be especially stressful for married Korean women. Working outside the home can protect the mental health of married Korean mothers who are affected by the social pressure to immerse themselves in child-rearing.

코로나19 이전과 비교한 한부모의 주관적 행복감, 경제적 여건의 변화에 기초한 잠재집단 분류 및 영향 요인 탐색

Objectives The purpose of this study is to identify the latent groups according to changes in subjective happiness and economic conditions of single parents compared to before COVID-19 and to explore variables affecting the identified potential groups. Furthermore, the study confirmed how groups of adolescent has changed compared to before COVID-19.&#x0D; Methods Using the Living Status of Korean Single-Parent Families Survey in 2021, this study analyzed 2,420 single parents through Latent Profile Analysis. In specific, R3STEP were used to determine whether single parent's gender, age, education, type of government support, and duration were affected by the potential group classification, and BCH were used to determine whether there was a difference in children's changes compared to before COVID-19.&#x0D; Results First, the latent groups based on subjective happiness and economic conditions compared to before COVID-19 perceived by single parents were identified as seven groups. Second, educational background of single parents, the type of government support, the period of becoming a single parent, and their age had an effect on the classification of latent groups. Third, it was confirmed that the degree of positive change of children was different for each group.&#x0D; Conclusions This study suggests that children from single parents family can have more positive changes in school life when subjective happiness and economic conditions of their single parents improve compared to before COVID-19.

Alarming Trend in Under-Five Indian Children's Exposure to Indoor Tobacco Smoke.

Children who are exposed to tobacco smoke (ETS) are at risk for a variety of health issues. There are enough legislative provisions in Indian law to safeguard children from ETS in outdoor settings, but no such specific rules exist to shield them from exposure indoors.This study aimed to examine the trend in under-five children's exposure to indoor tobacco smoke over the course of a decade (from 2005 to 2016) in India. Data from the National Family and Health Survey (NFHS) for the years 2005-2006 (NFHS-3) and 2015-2016 (NFHS-4) on under-five children have been taken into consideration in cross-sectional analyses of the Demographic and Health Survey on India. Based on different sociodemographic factors, the propensity of indoor ETS among Indian children has been estimated and compared using both bivariate and multivariate logistic regression models. The prevalence of indoor ETS among Indian children under the age of five has greatly risen over the past decade, rising from 4.12% to 52.70%. According to the findings, there has been a noticeable increase in every group of kids, regardless of their age, place of residence, geographic location, socioeconomic status, and literacy level of their mothers. In India, the incidence of indoor ETS among children under five has risen by 13 times in the last 10 years, endangering the country. As a result, the Indian government must prepare to take legislative action to safeguard children by passing laws that forbid smoking inside.

Serological Characteristics of Subtype A Caused by New A Allele Mutation and a Family Survey

In this study, the results of forward and reverse blood typing of a male patient diagnosed as bronchiectasis were inconsistent, which were type O and type A respectively. Multiple experiments including genotyping and sequencing and family investigation were carried out to determine the subtype of ABO blood group and explore the serological characteristics of this subtype. Standard serological techniques were used to conduct forward and reverse typing, reverse blood typing enhancement test, H antigen identification, absorption-elution test, salivary blood group substances test, and PCR-SSP method for ABO genotyping and exon 6 and 7 sequencing. The proband's blood group was type O by forward typing, but antigen A could be detected by absorption-elution test, anti-A1 could be detected by reverse blood typing enhancement test, it was found that there was substance H but no substance A in saliva, and the serological characteristics were consistent with Ael subtype. Gene sequencing analysis showed that there was a c.625T>G base substitution on the basis of A102, which had never been reported before. Family survey showed that c.625T>G base substitution appeared in three generations of the family. In this study, a new subtype A with Ael serological characteristics caused by c.625T>G mutation was identified. c.625T>G base substitution results in the weakening of A antigen, and this mutation can be stably passed down to future generations.

Fertility and Media Narratives of the Economy: Evidence From Italian News Coverage

We argue that media-conveyed economic narratives are crucial for understanding contemporary fertility dynamics, net of objective economic constraints. Individuals use these narratives to project themselves into an actionable imagined future and make decisions that may be relatively independent from their actual economic situation. We test this hypothesis for Italy by combining individual-level data from the 2009 and 2016 releases of the nationally representative Family and Social Subjects Survey with Media Tenor data on the coverage of the economy in the evening newscast of Italian TV's most-viewed channel (Rai 1). Our findings reveal that both the incidence and tone of news reports on the state of the economy are associated with fertility behavior. An increase in the number of negative economic news items is negatively associated with fertility, whereas an increase in positive items is positively correlated with fertility. Interestingly, when positive news items outnumber negative ones, an increase in the share of economic reports is positively associated with fertility. These associations are statistically significant and substantially relevant, net of traditional individual and contextual socioeconomic fertility correlates. Overall, our findings bolster the claim that media-conveyed narratives of the economy influence fertility behaviors.

Pekerja Anak dan Pendidikannya Di Masa Depan

Child labour has an impact not only on health but also on education in the future. Being a child labour, the minimum consequence is the disruption of the child's time to go to school and in some cases, the child cannot go to school at all. This study uses data from the Indonesia Life Family Survey (IFLS) where the individuals studied are the same for each IFLS period. The results show that there is a difference between those who have worked as child workers in the past, who have a lower level of education than those who were not child laborers. The difference can be seen 14 years later. This is reinforced by the results of statistical tests with Logistic Regression where there is a strong relationship between child labour and the level of final education. Those who are child workers have a greater chance of only graduating from elementary and junior high school compared to those who are not child laborers.

Australian military personnel perspectives on family, service, and deployment: An analysis of open-ended survey data

LAY SUMMARY Most research on military family health has involved talking to spouses, but what do military personnel think? Personnel may identify different issues that have not had the attention of research or armed forces. This study used the “Any other comments?” question in a military family survey to get their thoughts. Australian Defence Force regular and reserve personnel who were in the army, navy, or air force completed the survey. There were 264 personnel who talked about families, and key issues and views were identified from their responses. These included the challenge of living away from families for service reasons and a feeling of “talk, not action” on work and family balance. Responses revealed that non-family-friendly practices affected the health of families. They also caused personnel to leave regular service or the military altogether. Armed forces should work to match practices with policies. This study also shows how open-ended-comment questions in surveys are useful for research and give military personnel a chance to have their say.

What is needed to improve quality of implant removal services in Nigeria? results of a landscape assessment.

Stunning recent increases in subdermal contraceptive implant use, especially in sub-Saharan Africa, necessitate availability of quality implant removal services. In Nigeria, service delivery capacity and coverage for removal are lacking, despite strong government commitment and rapid uptake; there is a dearth of knowledge about barriers to quality implant removals in Nigeria. To determine access to and quality of contraceptive implant removal services, a landscape assessment was conducted in two states in Nigeria, focusing on four conditions for quality delineated in the Global Implant Removals Task Force framework. This mixed-methods approach integrated results from a desk review, a survey of health facilities and family planning managers, review of implant service statistics, and key informant interviews with providers and diverse stakeholders. Seventy percent of providers (N = 21 of 30) had experienced problems performing implant removal, usually due to deeply inserted implants and equipment shortages. Providers had low confidence in performing removal and poor knowledge of implant removal steps. No facilities assessed had comprehensive equipment required for implant removal. Few facilities maintained systems or referral pathways to support difficult removals; difficult removals are absent from training manuals, and no formal trainings have been conducted. While most facilities collect data on removals, family planning dashboards do not capture it; few facilities use data for quality improvement. This study identified numerous challenges to quality implant removal, including poorly trained providers, inadequate supplies, underutilization of data on removals, and inability to manage difficult removals. As demand for implant removals skyrockets, providers need improved training in implant removal, appropriate job aids, supportive supervision, and effective procurement systems to ensure availability of supplies and equipment for removal. Tracking removals and reasons for removal in information systems and the Family Planning dashboard could sensitize providers to need for implant removals and improve data for decision-making in facilities and health systems.

Active Engagement and Health Status of Older Malaysians: Evidence from a Household Survey

Malaysia is undergoing rapid age structural shift to becoming an ageing nation by 2030 when 14% of its population will be aged 60 and over. Population ageing strains the healthcare system due to the rapid rise in non-communicable diseases and poses enormous challenges in providing social protection. Health promotion can ameliorate these twin problems through the active engagement of older adults in the labour force and social activities. This paper used data from the 2014 Malaysian Population and Family Survey (MPFS) to study the factors associated with active engagement in social and economic activities, and the health status of older adults. The survey covered a nationally representative sample of 4,039 older Malaysians aged 60 and over. SPSS was used to perform bivariate and multivariate analyses. About one-quarter of older Malaysians are still working, and three-quarters participate in religious activities, but a small proportion is involved in NGO/community activities and regular exercise. Males are more active than females in all these activities. The majority perceived themselves to be in good or moderately good health. Active participation in social, economic, religious, and physical activities was positively associated with health. Given the relatively low level of labour force participation and social activities among older Malaysians, there is a need for intervention strategies to encourage and facilitate the active engagement of older adults to reduce their health problems and increase self-reliance for a better quality of life.

Factors Associated with Contraceptive Use in Malaysia and Pakistan

Most developing countries launched the national family planning program in the 1960s/70s. However, some countries’ contraceptive prevalence rate (CPR) remains low or stagnated. Despite having a similar religious belief, the level of contraceptive use differed between Malaysia and Pakistan. This study examines the factors associated with contraceptive use in Malaysia and Pakistan. This study used secondary data from the 2014 Malaysian Population and Family Survey and the 2017–2018 Pakistan Demographic and Health Survey. A total of 5,175 Malaysian and 14,502 Pakistani currently married women aged 15–49 were included in this study. The dependent variable is current contraceptive use. The independent variables include women’s age, age at first marriage, place of residence, women’s educational level, employment status, and the number of living children. Crosstabulations show that urban, better-educated, and working women in Pakistan reported higher modern CPR than their rural, lesser-educated, and non-working counterparts; however, the opposite was observed in Malaysia. Multinomial logistic regression analysis reveals that rural women were less likely to practice modern and traditional methods than non-use in Pakistan. In Pakistan, the odds of practising modern and traditional methods than non-use were higher among women who attained at least primary education, while working women were more likely to practice modern contraceptive methods than non-use and traditional methods. However, women’s education and employment factors were insignificant in the multivariate context of the case of Malaysia. Enhancing women’s socio-economic status and reaching out to rural, uneducated, and jobless women are essential to improving contraceptive use, especially in Pakistan.

Subjective social status and mental health among adolescents in Ethiopia: Evidence from a panel study

Numerous studies have found that a relationship between subjective status and measures of human health persists even after controlling for objective measures, including income, education, and assets. However, few studies have probed how status shapes health among adolescents, particularly those in low-and-middle-income settings. This study examines the relative effects of subjective and objective status on mental health among Ethiopian adolescents. Using data from two waves of the Jimma Longitudinal Family Survey of Youth (N = 1,045), this study uses a combination of linear regression and linear mixed-effects models to examine the relationships between objective social status, subjective social status, and mental well-being among adolescents in Ethiopia. Three measures of objective status, including household income, adolescent education, and a multidimensional measure of material wealth, were assessed. Social network and support variables were constructed using factor analysis. A community version of the 10-rung McArthur ladder was used to assess the subjective socioeconomic status of adolescents. The self-reporting questionnaire was used to assess mental well-being during both waves of the study. The significant effect of higher subjective status on reports of fewer non-specific psychological distress (−0.28; 95% CI: −0.43 to −0.14) was not mediated by objective status, material deprivation, or social support covariates. The observed relationship between status and mental well-being was consistent across successive study waves. Among a cohort of adolescents in Jimma, Ethiopia, several measures of objective status are associated with subjective status. However, akin to research among adults, the findings of our study suggest that the relationship between adolescent subjective social status and mental health persists above and beyond the effects of objective status. Future research is needed on the factors, environments, and experiences that inform adolescent perceptions of status and well-being over time.

The changing face of intimate premarital relationships in Taiwan

AbstractObjectiveThis paper examines changing intimate premarital relationships in Taiwan.BackgroundMarriages have been on the decline. Whether these foregone marriages are associated with a rise in cohabitation or other alternatives have become central to a thorough understanding of family changes, yet relevant research on Taiwan is limited.MethodsThe Taiwan Fertility and Family Survey collected nationally representative samples of 23,495 men and women aged 20–49 in four waves from 1998 to 2016. These were used to investigate changing patterns of cohabitation, marriage plans among cohabiting couples, premarital sex, and bridal pregnancies in addition to how the patterns vary by sex, education, and cohort.ResultsMore adults in Taiwan have experienced intimate premarital relationships since 1998, with a shift from no educational gradient to a negative one for cohabitation and premarital conception. These patterns were gendered during 2012–2016. With a persistently short duration and fewer adults living together with the idea of eventually getting married, cohabitation has become less of a prelude to marriage than an alternative to singlehood, and very few of these have involved children. These shifting behaviors have been driven mainly by the cohort replacement effect and intra‐cohort changes.ConclusionCohabitation has yet to become a long‐term stable union involving children. A lower birth rate caused by later and fewer marriages has not been offset by nonmarital births in cohabitation, and bridal pregnancies did not seem to have resulted in more marriages. Taiwan's socio‐cultural context likely plays a crucial role in the quasi‐Second Demographic Transition family changes here.