Transitory or Chronic? Gendered Loneliness Trajectories over Widowhood and Separation in Older Age.

We investigate how loneliness develops over the marital dissolution process in older age (i.e., transition at or after age 50) while paying close attention to heterogeneities by the dissolution pathway-widowhood and separation-and gender. Using data from over 8,000 Household, Income and Labour Dynamics in Australia survey respondents, we assess the association of interest using fixed effects regressions. Findings indicate that loneliness increased in the year before widowhood or separation among both women and men. Levels spiked in the year of dissolution, particularly for widowhood but less for separation. Widowed men were substantially more affected than widowed women, and gender differences were negligible for separation. Although loneliness levels gradually declined, widowed men remained vulnerable for remarkably long periods. Such chronic loneliness might be linked to other health disadvantages. These findings highlight the importance of long-term and gender-specific approaches to social support and integration after marital dissolution.

Does Children's Education Improve Parental Health and Longevity? Causal Evidence from Great Britain.

Parents with better-educated children are healthier and live longer, but whether there is a causal effect of children's education on their parents' health and longevity is unclear. First, we demonstrate an association between adults' offspring education and parental mortality in the 1958 British birth cohort study, which remains substantial-about two additional years of life-even when comparing parents with similar socioeconomic status. Second, we use the 1972 educational reform in England and Wales, which increased the minimum school leaving age from 15 to 16 years, to identify the presence of a causal effect of children's education on parental health and longevity using census-linked data from the Office for National Statistics Longitudinal Study. Results reveal that children's education has no causal effects on a wide range of parental mortality and health outcomes. We interpret these findings discussing the role of universal health care and education for socioeconomic inequality in Great Britain.

Inequalities in Retirement Life Span in the United States.

OBJECTIVES: The length of retirement life may be highly unequal due to persistent and significant discrepancies in old-age mortality. This study assesses gender and educational differences in the average retirement life span and the variation in retirement life span, taking into account individual labor force exit and reentry dynamics. METHODS: We used longitudinal data from the Health and Retirement Study from 1996 to 2016, focusing on respondents aged 50 and older (N = 32,228). Multistate life tables were estimated using discrete-time event history models. The average retirement life span, as well as absolute and relative variation in retirement life span, were calculated analytically. RESULTS: Among women, we found a persistent educational gradient in average retirement life span over the whole period studied; among men, the relationship between education and retirement expectancy differed across periods. Women and the lower-educated had higher absolute variation in retirement life span than men and the higher-educated-yet these relationships were reversed when examined by relative variation. DISCUSSION: Our multistate approach provides an accurate and comprehensive picture of the retirement life span of older Americans over the past two decades. Such findings should be considered in high-level discussions on Social Security. Potential reforms such as raising the eligibility age or cutting benefits may have unexpected implications for different social groups due to their differential effects on retirement initiation and reentry dynamics.

Childlessness and Development in Sub-Saharan Africa: Is There Evidence for a U-shaped Pattern?

In high-income countries, women increasingly remain permanently childless. Little is known about the relationship between childlessness and socioeconomic development in non-Western societies and particularly sub-Saharan Africa. At lower levels of development, poverty-driven (i.e., involuntary) childlessness may decrease with increases in levels of development, while at higher levels of development opportunity-driven (i.e., voluntary and circumstantial) childlessness may rise with development. Thus, we expect a U-shaped relationship between childlessness and development overall. We examine this idea for sub-Saharan Africa. We further contribute by differentiating between female and male childlessness; and between involuntary, voluntary and circumstantial childlessness. Moreover, we construct new indicators of subnational historical development to assess both inter- and intra-country variation, and distinguish between three components (health, education and income) to investigate the drivers behind the hypothesized U-shaped relationship. Using 291 Demographic and Health Surveys between 1986 and 2018 from 38 countries and 384 regions, we find a U-shaped relationship between female childlessness and development, and a linear relationship for men. The U-shape for women results from negative associations of female involuntary childlessness with health and educational advancements, combined with positive correlations of voluntary and circumstantial childlessness with education and income improvements. While these positive associations are stronger among men than women, the negative relationships of involuntary childlessness with health and education observed for women are absent for men, resulting in an overall positive and linear relationship between development and childlessness among men. Our findings have implications for how we might expect childlessness rates to evolve with future levels of development. Supplementary Information: The online version contains supplementary material available at 10.1007/s10680-022-09608-5.

Family Size and Parental Wealth: The Role of Family Transfers in Europe.

As baby boomers enter retirement, an increasing portion of the population in Europe will rely on wealth as a source of financial security. We address two research questions: what is the association between family size, i.e. the number of children, and wealth for adults who are preparing for or have entered retirement and does the generosity of family transfers moderate that association? Data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) are used to estimate the relationship between family size and the total household net worth of men and women between ages 50-65, born 1939-1967 from 14 European countries. We use logistic and linear regression modelling to investigate the probability of zero or negative wealth and net worth percentile rank. We find that adults with four or more children are more likely to be in debt and have less wealth than childless adults. In contrast, adults with two and three children have more wealth. We provide evidence that the generosity of family transfers ameliorates the negative association between larger family sizes and wealth, but may exacerbate wealth inequality by benefiting two and three child families most.

Stressful Life Events, Differential Vulnerability, and Depressive Symptoms: Critique and New Evidence.

Depressive symptoms are disproportionately high among women and less educated individuals. One mechanism proposed to explain this is the differential vulnerability hypothesis-that these groups experience particularly strong increases in symptoms in response to stressful life events. We identify limitations to prior work and present evidence from a new approach to life stress research using the UK Household Longitudinal Study. Preliminarily, we replicate prior findings of differential vulnerability in between-individual models. Harnessing repeated measures, however, we show that apparent findings of differential vulnerability by both sex and education are artifacts of confounding. Men and women experience similar average increases in depressive symptoms after stressful life events. One exception is tentative evidence for a stronger association among women for events occurring to others in the household. We term this the "female vulnerability to network events" hypothesis and discuss with reference to Kessler and McLeod's related "cost of caring" hypothesis.

Husbands' Dominance in Decision-Making About Women's Health: A Spatial Diffusion Perspective in Sub-Saharan Africa.

This article maps spatial and temporal variation in husbands' dominance in decision-making about their wives' health using pooled Demographic and Health Surveys from 28 countries in sub-Saharan Africa in an earlier (i.e., 2001-2005) and later (i.e., 2010-2014) period. First, we use adaptive bandwidth kernel density estimation to show how aggregate country-level estimates of husbands' decision-making dominance mask enormous spatial heterogeneity within countries. Our maps also reveal a geographic clustering of cells with similar levels of husband's decision-making dominance both within and between countries. Next, we use panel fixed-effects spatial regression methods to show that decreases in husbands' decision-making dominance in neighboring cells are associated with decreases in husbands' decision-making dominance in the reference cell. These findings support a diffusion explanation for declines in husbands' decision-making dominance over time. Our analyses also indicate that schooling and urbanization may be important channels through which diffusion occurs, which we speculate is because these are places where people are exposed to new ideas and gender norms.

Twin Peaks: more twinning in humans than ever before.

STUDY QUESTION: How many twins are born in human populations and how has this changed over recent decades? SUMMARY ANSWER: Since the 1980s, the global twinning rate has increased by a third, from 9.1 to 12.0 twin deliveries per 1000 deliveries, to about 1.6 million twin pairs each year. WHAT IS KNOWN ALREADY: It was already known that in the 1980s natural twinning rates were low in (East) Asia and South America, at an intermediate level in Europe and North America, and high in many African countries. It was also known that in recent decades, twinning rates have been increasing in the wealthier parts of our world as a result of the rise in medically assisted reproduction (MAR) and delayed childbearing. STUDY DESIGN, SIZE, DURATION: We have brought together all information on national twinning rates available from statistical offices, demographic research institutes, individual survey data and the medical literature for the 1980-1985 and the 2010-2015 periods. PARTICIPANTS/MATERIALS, SETTING, METHODS: For 165 countries, covering over 99% of the global population, we were able to collect or estimate twinning rates for the 2010-2015 period. For 112 countries, we were also able to obtain twinning rates for 1980-1985. MAIN RESULTS AND THE ROLE OF CHANCE: Substantial increases in twinning rates were observed in many countries in Europe, North America and Asia. For 74 out of 112 countries the increase was more than 10%. Africa is still the continent with highest twinning rates, but Europe, North America and Oceania are catching up rapidly. Asia and Africa are currently home to 80% of all twin deliveries in the world. LIMITATIONS, REASONS FOR CAUTION: For some countries, data were derived from reports and papers based on hospital registrations which are less representative for the country as a whole than data based on public administrations and national surveys. WIDER IMPLICATIONS OF THE FINDINGS: The absolute and relative number of twins for the world as a whole is peaking at an unprecedented level. An important reason for this is the tremendous increase in medically assisted reproduction in recent decades. This is highly relevant, as twin deliveries are associated with higher infant and child mortality rates and increased complications for mother and child during pregnancy and during and after delivery. STUDY FUNDING/COMPETING INTEREST(S): The contribution of CM was partially supported by the European Research Council (ERC) under the European Union's Horizon 2020 Research and Innovation Programme (grant No 681546, FAMSIZEMATTERS), Nuffield College, and the Leverhulme Trust. The contribution of GP was partially supported by the French Agence Nationale de la Recherche (grant No ANR-18-CE36-0007-07). The authors declare no conflict of interest. TRIAL REGISTRATION NUMBER: N/A.

Cohort Trends in the Association Between Sibship Size and Educational Attainment in 26 Low-Fertility Countries.

Children with many siblings have lower average educational attainment compared with children raised in smaller families, and this disadvantage by sibship size has been observed across many countries. We still know remarkably little, however, about how sibship size disadvantage has changed within countries and how such trends vary across countries. Using comparative data from 111 surveys from 26 low-fertility countries, we find an overall trend of growing sibship size disadvantage across cohorts in the majority of countries: between the 1931-1940 birth cohort and the 1971-1980 birth cohort, 16 of 26 countries showed a statistically significant increase in sibship size disadvantage in education, while only two countries showed a significant reduction in sibship size disadvantage. The disadvantage in years of education associated with having an additional sibling increased remarkably in post-socialist (0.3) and East Asian countries (0.34) and, to a lesser extent, Western European countries (0.2). In contrast, this disadvantage showed little change in Nordic countries (0.05) and even decreased in Anglo-Saxon countries (-0.11). We discuss explanations and implications of our comparative evidence in the context of the intergenerational transmission of education.

When does family size matter? Sibship size, socioeconomic status and education in England.

There is still no clear understanding of the relationship between sibship size and child outcomes. Research from across disciplines, and across settings, reports conflicting results suggesting that the relationship is complex and ecologically dependent. Evolutionary models predict that parents will make reproductive decisions based on their ability to invest in each child, but that this is not necessarily equal across children. Here we use data from the Next Steps study linked to National Pupil Database to examine the relationship between sibship size and Key Stage 4 (GCSE) maths and English grades in England for children born in 1989/1990. We were interested to further examine if and how associations might differ at the ends of the socioeconomic spectrum and we also tested if direct measures of parental investment could mitigate any negative impact of larger families. Multilevel ordinary least squares regression models with a random effect for school show that sibship sizes are associated with school grades, as is socioeconomic status. Moreover, the association between sibship size and grades holds true across the socioeconomic spectrum. Birth order was only weakly associated with school results, and only significant in some models. Parental investment is important, however, and might offset the some of the negative impact of larger families, for both maths and English attainment.

The Causal Effect of Maternal Education on Child Mortality: Evidence From a Quasi-Experiment in Malawi and Uganda.

Since the 1980s, the demographic literature has suggested that maternal schooling plays a key role in determining children's chances of survival in low- and middle-income countries; however, few studies have successfully identified a causal relationship between maternal education and under-5 mortality. To identify such a causal effect, we exploited exogenous variation in maternal education induced by schooling reforms introducing universal primary education in the second half of the 1990s in Malawi and Uganda. Using a two-stage residual inclusion approach and combining individual-level data from Demographic and Health Surveys with district-level data on the intensity of the reform, we tested whether increased maternal schooling reduced children's probability of dying before age 5. In Malawi, for each additional year of maternal education, children have a 10 % lower probability of dying; in Uganda, the odds of dying for children of women with one additional year of education are 16.6 % lower. We also explored which pathways might explain this effect of maternal education. The estimates suggest that financial barriers to medical care, attitudes toward modern health services, and rejection of domestic violence may play a role. Moreover, being more educated seems to confer enhanced proximity to a health facility and knowledge about the transmission of AIDS in Malawi, and wealth and improved personal illness control in Uganda.

Psychiatric morbidity and subsequent divorce: a couple-level register-based study in Finland.

PURPOSE: Studies that assess the role of mental health for the risk of divorce are scarce and mostly rely on individual-level data, although divorce is a couple-level phenomenon. Using data on couples, we examine the effects of both spouses' psychiatric morbidity on the risk of divorce, and whether socio-demographic factors affect these associations. METHODS: We followed 96,222 Finnish married couples for 6 years using register-based data on both spouses and their household. New incidence of psychiatric morbidity and subsequent divorce was identified from dates of prescription medication purchases and hospital admissions, and dates of registered divorce. Socio-demographic factors were measured annually for both spouses and their household. The effect of incident psychiatric morbidity on divorce risk was analyzed using Cox regression. RESULTS: Psychiatric morbidity in men increased the age-adjusted risk of divorce more than twofold and in women nearly twofold. The risk of divorce was particularly pronounced immediately after new incidence of psychiatric morbidity, before settling to a persistently high level. Psychiatric morbidity in both spouses increased the risk of divorce almost threefold. Adjustment for socio-economic factors had little effect on these associations. CONCLUSIONS: Psychiatric morbidity is a persistent risk factor of divorce. The risk is larger when both spouses experience psychiatric morbidity compared to only one spouse. The findings are consistent with the idea that poor relationship quality and dissatisfaction in couples suffering from mental health problems have long-term consequences for marital stability. Treatment of psychiatric morbidity should not focus only on the individual but on couple-level dynamics.

Disability pathways preceding death in England by socio-economic status.

The role of socio-economic status (SES) in the last years of life is an under-researched aspect of health inequalities. This study examines disability patterns preceding death using data from the English Longitudinal Study of Ageing. We use repeated measures latent class analysis to identify the most common pathways preceding death in terms of walking ability and limitations in activities of daily living. Three pathways emerge: one characterized by consistently low disability; a second by a constant high level of functional limitations; and a third by medium impairment. We examine how different SES indicators predict belonging to each disability pathway. Conditional on income, higher wealth is associated with a lower likelihood of belonging to the high disability pathway. Contrary to our expectations, we find no educational gradient in the pathways preceding death. Health inequalities in the last years of life seem to exist especially between individuals with different levels of wealth.

Mortality among twins and singletons in sub-Saharan Africa between 1995 and 2014: a pooled analysis of data from 90 Demographic and Health Surveys in 30 countries.

BACKGROUND: Sub-Saharan Africa has the world's highest under-5 and neonatal mortality rates as well as the highest naturally occurring twin rates. Twin pregnancies carry high risk for children and mothers. Under-5 mortality has declined in sub-Saharan Africa over the last decades. It is unknown whether twins have shared in this reduction. METHODS: We pooled data from 90 Demographic and Health Surveys for 30 sub-Saharan Africa countries on births reported between 1995 and 2014. We used information on 1 685 110 singleton and 56 597 twin livebirths to compute trends in mortality rates for singletons and twins. We examined whether the twin-singleton rate ratio can be attributed to biological, socioeconomic, care-related factors, or birth size, and estimated the mortality burden among sub-Saharan African twins. FINDINGS: Under-5 mortality among twins has declined from 327·7 (95% CI 312·0-343·5) per 1000 livebirths in 1995-2001 to 213·0 (196·7-229·2) in 2009-14. This decline of 35·0% was much less steep than the 50·6% reduction among singletons (from 128·6 [95% CI 126·4-130·8] per 1000 livebirths in 1995-2001 to 63·5 [61·6-65·3] in 2009-14). Twins account for an increasing share of under-5 deaths in sub-Saharan Africa: currently 10·7% of under-5 mortality and 15·1% of neonatal mortality. We estimated that about 315 000 twins (uncertainty interval 289 000-343 000) die in sub-Saharan African each year. Excess twin mortality cannot be explained by common risk factors for under-5 mortality, including birthweight. The difference with singletons was especially stark for neonatal mortality (rate ratio 5·0, 95% CI 4·5-5·6). 51·7% of women pregnant with twins reported receiving medical assistance at birth. INTERPRETATION: The fate of twins in sub-Saharan Africa is lagging behind that of singletons. An alarming one-fifth of twins in the region dies before age 5 years, three times the mortality rate among singletons. Twins account for a substantial and growing share of under-5 and neonatal mortality, but they are largely neglected in the literature. Coordinated action is required to improve the situation of this extremely vulnerable group. FUNDING: None.

Divorce and subsequent increase in uptake of antidepressant medication: a Finnish registry-based study on couple versus individual effects.

BACKGROUND: There is an average negative mental health effect for individuals who experience divorce. Little is known whether the pattern of such divorce effects varies within couples. We study whether the husband and wife experience similar harmful effects of divorce, whether they experience opposite effects, or whether divorce effects are purely individual. METHODS: We use Finnish registry data to compare changes over a period of 5 years in antidepressant use of husbands and wives from 4,558 divorcing couples to 108,637 continuously married pairs aged 40-64, all of whom were healthy at baseline. RESULTS: In the period three years before and after divorce antidepressant use increases substantially. However, the likelihood of uptake of antidepressant medication during this process of divorce by one partner appears to be independent of medication uptake in the other partner. In contrast, among continuously married couples there is a clear pattern of convergence: If one partner starts to use antidepressants this increases the likelihood of uptake of antidepressant medication in the other partner. CONCLUSIONS: Our findings suggest that divorce effects on antidepressant use are individual and show no pattern of either convergence or divergence at the level of the couple. The increased incidence of antidepressant use associated with divorce occurs in individuals independent of what happens to their ex-partner.

The importance of father's and own education for self-assessed health across Europe: an East-West divide?

How are one's own education, father's education, and especially the combination of the two, related to self-assessed health across European societies? In this study, we test hypotheses about differences in self-assessed health between 16 post-socialist countries in Central and Eastern Europe and 17 Western European countries. We find substantial cross-national variation in the (relative) importance of own and father's education for self-assessed health. Over 65 per cent of this cross-national variation is accounted for by the East-West divide. This simple dichotomy explains cross-national differences better than gross domestic product or income inequality. An individual's father's education is more important, both in absolute and relative terms, for self-assessed heath in Eastern Europe than in Western Europe. Intergenerational mobility moderates the relative effects of one's own and one's father's education. In Eastern Europe the relative importance of one's father's education is greater than it is in Western Europe--particularly for those who are downwardly mobile and have a father with tertiary education. The results are sometimes contradictory to initial expectations; the theoretical implications are discussed.

Maternal education is associated with reduced female disadvantages in under-five mortality in sub-Saharan Africa and southern Asia.

BACKGROUND: The male:female (M:F) mortality ratio for under-five mortality varies considerably across and within societies. Maternal education has been linked to better outcomes for girls, but the evidence is mixed. We examined how the M:F ratio for under-five mortality varies by maternal education in sub-Saharan Africa and southern Asia. METHODS: We used recent Demographic and Health Surveys from 31 sub-Saharan African and 4 southern Asian countries. M:F mortality ratios were determined using information on 49 769 deaths among 521 551 children. We estimate M:F ratios for under-five (month 0-59), neonatal (month 0), post-neonatal (month 1-11) and child mortality (month 12-59) by maternal education while controlling for demographic and household characteristics. M:F ratios for under-five mortality and child mortality are compared with more 'gender neutral' thresholds (of 1.25 and 1.17, respectively) estimated on the basis of the Human Mortality Database. RESULTS: In sub-Saharan Africa, the M:F ratio for under-five mortality is 1.09 [95% confidence interval (CI) 1.06-1.13] among non-educated mothers, 1.14 (95% CI 1.09-1.19) among mothers with some primary education and 1.25 (95% CI 1.16-1.34) among mothers with some secondary or more education. For southern Asia, the ratios are 0.88 (95% CI 0.82-0.95), 1.10 (95% CI 0.97-1.25) and 1.13 (95% CI 1.02-1.26), respectively. The M:F ratio for child mortality also shows an educational gradient in both regions, with the M:F ratio being lower among non-educated mothers. In southern Asia, the M:F ratio for child mortality is particularly low among mothers with no education, M:F ratio = 0.54 (95% CI 0.41-0.72). CONCLUSIONS: Among mothers with more education, the difference in the mortality chances of boys and girls more closely resembles a 'gender neutral' situation than among women with no or little education. Girls benefit both in absolute and relative terms from having a more educated mother.

Taller Indian women are more successful at the marriage market.

OBJECTIVES: Whereas being tall has consistently been found a favorable characteristic at the marriage market for men, much less is known about the association between stature and marital success among women. Taller women are healthier than shorter women, give birth more easily and their offspring are healthier. We therefore would expect them to be more successful at the marriage market. However, existing evidence is mixed. We study the association between women's height and the odds of being married, marrying young, experiencing a divorce, and becoming widowed, and the association between women's height and their husbands' educational attainment and occupational status. METHODS: Data come from the Indian National Family Health Survey 2005-2006, a representative study among 124,385 women and 74,369 men in all Indian states. Effects of female height on being married, marrying young, divorce, widowhood, and husband's occupation were estimated using logistic regression models. Effects of female height on husband's education were estimated using OLS regression models. Woman's education and age were always taken into account. Where possible controls for husband's height, husband's education, and age at marriage were included. RESULTS: Positive effects of women's height on favorable marital outcomes were found. Taller than average women are more likely to marry, get higher educated husbands with better jobs and are less likely to marry at a very young age or to lose their husbands through divorce or premature death. CONCLUSIONS: Taller Indian women seem to be more successful at the marriage market.

Twinning across the Developing World.

BACKGROUND: Until now, little was known about the variation in incidence of twin births across developing countries, because national representative data was lacking. This study provides the first comprehensive overview of national twinning rates across the developing world on the basis of reliable survey data. METHODS: Data on incidence of twinning was extracted from birth histories of women aged 15-49 interviewed in 150 Demographic and Health Surveys, held between 1987 and 2010 in 75 low and middle income countries. During the interview, information on all live births experienced by the women was recorded, including whether it was a singleton or multiple birth. Information was available for 2.47 million births experienced by 1.38 million women in a period of ten years before the interview. Twinning incidence was measured as the number of twin births per thousand births. Data for China were computed on the basis of published figures from the 1990 census. Both natural and age-standardized twinning rates are presented. RESULTS/CONCLUSIONS: The very low natural twinning rates of 6-9 per thousand births previously observed in some East Asian countries turn out to be the dominant pattern in the whole South and South-East Asian region. Very high twinning rates of above 18 per thousand are not restricted to Nigeria (until now seen as the world's twinning champion) but found in most Central-African countries. Twinning rates in Latin America turn out to be as low as those in Asia. Changes over time are small and not in a specific direction. SIGNIFICANCE: We provide the most complete and comparable overview of twinning rates across the developing world currently possible.

Do Measured and Unmeasured Family Factors Bias the Association Between Education and Self-Assessed Health?

The association between educational attainment and self-assessed health is well established but the mechanisms that explain this association are not fully understood yet. It is likely that part of the association is spurious because (genetic and non-genetic) characteristics of a person's family of origin simultaneously affect one's educational attainment and one's adult health. In order to obtain an unbiased estimate of the association between education and health, we have to control for all relevant family factors. In practice, however, it is impossible to measure all relevant family factors. Sibling models are particularly appropriate in this case, because they control for the total impact of family factors, even if not all relevant aspects can be measured. I use data on siblings from a US study (MIDUS) and Dutch study (NKPS) to assess the total family impact on self-assessed health and, more importantly, to assess whether there is a family bias in the association between educational attainment and self-assessed health. The results suggest that there is a substantial family effect; about 20% of the variation in self-assessed health between siblings can be ascribed to (measured and unmeasured) family factors. Measured family factors, such as parental education and father's occupation, could account only for a small part of the family effect. Furthermore, the results imply that it is unlikely that there is substantial bias due to family effects in the association between education and self-assessed health. This strengthens the conclusions from prior studies on the association between education and self-assessed health.