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Sequencing of Births by Wantedness: Implications for Changes in Mid-Life Health Among Aging NLSY79 Women
Abstract
Objectives:
As life course frameworks highlight and gerontological studies confirm, the health implications of early birth timing (e.g., adolescent births) and unplanned births (e.g., unwanted or mistimed births) extend years after those births into mid- and later-life. Yet past research often overlooks the considerable diversity in sequencing and timing of unplanned births even within the same individual (e.g., having both wanted and unwanted births), which are likely fundamental for women's long-term health trajectories. We develop a holistic understanding of birth timing and wantedness to provide insight into when and how childbearing histories matter for aging women's health.
Methods:
We use Sequence Analysis (SA) with hierarchical cluster method and estimate regression models using the 1979 National Longitudinal Survey of Youth (NLSY79; N=3,231) to examine how timing and patterning of births by wantedness (e.g., mistimed, unwanted) are associated with changes in physical and mental health from ages 40 to 50.
Results:
We identify seven clusters of childbearing sequences. Of those seven clusters, respondents with sequences characterized by wanted births in their 20s and 30s had the smallest declines in health in mid-life, whereas respondents with sequences with mainly unwanted births at any age or with mainly mistimed births beginning in adolescence had the greatest health declines. Adjusting for social and economic variables accounted for some, but not all, health differences across childbearing clusters.
Discussion:
This project demonstrates the need for comprehensive life course perspectives on long-term health implications of birth wantedness and timing, recognizing diversity within and between individuals.
... Additionally, union mandated leave plans may provide mothers with supplemental income or paid leave that doesn't require them to exhaust their accrued vacation/sick leave time (Gerstel and Clawson 2001). Having access to robust benefits may help to buffer some of the negative effects that certain childbearing characteristics have on midlife health (Thomeer, Reczek, Ross and Bijou 2023). ...
Workers in labor unions have better access to high-quality health insurance plans, better pensions, and higher wages leading to increased lifetime earnings likely leading to better health. Additionally, much of the gendered hiring, promotion, and wage discrimination faced by women in the workplace is dependent on social characteristics (marital status and/or their status as a mother). While many of the benefits associated with union membership can potentially buffer the gendered workplace inequalities that lead to poorer health outcomes, unions have been largely ignored in health disparities literature. Using 28 waves of data ( N = 3,409) from The National Longitudinal Survey of Youth 1979, this study creates a lifetime “union tenure” variable, tests its relationship to midlife physical and mental health, and tests ways in which motherhood and marital status may moderate this relationship. Findings suggest that long-term union membership is associated with better physical health among mothers but does not have a significant benefit for women without children. Further, in fully controlled models, this relationship is not dependent on marital status and both married and unmarried mothers see a union tenure health benefit. This study provides insight into how union membership may play a role in improving the midlife health of working mothers.
Objectives
Childbearing histories—for example, parity and age at first birth—matter for the health outcomes of mid- and later-life women. There is growing evidence that childbearing may shape cognitive outcomes. However, previous research is not definitive due to its inability to account for selection. Selection is critical to address given that multiple factors, including socioeconomic background and cognition in adolescence, place women at risk for both specific childbearing experiences and poor cognitive functioning.
Methods
We analyze the 1979 National Longitudinal Survey of Youth (NLSY79; N = 3,668), a longitudinal nationally representative data set from the United States that began collecting data during respondents’ late teens and early 20s. We estimate the average treatment effects of childbearing histories on midlife memory and cognition using propensity-score matching techniques that incorporate an expansive set of early life factors.
Results
In models adjusting for early life covariates, we find that any births, high parity, and early first birth are associated with worse self-reported memory, but not cognitive functioning scores. After addressing the influence of early life factors through matching techniques, the only robust differences relate to any births and early first births with self-reported memory.
Discussion
Selection into specific childbearing experiences partially drives the link between childbearing and cognition at midlife, with cascading implications into later life. We suggest incorporating childbearing and early life factors into models to identify social determinants of memory and cognitive functioning.
We test whether the negative association between socially “early” childbearing and women's health in later adulthood, well-established in prior research, differs across distinct historical contexts in the U.S.We further examine whether socioeconomic status explains this shift in the impact of childbearing timing and poor health and whether there are additional differences across racial groups. To address these questions, we pooled data from two nationally representative longitudinal surveys: the National Longitudinal Surveys’ Mature Women (born 1922–1937) and Youth 1979 (born 1957–1964). Together, these NLS cohorts include women who entered adolescence before and after the major economic, political, and demographic changes in the latter half of the twentieth century that gave women access to socioeconomic structures previously limited to White men. These data thus provide a unique opportunity to test cohort and racial differences. Overall, findings suggest that the negative association of young childbearing, which included adolescent childbearing and childbearing in early 20s, with midlife health grew across the two cohorts, with this largely explained by differences in adult educational attainment. This cohort shift appeared especially large for White women compared to Black women. This study highlights the importance of sociopolitical context in shaping the health consequences of major life events like childbearing.
Importance: Unintended pregnancy is common in the US and is associated with adverse maternal and infant health outcomes; however, estimates of these associations specific to current US populations are lacking.
Objective: To evaluate associations of unintended pregnancy with maternal and infant health outcomes during pregnancy and post partum with studies relevant to current clinical practice and public health in the US.
Data sources: Cochrane Central Register of Controlled Trials and Database of Systematic Reviews, PsycINFO, SocINDEX, and MEDLINE databases (January 1, 2000, to June 15, 2022) and manual review of reference lists.
Study selection: Epidemiologic studies relevant to US populations that compared key maternal and infant health outcomes for unintended vs intended pregnancies and met prespecified eligibility criteria were included after investigators' independent dual review of abstracts and full-text articles.
Data extraction and synthesis: Investigators abstracted data from publications on study methods, participant characteristics, settings, pregnancy intention, comparators, confounders, and outcomes; data were validated by a second investigator. Risk of bias was independently dual rated by investigators using criteria developed by the US Preventive Services Task Force. Results of studies controlling for confounders were combined by using a profile likelihood random-effects model.
Main outcomes and measures: Prenatal depression, postpartum depression, maternal experience of interpersonal violence, preterm birth, and infant low birth weight.
Results: Thirty-six studies (N = 524 522 participants) were included (14 cohort studies rated good or fair quality; 22 cross-sectional studies); 12 studies used large population-based data sources. Compared with intended pregnancy, unintended pregnancy was significantly associated with higher odds of depression during pregnancy (23.3% vs 13.9%; adjusted odds ratio [aOR], 1.59 [95% CI, 1.35-1.92]; I2 = 85.0%; 15 studies [n = 41 054]) and post partum (15.7% vs 9.6%; aOR, 1.51 [95% CI, 1.40-1.70]; I2 = 7.1%; 10 studies [n = 82 673]), interpersonal violence (14.6% vs 5.5%; aOR, 2.22 [95% CI, 1.41-2.91]; I2 = 64.1%; 5 studies [n = 42 306]), preterm birth (9.4% vs 7.7%; aOR, 1.21 [95% CI, 1.12-1.31]; I2 = 1.7%; 10 studies [n = 94 351]), and infant low birth weight (7.3% vs 5.2%; aOR, 1.09 [95% CI, 1.02-1.21]; I2 = 0.0%; 8 studies [n = 87 547]). Results were similar in sensitivity analyses based on controlling for history of depression for prenatal and postpartum depression and on study design and definition of unintended pregnancy for relevant outcomes. Studies provided limited sociodemographic data and measurement of confounders and outcomes varied.
Conclusions and relevance: In this systematic review and meta-analysis of epidemiologic observational studies relevant to US populations, unintended pregnancy, compared with intended pregnancy, was significantly associated with adverse maternal and infant outcomes.
Trial registration: PROSPERO Identifier: CRD42020192981.
This study examined the associations between childbirth decisions in women with unintended pregnancies and long-term psychological distress. An online survey of women selected from a representative research panel was conducted in July 2021. Among participants who experienced an unintended pregnancy, the childbirth decision was categorized: (i) wanted birth, (ii) abortion, (iii) adoption, and (iv) unwanted birth. Participants who made childbirth decisions more than 1 year ago were included. ANCOVA was conducted with psychological distress (Kessler 6) as the dependent variable and education, marital status, years from the decision, age of the first pregnancy, economic situation at the unintended pregnancy, and the number of persons consulted at the unintended pregnancy as covariates. Logistic regression analysis was conducted for high distress (K6 ≥ 13) by adjusting the same covariates. A total of 47,401 respondents participated in the study. Women with an experience of unintended pregnancy experienced more than 1 year before the study were analyzed (n = 7162). Psychological distress was the lowest for wanted birth and increased for abortion, adoption, and unwanted birth. In the adjusted model, abortion was associated with lower distress scores than both adoption and unwanted birth. Compared to the wanted birth, adoption and unwanted birth showed significantly higher levels of distress (adjusted odds ratio [aOR] = 2.03 [95% CI 1.36–3.04], aOR = 1.64 [95% CI 1.04–2.58], respectively). Long-term effects on psychological distress differed according to the childbirth decisions in unintended pregnancy. Healthcare professionals should be aware of this hidden effect of unintended pregnancy experience on women’s mental health.
This article marks the occasion of Social Science Research's 50th anniversary by reflecting on the progress of sequence analysis (SA) since its introduction into the social sciences four decades ago, with focuses on the developments of SA thus far in the social sciences and on its potential future directions.
The application of SA in the social sciences, especially in life course research, has mushroomed in the last decade and a half. Using a life course analogy, we examined the birth of SA in the social sciences and its childhood (the first wave), its adolescence and young adulthood (the second wave), and its future mature adulthood in the paper.
The paper provides a summary of (1) the important SA research and the historical contexts in which SA was developed by Andrew Abbott, (2) a thorough review of the many methodological developments in visualization, complexity measures, dissimilarity measures, group analysis of dissimilarities, cluster analysis of dissimilarities, multidomain/multichannel SA, dyadic/polyadic SA, Markov chain SA, sequence life course analysis, sequence network analysis, SA in other social science research, and software for SA, and (3) reflections on some future directions of SA including how SA can benefit and inform theory-making in the social sciences, the methods currently being developed, and some remaining challenges facing SA for which we do not yet have any solutions. It is our hope that the reader will take up the challenges and help us improve and grow SA into maturity.
Objectives
I work from a gendered life course perspective to examine the association between older parents’ fertility history (i.e., timing and parity) and their risk of cognitive impairment in the United States.
Method
I analyze nationally representative data from 9 waves over 16 years of the Health and Retirement Study (2000–2016). The sample includes 14,543 respondents (6,108 men and 8,435 women) aged 50 and older at the baseline survey. I examine the relationship between parity, age at first birth, and age at last birth with risk of cognitive impairment using non-linear discrete-time hazard models.
Results
Adjusting for the effects of full covariates, there are U-shaped relationships between women’s age at last birth and risk of cognitive impairment, and between women’s parity and risk of cognitive impairment. In the sensitivity tests, the relationships remain robust when sampling weights are applied, or mortality selection is corrected.
Discussion
Fertility timing and parity are likely factors associated with the risk of cognitive impairment for older women. Understanding fertility history and its impact on cognition can help identify the most vulnerable subpopulations so that more effective interventions can be made to improve cognitive functioning among older adults.
Due to increasing heterogeneity in if, when, and under what conditions women have children, the timing, spacing, and other demographic aspects of childbearing have drastically changed in the US over the past century. Existing science tends to examine demographic aspects of childbearing separately, creating an incomplete understanding of how childbearing patterns are distributed at the population level. In this research brief, we develop the concept of childbearing biographies to emphasize that multiple childbearing characteristics cluster together. We analyze nationally representative US data from the 1979 National Longitudinal Survey of Youth (NLSY79; N = 4052). Using eight childbearing variables (e.g., age at first birth, number of children, whether unmarried at any birth), we use Mixed-Mode Latent Class Analysis (MM-LCA) and identify five classes, or childbearing biographies: (1) early compressed childbearing, (2) staggered childbearing, (3) extended high-parity childbearing, (4) later childbearing, and (5) married planned childbearing. A childbearing biography approach highlights the increasingly heterogeneous contexts of parenthood today, showing how women with similar characteristics around one aspect of childbearing (e.g., early age at first birth) can also be highly divergent from each other when taking into consideration other childbearing characteristics. In showing this complexity, we highlight that a childbearing biography approach has the potential to shed new light on widening inequality among contemporary midlife women, with implications for aging and population health and well-being.
The Average Silhouette Width (ASW) is a popular cluster validation index to estimate the number of clusters. The question whether it also is suitable as a general objective function to be optimized for finding a clustering is addressed. Two algorithms (the standard version OSil and a fast version FOSil) are proposed, and they are compared with existing clustering methods in an extensive simulation study covering known and unknown numbers of clusters. Real data sets are analysed, partly exploring the use of the new methods with non-Euclidean distances. The ASW will be shown to satisfy some axioms that have been proposed for cluster quality functions. The new methods prove useful and sensible in many cases, but some weaknesses are also highlighted. These also concern the use of the ASW for estimating the number of clusters together with other methods, which is of general interest due to the popularity of the ASW for this task.
Objectives
The Pregnancy Risk Assessment Monitoring System (PRAMS), conducted by the Centers for Disease Control and Prevention in collaboration with state health departments, is the largest state-level surveillance system that includes a question on the intention status of pregnancies leading to live birth. In 2012, the question was changed to include an additional response option describing uncertainty before the pregnancy about the desire for pregnancy. This analysis investigated how this additional response option affected women’s responses.
Methods
We used the change in the pregnancy intention question in 2012 as a natural experiment, taking advantage of relatively stable distributions of pregnancy intentions during short periods of time in states. Using PRAMS data from 2009-2014 (N = 222 781), we used a regression discontinuity-in-time design to test for differences in the proportion of women choosing each response option in the periods before and after the question change.
Results
During 2012-2014, 13%-15% of women chose the new response option, “I wasn’t sure what I wanted.” The addition of the new response option substantially affected distributions of pregnancy intentions, drawing responses away from all answer choices except “I wanted to be pregnant then.” Effects were not uniform across age, parity, or race/ethnicity or across states.
Conclusions
These effects could influence estimated levels and trends of the proportion of births that are characterized as intended, mistimed, or unwanted, as well as estimates of differences between demographic groups. These findings will help to inform new strategies for measuring pregnancy and childbearing desires among women.
Understanding social aspects of parental well‐being is vital because parents' welfare has implications not only for the parents themselves but also for child development, fertility, and the overall health of a society. This article provides a critical review of scholarship on parenthood and well‐being in advanced economies published from 2010 to 2019. It focuses on the role of social, economic, cultural, and institutional contexts of parenting in influencing adult well‐being. The authors identify major themes, achievements, and challenges and organize the review around the demands‐rewards perspective and two other theoretical frameworks: the stress process model and the life course perspective. The analysis shows that rising economic insecurities and inequalities and a diffusion of intensive parenting ideology were major social contexts of parenting in the 2010s. Scholarship linking parenting contexts and parental well‐being illuminated how stressors related to providing and caring for children could unjustly burden some parents, especially mothers, those with fewer socioeconomic resources, and those with marginalized statuses. In that vein, researchers continued to emphasize how stressors diverged by parents' socioeconomic status, gender, and partnership status, with new attention to strains experienced by racial/ethnic minority, immigrant, and sexual minority parents. Scholars' comparisons of parents' positions in various countries expanded, enhancing knowledge regarding specific policy supports that allow parents to thrive. Articulating future research within a stress process model framework, the authors show vibrant theoretical pathways, including conceptualizing potential parental social supports at multiple levels, attending to the intersection of multiple social locations of parents, and renewing attention to local contextual factors and parenting life stages.
BACKGROUND
A long-standing and still unresolved debate has developed on whether the historical fertility transition was caused by ‘spacing’ (increasing the time between births) or by stopping (terminating childbearing at younger ages). Moreover, there is little consensus about the relative importance of gender relations in effecting reproductive change.
OBJECTIVE
First, we wish to shed new light on the stopping versus spacing debate by applying a sequence analysis approach, allowing us to describe changes in complete childbearing trajectories. Second, we want to understand the association between gender relations, among other factors, and reproductive trajectories during the historical fertility decline.
METHODS
We use longitudinal data from GENLIAS, a dataset constructed from linked civil registers of the province of Zeeland, the Netherlands, covering the period 1811‒1911. We employ cluster and sequence analysis to identify different types of childbearing trajectories and logistic regression to estimate their correlates.
RESULTS
We identified five often-experienced trajectories: two high-fertility traditional trajectories (differing in the length of the reproductive phase), a ‘Stoppers’ trajectory, a ‘Late Starters’ trajectory, and an ‘Almost Childless’ trajectory. Our results show that stopping was the way through which couples controlled their fertility during the early
phase of the historical fertility transition in Zeeland, the Netherlands. Although couples with more egalitarian relationships had a higher likelihood to follow a Stoppers trajectory rather than the highest-fertility trajectory, stopping was most clearly linked to birth cohort and social class.
CONTRIBUTION
Our paper extends the literature on the process of the historical fertility decline and its determinants via a detailed empirical examination of childbearing trajectories and the conditions under which these trajectories took place. With our sequence analysis
approach we add both substantively and methodologically to long-standing debates.
Importance
Over the past 2 decades, there has been a trend toward increasing maternal age in many high-income countries. Maternal age may lead to greater attendant morbidity and mortality for Canadian mothers.
Objective
To investigate the association of maternal age, adjusting for patient-level and hospital-level factors, with severe maternal morbidity (SMM) and maternal death in Canada.
Design, Setting, and Participants
A nationwide population-based cohort study of all antepartum, peripartum, and postpartum women and adolescents seen at Canadian acute care hospitals from April 1, 2004, to March 31, 2015. All analyses were completed on September 13, 2018.
Exposures
Maternal age at the index delivery.
Main Outcomes and Measures
Severe maternal morbidity and maternal death during pregnancy and within 6 weeks after termination of pregnancy.
Results
During the study period, there were 3 162 303 new pregnancies (mean [SD] maternal age, 29.5 [5.6] years) and 3 533 259 related hospital admissions. There were 54 219 episodes of SMM (17.7 cases per 1000 deliveries) in the entire study period, with a 9.8% relative increase from 2004-2005 to 2014-2015, in addition to an increasing proportion of pregnancies to older mothers. Independent patient-level factors associated with SMM included increasing Maternal Comorbidity Index; maternal age 19 years or younger and 30 years or older, with the greatest risk experienced by women 45 years or older (odds ratio [OR], 2.69; 95% CI, 2.34-3.06 compared with maternal age 20-24 years); and lowest income quintile (OR, 1.19; 95% CI, 1.14-1.22 compared with highest income quintile). Hospital-level factors associated with SMM included specific provinces. Independent patient-level factors associated with maternal mortality included increasing Maternal Comorbidity Index, age 40 to 44 years (OR, 3.39; 95% CI, 1.68-6.82 compared with age 20-24 years), age 45 years or older (OR, 4.39; 95% CI, 1.01-19.10 compared with age 20-24 years), and lowest income quintile (OR, 4.14; 95% CI, 2.03-8.50 compared with highest income quintile). Hospital-level factors associated with maternal mortality included lowest hospital pregnancy volume.
Conclusions and Relevance
In Canada, maternal age and SMM have increased over the past decade. Results of this study suggest that province of residence, maternal comorbidity, residence income quintile, and extremes of maternal age, especially those 45 years or older, were associated with SMM and mortality. These findings are relevant to prospective parents, their health care team, and public health planning.
In this article, we show that social science research on fertility and infertility consists of largely separate research traditions, despite shared interest in pregnancies and births (or lack thereof). We describe four ways these two traditions differ: (1) publication trajectories and outlets, (2) fields of study and major theoretical frameworks, (3) degree of attention to the other topic, and (4) language and definitions used. We then discuss why future integration of these bodies of research would be beneficial, outline potential steps toward rapprochement, and provide common areas of dialogue that could facilitate and enrich these bodies of research. We offer a more holistic framework using the reproductive career as an extension of existing lifecourse approaches in both fertility and infertility research. We conclude with a brief empirical example and discussion of methodological issues for measuring and modeling reproductive careers.
The United States has a surprisingly high rate of unintended fertility, particularly among women of color. Although studies have examined socioeconomic correlates of unintended fertility, the role of economic resources remains unclear. Wealth may provide an important context for whether a birth was intended or unintended. Moreover, staggering racial wealth disparities may contribute to racial/ethnic patterns of unintended childbearing. This study examines the linkages between wealth and unintended first births, drawing on data from the NLSY79 (N = 1508). Results suggest that net wealth is negatively related to the probability of having an unintended first birth, controlling for a host of sociodemographic characteristics. We also use decomposition analysis to quantify wealth’s contribution to racial/ethnic disparities in unintended childbearing. Second only to marital status, differences in net wealth account for 9–17% of racial/ethnic disparities in unintended childbearing. Our results suggest that wealth is a significant and heretofore overlooked correlate of unintended childbearing.
The last fifty years of women's social and economic progress have been lauded as the "grand gender convergence," the "second demographic transition," and the "rise of women"-terms pointing to the remarkable transformation in women's social and economic roles since the 1960s. Many metrics document these changes.
Methods: We analysed associations between number of children (parity) and timing of births with level and change in cognition among 11,233 men and women aged 50+ in England using latent growth curve models. Models were adjusted for age, socioeconomic position, health, depressive symptoms, control, social contacts, activities and isolation.
Results: Low (0-1 child) and high parity (3+ children) compared to medium parity (2 children) were associated with poorer cognitive functioning, as was an early age at entry to parenthood (35) was associated with better cognitive function.
Conclusion: Associations between fertility history and cognition were to large extent accounted for socioeconomic position, partly because this influenced health and social engagement. Poorer cognition in childless people and better cognition among mothers experiencing child birth at higher ages suggest factors related to childbearing/rearing that are beneficial for later cognitive functioning, although further research into possible earlier selection factors is needed.
Despite decades of research on unintended pregnancies, we know little about the health implications for the women who experience them. Moreover, no study has examined the implications for women whose pregnancies occurred before Roe v. Wade was decided-nor whether the mental health consequences of these unintended pregnancies continue into later life. Using the Wisconsin Longitudinal Study, a 60-year ongoing survey, we examined associations between unwanted and mistimed pregnancies and mental health in later life, controlling for factors such as early life socioeconomic conditions, adolescent IQ, and personality. We found that in this cohort of mostly married and White women, who completed their pregnancies before the legalization of abortion, unwanted pregnancies were strongly associated with poorer mental health outcomes in later life. (Am J Public Health. Published online ahead of print December 21, 2015: e1-e9. doi:10.2105/AJPH.2015.302973).
We study the causal impact of teenage motherhood on late-life health outcomes, using a retrospective survey of almost 12,000 women from 13 European countries containing detailed information on early-life circumstances. We find that, compared to other women, teenage mothers experience substantially lower self-reported late-life health and are more likely to display depressive symptoms. This effect is robust to controlling for early-life factors, both parametrically and through propensity score matching, and is unlikely to be driven by selection on unobservables. Studying potential transmission mechanisms by which teenage motherhood translates into adverse late-life health highlights the importance of life-cycle socio-economic conditions and societal values.
Fulltext (open access): http://onlinelibrary.wiley.com/doi/10.1111/rssa.12125/abstract
https://goo.gl/31sWpD
This is a comparative study of the multiple ways of measuring dissimilarities between state sequences. The originality of the study is the focus put on the differences between sequences that are sociologically important when studying life courses such as family life trajectories or professional careers. These differences essentially concern the sequencing (the order in which successive states appear), the timing and the duration of the spells in successive states. The study examines the sensitivity of the measures to these three aspects analytically and empirically by means of simulations. Even if some distance measures underperform, the study shows that there is no universally optimal distance index, and that the choice of a measure depends on which aspect we want to focus on. From the review and simulation results, the paper derives guidelines to help the end user to choose the right dissimilarity measure for her or his research objectives. This study also introduces novel ways of measuring dissimilarities that overcome some flaws in existing measures.
Pregnancy intention is important for maternal and child health outcomes. The purpose of this study was to examine the causal relation between pregnancy intention and maternal depression and parenting stress in Korean women who gave birth during 2008.
This study is a retrospective evaluation of prospectively collected data from the Panel Study on Korean Children from 2008 to 2010. Causal analyses were conducted using propensity score matching and inverse probability of treatment weighted methods. In addition, mediation analyses were performed to test mitigating effects of marital conflict, fathers' participation in childcare, and mothers' knowledge of infant development on the relation between unintended pregnancy and adverse maternal mental health.
Results showed that the overall effect of an unintended pregnancy on maternal depression and parenting stress was statistically significant. An unintended pregnancy was associated with 20-22% greater odds of maternal depression, 0.28-0.39 greater depression score, and 0.85-1.16 greater parenting stress score. Relations between pregnancy intention and maternal depression, maternal depression score and parenting stress score were moderately explained by marital conflict and fathers' participation in childcare.
Unintended pregnancy contributed to increased risks of maternal depression and parenting stress. Efforts to increase fathers' participation in childcare and decrease marital conflict might be helpful to mitigate adverse impacts of unintended pregnancy on perinatal maternal mental health.
In this article, the authors define a methodological framework for analyzing the relationship between state sequences and covariates. Inspired by the principles of analysis of variance, this approach looks at how the covariates explain the discrepancy of the sequences. The authors use the pairwise dissimilarities between sequences to determine the discrepancy, which makes it possible to develop a series of statistical significance-based analysis tools. They introduce generalized simple and multifactor discrepancy-based methods to test for differences between groups, a pseudo-R2 for measuring the strength of sequence-covariate associations, a generalized Levene statistic for testing differences in the within-group discrepancies, as well as tools and plots for studying the evolution of the differences along the time frame and a regression tree method for discovering the most significant discriminant covariates and their interactions. In addition, the authors extend all methods to account for case weights. The scope of the proposed methodological framework is illustrated using a real-world sequence data set.
The objective of this article is to examine the association of teen motherhood and long-term physical and mental health outcomes. The physical and mental health components (PCS and MCS) of the SF-12 Healthy Survey in the NLSY79 health module were used to assess long-term health outcomes of women who experienced teenage motherhood. Various familial, demographic, and environmental characteristics were indentified and controlled for that may have predicted teen motherhood and long-term health outcomes. The two comparison groups for teen mothers were women who experienced teen-pregnancy only and women who were engaged in unprotected sexual activity as a teenage but did not experience pregnancy. Multivariate ordinary least squares regression was used for analysis. The average PCS and MCS for teen mothers was 49.91 and 50.89, respectively. Teen mothers exhibited poorer physical health later in life compared to all women as well as the comparison groups. When controlling for age, teen mothers had significantly lower PCS and MCS scores compared to all other women. Furthermore, when controlling for familial, demographic, and environmental characteristics, teen mothers exhibited significantly lower PCS and MCS scores. When comparing teen mothers to the two comparison groups, PCS was not statistically different although MCS was significantly lower in the teen-pregnancy group. Teen motherhood does lead to poorer physical health outcomes later in life. On the other hand, poorer mental health outcomes in later life may be attributed to the unmeasured factors leading to a teen pregnancy and not teen motherhood itself. Additional research needs to be conducted on the long-term consequences of teen motherhood.
This article develops a series of hypotheses about the long-term effects of one's history of marriage, divorce, and widowhood on health, and it tests those hypotheses using data from the Health and Retirement Study. We examine four dimensions of health at mid-life: chronic conditions, mobility limitations, self-rated health, and depressive symptoms. We find that the experience of marital disruption damages health, with the effects still evident years later; among the currently married, those who have ever been divorced show worse health on all dimensions. Both the divorced and widowed who do not remarry show worse health than the currently married on all dimensions. Dimensions of health that seem to develop slowly, such as chronic conditions and mobility limitations, show strong effects of past marital disruption, whereas others, such as depressive symptoms, seem more sensitive to current marital status. Those who spent more years divorced or widowed show more chronic conditions and mobility limitations.
English
This paper examines the salient features of sequence analysis in demogrpahicresearch. The new approach allows a holistic perspective on life course analysis and is based on arepresentation of lives as sequences of states. Some of the methods for analyzing such data aresketched, from complex description to optimal matching ot monoethetic divisive algorithms. Afer ashort ilustration of a demographically-relevant example, the needs in terms of data collection and theopportunities of applying the same aproach to synthetic data are discussed.
French
On examine ici les principaux éléments de l’analyse par séquence endémographie. Cette nouvelle technique permet une perspective unifiée del’analyse du cours de la vie, en représentant la vie comme une série d’états.Certaines des méthodes pour de telles analyses sont décrites, en commençant parla description complexe, pour considérer ensuite les alignements optimales, etles algorithmes de division. Après un court exemple en démographie, onconsidère les besoins en données et les possibilités d’application aux donnéessynthétique.
We describe a general strategy to analyze sequence data and introduce SQ-Ados, a bundle of Stata programs implementing the proposed strategy. The programs include several tools for describing and visualizing sequences as well as a Mata library to perform optimal matching using the Needleman – Wunsch algorithm. With these programs Stata becomes the first statistical package to offer a complete set of tools for sequence analysis. Copyright 2006 by StataCorp LP.
Age and cumulative advantage/disadvantage theory have obvious logical, theoretical, and empirical connections, because both
are inherently and irreducibly related to the passage of time. Over the past 15 years, these connections have resulted in
the elaboration and application of the cumulative advantage–disadvantage perspective in social gerontology, especially in
relation to issues of heterogeneity and inequality. However, its theoretical origins, connections, and implications are not
widely understood. This article reviews the genesis of the cumulative advantage/disadvantage perspective in studies of science,
its initial articulation with structural-functionalism, and its expanding importance for gerontology. It discusses its intellectual
relevance for several other established theoretical paradigms in sociology, psychology, and economics. On the basis of issues
deriving from these perspectives and from the accumulating body of work on cumulative advantage and disadvantage, I identify
several promising directions for further research in gerontology.
Increasingly, social scientists are turning to childhood to gain a better understanding of the fundamental social causes of adult mortality. However, evidence of the link between childhood and the mortality of adults is fragmentary, and the intervening mechanisms remain unclear. Drawing on the National Longitudinal Survey of Older Men, our analysis shows that men's mortality is associated with an array of childhood conditions, including socioeconomic status, family living arrangements, mother's work status, rural residence, and parents' nativity. With the exception of parental nativity, socioeconomic-achievement processes in adulthood and lifestyle factors mediated these associations. Education, family income, household wealth, and occupation mediated the influence of socioeconomic status in childhood. Adult lifestyle factors, particularly body mass, mediated the effects of family living arrangements in childhood, mother's work status, and rural residence. Our findings bring into sharp focus the idea that economic and educational policies that are targeted at children's well-being are implicitly health policies with effects that reach far into the adult life course.
Objectives:
We introduce a "childbearing biography" approach to show how multiple childbearing characteristics cluster in ways significant for midlife health.
Methods:
We analyze the National Longitudinal Survey of Youth 1979 (NLSY79; N = 3992) using mixed-mode Latent Class Analysis with eight childbearing variables (e.g., age at first birth, parity, birth spacing, and mistimed births) to identify how childbearing biographies are associated with midlife health, adjusting for key covariates-including socioeconomic status (SES) and relationship history.
Results:
We identify six childbearing biographies: (1) early compressed, (2) staggered, (3) extended high parity, (4) later, (5) married planned, and (6) childfree. Childbearing biographies are strongly associated with physical health but not mental health, with differences primarily explained by SES.
Discussion:
Different childbearing biographies are related to physical health inequalities above what is demonstrated by the typical use of one or two childbearing measures, providing a new perspective into the growing health gap among aging midlife women.
The prevention of unplanned or unintended pregnancies continues to be a cornerstone of U.S. reproductive health policy, but the evidence that such pregnancies cause adverse maternal and child outcomes is limited. In this research note, we examine these relationships using recent large-scale data and inverse propensity weights estimated from generalized boosted models. We find that pregnancy timing is related to maternal experience during pregnancy, but not to infant outcomes at birth—both of which are consistent with prior research. In an addition to the literature, we show that pregnancy timing is relevant for a number of maternal outcomes, such as the onset of depression and intimate partner violence, changes in smoking behavior, and receipt of medical care. These findings suggest that policy intended to improve infant welfare by preventing unintended pregnancies has little empirical support, but that policy focused on increasing reproductive autonomy and maternal well-being has the potential to improve outcomes.
Objectives
An emerging literature suggests that fertility history, which includes measures of parity and birth timing, may influence cognitive health in older ages, especially among women given their differential exposure to pregnancy and sex hormones. Yet, few studies have examined associations between measures of fertility history and incident dementia in population-based samples.
Methods
We examined the associations between parity, younger age at first birth, and older age at last birth with incident dementia over a 16-year period in a prospective sample of 15,361 men and women aged 51-100 years at baseline drawn from the Health and Retirement Study. We used Cox regression and the Fine and Gray model to obtain cause-specific (csHRs) and subdistribution hazard ratios (sdHRs) for incident dementia from gender-stratified models in which we accounted for the semi-competing risk of death.
Results
During the follow-up period (median 13.0 years), the crude incidence rate for dementia was 16.6 and 19.9 per 1,000 person-years for men and women, respectively. In crude models estimating csHRs, higher parity (vs. parity 2) and younger age at first birth were associated with increased risk of dementia for both genders. These associations did not persist after full covariate adjustment. Across all models in which we estimated sdHRs, we observed a positive relationship between older age at last birth and incident dementia for women only.
Discussion
In this population-based, multi-ethnic cohort, we observed limited evidence for an association between measures of fertility history and incident dementia among men and women after adjusting for potential confounders.
Objective
The objective of this study was to explore sexual orientation disparities in unwanted births by race/ethnicity.
Background
Previous research has documented that sexual minority women (SMW) are more likely to report unintended pregnancy than heterosexual women and that Black and Latina women are more likely to report unintended pregnancy than White women. No research has examined how pregnancy intention varies at the intersection of these two identities.
Method
Data come from the pregnancy roster data in Waves 4 and Wave 5 subsample in the National Longitudinal Study of Adolescent to Adult Health. We used live births as the unit of analysis (n = 8,527) and multilevel logistic regression models to account for clustering of births within women. Women were asked if they “wanted” to be pregnant at the time of pregnancy. The authors conducted models stratified by race/ethnicity as well as models stratified by sexual identity.
Results
Among White women, SMW were more likely to describe their births as unwanted than were their heterosexual counterparts. Conversely, among Black and Latina women, SMW were less likely to describe their births as unwanted than were their heterosexual counterparts. Results stratified by sexual identity underscore these contrasting patterns: Among heterosexual women, White women were less likely to describe their births as unwanted when compared with Black and Latina women; among SMW, White women were more likely to describe their births as unwanted than were Black and Latina women.
Conclusion
Traditional race/ethnicity trends in pregnancy intention (i.e., greater unwanted pregnancy among Black/Latina than White women) are reversed among SMW.
Objective:
This article reviews research from the past decade on patterns, trends, and differentials in the pathway to parenthood.
Background:
Whether, and under what circumstances, people become parents has implications for individual identity, family relationships, the well-being of adults and children, and population growth and age structure. Understanding the factors that influence pathways to parenthood is central to the study of families and can inform policies aimed at changing childbearing behaviors.
Method:
This review summarizes recent trends in fertility as well as research on the predictors and correlates of childbearing, with a focus on the United States and on research most relevant to family scholars. We document fertility differentials and prevailing explanations for variation across sub-groups and discuss alternative pathways to parenthood, such as adoption. The article suggests avenues for future research, outlines emerging theoretical developments, and concludes with a discussion of fertility policy.
Results:
U.S. fertility has declined in recent years; whether fertility rates will increase is unclear. Elements of the broader social context such as the Great Recession and increasing economic inequality have impacted pathways to parenthood, and there is growing divergence in behaviors across social class. Scholars of childbearing have developed theories to better understand how childbearing is shaped by life course processes and social context.
Conclusion:
Future research on the pathways to parenthood should continue to study group differentials, refine measurement and theories, and better integrate men and couples. Childbearing research is relevant for social policy, but ideological factors impact the application of research to policy.
The SADI package provides tools for sequence analysis, which focuses on the similarity and dissimilarity between categorical time series such as life-course trajectories. SADI’s main components are tools to calculate intersequence distances using several different algorithms, including the optimal matching algorithm, but it also includes utilities to graph, summarize, and manage sequence data. It provides similar functionality to the R package TraMineR and the Stata package SQ but is substantially faster than the latter.
Research has found that both unintended and nonnormatively timed births have negative consequences, yet little is known about how birth timing and intention jointly influence mothers' mental health. This study explored how the interaction between intention and age at first birth influenced depression 5 to 13 years later by analyzing the 1979 National Longitudinal Survey of Youth (N = 2,573). We found that mistimed births, when compared with wanted births, were associated with depression, but only for normatively timed transitions to motherhood. Surprisingly, teen mothers who had unwanted births had better later-life mental health than teens who had wanted or mistimed births. Among women with wanted or mistimed first births, increasing age at birth was associated with lower probabilities of depression. Most, but not all, of these effects were explained by selection factors and life circumstances. Results show the importance of examining joint effects of first birth wantedness and timing.
Despite evidence that first-birth timing influences women’s health, the role of marital status in shaping this association has received scant attention. Using multivariate propensity score matching, we analyze data from the National Longitudinal Survey of Youth 1979 to estimate the effect of having a first birth in adolescence (prior to age 20), young adulthood (ages 20–24), or later ages (ages 25–35) on women’s midlife self-assessed health. Findings suggest that adolescent childbearing is associated with worse midlife health compared to later births for black women but not for white women. Yet, we find no evidence of health advantages of delaying first births from adolescence to young adulthood for either group. Births in young adulthood are linked to worse health than later births among both black and white women. Our results also indicate that marriage following a nonmarital adolescent or young adult first birth is associated with modestly worse self-assessed health compared to remaining unmarried.
The life course has emerged over the past 30 years as a major research paradigm. Distinctive themes include the relation between human lives and a changing society, the timing of lives, linked or interdependent lives, and human agency. Two lines of research converged in the formation of this paradigm during the 1960s; one was associated with an older ''social relationship'' tradition that featured intergenerational studies, and the other with more contemporary thinking about age. The emergence of a life course paradigm has been coupled with a notable decline in socialization as a research framework and with its incorporation by other theories. Also, the field has seen an expanding interest in how social change alters people's lives, an enduring perspective of sociological social psychology.
The life course has emerged over the past 30 years as a major research paradigm. Distinctive themes include the relation between human lives and a changing society, the timing of lives, linked or interdependent lives, and human agency. Two lines of research converged in the formation of this paradigm during the 1960s; one was associated with an older "social relationship" tradition that featured intergenerational studies, and the other with more contemporary thinking about age. The emergence of a life course paradigm has been coupled with a notable decline in socialization as a research framework and with its incorporation by other theories. Also, the field has seen an expanding interest in how social change alters people's lives, an enduring perspective of sociological social psychology.
Objectives:
Unintended pregnancy may have negative impacts on maternal health. However, no comprehensive studies have been undertaken on the health of women with intended and unintended pregnancies. This study aimed to compare the health status of women with intended and unintended pregnancies in Iran.
Study design:
Comparative study.
Methods:
Two hundred women were included in this study: of these, 100 had intended pregnancies and 100 had unintended pregnancies. The participants were recruited using a multi-stage sampling method from the health centres of Kerman, Iran in 2010. The tools for data collection included: a questionnaire to assess demographic characteristics and fertility history; the Short Form-36 (SF-36) questionnaire to assess general physical and mental health status; and a questionnaire to assess pregnancy-related health status. Validity and reliability of the questionnaires were assessed before use.
Results:
In comparison with women with intended pregnancies, women with unintended pregnancies had lower scores for physical and mental health status; less prenatal care; lower scores for self-care behaviours such as use of supplements, vaccination and nutrition; lower scores for personal health; and higher rates of risky behaviours such as smoking, drinking alcohol and drug abuse during pregnancy (P < 0.05).
Conclusion:
Unintended pregnancy is a threat to the physical and mental health of women. As unintended pregnancy is associated with lower self-care behaviours and higher rates of risky behaviours during pregnancy, special care and counselling are recommended.
Social class inequalities in health and mortality have become an increasingly prominent topic of study among sociologists, demographers, economists, and social epidemiologists. Considerable progress has been made in documenting such inequalities in a wide variety of settings using multiple measures of health and all-cause and cause-specific mortality. That social class inequalities are pervasive is now well established, but factors that underlie them are less clearly understood. This review discusses various measures used to define social class in studies of health inequalities. It then reviews the literature on patterns of these inequalities in developed countries as well as their potential explanations. Promising new research approaches include those that employ a life course perspective in the study of health inequalities and those that integrate multiple levels of analysis, including biological pathways that are likely to be involved in translating cumulative adversity to poor health.
Study of the effect of transitions on individual and family outcomes is central to understanding families over the life course. There is little consensus, however, on the appropriate statistical methods needed to study transitions in panel data. This article compares lagged dependent variable (LDV) and change score (CS) methods for analyzing the effect of events in two-wave panel data. The methods are described, and their performances are compared both with a simulation and a substantive example using the National Survey of Families and Households two-wave panel. The results suggest that CS methods have advantages over LDV techniques in estimating the effect of events on outcomes in two-wave panel data.
A wide variety of work in social science concerns sequences of events or phenomena. This essay reviews concepts of sequence and methods for analyzing sequences. After a brief definitional discussion, I consider sequence literatures from various areas. I then discuss recent methodologies for sequence analysis. I review stepwise approaches like Markovian and event history analysis as well as whole sequence approaches resting on new developments in biology and other fields.
A procedure for forming hierarchical groups of mutually exclusive subsets, each of which has members that are maximally similar with respect to specified characteristics, is suggested for use in large-scale (n > 100) studies when a precise optimal solution for a specified number of groups is not practical. Given n sets, this procedure permits their reduction to n − 1 mutually exclusive sets by considering the union of all possible n(n − 1)/2 pairs and selecting a union having a maximal value for the functional relation, or objective function, that reflects the criterion chosen by the investigator. By repeating this process until only one group remains, the complete hierarchical structure and a quantitative estimate of the loss associated with each stage in the grouping can be obtained. A general flowchart helpful in computer programming and a numerical example are included.
This paper compares the meanings and applications of concepts relevant to both the life course and the stress process frameworks. Some of these concepts bear the same labels but serve quite different scholarly agendas. Other concepts have different labels but have closely related applications. The purpose of this kind of comparative analysis is to help both fields clarify the conceptual tools needed to advance their scholarly goals.
This paper investigates the relationships among unwanted childbearing, health, and mother-child relationships. We hypothesize that unwanted childbearing affects mother-child relationships in part because of the physical and mental health consequences of unwanted childbearing. Impaired mental health hampers women's interaction with their infants, and these poor neonatal relationships translate into poor mother-adult child relationships. Using the Intergenerational Panel Study of Mothers and Children--a 31-year longitudinal survey of a probability sample of 1,113 mother-child pairs begun in 1961--we demonstrate that mothers with unwanted births have lower quality relationships with their children from late adolescence (age 18) throughout early adulthood (ages 23 and 31). Furthermore, these lower quality relationships are not limited to the child born as a result of the unwanted pregnancy; all the children in the family suffer. Using the 1987-88 wave of the National Survey of Families and Households, a survey of a national probability sample of U.S. households, we show that mothers with unwanted births suffer from higher levels of depression and lower levels of happiness. We also demonstrate that they spank their young children more and spend less leisure time with them. We conclude that experiencing unwanted childbearing reduces the time and attention that mothers give their young children and that these early mother-child interactions set the stage for long-term, lower quality relationships.
This article examines the relationship between a woman's childbearing history and her later health and mortality, with primary focus on whether the association between them is due to early and later socioeconomic status. Data are drawn from the Health and Retirement Study birth cohort of 1931-1941. Results indicate that, conditional on reaching midlife and controlling for early and later socioeconomic status, a first birth before age 20 is associated with a higher hazard of dying. In addition, having an early birth is associated with a higher prevalence of reported heart disease, lung disease, and cancer in 1994. Being unmarried at the time of the first birth is associated with earlier mortality, but this association disappears when midlife socioeconomic status is controlled. The number of children ever born does not significantly affect mortality but is associated with prevalence of diabetes.
Family size among mothers. Pew Research Center
- G Livingston
Livingston, G. (2015). Family size among mothers. Pew Research Center. https://www.pewresearch.org/social-trends/2015/05/07/family-size-among-mothers/