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Despite its importance in studies of migrant health, selectivity of migrants-also known as migration health selection-has seldom been examined in sub-Saharan Africa (SSA). This neglect is problematic because several features of the context in which migration occurs in SSA-very high levels of HIV, in particular-differ from contextual features in regions that have been studied more thoroughly. To address this important gap, we use longitudinal panel data from Malawi to examine whether migrants differ from nonmigrants in pre-migration health, assessed via SF-12 measures of mental and physical health. In addition to overall health selection, we focus on three more-specific factors that may affect the relationship between migration and health: (1) whether migration health selection differs by destination (rural-rural, rural-town, and rural-urban), (2) whether HIV infection moderates the relationship between migration and health, and (3) whether circular migrants differ in pre-migration health status. We find evidence of the healthy migrant phenomenon in Malawi, where physically healthier individuals are more likely to move. This relationship varies by migration destination, with healthier rural migrants moving to urban and other rural areas. We also find interactions between HIV-infected status and health: HIV-infected women moving to cities are physically healthier than their nonmigrant counterparts. [ABSTRACT FROM AUTHOR]

Very few studies have investigated mental health in sub-Saharan Africa (SSA). Using data from Malawi, this article provides a first picture of the demography of depression and anxiety (DA) among mature adults (aged 45 or older) in a low-income country with high HIV prevalence. DA are more frequent among women than men, and individuals affected by one are often affected by the other. DA are associated with adverse outcomes, such as poorer nutrition intake and reduced work efforts. DA also increase substantially with age, and mature adults can expect to spend a substantial fraction of their remaining lifetime-for instance, 52 % for a 55-year-old woman-affected by DA. The positive age gradients of DA are not due to cohort effects, and they are in sharp contrast to the age pattern of mental health that has been shown in high-income contexts, where older individuals often experience lower levels of DA. Although socioeconomic and risk- or uncertainty-related stressors are strongly associated with DA, they do not explain the positive age gradients and gender gap in DA. Stressors related to physical health, however, do. Hence, our analyses suggest that the general decline of physical health with age is the key driver of the rise of DA with age in this low-income SSA context. [ABSTRACT FROM AUTHOR]

This article assesses how married individuals' knowledge of HIV status gained through HIV testing and counseling (HTC) affects divorce, the number of sexual partners, and the use of condoms within marriage. This study improves upon previous studies on this topic because the randomized incentives affecting the propensity to be tested for HIV permit control for selective testing. Instrumental variable probit and linear models are estimated, using a randomized experiment administered as part of the Malawi Longitudinal Study of Families and Health (MLSFH). The results indicate that knowledge of HIV status (1) does not affect chances of divorce for either HIV-negative or HIV-positive respondents; (2) reduces the number of reported sexual partners among HIV-positive respondents; and (3) increases reported condom use with spouses for both HIV-negative and HIV-positive respondents. These results imply that individuals actively respond to information about their HIV status that they learn during HTC, invoking protective behavior against future risk of HIV/AIDS for themselves and their actual and potential sexual partners. Some limitations of this study are a small sample size for those who are HIV-positive and dependence on self-reported sexual behaviors. [ABSTRACT FROM AUTHOR]

We investigate the causal impact of learning HIV status on HIV/AIDS-related expectations and sexual behavior in the medium run. Our analyses document several unexpected results about the effect of learning one's own, or one's spouse's, HIV status. For example, receiving an HIV-negative test result implies higher subjective expectations about being HIV-positive after two years, and individuals tend to have larger prediction errors about their HIV status after learning their HIV status. If individuals in HIV-negative couples also learn the status of their spouse, these effects disappear. In terms of behavioral outcomes, our analyses document that HIV-positive individuals who learned their status reported having fewer partners and using condoms more often than those who did not learn their status. Among married respondents in HIV-negative couples, learning only one's own status increases risky behavior, while learning both statuses decreases risky behavior. In addition, individuals in sero-discordant couples who learned both statuses are more likely to report some condom use. Overall, our analyses suggest that ensuring that each spouse learns the HIV status of the other, either through couple's testing or through spousal communication, may be beneficial in high-prevalence environments. [ABSTRACT FROM AUTHOR]

Schooling generally is positively associated with better health-related outcomes-for example, less hospitalization and later mortality-but these associations do not measure whether schooling causes better health-related outcomes. Schooling may in part be a proxy for unobserved endowments-including family background and genetics-that both are correlated with schooling and have direct causal effects on these outcomes. This study addresses the schooling-health-gradient issue with twins methodology, using rich data from the Danish Twin Registry linked to population-based registries to minimize random and systematic measurement error biases. We find strong, significantly negative associations between schooling and hospitalization and mortality, but generally no causal effects of schooling. [ABSTRACT FROM AUTHOR]

Understanding the determinants of individuals' perceptions of their risk of becoming infected with HIV and their perceptions of acceptable strategies of prevention is an essential step toward curtailing the spread of this disease. We focus in this article on learning and decision-making about AIDS in the context of high uncertainty about the disease and appropriate behavioral responses. We argue that social interactions are important for both. Using longitudinal survey data from rural Kenya and Malawi, we test this hypothesis. We investigate whether social interactions--and especially the extent to which social network partners perceive themselves to be at risk--exert causal influences on respondents' risk perceptions and on one approach to prevention, spousal communication about the threat of AIDS to the couple and their children. The study explicitly allows for the possibility that important characteristics, such as unobserved preferences or community characteristics, determine not only the outcomes of interest but also the size and composition of networks. The most important empirical result is that social networks have significant and substantial effects on risk perceptions and the adoption of new behaviors even after we control for unobserved factors. [ABSTRACT FROM AUTHOR]

We investigated the timing of fertility and marriage in Sweden using exogenous variation in the age at school graduation that results from differences in birth month. Our analysis found that the difference of 11 months in the age at leaving school between women who were born in two consecutive months, December and January, implies a delay in the age at first birth of 4.9 months. This effect of delayed graduation also persists for the timing of second births and first marriages, but it does not affect completed fertility or the overall probability of marriage before age 45. These results suggest the existence of a relatively rigid sequencing of demographic events in early adulthood, and the age at graduation from school emerges as an important factor in determining the timing--but not the quantum--of familyformation. In addition, these effects point to a potentially important influence of social age, defined by an individual's school cohort, instead of biological age. The relevance of social age is likely due to social interactions and peer-group influences exerted by individuals who are in the same school cohort but are not necessarily of the same age. [ABSTRACT FROM AUTHOR]

The impacts of social networks on changes in contraception in rural Kenya are investigated using special data from a longitudinal household survey. An analytic model, informed by detailed knowledge of the setting, yielded estimates that indicate that (1) social networks have substantial effects even after unobserved factors (e.g., homophily) that may determine social networks are controlled; (2) controlling for these unobserved factors may substantially alter the estimated effects of networks (these controls were not used in previous studies); (3) network effects are important for both men and women; and (4) network effects are nonlinear and asymmetric, suggesting that networks provide information primarily through social learning, rather than by exerting social influence. [ABSTRACT FROM AUTHOR]

Demographers have argued increasingly that social interaction is an important mechanism for understanding fertility behavior. Yet it is still quite uncertain whether social learning or social influence is the dominant mechanism through which social networks affect individuals' contraceptive decisions. In this paper we argue that these mechanisms can be distinguished by analyzing the density of the social network and its interaction with the proportion of contraceptive users among network partners. Our analyses indicate that social learning is most relevant with high market activity; in regions with only modest market activity, however, social influence is the dominant means by which social networks affect women's contraceptive use. [ABSTRACT FROM AUTHOR]

Behavior genetic designs and analysis can be used to address issues of central importance to demography. We use this methodology to document genetic influence on human fertility. Our data come from Danish twin pairs born from 1953 to 1959, measured on age at first attempt to get pregnant (FirstTry) and number of children (NumCh). Behavior genetic models were fitted using structural equation modeling and DF analysis. A consistent medium-level additive genetic influence was found for NumCh, equal across genders; a stronger genetic influence was identified for FirstTry, greater for females than for males. A bivariate analysis indicated significant shared genetic variance between NumCh and FirstTry. [ABSTRACT FROM AUTHOR]

Bongaarts and Feeney have recently proposed an adjusted total fertility rate to disentangle tempo effects from changes in the quantum of fertility. We propose an extension to the Bongaarts and Feeney formula that includes variance effects: that is, changes in the variance of the fertility schedule over time. If these variance effects are ignored, the mean age at birth and the adjusted total fertility rate are biased. We provide approximations for these biases, and we extend the TFR adjustment to fertility schedules with changing variance. We apply our method to the Swedish baby boom and bust, and show that variance effects are important for evaluating the relative contributions of tempo and quantum effects to the fertility change from 1985 to 1995. [ABSTRACT FROM AUTHOR]

This article presents information about a study which focuses on the persistent diversity in contraceptive practices across communities, or social strata while focusing on a proposed model of learning in social networks for modern fertility control. Understanding contraceptive choice is essential for improving women's reproductive health and for providing effective family planning services. Markets for contraceptive information are frequently absent and media may fail to convey the complex set of ideas and procedures involved in the adoption of fertility control. Faced with this market failure, women make contraceptive decisions based on information from early adopters in their social networks. Results of the study suggests that regional diversity and social stratification in contraceptive practices arise due to informal communications, rather than in-depth discussions about fertility control. The information shared among network partners is limited and there is unobserved heterogeneity with respect to women's attributes and characteristics. The qualitative choice model used in this study, yields the prediction that the probability of a woman adopting modem contraception equals the proportion of number of users in her social network.