Jane Menken

Age-specific fecundability among conception seekers is frequently treated as evidence of how much individuals should expect their own fecundability to decline. Demographers caution against this practice because of negative selection on fecundability among people seeking to conceive at older ages. We revisit this classic result, using simulation to investigate the plausible degree of selection introduced by two processes: on average, first, those with higher fecundability have more births before seeking to conceive; and second, these individuals achieve their desired births sooner, and thus seek to conceive higher-parity births at younger ages. We simulate full reproductive lives for cohorts in which fecundability is constant with age for individuals but varies across individuals. Thus, any change in the age-specific fecundability of conception seekers comes from selection. Our results demonstrate that selection alone can generate substantial depression in observed fecundability at later ages. We call for greater caution in interpreting age patterns of observed fecundability as straightforward evidence of individual age-related decline.

We use restricted‐access birth records from the National Vital Statistics System (NVSS) to document the full age and parity fertility effects of the Colorado Family Planning Initiative (CFPI). The CFPI provided access to every FDA approved method of contraception for free to anyone living below approximately 200% of the federal poverty line from 2009 to 2015. Previous research has demonstrated important effects on fertility at ages 15–29. We estimate the statewide fertility effect of the CFPI for all age groups (15–44) and for all births and for first and non‐first births using the synthetic control method. We find large and statistically significant reductions in birth rates for 15–24‐year‐olds that largely line up with other recent studies, but we find important heterogeneity across parity. For teenagers, we find reductions in first birth rates of about 9%, but much larger reductions in non‐first birth rates of 17%–25%. We also find reductions in overall fertility for 20–24 and 25–29‐year‐olds, but these are entirely driven by reductions of 5%–9% in non‐first birth rates, with no significant changes in first births. For 30–39‐year‐olds, we find small but statistically significant reductions in fertility of 3%–7% across parity levels, and we find a 6% reduction in fertility for 40–44‐year‐olds. We also conduct inference using synthetic difference‐in‐differences (SDID) and placebo‐based methods. When we do this, our coefficient estimates are similar, though confidence intervals are wider, with specifications on older age groups no longer statistically significant.

Fertility is a life course process that is strongly shaped by geographic and sociodemographic subgroup contexts. In the United States, scholars face a choice: they can situate fertility in a life course perspective using panel data, which is typically representative only at the national level; or they can attend to subnational contexts using rate schedules, which do not include information on life course statuses. The method and data source we introduce here, Census-Held Linked Administrative Records for Fertility Estimation (CLAR-FE), permits both. It derives fertility histories and rate schedules from U.S. Census Bureau–held data for the nation and by state, racial and ethnic subgroups, and the important life course status of parity. We generate three types of rates for 2000–2020 at the national and state levels by race and ethnicity: age-specific rates and both unconditional and conditional parity- and age-specific rates. Where possible, we compare these rates with those produced by the National Center for Health Statistics. Our new rate schedules illuminate state and racial and ethnic differences in transitions to parenthood, providing evidence of the important subgroup heterogeneity that characterizes the United States. CLAR-FE covers nearly the entire U.S. population and is available to researchers on approved projects through the Census Bureau's Federal Statistical Research Data Centers.

Investigations into household structure in low- and middle-income countries (LMICs) provide important insight into how families manage domestic life in response to resource allocation and caregiving needs during periods of rapid sociopolitical and health-related challenges. Recent evidence on household structure in many LMICs contrasts with long-standing viewpoints of worldwide convergence to a Western nuclearized household model. Here, we adopt a household-centered theoretical and methodological framework to investigate longitudinal patterns and dynamics of household structure in a rural South African setting during a period of high AIDS-related mortality and socioeconomic change. Data come from the Agincourt Health and Socio-Demographic Surveillance System (2003–2015). Using latent transition models, we derived six distinct household types by examining conditional interdependency between household heads’ characteristics, members’ age composition, and migration status. More than half of households were characterized by their complex and multigenerational profiles, with considerable within-typology variation in household size and dependency structure. Transition analyses showed stability of household types under female headship, while higher proportions of nuclearized household types dissolved over time. Household dissolution was closely linked to prior mortality experiences—particularly, following death of a male head. Our findings highlight the need to better conceptualize and contextualize household changes across populations and over time.

Family planning programs are believed to have substantial long-term benefits for women’s health and well-being, yet few studies have established either extent or direction of long-term effects. The Matlab, Bangladesh, maternal and child health/family planning (MCH/FP) program afforded a 12-y period of well-documented differential access to services. We evaluate its impacts on women’s lifetime fertility, adult health, and economic outcomes 35 y after program initiation. We followed 1,820 women who were of reproductive age during the differential access period (born 1938–1973) from 1978 to 2012 using prospectively collected data from the Matlab Health and Demographic Surveillance System and the 1996 and 2012 Matlab Health and Socioeconomic Surveys. We estimated intent-to-treat single-difference models comparing treatment and comparison area women. MCH/FP significantly increased contraceptive use, reduced completed fertility, lengthened birth intervals, and reduced age at last birth, but had no significant positive impacts on health or economic outcomes. Treatment area women had modestly poorer overall health (+0.07 SD) and respiratory health (+0.12 SD), and those born 1950–1961 had significantly higher body mass index (BMI) in 1996 (0.76 kg/m²) and 2012 (0.57 kg/m²); fewer were underweight in 1996, but more were overweight or obese in 2012. Overall, there was a +2.5 kg/m² secular increase in BMI. We found substantial changes in lifetime contraceptive and fertility behavior but no long-term health or economic benefits of the program. We observed modest negative health impacts that likely result from an accelerated nutritional transition among treated women, a transition that would, in an earlier context, have been beneficial. Significance Few studies have addressed links between family planning programs and long-term benefits for women’s health and economic outcomes, especially in societies where old-age support and women’s status are tied to childbearing and where smaller families may carry negative consequences for women. We analyzed the maternal and child health/family planning (MCH/FP) program, a highly effective intervention introduced in the rural Matlab subdistrict of Bangladesh in 1977 with a subsequent 12-y differential in service access. We found significant differences in lifetime contraceptive behavior and completed fertility among women born 1938−1973. We found few effects on later health or economic outcomes except for an association of MCH/FP with poorer overall health and poorer metabolic health among women born 1950−1961.

Expanded access to the full range of contraceptive methods increased young women’s high school graduation.

Understanding how sexual behaviors cluster in distinct population subgroups along the life course is critical for effective targeting and tailoring of HIV prevention messaging and intervention activities. We examined interrelatedness of sexual behaviors and variation between men and women across a wide age range in a rural South African setting with a high HIV burden. Data come from the Ha Nakekela population-based survey of people aged 15–85-plus drawn from the Agincourt Health and Socio-Demographic Surveillance System. We used latent class analysis of six sexual behavior indicators to identify distinct subgroup sexual behavior clusters. We then examined associations between class membership and sociodemographic and other behavioral risk factors and assessed the accuracy of a reduced set of sexual behavior indicators to classify individuals into latent classes. We identified three sexual behavior classes: (1) single with consistent protective behaviors; (2) risky behaviors; and (3) in union with lack of protective behaviors. Patterns of sexual behaviors varied by gender. Class membership was also associated with age, HIV status, nationality, and alcohol use. With only two sexual behavior indicators (union status and multiple sexual partners), individuals were accurately assigned to their most likely predicted class. There were distinct multidimensional sexual behavior clusters in population subgroups that varied by sex, age, and HIV status. In this population, only two brief questions were needed to classify individuals into risk classes. Replication in other situations is needed to confirm these findings.

Noncontributory pensions serve as an important resource for poverty-affected households in low- and middle-income countries. This study explores how a recent policy change to pension receipt influences perceived quality of life among older South Africans. We use survey data from the longitudinal World Health Organization Study on global AGEing and adult health and from the Agincourt Health and Socio-Demographic Surveillance System census. We find pension receipt to have a positive impact on both men’s and women’s perceived quality of life. These findings hold when controlling for prior well-being status. We find a significant moderating factor of physical limitations on the relationship between pension receipt and quality of life. Individuals reporting the highest levels of physical limitation report a larger increase in their quality of life upon pension receipt than those with less severe physical limitations. We conclude that despite the well-documented household income-pooling in this population, pension receipt still leads to a significant positive impact on pensioners’ perceived quality of life.