Background: For the past two decades, more and more women in certain European countries, Japan, and the United States are giving birth to their first child at a considerably later age than ever before. It remains unclear as to what extent this age-related general fertility decline is affected by changing social and cultural norms.

Method: The Global Centers of Excellence Survey was conducted by Osaka University in Japan (n=5313) in 2009. Multivariate regression analyses were conducted to examine the impact of psychosocial norms, cultural differences, and economic conditions on the perception of childbearing.

Results: The findings suggest that a subjective measure of happiness has a significant influence on childbearing. A society with income inequalities between classes discourages childbearing. It is observed that women’s higher labor force participation generates a negative impact on mother-child relations which causes discouragement of childbearing. A higher female labor force participation stemmed from a transition of a traditional society into a modern and market-oriented society discourages childbearing.

Conclusions/implications: A woman’s decision to delay childbearing is based on her perception of psychosocial norms with surrounding economic environment and her own value of opportunity in the market oriented society. Childbearing also imposes psycho-economic burdens on the working population under mix of a traditional, patriarchal society, and a modern market oriented framework. Childbearing incentives could be a strategic policy to encourage positive attitudes of childbearing in general and proper welfare policy, labor law(s), employment conditions, and social security system for a working mother with a child or children.

Key words: Childbearing, socioeconomic factors, psychosocial norms, subjective happiness

This paper shows that the individual’s bargaining power within the household, proxied by gender and educational attainment of household head, affects how remittances sent by Overseas Filipino Workers are spent in the Philippines. Gender of the household head, not of the remitter, matters in the allocation of remittances. As remittances increase, female heads with absent spouses spend less on alcohol and tobacco while male heads with absent spouses spend more on these goods; regardless of gender, household heads with less education allocate more to education than those with more education.

"Old while not affluent" situation, together with an unsustainable high investment rate and high dependency on foreign trade, spurs hot debates on the challenges of a fast-aging population and the exploitation of the second demographic dividend in today’s China. Literature related to elderly health in countries other than China often starts with medical concepts and then dwells on economic issues, mainly focusing on socioeconomic, behavioral, and environmental factors and their effects on the health of the elderly. This article reviews economic research on these topics and then discusses possible implications for the economic analysis of aging China.

Much research has linked an increase in adult mortality with the socioeconomic transition of former European socialist societies after 1989. Few studies examine corresponding experiences in China, however. Using the death certificates of Shanghai residents, we examined any such sudden mortality change and crisis when China went through economic transformation. We explored trends in life expectancy at birth and age-specific mortality in Shanghai. We applied Arriaga’s decomposition method to analyze the contributions of specific ages and the causes to the changes in life expectancy. We used harmonic regression models to assess the statistical significance of rising and falling mortality over time. The analysis shows that, coinciding with the economic transition of 1992–1996, the previously steady improvement of life expectancy in Shanghai slowed down. Mortality among working-age males (20–44 years old) increased (P<.001) in Shanghai, largely due to rising cardiovascular disease (CVD) (P<.05) and injury (P<.001). Suicide and liver disease remained stable or fell, while transportation deaths increased in Shanghai. The economic reform in Shanghai seems to include the privatization of state-owned enterprises, economic growth, and initial increases in working-age male mortality in the 1990s.

This paper investigates whether agricultural households in the rural Philippines insure their consumption against income shocks and whether they use migration, remittances, informal loans, or assets as ex post risk-coping mechanisms. Since these households have limited access to formal insurance and credit markets, any shocks to their volatile income can have substantial impacts. Using panel data, and rainfall shocks as the instrumental variable for income shocks, this paper finds little evidence of effective risk-sharing within the networks of family and friends. 2SLS, OLS, and SUR estimates show that only about 16 percent of consumption is insured. While domestic remittances from other families replace about 51 percent of income decline, informal loans decrease by about 34 percent. Additional tests, however, reveal that agricultural households
engage in entrepreneurial activity when rainfall increases and children are somehow protected from the adverse effects of rainfall shocks. Hours spent on own family-operated businesses likewise increase.

Published:  Pajaron, Marjorie C. Remittances, informal loans, and assets as risk-coping mechanisms: evidence from agricultural households in rural Philippines. No. 2014-16. Discussion Paper, School of Economics, University of the Philippines, 2014.

Nutrition, physical activity, smoking, and alcohol consumption are major causes of morbidity and mortality related to noncommunicable diseases (NCDs). Hypertension, diabetes type II, cancer, and chronic pulmonary diseases cause 60 percent of deaths worldwide and will likely increase by 17 percent during the next 10 years. Eighty percent of deaths caused by NCDs are registered in low- and middle-income countries in the working-age population and contribute to the growth of poverty [1,2,3].

During the last 15 years in Mongolia the leading causes of mortality have been cardiovascular disease and cancer.

This qualitative survey is one part of the Facility-Based Impact Study (FBIS) and was funded by the MCA Health Project. The overall goal of the MCA Health Project is to reduce mortality and morbidity caused by NCD and traffic accidents. Over a period of five years, the project aims to provide the population with essential knowledge about health promotion, the prevention and early detection of NCDs, and the adoption of healthy lifestyles through capacity building for the health system and, more specifically, for the preventive facilities. One main activity of the project is to improve primary health services related to NCDs through interventions for capacity building on the level of health facilities. This FBIS focuses on assessing the current situation in the facilities to enable a later comparison of the results of this baseline study and a later follow-up study to evaluate the impact of the Health Project on the performance of health staff, their knowledge, attitudes, and practice in the facilities, and the preparedness of facilities in terms of equipment and staff. The survey was carried out by a joint team of local and international consultants from the MCA Health Project, EPOS Health Management and THL Finland, and researchers from the School of Public Health.  

The share of increases in life expectancy realized after age 65 was only about 20 percent at the beginning of the 20th century for the United States and 16 other countries at comparable stages of development; but that share was close to 80 percent by the dawn of the 21st century, and is almost certainly approaching 100 percent asymptotically. This new demographic transition portends a diminished survival effect on working life. For high-income countries at the forefront of the longevity transition, expected lifetime labor force participation as a percent of life expectancy is declining. Innovative policies are needed if societies wish to preserve a positive relationship running from increasing longevity to greater prosperity.

Published: Eggleston, Karen N., and Victor R. Fuchs. "The new demographic transition: most gains in life expectancy now realized late in life." The journal of economic perspectives 26.3 (2012): 137-156.

The elderly share of China’s population is projected to grow well beyond the capacity of the nation’s social security system. Meanwhile, family care is being challenged by a decline in fertility and an increase in migration from rural to urban areas. This paper examines the short-, mid-, and long-term effects of family support on elderly well-being in rural China, using four-wave panel data on 1,456 persons aged 60 and above in the Chaohu region of China. Findings showed that compared with living alone, being coresident with others lowered the mortality risk of several chronic diseases; but being coresident with adult children increased the mortality risk of cardiovascular diseases, though it was associated with a higher quality of life in the short and middle term. Children’s educational attainment and financial support increased the quality of life except for an increased risk of new incidence of cardiovascular disease in the middle term.

Published: Liu, Huijun, et al. "The Quality of Life and Mortality Risk of Elderly People in Rural China The Role of Family Support." Asia-Pacific Journal of Public Health (2013): 1010539512472362.

Emerging infectious diseases (EIDs) pose international security threats because of their potential to inflict harm upon humans, crops, livestock, health infrastructure, and economies. The following questions stimulated the research described in this paper: What infrastructure is necessary to enable EID surveillance in developing countries? What cultural, political, and economic challenges stand in the way of setting up such infrastructure? And are there general principles that might guide engagement with developing countries and support EID surveillance infrastructure?

Using the U.S. Naval Area Medical Research Unit No. 2 as a common denominator, this paper compares barriers to EID surveillance in Cambodia and Indonesia and presents key factors—uncovered through extensive interviews—that constrain disease surveillance systems. In Cambodia, the key factors that emerged were low salaries; poor staff and human resources management; the effect of patronage networks; a culture of donor dependence; contrasting priorities between the government and international donors; and a lack of compensation for animal culling. The Cambodian military has also played a part. The government ceased a merit-based salary supplement scheme for civil servants after the military is alleged to have demanded similar pay incentives that donors had no interest in funding.

In Indonesia the key issues emerging as barriers to effective surveillance include poor host-donor relationships, including differing host-donor priorities and a misunderstanding of NAMRU-2 by Indonesian authorities; low salaries; a decline in the qualifications of personnel in the Ministry of Health; poor compensation for animal culling; and difficulties incentivizing local-level reporting in an era of decentralization.

As the interviews with in-country practitioners revealed, low levels of development in general are the main impediments to building EID surveillance infrastructure and are perhaps beyond the scope of health and scientific agencies at this point. Nevertheless, promoting greater understanding of these issues is a critical first step in mitigating negative outcomes.

Published: Ear, Sophal. "Emerging Infectious Disease Surveillance in Southeast Asia: Cambodia, Indonesia, and the US Naval Area Medical Research Unit 2." Asian Security 8.2 (2012): 164-187.

What kind of a health care system do China’s 1.3 billion turn to when ill, injured, or in need of care? This article provides a brief overview of how China’s health system has transformed alongside China’s society and economy since the Mao era, including how the current system is financed, organized, regulated, and being reformed. It first provides a brief description of the Mao-era health system and China’s demographic and epidemiologic transitions. Then it gives an overview of China’s contemporary health care system, including the dramatic expansion of health insurance over the last eight years and the progress of national health system reforms initiated in 2009.

A condensed and revised version of this paper is published in The Milken Institute Review 2012 second quarter: 16-27. 

Published: Eggleston, Karen. "Health care for 1.3 billion: An overview of China’s health system." (2012).