Demographic Research最新文献

Background: Quantitative studies of Amish population dynamics have been methodologically constrained by difficulties identifying Amish in national surveys. If Amish could be reliably identified in, for example, the American Community Survey (ACS), researchers could leverage its rich variables to document both demographic outcomes and their social predictors.

Objective: Cross-validate two methods for studying Amish populations by comparing fertility measures in the ACS with the Cross-sectional Amish Population and Environment Database-2010s (CAPED-2010s), a large administrative record database of North American Amish.

Methods: We identify potential Amish ACS respondents through combinations of the attributes (1) Pennsylvania Dutch language use, (2) absence of household telephone, and (3) farming. We then calculate fertility measures derived from both the CAPED data and ACS data samples (2000-2021). This comparative method allows us to assess whether the two samples produce demographic comparable estimates.

Results: Both methods produce remarkably consistent fertility statistics, including total fertility rates (just over six children), age-specific fertility rates (highest ages 20-29), and non-marital fertility (very low).

Conclusions: The strong agreement between ACS- and CAPED-2010s-derived demographic estimates validates both approaches for studying Amish populations.

Contribution: The ACS's rich social variables complement CAPED-2010s' comprehensive demographic coverage, demonstrating the credibility of two separate large databases for studies of the Amish.

Background: Incomplete vital statistics systems in resource-limited countries hinder accurate HIV epidemic assessments. Population-based survey data combined with HIV infection biomarkers may partially address this gap, providing excess mortality estimates in households where people living with HIV (PLWH) reside.

Objective: Examine household-level excess HIV mortality in households with PLWH using population-based survey data, including mortality reported by heads of households, and HIV biomarkers.

Methods: We compared mortality between households with and without PLWH using publicly available data from 11 Population-based HIV Impact Assessments conducted between 2015 and 2019 in Cameroon, Côte d'Ivoire, Eswatini, Kenya, Malawi, Namibia, Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe. Eligible, consenting household members provided blood for HIV testing. Household-level regression models estimated deaths per 1,000 person-years (PY) for the three-year period before the survey; death rate ratios were calculated. Quasi-Poisson distribution accounted for household death over-dispersion.

Results: Country-specific deaths rates per 1,000 PY were significantly higher among rural versus urban households for five countries. For example, in Cameroon, the rates were 9.3 (95% confidence interval [CI]: 8.7-9.9) versus 6.5 (95% CI: 5.9-7.1). In six countries, death rates were significantly higher (1.3-1.7-fold) among households with PLWH versus those without. Death rate ratios were significantly higher among rural (1.4-1.8-fold) and urban households (1.6-2.3-fold) with PLWH versus those without in four and three countries, respectively.

Conclusions: General population household survey findings in multiple countries in Africa indicate that households where PLWH resided experienced excess mortality relative to other households.

Contribution: The novel approach we use to describe HIV-related household-level mortality offers an additional method to measure progress toward zero AIDS-related deaths.