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Inequalities in the distribution of childhood adversity from birth to 11 years
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Objective Exposure to early adversity carries long term harmful consequences for children's health and development. This study aims to 1) estimate the prevalence of childhood adversity for Australian children from infancy to 10-11 years, and 2) document inequalities in the distribution of adversity according to socioeconomic position (SEP), Indigenous status, and ethnicity. Methods Adversity was assessed every two years from 0-1 to 10-11 years in the nationally representative birth cohort of the Longitudinal Study of Australian Children (N=5,107). Adversity included legal problems; family violence; household mental illness; household substance abuse; harsh parenting; parental separation/divorce; unsafe neighborhood; family member death; and bullying (from 4-5 years). Adversities were examined individually and summed for a measure of multiple adversity (2+ adverse experiences). Results By 10-11 years, 52.8% (95% CI 51.0-54.7) of children had been exposed to two or more adversities. When combined with low SEP, children from ethnic minority and from Indigenous backgrounds had four to eight times the odds of exposure to two or more adversities than children from higher SEP Anglo-Euro backgrounds, respectively (OR 4.3, 95% CI 2.8-6.6 and OR 8.1, 95% CI 4.4-14.8). Ethnic minority and Indigenous children from higher SEP backgrounds had increased odds of exposure to multiple adversity than similarly advantaged Anglo-Euro children (OR 1.8, 95% CI 1.4-2.3 and OR 2.3, 95% CI 1.3-4.3, respectively). Conclusions Addressing early adversity is a significant opportunity to promote health over the life course, and reduce health inequalities experienced by marginalized groups of children.
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Retired Persons
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Natalie Slopen, Sc.D.
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Natalie Slopen Publications
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Inequities in childrens' exposure to neurotoxicants
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Payne-Sturges' scoping review of the literature and recommendations to narrow health disparities
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Research
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Selected Research
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Insurance coverage and health care utilization among Asian youth before and after the Affordable Care Act
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Objective: We examined changes in insurance coverage and health care utilization associated with the Affordable Care Act (ACA) among subgroups of Asian youth relative to non-Latino white youth. Methods: Data were from the 2010-2017 American Community Survey and National Health Interview Survey. Difference-in-difference models were used to examine changes in insurance coverage and health care utilization associated with the ACA among subgroups of Asian youth relative to white youth and subgroups of Asian youth in households below 200% of the federal poverty level (FPL) relative to comparable white youth. Results: Since the implementation of the ACA, insurance coverage increased among all Asian subgroups and white youth. The magnitude of the increase in insurance coverage was larger among Asian subgroups than white youth. More pronounced increases were found among almost all Asian subgroups in households below 200% FPL. Changes in health care utilization were limited and varied by subgroup. Increases in well-child visits were observed only among Chinese and “other” Asian youth. Conclusions: Insurance coverage increased among Asian youth after the implementation of the ACA. Improvements in health care utilization were limited and differed by subgroups. Programs to improve health care utilization should be tailored to Asian youth according to subgroup.
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MPRC People
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Jie Chen, Ph.D.
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Jie Chen Publications
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Intentionally or Ambivalently Risking a Short Interpregnancy Interval: Reproductive-Readiness Factors in Women’s Postpartum Non-Use of Contraception
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A focus of research on short interpregnancy intervals (IPI) has been on young disadvantaged women whose births are likely to be unintended. Later initiation of family formation in the United States and other high-income countries points to the need to also consider a woman’s attributes indicative of readiness for purposefully accelerated family formation achieved through short IPIs. We test for whether factors indicating “reproductive readiness”—including being married, being older, and having just had a first birth or a birth later than desired—predict a woman’s non-use of contraception in the postpartum months. We also test for whether this contraceptive non-use results explicitly from wanting to become pregnant again. The data come from the 2012–2015 Pregnancy Risk Assessment Monitoring System, representing women who recently gave birth in any of 35 U.S. states and New York City ( N = 120,111). We find that these reproductive-readiness factors are highly predictive of women’s postpartum non-use of contraception because of a stated desire to become pregnant and are moderately predictive of contraceptive non-use without an explicit pregnancy intention. We conclude that planning for, or ambivalently risking, a short IPI is a frequent family-formation strategy for women whose family formation has been delayed. This is likely to become increasingly common as family formation in the United States is initiated later in the reproductive life course.
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MPRC People
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Monica Caudillo, Ph.D.
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Monica Caudillo Publications
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Intergenerational Parenting and Health
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MPRC Associate Terrence Thornberry is studying Intergenerational Health using the Rochester Youth Development Study
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Research
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Selected Research
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Intimate Partner Violence and Effectiveness Level of Contraceptive Selection Post-Abortion
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Materials and Methods: Using data on 245 women who were attending an urban hospital abortion clinic, we assessed whether women had ever experienced emotional, physical, or sexual IPV. Effectiveness of women's post-abortion contraceptive method selection was categorized into high (intrauterine device [IUD] and implant), moderate (pill, patch, ring, and shot), and low (condoms, emergency contraception, and none) effectiveness. Using multinomial logistic regression, we examined the relationship between number of types of IPV experienced and post-abortion contraceptive method effectiveness, adjusting for sociodemographics, prior abortion, having children, abortion trimester, importance of avoiding pregnancy in the next year, pre-abortion psychological distress, and effectiveness level of the contraceptive method women were planning to use before contraceptive counseling. Results: Twenty-seven percent (27%) of women experienced two or three types of IPV, 35% experienced one IPV type, and 38% experienced no IPV. Compared to women with no histories of IPV, women who experienced two or more types of IPV during their lifetimes were more likely to choose contraceptive methods with moderate effectiveness (adjusted odds ratio [AOR] = 5.23, 95% confidence interval [CI]: 1.13–24.23, p = 0.035) and high effectiveness (AOR = 5.01, 95% CI: 1.12–22.39, p = 0.035) than those with low effectiveness. Conclusion: Women who experienced two or more types of lifetime IPV selected more effective contraceptive methods post-abortion. Access to contraceptives that are not partner dependent, including long-acting reversible contraceptives (LARC), may be particularly important for women who have experienced multiple types of IPV.
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MPRC People
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Mona Mittal, Ph.D.
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Mona Mittal Publications
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Intimate Partner Violence and Effectiveness Level of Contraceptive Selection Post-Abortion
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Materials and Methods: Using data on 245 women who were attending an urban hospital abortion clinic, we assessed whether women had ever experienced emotional, physical, or sexual IPV. Effectiveness of women's post-abortion contraceptive method selection was categorized into high (intrauterine device [IUD] and implant), moderate (pill, patch, ring, and shot), and low (condoms, emergency contraception, and none) effectiveness. Using multinomial logistic regression, we examined the relationship between number of types of IPV experienced and post-abortion contraceptive method effectiveness, adjusting for sociodemographics, prior abortion, having children, abortion trimester, importance of avoiding pregnancy in the next year, pre-abortion psychological distress, and effectiveness level of the contraceptive method women were planning to use before contraceptive counseling. Results: Twenty-seven percent (27%) of women experienced two or three types of IPV, 35% experienced one IPV type, and 38% experienced no IPV. Compared to women with no histories of IPV, women who experienced two or more types of IPV during their lifetimes were more likely to choose contraceptive methods with moderate effectiveness (adjusted odds ratio [AOR] = 5.23, 95% confidence interval [CI]: 1.13–24.23, p = 0.035) and high effectiveness (AOR = 5.01, 95% CI: 1.12–22.39, p = 0.035) than those with low effectiveness. Conclusion: Women who experienced two or more types of lifetime IPV selected more effective contraceptive methods post-abortion. Access to contraceptives that are not partner dependent, including long-acting reversible contraceptives (LARC), may be particularly important for women who have experienced multiple types of IPV.
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MPRC People
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Julia Steinberg, Ph.D.
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Julia Steinberg Publications
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Intimate Partner Violence and Effectiveness Level of Contraceptive Selection Post-Abortion
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Materials and Methods: Using data on 245 women who were attending an urban hospital abortion clinic, we assessed whether women had ever experienced emotional, physical, or sexual IPV. Effectiveness of women's post-abortion contraceptive method selection was categorized into high (intrauterine device [IUD] and implant), moderate (pill, patch, ring, and shot), and low (condoms, emergency contraception, and none) effectiveness. Using multinomial logistic regression, we examined the relationship between number of types of IPV experienced and post-abortion contraceptive method effectiveness, adjusting for sociodemographics, prior abortion, having children, abortion trimester, importance of avoiding pregnancy in the next year, pre-abortion psychological distress, and effectiveness level of the contraceptive method women were planning to use before contraceptive counseling. Results: Twenty-seven percent (27%) of women experienced two or three types of IPV, 35% experienced one IPV type, and 38% experienced no IPV. Compared to women with no histories of IPV, women who experienced two or more types of IPV during their lifetimes were more likely to choose contraceptive methods with moderate effectiveness (adjusted odds ratio [AOR] = 5.23, 95% confidence interval [CI]: 1.13–24.23, p = 0.035) and high effectiveness (AOR = 5.01, 95% CI: 1.12–22.39, p = 0.035) than those with low effectiveness. Conclusion: Women who experienced two or more types of lifetime IPV selected more effective contraceptive methods post-abortion. Access to contraceptives that are not partner dependent, including long-acting reversible contraceptives (LARC), may be particularly important for women who have experienced multiple types of IPV.
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MPRC People
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Marie Thoma, Ph.D.
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Marie Thoma Publications
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IPUMS - Time Use website launched
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Hofferth and colleagues help make time use data readily accessible
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Research
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Selected Research
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Jamie Trevitt, University of Maryland Baltimore County
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Post-abortion Contraception Preference
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Coming Up