This study explores rural, suburban and urban differences in coronary heart disease (CHD) using the 2005 Behavior Risk Factor Surveillance Survey conducted in the United States. Although areal context is not often considered in morbidity studies, this study evaluates the importance of place of residence given that areas offer differential access to health infrastructures and different contextual factors that could affect health. Also examined is the role of geographic heterogeneity on the recent racial divergence in CHD in the United States. Results indicate that area of residence is associated with CHD diagnosis, net of health and demographic variables. The area-stratified analysis documents that rural residents are most impacted by exercise and smoking, while being male or above age 50 are most detrimental for suburban residents. In addition, the racial divergence in CHD is driven by differences in rural locales. These findings indicate a disparate impact of geography on CHD and highlight the need for health research to take into account areal context.

The Muslims of Aligarh city are predominantly Sunnis, although there are also a considerable number of Shias. Among the Sunnis, approximately a quarter belong to Syed, Sheikh, Moghal and Pathan groups, and three-quarters belong to various lower biradaris. In the present study, 304 women attending the Primary Health Centre of the J. N. Medical College and Hospital, Aligarh Muslim University, Uttar Pradesh, were surveyed and the following recorded among Muslim women of high-rank (Ashraf) and low-rank (Ajlaf) castes: incidence of marriage, age of the mother at the time of marriage, present age of the mother, abortions, still births, pre-reproductive mortality and overall mortality. The Ashraf are comprised of the Sheikh, Syed and Pathan, whereas the Ajlafs have Qureshi, Saifi and Ansari biradaris. Maternal age was scored as above and below 45 years in each biradari. Significant effects of maternal age were seen on mortality of offspring, whereas populations did not show consistent differences, except when Ashrafs and Ajlafs were considered separately. The results show higher mortality and abortions for various groups. This may be due to various biological and socio-cultural factors, including hidden inbreeding in the remote past.

This paper examines the role of observed contextual factors like topography, development and literacy on severe malnutrition among social groups in rural Maharashtra based on the Reproductive and Child Health District Level Household Survey (RCH-DLHS) Round II (2002–04) data. Multilevel modelling techniques were applied in order to examine the district-wise variations in severe malnutrition associated with the characteristics of the places (contextual effects), as the relationships with the type of people (compositional effects) have already been well established. The results show that developmental aspects such as road connectivity, community literacy, toilet facilities and household standard of living contribute positively to the status of severe malnutrition. Also, the scheduled tribe, aboriginal underprivileged group are more at risk of severe malnourishment due to a lack of proper development, poor awareness about maintaining and enhancing the nutritional value of food and lack of hygiene and sanitation as compared with the scheduled castes, another aboriginal group.

The Azores archipelago (Portugal) is formed by nine islands whose relative positions define them as three geographical groups: Eastern (S. Miguel and Sta. Maria), Central (Terceira, Faial, Pico, Graciosa and S. Jorge) and Western (Flores and Corvo). Using the father’s surname of 187,398 individuals living on the nine Azorean Islands, a population analysis based on inter-island relationship and hierarchical organization was conducted. The relation between islands was investigated using summary statistics, analysis of molecular variance (AMOVA) as well as graphical methods. When the values of heteronymy were contrasted with values of gene diversity based on haplogroup frequencies of the Y chromosome, it was possible to verify that Graciosa and Sta. Maria appeared to have the least diverse populations, and that Flores, despite its smaller population size and geographical isolation, has considerably higher levels of diversity. As for inter-island relationships, the difficulty of directly interpreting summary statistics values was evidenced. The AMOVA revealed that only 0·77% of the variation in surnames can be attributed to among-island variation, a value that, although small, can be considered significant. Application of Malécot’s model revealed that geographic distance has an important impact in the genetic structure of the archipelago. Monmonier’s maximum-difference algorithm demonstrated that the most isolated island of the archipelago appears to be Graciosa, followed by the islands of the Western group and by Sta. Maria. After integrating values of summary statistics with results from AMOVA and graphical methods, a more accurate genetic profile of the Azores, highly supported by genetic data, has emerged.

Although studies have examined religious differences in fertility in sub-Saharan Africa, it is argued in this paper that using women-only sample data may be conceptually problematic in patriarchal African societies where the influence of husbands on their wives’ reproductive preferences is paramount. The present study contributes to this discourse by examining the relationship between religion and fertility behaviour using matched-couple data from Ghana. Guided by the ‘religious values’ and ‘characteristics’ hypotheses, the results indicate significant religious differences in fertility. Compared with Traditionalists, Christians and Muslims have lower fertility, albeit these differences diminish significantly after controlling for socioeconomic variables. The impact of wife’s religious denomination on marital fertility is attenuated after controlling for husband’s religious affiliation. Also, fertility was found to be higher if couples belong to the same faith compared with those of different faiths.

Consanguineous marriage has been the culturally preferred form of marriage in Iran. This paper examines the extent to which education, urbanization and changes in modes of economic production have affected the incidence of consanguineous marriage and attitudes towards consanguineous marriages. The 2002 Iran Fertility Transition Survey conducted in the four provinces of Gilan, Sistan and Baluchistan, Yazd and West Azarbaijan provides information on the degree of relationship of marriage partners from around 6550 ever-married women aged 15–49. Attitudinal data were also obtained. Overall, the level of marriage to biological relatives ranged from 23% in Gilan to 78% in Sistan and Baluchistan. The paper finds that the practice of marriage to biological relatives has remained surprisingly resilient in the face of modernizing influences and that ethnicity, province and area of residence remain important determinants. On the other hand, attitudes have shifted towards marriage with a non-relative. Anthropological research would illuminate the processes of consanguineous marriage in Iran.

Available data in Uganda indicate a resurgence of malaria morbidity and mortality countrywide. This study assessed the burden of malaria, treatment and prevention practices in order initiate a policy debate on the scaling-up of current interventions. A triangulation of methods using a cross-sectional survey and key informant interviews was used to assess self-reported malaria at a household level in Mukono District, Uganda. A total of 5583 households were surveyed, and a high proportion (2897, 51·9%) reported a person with malaria two weeks prior to the survey. Only 546 households (9·8%) owned and used insecticide-treated nets (ITNs) for malaria prevention. Similarly, only a few households (86, 1·5%) used indoor residual spraying. Self-treatment with home-stocked drugs was high, yet there was low awareness of the effectiveness of expired drugs on malaria treatment. Self-reported malaria was associated with socioeconomic, behavioural and environmental factors, but more especially with household ownership of ITNs. These results will contribute to the current debate on identifying new approaches for scaling-up prevention interventions and effective case management, as well as selection of priority interventions for malaria control in Uganda.

A range of activities are currently underway to improve access to malaria prevention and control interventions. As disease control strategies change over time, it is crucial to understand the health-seeking behaviour and the local socio-cultural context in which the changes in interventions operate. This paper reflects on how people in an area of seasonal malaria perceive the causes and transmission of the disease, and what prevention and treatment measures they practise to cope with the disease. It also highlights some of the challenges of malaria treatment for health care providers. The study was undertaken in 2003 in Adami Tulu District in south-central Ethiopia, where malaria is a major health problem. Pre-tested structured questionnaires and focus group discussions were conducted among men and women. Malaria, locally known as busa, was perceived as the most important cause of ill health in the area. Respondent’s perception and knowledge about the cause and transmission of the disease were relatively high. The newly introduced insecticide-treated nets were not popular in the area, and only 6·4% of households possessed at least one. The results showed that patients use multiple sources of health care for malaria treatment. Public health facilities, private clinics and community health workers were the main providers of malaria treatment. Despite higher treatment costs, people preferred to use private health care providers for malaria treatment due to the higher perceived quality of care they offer. In conclusion, effort in the prevention and control of malaria should be intensified through addressing not only public facilities, but also the private sector and community-based control interventions. Appropriate and relevant information on malaria should be disseminated to the local community. The authors propose the provision of effective antimalarial drugs and malaria prevention tools such as subsidized or free insecticide-treated nets.

The remarkable decline in fertility in Iran, which saw the total fertility rate fall from 7 children per woman in 1986 to 2 in 2000, has received only limited analysis in the demographic literature. Using the 2000 Iran Demographic and Health Survey and Bongaarts’ age-specific fertility model, this paper examines the role of the major proximate determinants of fertility in bringing about the rapid decrease in fertility in Iran. The analysis indicates that contraception had the largest effect on fertility, accounting for 61% of the reduction in fertility from its theoretical maximum. The fertility-inhibiting effect of marriage patterns accounted for an additional 31% reduction, and was most important among the young. Further analysis of contraceptive behaviour suggests that the current period fertility rate of 2·0 children per woman is an outcome of a synchronization of delaying and spacing of births among younger women with stopping of childbearing among women in the middle and late reproductive ages. The policy implications of the results are discussed.

In recent years, sex differences in mortality have followed diverse patterns of change in developed countries. As there is no analogous evidence from Poland, the aim of this study was to describe the pattern of change in excess male mortality among Polish inhabitants aged 35–64 during 1995–2002, when the major socioeconomic transformation occurred, and compare it with sex differences in mortality observed in the late 1980s. During the study period, excess male mortality decreased significantly, independently of age and educational level. The reduction in mortality was observed in both sexes, but its magnitude was greater in men. These changes resulted mainly from a reduction in mortality rates due to cardiovascular disease and lung cancer in males and a concomitant increase in mortality rates due to lung cancer and suicides in females. Although, in general, excess male mortality decreased, social gradients related to this phenomenon increased. Subjects (in particularly men) who had graduated from university benefited the most, their magnitude of reduction in mortality rates being the greatest. Changes in social environment during the transformation period in Poland are suggested as major determinants of these changes, but further studies are needed.

On 26th December 2003, a severe earthquake hit the city of Bam in Kerman province, southern Iran. It destroyed around 90% of houses and at least 60% of the public buildings, and claimed the lives of more than 20,000 persons. To investigate whether acute stress caused by the Bam earthquake could alter the sex ratio at birth (SRB) 6–12 months later, the present study was done. The number of live births by sex was obtained from the National Organization for Civil Registration (Kerman province). The SRB was expressed as the male proportion. A prominent decline in the SRB (̃0·467) 11 months after the earthquake was observed (χ2=6·68, df=1, p=0·009). There was no significant difference between Bam and Kerman province (excluding Bam) for SRB (χ2=0·44, df=1, p=0·51) for a period of 33 month before the earthquake (from April 2001 to December 2003). It might be concluded that psychological tensions and stress are associated with a decrease in SRB.

No information is currently available on the marriage patterns of German-speaking communities of the South Tyrol area. The aim of this study is to investigate the reproductive isolation of four South Tyrolean mountain villages during the 19th century. Data about 3953 marriages were drawn from existing pedigrees and completed with data from the parish registers of the studied villages to calculate the following indicators: age at marriage, endogamy, inbreeding from dispensations and from isonymy and repeated pairs of surnames among couples. The results show high levels of endogamy (78–87%) and an elevated age at marriage in all the studied villages. The percentages of consanguineous marriages (10–33%) vary considerably but result overall in relatively low inbreeding values (α 0·0015–0·0036; Ft 0·0098–0·0138). Levels of endogamy are consistent with the geographic characteristics of the area, while inbreeding values are lower than those observed in previous studies on Alpine communities. This is due to a low frequency of marriages between close relatives, probably related to the peculiar demographic and cultural characteristics of the studied populations that differentiate them from neighbouring Italian-speaking villages.

The relation between women’s timing of menarche and father absence was examined in a national probability sample of Great Britain (NATSAL 2000; N>5000). Current body mass index (as a proxy for childhood weight) was examined as a potential mediator of this relationship, along with the potential moderating role that siblings (e.g. number of older brothers) had on this relationship. As in a number of previous studies, an absent father (but not an absent mother) during childhood predicted an earlier age of puberty (i.e. an early menarche). There was no evidence that weight mediated this relationship or that siblings moderated it. Both a lower body mass index and more siblings (e.g. more younger sisters and brothers) were independent predictors of a later timing of puberty. The results confirm that certain psychosocial factors (i.e. father absence; presence of siblings) may affect the timing of sexual maturation in adolescent girls.

The aim of this study was to determine the prevalence and sociodemographic correlates of consanguineous marriages in Turkey using data derived from the 2003 Turkey Demographic and Health Survey (TDHS-2003). Demographic surveys conducted in the last 40 years consistently show that Turkey is a country with a high level of consanguinity. In the latest demographic survey (TDHS-2003), a nationally representative sample of 8075 ever-married women, consanguineous marriages accounted for 22% of the total, which is equivalent to a mean coefficient of inbreeding (α) of 0·011. There are changing secular profiles in the rates of consanguinity in general and of the specific sub-types of cousin marriages in particular in Turkey. The prevalence of first cousin marriages among all consanguineous marriages presents a steady decline from one marriage cohort to the next. The changes observed over time may be attributable to several factors such as the increase in educational level of women, the nuclearization of the family system, the mobility from rural to urban settings, a better socioeconomic status of families, an increase in women’s labour force participation in formal sectors, lower fertility rates resulting in a smaller number of cousins available for marriage, and an increased awareness of the effects of consanguineous unions on child health in cases where there is an inherited recessive disease in the family. Any attempts to discourage consanguinity at the population level appear to be inappropriate and undesirable, especially when the consanguineous union remains an integral part of the cultural and social life of Turkey. Nevertheless the WHO-recommended approach to minimizing the negative effects of consanguinity on child health should be followed, i.e. the identification of families with a high risk of a genetic disease and the provision of prospective genetic counselling.

This study of family planning in rural Adana, Turkey, collected data from 519 women aged between 16 and 55. Questionnaires were distributed in different districts during February 2006. The results showed that 81·3% of women used a contraceptive method. The IUD was the most widely used modern contraceptive method. There is a decrease in the average number of births per woman as the educational level of women increases.

In a recent article in this journal, Lynn et al. (2007) found a high correlation between average national IQs and achievement test scores in 67 countries and concluded ‘The correlation is so high that national IQs and educational achievement appear to be measures of the same construct.’ The author finds here the data do not support this conclusion.

The origin of talent and expertise is currently the subject of intense debate, with explanations ranging from purely biological to purely environmental. This report shows that the population of expert chess players in the northern hemisphere shows a seasonal pattern, with an excess of births in late winter and early spring. This effect remains when taking into account the distribution of births in the population at large, using statistics from the European Union member countries. A similar pattern has been found with schizophrenia, and the possible link between these two phenomena is discussed.