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L’impact de la perception des crises sur les intentions de fécondité en France et en Allemagne
No full textThe burden of very early dropout in infertility care: a nationwide population-based cohort study
No full textWhat is the frequency and the associated factors of very early dropout following unsuccessful clomiphene citrate (CC)/gonadotropin treatment in the context of full coverage of treatment cost.Despite free treatment, almost one in four women had a very early dropout following unsuccessful CC/gonadotropin treatment, with patients below the poverty line being more likely to drop out early.Success of infertility care is tarnished by very high dropout rates. Infertility care dropout has been considered as resulting principally from financial barriers because of the high cost of treatment. Nearly all previous work addressed dropout following IVF/ICSI. Factors associated with dropout following CC/gonadotropins may be different and also need to be investigated.Nationwide population-based cohort study.Using the French national health insurance and hospital databases, we included in the cohort 27 416 women aged 18–49 years unsuccessfully treated with CC/gonadotropins in 2017. The main outcome was very early dropout, defined as discontinuation of all infertility treatment after unsuccessful treatment for 1–3 months. Very early treatment dropout was analysed by multivariate logistic regression.Among women unsuccessfully treated with CC/gonadotropins, 22% dropped out of infertility care within 3 months. In multivariate analysis, higher early dropout following unsuccessful CC/gonadotropin treatment was associated with older and younger ages (≥35 and <25 years), being below the poverty line, being treated with CC prescribed by a general practitioner and lack of infertility tests or monitoring.This study is based on health administrative data that do not include reasons for dropout and record only a limited amount of information. It is thus not possible to analyse the reason for early dropout.Despite full coverage of all infertility treatment, women under the poverty line have a higher risk of very early dropout following unsuccessful CC/gonadotropin treatment. Better understanding is needed of the non-financial barriers and difficulties faced by these patients. To address disparities in infertility treatment, practitioner training could be reinforced to adapt to patients from different social and cultural backgrounds.This work was supported by the ANR StimHo project, grant ANR-17-CE36-0011-01 from the French Agence Nationale de la Recherche. The authors have no conflict of interest to declare
Mapping the massive global fertility decline over the last 20 years
No full textThe world fertility map illustrates the major fertility decline across the world, including in Africa, over the last 2 decades. In 2021, almost two-thirds of the world population lived in zones where fertility is now below replacement level; with a few rare exceptions, fertility decline is a worldwide phenomenon. By breaking down the world into geographical regions of around 35 million inhabitants, the fertility map shows subnational variations in the most populated countries and reveals models of a fertility decline that diffuses from the most urbanized zones towards more outlying areas
Reassessing socioeconomic inequalities in mortality via distributional similarities
No full textCommonly used measures of socioeconomic inequalities in mortality, such as the slope and the relative index of inequality, are based on summary measures of the group-specific age-at-death distributions (e.g. life expectancy). While this approach is informative, it ignores valuable information contained in the group-specific distributions. We apply and evaluate a novel measure of socio-economic inequality in mortality. Leveraging a metric of statistical distance, our Population Total Variation (PTV) measure is sensitive not only to
changes in the means or variances, but also to broader mortality changes that affect distributional shapes. The PTV also allow the levels and trends of socioeconomic inequalities in mortality to be decomposed into mortality changes versus changes in the composition of the population. We use mortality data by socioeconomic groups to assess mortality inequalities with both established measures and our proposed PTV. Our findings suggest that levels and trends in mortality inequalities computed with the PTV differ compared to other
conventional summary-based measures. The method we propose can be applied to any context where mortality rates are available by socio-economic groups. We conclude that measuring distributional similarities in mortality enhances our understanding of between groups inequalities in mortality
Are Female-Breadwinner Couples Always Less Stable? Evidence from French Administrative Data
No full textThe paper studies the association between partners' relative incomes and union dissolution among couples in France. With the increase in dual-earner couples and women’s educational level, couples in which women earn more than their partners are structurally becoming more widespread. Because female breadwinning challenges long-lived social norms regarding traditional gender roles, scholars have theorized a higher risk of union dissolution among female-breadwinner couples compared to couples in other income arrangements. We estimate the risk of union dissolution using regression analyses on unique longitudinal data from French administrative sources containing an unconventionally high number of couples (4% of the population) and separation events (more than 100,000), as well as precise and reliable income measurement. Female-breadwinner couples face a higher risk of union dissolution compared to other couple types. This result is robust to various definitions of female breadwinning and controls for partners’ employment status. Contrary to recent research on other countries, we find no sign of a fading effect among younger cohorts. However, among younger, cohabiting couples and couples in registered partnerships the risk of union dissolution is lowest when both partners are employed and provide a similar share of the total couple’s income, suggesting the emergence of a new profile of stable couples. The female-breadwinner penalty in union dissolution is in place; also in France, it holds among married and cohabiting couples and registered partnerships, across all birth cohorts and levels of household income
Digital instructional leadership and teaching practices in an emergency context: Evidence from Italy
No full textWith the COVID-19 pandemic, students around the world faced a disruption of unprecedented intensity. In Italy as in many other countries, for several months emergency remote teaching was the only possible form of schooling. The impacts of the COVID-19 on student achievement could be heterogeneous, depending notably on teachers’ digital instructional practices. Moreover, it was also possible that school principals’ approach to digital instructional leadership would have an impact on student outcomes. In this article, we explore these impacts using a two-level latent class analysis on a representative survey of primary and middle schools at the national level. We begin by analyzing how teachers and principals can be grouped on the basis of their instructional approach and practices during the pandemic, and examine the interaction between the two roles within schools. In the second step, by linking our survey to INVALSI standardized test scores in 2021, we analyze teachers’ and principals’ practices during the emergency on student academic performance. Our results highlight that teachers who were particularly involved in relations and communication with staff and students were (a) more likely to have highly involved principals and (b) associated with better student performance in mathematics one year later
Telework, working conditions, health and wellbeing during the Covid crisis: A gendered analysis
No full textObjective
Telework was massively adopted during the COVID-19 crisis. Related changes in working conditions may have affected women's and men's health differently due to the gendered division of work. Our study aimed to assess the gendered association of telework with physical and mental health outcomes one year after the onset of the pandemic and to determine whether the pathways of working conditions underlying these associations are gender-related.
Methods
We compared pre-pandemic and Covid-crisis work contexts using a large representative sample of French employees surveyed in early 2021. We identified potential work-related mediators of the relationship between telework and well-being, i.e., change in autonomy, low support, work overload, digital issues, atypical working time, meaning at work, and work-life balance, and used multiple-matching and adjusting for confounders.
Results
All things being equal, the health and well-being of teleworkers were, on average, less favourable than that of on-site workers, with little gender differences. The selected working conditions mediated a substantial part of the relationship, indicating that important pathways were captured, such as meaning at work. These pathways partly differed between women and men. In particular, in new teleworkers, the largest contributions came from digital issues for women, and from low support at work and work overload for men.
Conclusion
People who teleworked during the pandemic were at higher odds of deterioration of health and well-being than onsite workers. Health patterns were similar among male and female teleworkers; however, the pathways differed. These negative effects may yet have been absorbed once the government pandemic response became less stringent
Gradients in low birthweight by maternal education: a comparative perspective
No full textBackground
Longstanding research has shown strong inequalities in low birthweight by household income. However, most such research has focused on Anglophone countries, while evidence emerging from other developed countries suggest a stronger role of education rather than incomes in creating inequalities at birth. This paper compares gradients in low birthweight by maternal education, as well as explores underlying mechanisms contributing to these gradients, in France, the United States, and the United Kingdom.
Methods
Analyses are based on harmonized data from large, nationally-representative samples from France, UK and US. We use regression models and decomposition methods to explore the relative role of several possible mechanisms in producing birthweight inequalities.
Results
Inequalities in low birth weight across maternal education groups were relatively similar in the United States, the United Kingdom and France. However, the individual-level mechanisms producing such inequalities varied substantially across the three countries, with income being most important in the US, pregnancy smoking being most evident in France, and the UK occupying an intermediate position. Differences in the mechanisms producing birth health inequalities mirror differences in the policy environment in the three countries.
Conclusion
While inequalities in health appear from the earliest moments in many countries, our results suggest research on birth health inequalities, and therefore policies, is not easily generalizable across national contexts, and call for more scholarship in uncovering the “whys” of health inequalities in a variety of contexts
Spatial disparities in the mortality burden of the covid-19 pandemic across 569 European regions (2020-2021)
No full textThe.R code needed to replicate our estimates for the 95 French NUTS-3 regions is available at: https://osf.io/fwtsa/?view_only=ba00308358dc4fbaa23de72f9c82d1db" rel="noopener noreferrer nofollow">https://osf.io/fwtsa/?view_only=ba00308358dc4fbaa23de72f9c82d1d