Fertility decline and social service access: Reconciling behavioral and medical models

In this summary of fertility literature the author attempts to differentiate between the effects of behavioral and medical models of family planning programs on the fertility rate. This is done by determining the effects of access to social welfare services by assessment of: the function of children within the family life survey conducted in the Cameroons are also used. It was found that 7 interdependent elements of social service are involved: 1) general health care; 2) social security for sick and aged; 3) employment training and opportunities for adults; 4) literacy and education; 5) communication and transportation systems; 6) housing and infrastructure; 7) child care and welfare. The presence of these elements is shown to accompany low fertility while their absence is expressed in high rates of child bearing. These elements are major variables in both the nomological and public policy senses. 2 additional components are knowledge of and favorable attitudes towards effective means of fertility control plus effective mechanical, chemical, or natural means of limiting fertility. The concept of fertility norm and its impact on the fertility rate is explained as being the result of the collective force which social affiliations exert on people to reproduce in a certain way. The "stopping rule" is that which will fulfill the fertility norm. An example of this is a culture which continues child bearing until a son has been born and then controls reproduction after this has happened. Such factors must be considered for family planning programs to succeed in these cultures. Therefore fertility levels are found to be the product of prevailing norms and technical ability to achieve these norms. Improvement in levels of access to social services can bring about the lowering of these norms.     

A Global Model for Forecasting Political Instability

Examining onsets of political instability in countries worldwide from 1955 to 2003, we develop a model that distinguishes countries that experienced instability from those that remained stable with a two-year lead time and over 80% accuracy. Intriguingly, the model uses few variables and a simple specification. The model is accurate in forecasting the onsets of both violent civil wars and nonviolent democratic reversals, suggesting common factors in both types of change. Whereas regime type is typically measured using linear or binary indicators of democracy/autocracy derived from the 21-point Polity scale, the model uses a nonlinear five-category measure of regime type based on the Polity components. This new measure of regime type emerges as the most powerful predictor of instability onsets, leading us to conclude that political institutions, properly specified, and not economic conditions, demography, or geography, are the most important predictors of the onset of political instability.     

The Use of Race and Ethnicity in Medicine: Lessons from the African-American Heart Failure Trial

Race or ethnic identity, despite its imprecise categorization, is a useful means of identifying population differences in mechanisms of disease and treatment effects. Therefore, race and other arbitrary demographic and physiological variables have appropriately served as a helpful guide to clinical management and to clinical trial participation. The African-American Heart Failure Trial was carried out in African-Americans with heart failure because prior data had demonstrated a uniquely favorable effect in this subpopulation of the drug combination in BiDil. The remarkable effect of the drug in reducing mortality in this study has illuminated an important new mechanism of therapy for heart failure. Application of these findings need not be confined to the population studied, but the observation highlights the need for more precise ways to identify individual responsiveness to therapy.