This paper focuses on age restrictions on access to infertility treatments and eligibility for their public reimbursement, exploring their relevancy in contexts of rising late birth rates (40+). I explore how age-based reimbursement policies for in vitro fertilization treatments have responded to these fertility trends in 27 high-income countries and in which regulatory frameworks for medically assisted reproduction (MAR) very late births (45+) have particularly increased. First, I show that while age limits for treatment reimbursement are well aligned with the prevalence of late fertility in some national contexts, in most countries, strict age restrictions are lagging behind the rise in late births. In others, pronatalist policies have prompted permissive age criteria or law revisions, anticipating or adapting to rising trends in late births. Second, the rise in very late births has been limited in some contexts with strict age-based rules. However, the analysis suggests that the impact of MAR on very late births may also be influenced by contextual factors other than regulations.

Recognizing the prolonged, uneven, and evolving nature of the Covid-19 pandemic, this study provides one of the first dynamic, multilevel perspectives of women's fertility intentions in response to the pandemic and its multifaceted impacts. We examine how evolving individual- and community-level Covid-19 risk mechanisms and socioeconomic and life-course conditions are associated with continuity and change in women's fertility intentions. We combine individual-level panel data from a population-based sample of women aged 18-34 in Pernambuco, Brazil in 2020 and 2021 with corresponding administrative data from 94 municipalities. We use multinomial logit regressions to model continuity and change in fertility intentions across waves. We then estimate fixed effect models to highlight the time-varying determinants of changing fertility intentions while accounting for unobserved, time-invariant individual factors. We find that high and/or increasing individual and community-level Covid-19 exposure is associated with a greater likelihood of abandoning initial childbearing plans and a greater likelihood to maintain intentions to forego versus to intend having additional children. We advance the literature by highlighting how individual-level Covid-19 infection risk perceptions matter for fertility intentions, net of community-level exposure, and the necessity of dynamic perspectives for understanding how fertility intentions have changed (or not) in response to the pandemic.

The COVID-19 pandemic was accompanied by social and economic changes previously associated with fertility delay and reduction, sparking widespread discussion of a "baby bust" in the U.S. We examine fertility trends using restricted vital statistics data from California, a diverse population of 40 million contributing 12% of U.S. births. Using time series models that account for longer-run fertility trends, we observe modest, short-term reductions in births from mid 2020 through early 2021. Birth counts in subsequent months matched or even eased the pace of fertility decline since the 2008 recession and are unlikely a function of the pandemic alone. Responses to the pandemic were heterogeneous. Fertility declined markedly among the foreign-born population, largely driven by changes in net migration. Among the U.S.-born population, the short-term pandemic-attributable reductions were largest among older, highly educated people, suggesting mechanisms of fertility reduction disparately accessible to those with the most resources. We find no evidence of a strong population fertility response to the pandemic's accompanying employment shock, providing additional evidence of a growing divide between macroeconomic conditions and fertility patterns in the U.S.

Women in Africa may have experienced conflicting pressures during the COVID-19 pandemic. While the unpredictable nature of the pandemic was prompting some women to delay pregnancies, the pandemic was potentially limiting access to reproductive health services due to supply shortages, fears of virus exposure, and mobility restrictions. In this study, we used longitudinal data from Kenya and Burkina Faso and applied a multilevel perspective to better understand the factors contributing to change or persistence in contraceptive use during the early months of the pandemic. We found a marginal increase in contraceptive uptake in the early days of the pandemic. Multilevel logistic regression results revealed that interpersonal trust and accurate knowledge of COVID-19 precautions were associated with a greater likelihood of initiating contraception. These factors appeared to have provided women with confidence to navigate the complicated COVID-19 landscape. At the same time, we observed a decrease in contraceptive use in regions with high COVID-19 cases, suggesting the virus was limiting access to contraception in some contexts. These findings highlighted the need for public health officials to ensure that women have the necessary knowledge and ability to safely access contraception during public health crises, when overall demand for contraception may be increasing.

Demographers have long been interested in how fertility ideals vary in response to perceived existential threats. Although migration scholars document the increasingly threatening nature of U.S. immigration policies, little research explores how these policies shape the fertility ideals of those most affected by them. To that end, we exploit spatiotemporal variation in states' evolving immigrant policy contexts to understand the effects of different policies on the ideal family size of Hispanics-a group who is most likely to be stereotyped as undocumented and most likely to live in mixed-status households or communities. Specifically, we combine time-varying information on state-level immigrant policies with georeferenced data from the General Social Survey (GSS). Results suggest that the gap in ideal family size between Hispanic and white respondents is significantly larger in state-years with omnibus policies-which bundle multiple restrictive laws together and thus impose sweeping restrictions- compared to state-years without these policies. On the other hand, sanctuary policies, which aim to curb federal immigration enforcement, and E-verify mandates, which aim to curb the employment of undocumented immigrants, are not associated with significant differences. Our analyses provide new insights into the complex ways in which the evolving U.S. immigrant policy landscape has far-reaching impacts on reproductive and family life.

The disparity in life expectancy between white and black Americans exceeds five years for men and three years for women. While prior research has investigated the roles of healthcare, health behaviors, biological risk, socioeconomic status, and life course effects on black mortality, the literature on the geographic origins of the gap is more limited. This study examines how the black-white life expectancy gap varies across counties and how much of the national gap is attributable to within-county racial inequality versus differences between counties. The estimates suggest that over 90% of the national gap can be attributed to within-county factors. Using a quasi-experimental research design, I find that black-white residential segregation increases the gap by approximately 16 years for men and five years for women. The segregation effect loads heavily on causes of death associated with access to and quality of healthcare; safety and violence; and public health measures. Residential segregation does not appear to operate through health behaviors or individual-level factors, but instead acts primarily through institutional mechanisms. Efforts to address racial disparities in mortality should focus on reducing racial residential segregation or reducing inequalities in the mechanisms through which residential segregation acts: public services, employment opportunities, and community resources.

Individuals age at vastly different rates resulting in significant within-population heterogeneity in health and aging outcomes. This diversity in health and aging trajectories has rarely been investigated among low-income aging populations that have experienced substantial hardships throughout their lifecourses. Utilizing 2006-2018 data from the Malawi Longitudinal Study of Families and Health (MLSFH) and estimating group-based trajectory models (GBTM), our analyses identified three distinct lifecourse health trajectories: (1) comparatively good initial mental and physical health that persisted throughout the lifecourse ("resilient aging"); (2) relatively good initial mental and physical health that started to deteriorate during mid-adulthood ("accelerated aging"); and (3) poor initial mental and physical health that further declined over the lifecourse ("aging with persistently poor health"). For both physical and mental health, men were more likely to enjoy resilient aging than women. Predictors other than gender of trajectory membership sometimes confirmed, and sometimes contradicted, hypotheses derived from high-income country studies. Our analyses highlight the long arm of early life conditions and gender in determining aging trajectories and show that a non-trivial sub-population is characterized by aging with persistently poor health. The study uncovers widening gaps in health outcomes between those who age with resilience and those who experience accelerated aging.

The U.S. Census has grappled with public concerns about privacy since the first enumeration in 1790. Beginning in the mid-nineteenth century, census officials began responding to concerns about privacy with promises of confidentiality. In recent years, escalating concerns about confidentiality have threatened to reduce the usability of publicly accessible population data. This paper traces the history of privacy and disclosure control since 1790. We argue that controlling public access to census information has never been an effective response to public concerns about government intrusion. We conclude that the Census Bureau should weigh the costs of curtailing access to reliable data against realistic measures of the benefit of new approaches to disclosure control.

In the post-Recession era, U.S. fertility rates have continued to fall. It is unclear if these declines are driven by shifts in fertility goals or growing difficulty in achieving goals. In this paper, we construct synthetic cohorts of men and women to examine both cross-cohort and within-cohort changes in fertility goals using multiple cycles of the National Survey of Family Growth. Although more recent cohorts exhibit lower achieved fertility at younger ages than earlier cohorts at the same age, intended parity remains around two children, and intentions to remain childless rarely exceed 15%. There is weak evidence of a growing fertility gap in the early 30s, suggesting more recent cohorts will need considerable childbearing in the 30s and early 40s to 'catch up' to earlier goals, yet low-parity women in their early 40s are decreasingly likely to have unfulfilled fertility desires or intentions to have children. Low-parity men in their early 40s, though, are increasingly likely to intend children. Declines in U.S. fertility thus seem to be largely driven not by changes in early-life fertility goals so much as either a decreasing likelihood of achieving earlier goals or, perhaps, shifts in the preferred timing of fertility that depress period measures.

The United States has experienced a sustained fertility decline, with those currently in their childbearing years facing unique constraints. Drawing from the Theory of Conjunctural Action and the Narratives of the Future framework, this work considers how objective and subjective socioeconomic conditions, psychosocial characteristics, and perceptions of well-being are linked to mothers' and childless women's (a) prospective fertility intentions during the Great Recession, (b) realization of those intentions in the post-Recession period, and (c) fertility intentions toward the end of the reproductive years, using Waves IV and V of the National Longitudinal Study of Adolescent to Adult Health. The results confirm the role of standard socioeconomic measures and also highlight the importance of subjective measures. In general, more advantaged women were more likely to intend to have (more) children at both waves and to have children between waves. Furthermore, women who already had children by the Great Recession were more likely than their childless peers to have a(nother) child in the post-Recession period. As this cohort approaches the end of its childbearing years, having unfulfilled fertility plans from earlier in the reproductive life course is a strong predictor of continuing to intend at least one birth.

As the rest of the developing world, Sub-Saharan Africa has experienced profound transformations in the institution of marriage. Yet, unlike most other regions, polygyny has remained widespread across the subcontinent. There is, however, evidence to suggest that the practice of polygyny is declining and that selection into polygynous unions based on sociodemographic characteristics is increasing assub-Saharan Africa undergoes rapid sociocultural, demographic, and economic change. Using data from 111 Demographic and Health Surveys conducted in 27 countries since the 1990s, we study recent trends in the prevalence of polygyny among currently married women, examine sociodemographic characteristics of women in polygynous unions, and test whether selection on these characteristics into polygynous unions has increased over time. We find that, net of other factors, the likelihood of being in a polygynous union has declined in most countries. We show that women who are less educated, non-Christian, and living in rural areas are more likely to be in a polygynous union and that in many countries, selection into polygynous unions on these characteristics has been growing. These findings contribute to the broader literature on marital and family change by providing new insights into recent trends in and patterns of polygyny across the subcontinent.

Prior research on early-life exposures to famine has established in utero development as a critical period of vulnerability to malnutrition. Yet, previous research tends to focus narrowly on this stage, at the expense of a more comprehensive examination of childhood. As a result, the literature has yet to compare the severity of the consequences of exposure to malnutrition across developmentally salient periods. Such comparison is crucial not only in the magnitude of effects but also in the nature of outcomes. Using a restricted population registry-linked health survey, this study examines the Dutch Hunger Winter to provide a comprehensive examination of the long-term consequences of in utero, infant, childhood, and adolescent exposure to famine. The results show malnutrition leads to heterogeneous effects depending on when the exposure occurs. In utero exposure to malnutrition leads to deleterious conditions in physical health and lower socioeconomic attainment. For older cohorts, results suggest a resilience to the effects of malnutrition on physical health in late life, but a higher vulnerability to socioeconomic stunting. Furthermore, the results suggest important gender differences in the long-term impact of malnutrition. Males consistently show stronger negative consequences across a wider array of conditions.

The literature on climate exposures and human migration has focused largely on assessing short-term responses to temperature and precipitation shocks. In this paper, we suggest that this common coping strategies model can be extended to account for mechanisms that link environmental conditions to migration behavior over longer periods of time. We argue that early-life climate exposures may affect the likelihood of migration from childhood through early adulthood by influencing parental migration, community migration networks, human capital development, and decisions about household resource allocation, all of which are correlates of geographic mobility. After developing this conceptual framework, we evaluate the corresponding hypotheses using a big data approach, analyzing 20 million individual georeferenced records from 81 censuses implemented across 31 countries in tropical Africa, Latin America, and Southeast Asia. For each world region, we estimate regression models that predict lifetime migration (a change in residence between birth and ages 30-39) as a function of temperature and precipitation anomalies in early life, defined as the year prior to birth through age four. Results suggest that early-life climate is systematically associated with changes in the probability of lifetime migration in most regions of the tropics, with the largest effects observed in sub-Saharan Africa. In East and Southern Africa, the effects of temperature shocks vary by sex and educational attainment and in a manner that suggests women and those of lower socioeconomic status are most vulnerable. Finally, we compare our main results with models using alternative measures of climate exposures. This comparison suggests climate exposures during the prenatal period and first few years of life are particularly (but not exclusively) salient for lifetime migration, which is most consistent with the hypothesized human capital mechanism.

Despite its central importance to global family planning, the "unmet need for contraception" metric is frequently misinterpreted. Often conflated with a lack of access, misinterpretation of what unmet need means and how it is measured has important implications for family planning programs. We review previous examinations of unmet need, with a focus on the roles of access and demand for contraception, as well as the role of population control in shaping the indicator's priorities. We suggest that disaggregating unmet need into "demand-side unmet need" (stemming from lack of demand) and "supply-side unmet need" (stemming from lack of access) could allow current data to be leveraged into a more person-centered understanding of contraceptive need. We use Demographic and Health Survey data from seven sub-Saharan African countries to generate a proof-of-concept, dividing women into unmet need categories based on reason for contraceptive nonuse. We perform sensitivity analyses with varying conceptions of access and disaggregate by education and marital status. We find that demand-side unmet need far exceeds supply-side unmet need in all scenarios. Focusing on supply-side rather than overall unmet need is an imperfect but productive step toward person-centered measurement, while more sweeping changes to family planning measurement are still required.

This study examines how population aging will shape a crucial aspect of mental health and social well-being - loneliness. Drawing on theories of demographic metabolism, United Nations' population estimates and projections, and survey data covering approximately 50% of the world's population aged 50 and above living in 27 countries, we estimate the role of population aging in shaping cross-national differences in loneliness from 1990 to 2050. We use survey data to estimate the prevalence of late middle age and older adult loneliness by age and sex, and then apply these rates to the evolving age and sex distributions of the populations. Our results highlight massive increases in loneliness at ages 50 and above with a tripling of the number of lonely adults in these age groups in our sample countries from 104.9 million in 1990 to 333.5 million in 2050, increasing variability across countries in the share of their populations composed of lonely adults 50 and above, and the feminization of global later life loneliness with an increasing share of lonely adults in these age ranges being women. These results illustrate the power of demographic modeling to advance understandings of national profiles of mental health and social well-being.

In the context of broad increases in gender equality and growing socioeconomic disparities along multiple dimensions of family life, we examine changes in within-family earnings equality following parenthood and the extent to which they have played out differently by education. Our analysis relies on links between rich surveys and administrative tax records that provide high quality earnings data for husbands and wives spanning two years before and up to 10 years following first births from the 1980s to the 2000s in the United States (Survey of Income and Program Participation Synthetic Beta files; =21,300 couples and 194,100 couple-years). Accounting for time-invariant couple characteristics and year and age fixed effects, we find that wives' share of total couple earnings declines substantially after parenthood and remains lower over the observation window. Cohort changes in within-family earnings equality are modest and concentrated among the earliest cohort of parents, and data provide little evidence of differential change by education. Wives' financial dependence on their husbands increases substantially after parenthood, irrespective of education and cohort. These findings have implications for women's vulnerability, particularly in the U.S. where divorce remains common and public support for families is weak.

This paper studies long-term trends and patterns in global refugee migration. We explore the intensity, spread, and distance of refugee migration at a global, regional, and country level between 1951 and 2018. The analysis did not detect a long-term increase in the global intensity of refugee migration. Primarily depending on levels of conflict, refugee numbers have fluctuated at levels of between 0.1 and 0.3 percent of the world population. Apparent increases in numbers of the globally displaced are driven by the inclusion of populations and countries that were previously excluded from the data. While refugee populations continue to be concentrated in countries with low-to-medium income levels, the analysis reveals several geographic shifts in refugee migration. Refugees tend to come from a shrinking number of origin countries and move to an increasing variety of destination countries. This trend seems to reflect a concentration of recurrent conflict cycles in a relatively small number of countries and a parallel increase in the number of safe destinations. Although the vast majority of refugees remain near to origin countries, the average distance between origin and destination countries has increased over time, presumably linked to the greater ease of travel and migration-facilitating networks.

Scientific ideas on the human population tend to be rooted in a "slow demography" paradigm, which emphasizes an inertial, predictable, self-contained view of population dynamics, mostly dependent on fertility and mortality. Yet, demography can also move fast. At the country level, it is crucial to empirically assess how fast demography moves by taking migratory movements into account, in addition to fertility and mortality. We discuss these ideas and present new estimates of the speed of population change, that is, country-level population turnover rates, as well as the share of turnover due to migration, for all countries in the world with available data between 1990 and 2020. Population turnover is inversely related to population size and development, and migratory movements tend to become important factors in shaping demography for both small and highly developed countries. Longitudinally, we analyze annual turnover data for Italy and Germany, documenting the changing speed of population change over time and its determinants. Accepting the "fast and slow" demography perspective has several implications for science and policy, which we discuss.

This study investigates whether young people in low- and middle-income countries (LMICs) have experienced processes of destandardization of the life course similar to those observed in high-income societies. We provide two contributions to the relevant literature. First, we use data from 263 Demographic and Health Surveys (DHS) across 69 LMICs, offering the richest comparative account to date of women's transition to adulthood (TTA) patterns in the developing world. In so doing, we adopt sequence analysis and shift the focus from individual life-course events-namely first sexual intercourse, first union, and first birth-to a visually appealing approach that allows us to describe interrelations among events. By focusing on the analysis of trajectories rather than the occurrence of single events, the study provides an in-depth focus on the timing of events, time intervals between events, and how experiencing (or not) one event might have consequences for subsequent markers in the TTA in cross-national comparative perspective. Second, we identify clusters of TTA and explore their changes across cohorts by region and household location of residence (rural vs. urban). We document significant differences by macro-regions, yet relative stability across cohorts. We interpret the latter as suggestive of cultural specificities that make the TTA resistant to change and slow to converge across regions, if converging at all. Also, we find that much of the difference across cluster typologies ensues from variation related to the transition begins (early vs. late), rather than from the duration between events, which tends to be uniformly quick across three out of four clusters.