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<title>PSC Working Paper Series</title>
<copyright>Copyright (c) 2013 University of Pennsylvania All rights reserved.</copyright>
<link>http://repository.upenn.edu/psc_working_papers</link>
<description>Recent documents in PSC Working Paper Series</description>
<language>en-us</language>
<lastBuildDate>Wed, 03 Apr 2013 01:42:28 PDT</lastBuildDate>
<ttl>3600</ttl>


	
		
	







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<title>An Equilibrium Model of the African HIV/AIDS Epidemic</title>
<link>http://repository.upenn.edu/psc_working_papers/43</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/43</guid>
<pubDate>Mon, 01 Apr 2013 10:52:42 PDT</pubDate>
<description>
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	<p>Eleven percent of the Malawian population is HIV infected. Eighteen percent of sexual encounters are casual. A condom is used one quarter of the time. A choice-theoretic general equilibrium search model is constructed to analyze the Malawian epidemic. In the developed framework, people select between different sexual practices while knowing the inherent risk. The analysis suggests that the efficacy of public policy depends upon the induced behavioral changes and general equilibrium effects that are typically absent in epidemiological studies and small-scale field experiments. For some interventions (some forms of promoting condoms or marriage), the quantitative exercise suggests that these effects may increase HIV prevalence, while for others (such as male circumcision or increased incomes) they strengthen the effectiveness of the intervention. The underlying channels giving rise to these effects are discussed in detail.</p>

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<author>Jeremy Greenwood et al.</author>


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<title>The Impact of Married Individuals Learning HIV Status in Malawi: Divorce, Number of Sexual Partners, Condom Use with Spouses</title>
<link>http://repository.upenn.edu/psc_working_papers/42</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/42</guid>
<pubDate>Wed, 20 Mar 2013 07:58:27 PDT</pubDate>
<description>
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	<p>This paper assesses how knowledge of HIV status gained through HIV testing and counseling (HTC) by married individuals affects divorce, the number of sexual partners and the use of condoms within marriage. Instrumental variable probit and linear models are estimated, using a randomized experiment administered as part of the Malawi Longitudinal Study of Families and Health. The results indicate that knowledge of HIV status (1) does not affect chances of divorce for either HIV-negative or HIV-positive respondents; (2) reduces the number of sexual partners among HIV-positive respondents, and (3) increases condom use with spouses for both HIV-negative and HIV-positive respondents. These results imply that individuals actively respond to learning HIV status through HTC, invoking protective behavior against future risk of HIV/AIDS for themselves and their actual and potential sexual partners.</p>

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<author>Theresa M. Fedor et al.</author>


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<title>The Social and the Sexual: Networks in Contemporary Demographic Research</title>
<link>http://repository.upenn.edu/psc_working_papers/41</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/41</guid>
<pubDate>Tue, 05 Feb 2013 10:57:48 PST</pubDate>
<description>
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	<p>The analysis of networks has become an important theme in contemporary demographic research in both developed and developing countries, including investigations of the determinants of fertility behaviors, the interaction between social network and social structures and population policies, the role of intergenerational networks in aging societies, and the relevance for sexual networks for the spread of HIV AIDS. This paper reviews the current research on networks across several domains in demographic research, and it discusses some of the specific challenges of network-based approaches with respect to data collection, analytic approaches and methodologies, interpretation of results, and micro-to-macro aggregation by drawing on research conducted as part of the Kenyan Diffusion and Ideational Change Project (KDICP), the Malawi Longitudinal Study of Families and Health (MLSFH) and the Likoma Network Study (LNS).</p>

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<author>Hans-Peter Kohler et al.</author>


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<title>Marriage as a Mechanism: Women’s Education and Wealth in Malawi</title>
<link>http://repository.upenn.edu/psc_working_papers/40</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/40</guid>
<pubDate>Thu, 01 Nov 2012 07:36:51 PDT</pubDate>
<description>
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	<p>Research has found that in the United States women have greater economic returns to a college degree than men, because of more stable marriages and other family income. Using cross-sectional data of women aged 19-40 years in Malawi from the Malawi Longitudinal Study of Families and Health (<em>n </em>= 898), we test whether higher education is associated with these same benefits in a context with lower educational attainment levels, fewer job opportunities, and different marriage patterns. We find that better educated women are more likely to have better educated spouses and higher household wealth. Though divorce is negatively associated with wealth, we do not find an association between education and divorce. This analysis provides motivation for further research on the how education is associated with outcomes for women in developing countries.</p>

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<author>Sarah Spell et al.</author>


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<title>The Indirect Impact of Antiretroviral Therapy</title>
<link>http://repository.upenn.edu/psc_working_papers/39</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/39</guid>
<pubDate>Mon, 01 Oct 2012 08:52:53 PDT</pubDate>
<description>
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	<p>In response to AIDS mortality in Sub-Saharan Africa, international donors have collaborated with many national governments to provide free antiretroviral therapy (ART) to people with HIV. We explore the impact of this decline in objective mortality risk on subjective perceptions of mortality risk, as well as mental health, and agricultural labor supply and output. Through a difference-indifference identification strategy, we find that ART availability substantially reduces subjective mortality risk and improves mental health in rural Malawi, including among HIV-negative respondents. People allocate significantly more time to subsistence maize cultivation and increase maize output. These results show a novel link between mortality conditions and economic development through the channel of mental health. Findings for the HIV-negative subpopulation also demonstrate that the impact of the AIDS epidemic and ART are broader than previously understood.</p>

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<author>Victoria Baranov et al.</author>


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<title>Education Fever and the East Asian Fertility Puzzle:  A Case Study of Low Fertility in South Korea</title>
<link>http://repository.upenn.edu/psc_working_papers/38</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/38</guid>
<pubDate>Mon, 01 Oct 2012 08:02:03 PDT</pubDate>
<description>
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	<p>Fertility throughout East Asia has fallen rapidly over the last five decades and is now below the replacement rate of 2.1 in every country in the region.  While similar but less extreme declines occurred throughout Europe during this same period, the declines to lowest-low fertility during the 1990s have been reversed in the last ten years as the pace of tempo changes (i.e., the postponement of childbearing) has slowed. Recent literature has shown that many European countries have in fact also experienced increases in cohort fertility.  No such widespread fertility reversal has occurred in East Asia, where family size (i.e., cohort fertility) continues to decline. In this paper we seek to explain the precipitous (and in some cases, continual) fertility declines in East Asia.  Using South Korea as a case study, we argue that East Asia’s ultra-low fertility rates can be partially explained by the steadfast parental drive to have competitive and successful children.  Parents throughout the region invest high amounts of time and money to ensure their children are able to enter prestigious universities and obtain top jobs.  Accordingly, children have become so expensive that the average couple cannot afford to have more than just one or two.  We argue that the trend of high parental investment in child education, also known as “education fever”, exemplifies the notion of “quality over quantity” and is an important contributing factor to understanding low-fertility in East Asia.</p>

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<author>Thomas M. Anderson et al.</author>


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<title>Interdisciplinarity in Recently Founded Academic Journals</title>
<link>http://repository.upenn.edu/psc_working_papers/37</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/37</guid>
<pubDate>Wed, 15 Aug 2012 13:32:40 PDT</pubDate>
<description>
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	<p>Despite the substantial growth of research interest on interdisciplinary collaboration and intellectual exchange, relatively little attention has focused on interdisciplinarity in the context of the academic journal system. In this paper, we ask a series of questions about peer-reviewed, academic journals which aim to span disciplinary boundaries. Data on a total of 789 journals established in 2008 were culled from Ulrich’s Periodicals and classified into discipline-based and interdisciplinary journals based on their mission statements.</p>
<p>Principal findings:  <ul> <li>Roughly 25 percent of peer-reviewed journals established in 2008 claimed interdisciplinarity as part of their mission;</li> <li>Interdisciplinarity varies substantially by primary subject classification, from less than 10 percent in mathematics and physics to a majority of journals in public health and communications;</li> <li>Despite the prominence of biology and biomedical fields in discussions of interdisciplinarity, few of the new journals in these fields are interdisciplinary in focus.</li> <li>Paradoxically, many interdisciplinary journals are highly specialized; that is, while they span more than one field or one approach (basic research, clinical applications), their span of inquiry needs to be understood as focused on a highly delimited topic area.</li> <li>A typology of six types of interdisciplinary journals emerges from the data.</li> <li>While some high-status interdisciplinary journals, eg Science and Nature, are tremendously valuable in facilitating cross-disciplinary communication, the proliferation of comprehensive interdisciplinary journals would most likely hinder rather than facilitate scholarly communication.</li> </ul></p>

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<author>Jerry A. Jacobs et al.</author>


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<title>Evaluating Health and Disease in Sub-Saharan Africa: Minimally Invasive Collection of Plasma in the Malawi Longitudinal Study of Families and Health (MLSFH)</title>
<link>http://repository.upenn.edu/psc_working_papers/36</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/36</guid>
<pubDate>Mon, 30 Jul 2012 11:43:05 PDT</pubDate>
<description>
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	<p>Background: The collection of biomarker-based indicators of adult health and fitness is an important addition to socioeconomic surveys since these indicators provide valuable insights into the biological functions, and the complex causal pathways between socioeconomic environments and health of adult individuals. Other than select Demographic and Health Surveys (DHS), there are almost no population-based sources of biomarker-based indicators of adult health in sub-Saharan Africa (SSA), where most population-based biologic data are focused on HIV, other STDs, malaria, or nutritional status. While infectious diseases---such as HIV and malaria---attract the majority of research and NGOs attention in sub-Saharan Africa, there is an important need to understand the general determinants of adult health in SSA since the region will rapidly age in the next decades in ways that are significantly different from the aging patterns in other developing regions due to the AIDS epidemic, and chronic diseases will increasingly become relevant for understanding the health of sub-Saharan populations.   Methods and Design: We document our protocol for the collection of biomarker-based health indicators as a  pilot project within the Malawi Longitudinal Study of Families and Health (MLSFH), and we provide basic descriptive information about the study population and the collected biomarker-based indicators of adult health obtained from respondents in rural Malawi. LabAnywhere kits were used to obtain blood plasma from 980 adult men and women living in Balaka, the southern-most region in rural Malawi. The procedure allows for the non-invasive collection of blood plasma, but has not been  been previously used in the context of a developing country. We collected biomarkers for inflammation and immunity, lipids, organ function, and metabolic processes. We specifically collected  wide-range CRP, total cholesterol, LDL, HDL, total protein, urea, albumin, blood urea nitrogen, creatinine, random blood glucose and HbA1c assays. Overall, the mean values of the biomarkers are below the lower limits of clinical guidelines for adult populations in the U.S. and other developed countries, and only small proportions of the sample are above the upper limits of the normal clinical ranges as defined by U.S. standards. The  correlationional patterns of the collected biomarkers are consistent with observations from developed countries, and the comparison with other low-income populations such as the Tsimane in Bolivia or the Yakuts in Siberia show remarkably similar age-specific patterns of the biomarkers despite differences in the mode of blood sampling.   Discussion: The MLSFH biomarker sample makes a potentially important contribution to understanding the health of the adult populations in low income environments. The present study confirms that the collection of such biomarkers using the LabAnywhere system is feasible in rural sub-Saharan contexts: the refusal rate was very low in the MLSFH and following the procedures described above, only a small fraction of the biomarker samples could not be analyzed by LabAnywhere. The system therefore provides an attractive alternative to the collection of dried blood spots (DBS) and venous blood samples, providing a broader range of potential biomarkers than DBS and being logistically easier than the collection of venous blood.</p>

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<author>Iliana V. Kohler et al.</author>


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<title>Performance-Support Bias and the Gender Pay Gap among Stockbrokers</title>
<link>http://repository.upenn.edu/psc_working_papers/35</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/35</guid>
<pubDate>Tue, 12 Jun 2012 11:47:19 PDT</pubDate>
<description>
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	<p>Organizational mechanisms, and their contexts, leading to gender inequality among stockbrokers in two large brokerages are analyzed. Inequality is the result of gender differences in sales, as both firms use performance-based pay, paying entirely by commissions. This paper develops and tests whether <em>performance-support bias</em>, whereby women receive inferior sales support and sales assignments, causes the commissions gap. Newly available data on the brokerages’ internal transfers of accounts among brokers allows measurement of performance-support bias. Gender differences in the quality and quantity of transferred accounts provide a way to measure gender differences in the assignment of sales opportunities and support. Sales generated from internally transferred accounts, controlling for the accounts’ sales histories, provide a “natural experiment” testing for gender differences in sales capacities. The evidence for performance-support bias is: (1) women are assigned inferior accounts; and (2) women produce sales equivalent to men when given accounts with equivalent prior sales histories.</p>

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<author>Janice F. Madden</author>


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<title>Copenhagen Consensus 2012: Challenge Paper on &quot;Population Growth&quot;</title>
<link>http://repository.upenn.edu/psc_working_papers/34</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/34</guid>
<pubDate>Tue, 05 Jun 2012 08:12:25 PDT</pubDate>
<description>
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	<p>While the majority of the population is now estimated to live in regions with below replacement fertility, high fertility, poor reproductive health outcomes and relatively rapid population growth remain an important concern in several low income countries. International and national spending devoted to family planning, however, has declined significantly in recent years. Recent research has brought about a revision in the understanding of the interactions between population growth and economic development, as well as the effects of family planning programs in terms of reduced fertility, improved reproductive health outcomes and other life-cycle and intergenerational consequences. This paper discusses recent evidence about the benefits of family planning programs and the interactions between population growth and developments, and it attempts to estimate benefit-cost ratios for increased spending on family planning.</p>

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<author>Hans-Peter Kohler</author>


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<title>The Rise and Fall of Unions in the U.S.</title>
<link>http://repository.upenn.edu/psc_working_papers/33</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/33</guid>
<pubDate>Tue, 15 May 2012 08:48:45 PDT</pubDate>
<description>
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	<p>Union membership displayed a n-shaped pattern over the 20th century, while the distribution of income sketched a u. A model of unions is developed to analyze these phenomena. There is a distribution of firms in the economy. Firms hire capital, plus skilled and unskilled labor. Unionization is a costly process. A union decides how many firms to organize and its members wage rate. Simulation of the developed model establishes that skilled-biased technological change, which affects the productivity of skilled labor relative to unskilled labor, can potentially explain the above facts. Statistical analysis suggests that skill-biased technological change is an important factor in de-unionization.</p>

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<author>Emin Dinlersoz et al.</author>


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<title>Technology and the Changing Family: A Unified Model of Marriage, Divorce, Educational Attainment and Married Female Labor-Force Participation</title>
<link>http://repository.upenn.edu/psc_working_papers/32</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/32</guid>
<pubDate>Tue, 03 Jan 2012 07:29:34 PST</pubDate>
<description>
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	<p>Marriage has declined since 1960, with the drop being bigger for non-college educated individuals versus college educated ones. Divorce has increased, more so for the non-college educated vis-a-vis the college educated. Additionally, assortative mating has risen; i.e., people are more likely to marry someone of the same educational level today than in the past. A unified model of marriage, divorce, educational attainment and married female labor-force participation is developed and estimated to fit the postwar U.S. data. The role of technological progress in the household sector and shifts in the wage structure for explaining these facts is gauged.</p>

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<author>Jeremy Greenwood et al.</author>


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<title>Do More-Schooled Women have Fewer Children and Delay Childbearing? Evidence from a Sample of U.S. Twins</title>
<link>http://repository.upenn.edu/psc_working_papers/31</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/31</guid>
<pubDate>Mon, 05 Dec 2011 06:30:28 PST</pubDate>
<description>
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	<p>Using data on MZ (monozygotic, identical) female twins from the Minnesota Twin Registry, we estimate the causal effect of schooling on completed fertility, probability of being childless and age at first birth, using the within-MZ twins methodology. We find strong cross-sectional associations between schooling and the fertility outcomes and some evidence that more schooling causes women to have fewer children and delay childbearing, though not to the extent that interpreting cross-sectional associations as causal would imply. Our conclusions are robust when taking account of (1) endogenous within-twin pair schooling differences due to reverse causality and (2) measurement error in schooling. We also investigate possible mechanisms and find that the effect of women’s schooling on completed fertility is not mediated through husband’s schooling but rather through age at first marriage.</p>

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<author>Vikesh Amin et al.</author>


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<title>High Development and Fertility: Fertility at Older Reproductive Ages and Gender Equality Explain the Positive Link</title>
<link>http://repository.upenn.edu/psc_working_papers/30</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/30</guid>
<pubDate>Mon, 03 Oct 2011 06:34:42 PDT</pubDate>
<description>
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	<p>A fundamental switch in the fertility—development relationship has occurred so that among highly developed countries, further socioeconomic development may reverse the declining fertility trend. Here we shed light on the mechanisms underlying this reversal by analyzing the links between development and age and cohort patterns of fertility, as well as the role of gender equality. Using data from 1975 to 2008 for over 100 countries, we show that the reversal exists both in a period and a cohort perspective and is mainly driven by increasing older reproductive-age fertility. We also show that the positive impact of development on fertility in high-development countries is conditional on gender equality: countries ranking high in development as measured by health, income, and education but low in gender equality continue to experience declining fertility. Our findings suggest that gender equality is crucial for countries wishing to reap the fertility dividend of high development.</p>

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<author>Mikko Myrskylä et al.</author>


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<title>Journal Rankings in Sociology: Using the H Index with Google Scholar</title>
<link>http://repository.upenn.edu/psc_working_papers/29</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/29</guid>
<pubDate>Thu, 15 Sep 2011 08:43:59 PDT</pubDate>
<description>
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	<p>This paper proposes using a new metric, h, and new data, drawn from Google Scholar, for ranking sociology journals. This approach is more comprehensive in several ways than the commonly used “journal impact factor.” It includes a longer time-frame and draws on a broader data base. It provides editors and prospective authors with a more informative picture of the strengths and weaknesses of different journals. Moreover, readily available software enables do-it-yourself assessments of journals. While the position of individual journals varies with the new measure, a clear hierarchy of journals remains no matter what assessment metric is used.</p>

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<author>Jerry A. Jacobs</author>


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<title>HIV/AIDS-related Expectations and Risky Sexual Behavior in Malawi</title>
<link>http://repository.upenn.edu/psc_working_papers/28</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/28</guid>
<pubDate>Fri, 29 Jul 2011 07:15:44 PDT</pubDate>
<description>
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	<p>Subjective expectations are likely to be an important determinant of  health-related behaviors in a high-HIV-prevalence environment. We use  probabilistic expectations data elicited from survey respondents in  rural Malawi to investigate how risky sexual behavior may be influenced  by individuals’ survival expectations, which in turn depend on the  perceived impact of HIV/AIDS on survival; expectations about their own  and their partner’s HIV status; and expectations about HIV transmission  rates. We find that subjective expectations play an important role in  determining the decision to have multiple sexual partners. Using our  estimated parameters, we simulate the impact of various policies that  would influence expectations. An information campaign on mortality risk  would decrease risky sexual behavior, while an information campaign on  HIV transmission risks, which tend to be overestimated by respondents,  would actually increase risky behavior. Also, the expansion of  anti-retroviral therapy (ART) treatments to all individuals sick with  AIDS would increase risky sexual behavior among HIV-negative individuals  or those who have not been tested because individuals are aware that ART  increases life expectancy, and thus reduces the cost of becoming  HIV-positive.</p>

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<author>Adeline Delavande et al.</author>


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<title>Intergenerational Transfers in the Era of HIV/AIDS: Evidence from Rural Malawi</title>
<link>http://repository.upenn.edu/psc_working_papers/27</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/27</guid>
<pubDate>Wed, 25 May 2011 07:42:53 PDT</pubDate>
<description>
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	<p>Intergenerational transfers and relations in sub-Saharan Africa are only poorly understood, despite the alleged importance of family networks and family resource transfers to ameliorate the implications of the HIV/AIDS epidemic and the effect of the epidemic on the availability of kin and the structure of multi-generational families. Our analyses fill an important niche in the literature by using innovative longitudinal data from rural Malawi that includes extensive information on intergenerational transfer relations across three generations living in a context characterized by high poverty, a generalized HIV/AIDS epidemic and high levels of morbidity and mortality. We estimate the age patterns of transfers and the multiple directions of transfer flows—from prime-aged respondents to their elderly parents as well as their co-residing and non-coresiding adult children age 15+. Our major findings include that: (1) Financial net transfers are strongly age-patterned and the middle generations are net providers of transfers to their adult children and elderly parents; (2) Non-financial transfers are based on mutual assistance rather than reallocation of resources to worse-off family members; and (3), Provision and receipt of transfers are generally not related to the health status of our adult respondents, including HIV+ status and perception of HIV infection despite widespread perceptions that HIV+ status is primary determinant of such transfers.</p>

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<author>Iliana V. Kohler et al.</author>


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<title>Estimating Smoking-attributable Mortality in the United States</title>
<link>http://repository.upenn.edu/psc_working_papers/26</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/26</guid>
<pubDate>Fri, 25 Feb 2011 08:34:30 PST</pubDate>
<description>
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	<p>Tobacco is the largest single cause of premature death in the developed world. Two methods of estimating the number of deaths attributable to smoking use mortality from lung cancer as an indicator of the damage from smoking. We reestimate the coefficients of one of these, the Preston/Glei/Wilmoth model, using recent data from U.S. states. We calculate smoking attributable fractions for the 50 states and the U.S. as a whole in 2000 and 2004. We estimate that 21% of adult deaths among men and 17% among women were attributable to smoking in 2004. Across states, attributable fractions range from 11% to 30% among men and from 7% to 23% among women. Smoking related mortality also explains as much as 60% of the mortality disadvantage of Southern states.  At the national level, our estimates are in close agreement with those of the Centers for Disease Control (CDC) and Preston/Glei/Wilmoth, particularly for men. But we find greater variability by state than does CDC. We suggest that our coefficients are suitable for calculating smoking-attributable mortality in contexts with relatively mature cigarette smoking epidemics.</p>

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<author>Andrew Fenelon et al.</author>


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<title>International Trade Openness and Gender Gaps in Pakistani Labor Force Participation Rates Over 57 Years</title>
<link>http://repository.upenn.edu/psc_working_papers/25</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/25</guid>
<pubDate>Wed, 02 Feb 2011 12:31:23 PST</pubDate>
<description>
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	<p>The extent of openness to international trade may alter incentives differentially by gender for labor force participation, particularly in economies in which gender differentials in human capital investments such as schooling are large and in which norms about gender behaviors are strong. This paper uses historical census data since 1951 and two recent Labor Force Surveys to investigate the impact of international trade openness on gender differences in labor force participation rates in broad occupational categories in Pakistan. The method used controls for average gender differences in these occupational categories and the unobserved factors that affect male and female labor force participation rates equally. The estimates indicate that increased international trade significantly reduces the gap between male and female labor force participation.</p>

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<author>Asma Hyder et al.</author>


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<title>Is the High Level of Obesity in the United States Related to Its Low Life Expectancy?</title>
<link>http://repository.upenn.edu/psc_working_papers/24</link>
<guid isPermaLink="true">http://repository.upenn.edu/psc_working_papers/24</guid>
<pubDate>Fri, 28 Jan 2011 10:31:36 PST</pubDate>
<description>
	<![CDATA[
	<p>Background. The US has the highest prevalence of obesity and one of the lowest life expectancies among OECD countries. While it is plausible to assume that these two phenomena are related, no previous attempt has been made to identify the connection between them. Our paper uses primary data on body mass index (BMI) in 16 countries and detailed information on the mortality risks of obesity to estimate the effect of international differences in obesity on comparative levels of longevity.  Methods. We estimate the fraction of deaths from all causes attributable to obesity by country, age and sex. We then re-estimate life tables in 2006 by removing deaths attributable to obesity. To allow for the possibility of a secular decline in obesity risks, we employ two alternative sets of risks drawn from a more recent period than the baseline risks.  Results. In our baseline analysis, we estimate that US life expectancy at age 50 in 2006 was reduced by 1.54 years (95% condence interval (CI) 1.37-1.93) for women and by 1.85 years (1.62-2.10) for men as a result of obesity. Relative to higher life expectancy countries, allowance for obesity reduces the US shortfall in life expectancy by 42% (36-48) for women and 67% (57-76) for men. Using obesity risks that were recorded more recently, differences in obesity still account for a fifth to a third of the shortfall of life expectancy in the US relative to longer-lived countries.  Conclusions. The high prevalence of obesity in the US contributes substantially to its poor international ranking in longevity.</p>

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<author>Samuel H. Preston et al.</author>


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