The mental health of youth and young adults during the transition to adulthood in Egypt

BackgroundThere has been growing interest in the stalled transition to adulthood in the Middle East and North Africa (MENA) and its consequences for young people's socioeconomic outcomes. However, little is known about how important life transitions relate to youth psychosocial well-being in the region.ObjectiveDrawing on a life course framework, we estimate the associations between making transitions in education, employment, and marriage with changes in mental health among young people in Egypt.MethodsWe descriptively analyze mental health scores, measured via the Self-Reporting Questionnaire-20 and disaggregated by gender, for a panel of young people first surveyed in 2009 at ages 13-29 and followed up in late 2013 and early 2014. We regress change in mental health scores against indicators of making different transitions.ResultsYoung women experience worse mental health than young men overall. Lower school achievement was associated with poorer mental health; being out of the labor force was an additional risk factor for young men. While average mental health scores improved over time, over a quarter of the sample experienced worsening mental health, related to failure to marry and find a job among older men, and failure to finish schooling among younger women.ConclusionsMental health is an important but often overlooked component of youth well-being during the transition to adulthood in MENA, and potentially other low- and middle-income countries.ContributionThis is the first paper to empirically examine the relationship between psychosocial well-being and achieving important socioeconomic milestones among a nationally representative cohort of young people in MENA

Job Demand and Early Retirement

on retirement issues by scholars in a wide variety of disciplines, including actuarial science

Exploration of pathways related to the decline in female circumcision in Egypt

BACKGROUND: There has been a large decline in female genital circumcision (FGC) in Egypt in recent decades. Understanding how this change has occurred so rapidly has been an area of particular interest to policymakers and public health officials alike who seek to further discourage the practice elsewhere. METHODS: We document the trends in this decline in the newest cohorts of young girls and explore the influences of three pathways—socioeconomic development, social media messages, and women’s empowerment—for explaining the observed trends. Using the 2005 and 2008 Egypt Demographic and Health Surveys, we estimate several logistic regression models to (1) examine individual and household determinants of circumcision, (2) assess the contributions of different pathways through which these changes may have occurred, and (3) assess the robustness of different pathways when unobserved community differences are taken into account. RESULTS: Across all communities, socioeconomic status, social media messages, and women’s empowerment all have significant independent effects on the risk of circumcision. However, after accounting for unobserved differences across communities, only mother’s education and household wealth significantly predict circumcision outcomes. Additional analyses of maternal education suggest that increases in women’s education may be causally related to the reduction in FGC prevalence. CONCLUSIONS: Women’s empowerment and social media appear to be more important in explaining differences across communities; within communities, socioeconomic status is a key driver of girls’ circumcision risk. Further investigation of community-level women’s educational attainment for mothers suggests that investments made in female education a generation ago may have had echo effects on girls’ FGC risk a generation later

The economic benefits of malaria elimination: do they include increases in tourism?

BACKGROUND: Policy makers have speculated that one of the economic benefits of malaria elimination includes increases in foreign direct investment, particularly tourism. METHODS: This study examines the empirical relationship between the demand for travel and malaria cases in two countries with large tourism industries around the time in which they carried out malaria-elimination campaigns. In Mauritius, this analysis examines historical, yearly tourist arrivals and malaria cases from 1978–1999, accounting for the background secular trend of increasing international travel. In Dominican Republic, a country embarking upon malaria elimination, it employs a time-series analysis of the monthly, international tourist arrivals from 1998–2010 to determine whether the timing of significant deviations in tourist arrivals coincides with malaria outbreaks. RESULTS: While naïve relationships exist in both cases, the results show that the relationships between tourist arrivals and malaria cases are relatively weak and statistically insignificant once secular confounders are accounted for. CONCLUSIONS: This suggests that any economic benefits from tourism that may be derived from actively pursuing elimination in countries that have high tourism potential are likely to be small when measured at a national level. Rather, tourism benefits are likely to be experienced with greater impact in more concentrated tourist areas within countries, and future studies should seek to assess these relationships at a regional or local level

Income Inequality and Mortality: The Costa RIcan Case

In recent decades there has been much debate on the extent to which income inequality affects health outcomes. The majority of studies in this literature have examined the relationship between income distribution and health outcomes in the contexts of high-income nations. This dissertation evaluates both the ecological and individual-level relationship between income inequality and mortality in the context of a middle-income country, Costa Rica. The Costa Rican case is particularly interesting because its strong social safety net, political organization, and history limit the effects of income inequality on health through indirect channels. Using 20 years of household data, this study begins by documenting changes in income inequality at the canton level. These data reveal that on average inequality has been growing at an annual rate of 0.5%. Using these inequality data, Vital Statistics Mortality records, and longitudinal methods, this study next examines whether cantons with greater growth in inequality also experienced increasing mortality. The analyses indicate that there is no relationship between changes in income inequality and changes in all-cause mortality; however, a relationship does exist for specific causes of death. Area-level inequality was found to be associated with an increase in suicide mortality rates, and a decrease in cardiovascular, respiratory cancer, and breast cancer mortality rates. At the individual-level survival analysis was applied to a new census-mortality linked dataset that allows for a 20-year prospective follow-up. These individual level analyses also test whether income inequality disproportionately affects the poor. In the case of all-cause mortality, the results suggest that there is no association between income inequality and time to death for either the entire sample or for the poor. Contrary to expectations the magnitudes of the estimated effects indicate that residents living in areas with increasing income inequality had a survival advantage for cardiovascular mortality, which further confirms the results found at the ecological level. Overall, this study finds that while inequality has been increasing in Costa Rica, it had limited effect on mortality, indicating that in an environment where safety net services are available, the negative effects of income inequality may be limited to suicide mortality

THE INTERGENERATIONAL EFFECTS OF THE NEW DEAL WORK RELIEF PROGRAMS ON LATE-LIFE OUTCOMES: AN 80-PLUS-YEAR FOLLOW-UP STUDY

Abstract Evidence from multiple disciplines suggests that early-life conditions and environments affect outcomes across the life course. However, less is known about the effects of policy interventions targeted to adults and communities that may have intergenerational consequences on exposed children. In this study, we undertake novel data linkages to examine the effects of the New Deal work–relief programs on long-term health, disability and mortality outcomes of children born between 1920-1940. We first link the American Manufacturing Cohort (AMC) workforce backward to their childhood census records to capture parental and community exposure to New Deal work-relief programs. We then test the hypothesis that employment in New Deal work-relief programs is associated with lower levels of chronic disease, lower rates of disability and delayed mortality for both the children in benefitting households and children in non-benefit households living in areas that received greater amounts of New Deal funding.</jats:p