This paper documents a set of facts about the dramatic decline in birth rates in the United States between 2007 and 2020 and explores possible explanations for it. The overall reduction in the birth rate reflects both very large declines within certain groups of women, including teens and Hispanic women – and smaller declines among demographic groups that comprise a large population share, including college-educated white women. We explore potential economic, policy, and social factors that might be responsible for the overall decline. We conclude from our empirical examination of possible factors that there is not a readily identifiable economic or policy factor or set of factors this is likely responsible for a substantial share of the decline. Instead, the patterns observed suggest that widespread, hard to quantify changes in preferences for having children, aspirations for life, and the nature of parenting are more likely behind the recent decline in US births. We conclude with a brief discussion about the societal consequences for a declining birth rate and what the United States might do about it.

United States US: Prevalence of Wasting: Weight for Height: Female: % of Children Under 5 data was reported at 0.700 % in 2012. This records an increase from the previous number of 0.500 % for 2009. United States US: Prevalence of Wasting: Weight for Height: Female: % of Children Under 5 data is updated yearly, averaging 0.550 % from Dec 1991 (Median) to 2012, with 6 observations. The data reached an all-time high of 0.800 % in 2005 and a record low of 0.100 % in 2001. United States US: Prevalence of Wasting: Weight for Height: Female: % of Children Under 5 data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s United States – Table US.World Bank.WDI: Health Statistics. Prevalence of wasting, female, is the proportion of girls under age 5 whose weight for height is more than two standard deviations below the median for the international reference population ages 0-59.; ; World Health Organization, Global Database on Child Growth and Malnutrition. Country-level data are unadjusted data from national surveys, and thus may not be comparable across countries.; Linear mixed-effect model estimates; Undernourished children have lower resistance to infection and are more likely to die from common childhood ailments such as diarrheal diseases and respiratory infections. Frequent illness saps the nutritional status of those who survive, locking them into a vicious cycle of recurring sickness and faltering growth (UNICEF, www.childinfo.org). Estimates of child malnutrition, based on prevalence of underweight and stunting, are from national survey data. The proportion of underweight children is the most common malnutrition indicator. Being even mildly underweight increases the risk of death and inhibits cognitive development in children. And it perpetuates the problem across generations, as malnourished women are more likely to have low-birth-weight babies. Stunting, or being below median height for age, is often used as a proxy for multifaceted deprivation and as an indicator of long-term changes in malnutrition.

This layer shows fertility in past 12 months by age of mother. This is shown by tract, county, and state boundaries. This service is updated annually to contain the most currently released American Community Survey (ACS) 5-year data, and contains estimates and margins of error. There are also additional calculated attributes related to this topic, which can be mapped or used within analysis. The calculated percentages are slightly different from traditional age-specific fertility rates in that the total number of live births (due to twins or higher-order multiple births) is not available in this table. This layer is symbolized to show the percent of women age 15 to 50 who had a birth in the past 12 months. To see the full list of attributes available in this service, go to the "Data" tab, and choose "Fields" at the top right. Current Vintage: 2019-2023ACS Table(s): B13016 Data downloaded from: Census Bureau's API for American Community Survey Date of API call: December 12, 2024National Figures: data.census.govThe United States Census Bureau's American Community Survey (ACS):About the SurveyGeography & ACSTechnical DocumentationNews & UpdatesThis ready-to-use layer can be used within ArcGIS Pro, ArcGIS Online, its configurable apps, dashboards, Story Maps, custom apps, and mobile apps. Data can also be exported for offline workflows. For more information about ACS layers, visit the FAQ. Please cite the Census and ACS when using this data.Data Note from the Census:Data are based on a sample and are subject to sampling variability. The degree of uncertainty for an estimate arising from sampling variability is represented through the use of a margin of error. The value shown here is the 90 percent margin of error. The margin of error can be interpreted as providing a 90 percent probability that the interval defined by the estimate minus the margin of error and the estimate plus the margin of error (the lower and upper confidence bounds) contains the true value. In addition to sampling variability, the ACS estimates are subject to nonsampling error (for a discussion of nonsampling variability, see Accuracy of the Data). The effect of nonsampling error is not represented in these tables.Data Processing Notes:This layer is updated automatically when the most current vintage of ACS data is released each year, usually in December. The layer always contains the latest available ACS 5-year estimates. It is updated annually within days of the Census Bureau's release schedule. Click here to learn more about ACS data releases.Boundaries come from the US Census TIGER geodatabases, specifically, the National Sub-State Geography Database (named tlgdb_(year)_a_us_substategeo.gdb). Boundaries are updated at the same time as the data updates (annually), and the boundary vintage appropriately matches the data vintage as specified by the Census. These are Census boundaries with water and/or coastlines erased for cartographic and mapping purposes. For census tracts, the water cutouts are derived from a subset of the 2020 Areal Hydrography boundaries offered by TIGER. Water bodies and rivers which are 50 million square meters or larger (mid to large sized water bodies) are erased from the tract level boundaries, as well as additional important features. For state and county boundaries, the water and coastlines are derived from the coastlines of the 2023 500k TIGER Cartographic Boundary Shapefiles. These are erased to more accurately portray the coastlines and Great Lakes. The original AWATER and ALAND fields are still available as attributes within the data table (units are square meters). The States layer contains 52 records - all US states, Washington D.C., and Puerto RicoCensus tracts with no population that occur in areas of water, such as oceans, are removed from this data service (Census Tracts beginning with 99).Percentages and derived counts, and associated margins of error, are calculated values (that can be identified by the "_calc_" stub in the field name), and abide by the specifications defined by the American Community Survey.Field alias names were created based on the Table Shells file available from the American Community Survey Summary File Documentation page.Negative values (e.g., -4444...) have been set to null, with the exception of -5555... which has been set to zero. These negative values exist in the raw API data to indicate the following situations:The margin of error column indicates that either no sample observations or too few sample observations were available to compute a standard error and thus the margin of error. A statistical test is not appropriate.Either no sample observations or too few sample observations were available to compute an estimate, or a ratio of medians cannot be calculated because one or both of the median estimates falls in the lowest interval or upper interval of an open-ended distribution.The median falls in the lowest interval of an open-ended distribution, or in the upper interval of an open-ended distribution. A statistical test is not appropriate.The estimate is controlled. A statistical test for sampling variability is not appropriate.The data for this geographic area cannot be displayed because the number of sample cases is too small.

The Ukraine Demographic and Health Survey (UDHS) is a nationally representative survey of 6,841 women age 15-49 and 3,178 men age 15-49. Survey fieldwork was conducted during the period July through November 2007. The UDHS was conducted by the Ukrainian Center for Social Reforms in close collaboration with the State Statistical Committee of Ukraine. The MEASURE DHS Project provided technical support for the survey. The U.S. Agency for International Development/Kyiv Regional Mission to Ukraine, Moldova, and Belarus provided funding. The survey is a nationally representative sample survey designed to provide information on population and health issues in Ukraine. The primary goal of the survey was to develop a single integrated set of demographic and health data for the population of the Ukraine. The UDHS was conducted from July to November 2007 by the Ukrainian Center for Social Reforms (UCSR) in close collaboration with the State Statistical Committee (SSC) of Ukraine, which provided organizational and methodological support. Macro International Inc. provided technical assistance for the survey through the MEASURE DHS project. USAID/Kyiv Regional Mission to Ukraine, Moldova and Belarus provided funding for the survey through the MEASURE DHS project. MEASURE DHS is sponsored by the United States Agency for International Development (USAID) to assist countries worldwide in obtaining information on key population and health indicators. The 2007 UDHS collected national- and regional-level data on fertility and contraceptive use, maternal health, adult health and life style, infant and child mortality, tuberculosis, and HIV/AIDS and other sexually transmitted diseases. The survey obtained detailed information on these issues from women of reproductive age and, on certain topics, from men as well. The results of the 2007 UDHS are intended to provide the information needed to evaluate existing social programs and to design new strategies for improving the health of Ukrainians and health services for the people of Ukraine. The 2007 UDHS also contributes to the growing international database on demographic and health-related variables. MAIN RESULTS Fertility rates. A useful index of the level of fertility is the total fertility rate (TFR), which indicates the number of children a woman would have if she passed through the childbearing ages at the current age-specific fertility rates (ASFR). The TFR, estimated for the three-year period preceding the survey, is 1.2 children per woman. This is below replacement level. Contraception : Knowledge and ever use. Knowledge of contraception is widespread in Ukraine. Among married women, knowledge of at least one method is universal (99 percent). On average, married women reported knowledge of seven methods of contraception. Eighty-nine percent of married women have used a method of contraception at some time. Abortion rates. The use of abortion can be measured by the total abortion rate (TAR), which indicates the number of abortions a woman would have in her lifetime if she passed through her childbearing years at the current age-specific abortion rates. The UDHS estimate of the TAR indicates that a woman in Ukraine will have an average of 0.4 abortions during her lifetime. This rate is considerably lower than the comparable rate in the 1999 Ukraine Reproductive Health Survey (URHS) of 1.6. Despite this decline, among pregnancies ending in the three years preceding the survey, one in four pregnancies (25 percent) ended in an induced abortion. Antenatal care. Ukraine has a well-developed health system with an extensive infrastructure of facilities that provide maternal care services. Overall, the levels of antenatal care and delivery assistance are high. Virtually all mothers receive antenatal care from professional health providers (doctors, nurses, and midwives) with negligible differences between urban and rural areas. Seventy-five percent of pregnant women have six or more antenatal care visits; 27 percent have 15 or more ANC visits. The percentage is slightly higher in rural areas than in urban areas (78 percent compared with 73 percent). However, a smaller proportion of rural women than urban women have 15 or more antenatal care visits (23 percent and 29 percent, respectively). HIV/AIDS and other sexually transmitted infections : The currently low level of HIV infection in Ukraine provides a unique window of opportunity for early targeted interventions to prevent further spread of the disease. However, the increases in the cumulative incidence of HIV infection suggest that this window of opportunity is rapidly closing. Adult Health : The major causes of death in Ukraine are similar to those in industrialized countries (cardiovascular diseases, cancer, and accidents), but there is also a rising incidence of certain infectious diseases, such as multidrug-resistant tuberculosis. Women's status : Sixty-four percent of married women make decisions on their own about their own health care, 33 percent decide jointly with their husband/partner, and 1 percent say that their husband or someone else is the primary decisionmaker about the woman's own health care. Domestic Violence : Overall, 17 percent of women age 15-49 experienced some type of physical violence between age 15 and the time of the survey. Nine percent of all women experienced at least one episode of violence in the 12 months preceding the survey. One percent of the women said they had often been subjected to violent physical acts during the past year. Overall, the data indicate that husbands are the main perpetrators of physical violence against women. Human Trafficking : The UDHS collected information on respondents' awareness of human trafficking in Ukraine and, if applicable, knowledge about any household members who had been the victim of human trafficking during the three years preceding the survey. More than half (52 percent) of respondents to the household questionnaire reported that they had heard of a person experiencing this problem and 10 percent reported that they knew personally someone who had experienced human trafficking.

United States US: Prevalence of Underweight: Weight for Age: Male: % of Children Under 5 data was reported at 0.500 % in 2012. This records a decrease from the previous number of 1.000 % for 2009. United States US: Prevalence of Underweight: Weight for Age: Male: % of Children Under 5 data is updated yearly, averaging 1.150 % from Dec 1991 (Median) to 2012, with 6 observations. The data reached an all-time high of 1.600 % in 2002 and a record low of 0.500 % in 2012. United States US: Prevalence of Underweight: Weight for Age: Male: % of Children Under 5 data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s United States – Table US.World Bank.WDI: Health Statistics. Prevalence of underweight, male, is the percentage of boys under age 5 whose weight for age is more than two standard deviations below the median for the international reference population ages 0-59 months. The data are based on the WHO's new child growth standards released in 2006.; ; World Health Organization, Global Database on Child Growth and Malnutrition. Country-level data are unadjusted data from national surveys, and thus may not be comparable across countries.; Linear mixed-effect model estimates; Undernourished children have lower resistance to infection and are more likely to die from common childhood ailments such as diarrheal diseases and respiratory infections. Frequent illness saps the nutritional status of those who survive, locking them into a vicious cycle of recurring sickness and faltering growth (UNICEF, www.childinfo.org). Estimates of child malnutrition, based on prevalence of underweight and stunting, are from national survey data. The proportion of underweight children is the most common malnutrition indicator. Being even mildly underweight increases the risk of death and inhibits cognitive development in children. And it perpetuates the problem across generations, as malnourished women are more likely to have low-birth-weight babies. Stunting, or being below median height for age, is often used as a proxy for multifaceted deprivation and as an indicator of long-term changes in malnutrition.

United States US: Prevalence of Overweight: Weight for Height: Female: % of Children Under 5 data was reported at 6.900 % in 2012. This records an increase from the previous number of 6.400 % for 2009. United States US: Prevalence of Overweight: Weight for Height: Female: % of Children Under 5 data is updated yearly, averaging 6.900 % from Dec 1991 (Median) to 2012, with 6 observations. The data reached an all-time high of 8.700 % in 2005 and a record low of 5.100 % in 1991. United States US: Prevalence of Overweight: Weight for Height: Female: % of Children Under 5 data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s USA – Table US.World Bank: Health Statistics. Prevalence of overweight, female, is the percentage of girls under age 5 whose weight for height is more than two standard deviations above the median for the international reference population of the corresponding age as established by the WHO's new child growth standards released in 2006.; ; World Health Organization, Global Database on Child Growth and Malnutrition. Country-level data are unadjusted data from national surveys, and thus may not be comparable across countries.; Linear mixed-effect model estimates; Estimates of overweight children are also from national survey data. Once considered only a high-income economy problem, overweight children have become a growing concern in developing countries. Research shows an association between childhood obesity and a high prevalence of diabetes, respiratory disease, high blood pressure, and psychosocial and orthopedic disorders (de Onis and Blössner 2003). Childhood obesity is associated with a higher chance of obesity, premature death, and disability in adulthood. In addition to increased future risks, obese children experience breathing difficulties and increased risk of fractures, hypertension, early markers of cardiovascular disease, insulin resistance, and psychological effects. Children in low- and middle-income countries are more vulnerable to inadequate nutrition before birth and in infancy and early childhood. Many of these children are exposed to high-fat, high-sugar, high-salt, calorie-dense, micronutrient-poor foods, which tend be lower in cost than more nutritious foods. These dietary patterns, in conjunction with low levels of physical activity, result in sharp increases in childhood obesity, while under-nutrition continues

United States US: Prevalence of Stunting: Height for Age: Male: % of Children Under 5 data was reported at 3.000 % in 2012. This records a decrease from the previous number of 3.200 % for 2009. United States US: Prevalence of Stunting: Height for Age: Male: % of Children Under 5 data is updated yearly, averaging 3.600 % from Dec 1991 (Median) to 2012, with 6 observations. The data reached an all-time high of 4.500 % in 2002 and a record low of 3.000 % in 2012. United States US: Prevalence of Stunting: Height for Age: Male: % of Children Under 5 data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s United States – Table US.World Bank.WDI: Health Statistics. Prevalence of stunting, male, is the percentage of boys under age 5 whose height for age is more than two standard deviations below the median for the international reference population ages 0-59 months. For children up to two years old height is measured by recumbent length. For older children height is measured by stature while standing. The data are based on the WHO's new child growth standards released in 2006.; ; World Health Organization, Global Database on Child Growth and Malnutrition. Country-level data are unadjusted data from national surveys, and thus may not be comparable across countries.; Linear mixed-effect model estimates; Undernourished children have lower resistance to infection and are more likely to die from common childhood ailments such as diarrheal diseases and respiratory infections. Frequent illness saps the nutritional status of those who survive, locking them into a vicious cycle of recurring sickness and faltering growth (UNICEF, www.childinfo.org). Estimates of child malnutrition, based on prevalence of underweight and stunting, are from national survey data. The proportion of underweight children is the most common malnutrition indicator. Being even mildly underweight increases the risk of death and inhibits cognitive development in children. And it perpetuates the problem across generations, as malnourished women are more likely to have low-birth-weight babies. Stunting, or being below median height for age, is often used as a proxy for multifaceted deprivation and as an indicator of long-term changes in malnutrition.

The 1996 Uzbekistan Demographic and Health Survey (UDHS) is a nationally representative survey of 4,415 women age 15-49. Fieldwork was conducted from June to October 1996. The UDHS was sponsored by the Ministry of Health (MOH), and was funded by the United States Agency for International Development. The Institute of Obstetrics and Gynecology implemented the survey with technical assistance from the Demographic and Health Surveys (DHS) program. The 1996 UDHS was the first national-level population and health survey in Uzbekistan. It was implemented by the Research Institute of Obstetrics and Gynecology of the Ministry of Health of Uzbekistan. The 1996 UDHS was funded by the United States Agency for International development (USAID) and technical assistance was provided by Macro International Inc. (Calverton, Maryland USA) through its contract with USAID. OBJECTIVES AND ORGANIZATION OF THE SURVEY The purpose of the 1996 Uzbekistan Demographic and Health Survey (UDHS) was to provide an information base to the Ministry of Health for the planning of policies and programs regarding the health of women and their children. The UDHS collected data on women's reproductive histories, knowledge and use of contraception, breastfeeding practices, and the nutrition, vaccination coverage, and episodes of illness among children under the age of three. The survey also included, for all women of reproductive age and for children under the age of three, the measurement of the hemoglobin level in the blood to assess the prevalence of anemia and measurements of height and weight to assess nutritional status. A secondary objective of the survey was to enhance the capabilities of institutions in Uzbekistan to collect, process and analyze population and health data so as to facilitate the implementation of future surveys of this type. MAIN RESULTS Fertility Rates. Survey results indicate a total fertility rate (TFR) for all of Uzbekistan of 3.3 children per woman. Fertility levels differ for different population groups. The TFR for women living in urbml areas (2.7 children per woman) is substantially lower than for women living in rural areas (3.7). The TFR for Uzbeki women (3.5 children per woman) is higher than for women of other ethnicities (2.5). Among the regions of Uzbekistan, the TFR is lowest in Tashkent City (2.3 children per woman). Family Planning. Knowledge. Knowledge of contraceptive methods is high among women in Uzbekistan. Knowledge of at least one method is 89 percent. High levels of knowledge are the norm for women of all ages, all regions of the country, all educational levels, and all ethnicities. However, knowledge of sterilization was low; only 27 percent of women reported knowing of this method. Fertility Preferences. A majority of women in Uzbekistan (51 percent) indicated that they desire no more children. Among women age 30 and above, the proportion that want no more children increases to 75 percent. Thus, many women come to the preference to stop childbearing at relatively young ages when they have 20 or more potential years of childbearing ahead of them. For some of these women, the most appropriate method of contraception may be a long-acting method such as female sterilization, However, there is a deficiency of both knowledge and use of this method in Uzbekistan. In the interest of providing couples with a broad choice of safe and effective methods, information about this method and access to it should be made available so that informed choices about its suitability can be made by individual women and couples. Induced Aboration : Abortion Rates. From the UDHS data, the total abortion rate (TAR)the number of abortions a woman will have in her lifetime based on the currently prevailing abortion rateswas calculated. For Uzbekistan, the TAR for the period from mid-1993 to mid-1996 is 0.7 abortions per woman. As expected, the TAR for Uzbekistan is substantially lower than recent estimates of the TAR for other areas of the former Soviet Union such as Kazakstan (1.8), Romania (3.4 abortions per woman), and Yekaterinburg and Perm in Russia (2.3 and 2.8, respectively). Infant mortality : In the UDHS, infant mortality data were collected based on the international definition of a live birth which, irrespective of the duration of pregnancy, is a birth that breathes or shows any sign of life (United Nations, 1992). Mortality Rates. For the five-year period before the survey (i.e., approximately mid- 1992 to mid- 1996), infant mortality in Uzbekistan is estimated at 49 infant deaths per 1,000 births. The estimates of neonatal and postneonatal mortality are 23 and 26 per 1,000. Maternal and child health : Uzbekistan has a well-developed health system with an extensive infrastructure of facilities that provide maternal care services. This system includes special delivery hospitals, the obstetrics and gynecology departments of general hospitals, women's consulting centers, and doctor's assistant/midwife posts (FAPs). There is an extensive network of FAPs throughout rural areas. Nutrition : Breastfeeding. Breastfeeding is almost universal in Uzbekistan; 96 percent of children born in the three years preceding the survey are breastfed. Overall, 19 percent of children are breastfed within an hour of delivery and 40 percent within 24 hours of delivery. The median duration of breastfeeding is lengthy (17 months). However, durations of exclusive breastfeeding, as recommended by WHO, are short (0.4 months). Prevalence of anemia : Testing of women and children for anemia was one of the major efforts of the 1996 UDHS. Anemia has been considered a major public health problem in Uzbekistan for decades. Nevertheless, this was the first anemia study in Uzbekistan done on a national basis. The study involved hemoglobin (Hb) testing for anemia using the Hemocue system. Women. Sixty percent of the women in Uzbekistan suffer from some degree of anemia. The great majority of these women have either mild (45 percent) or moderate anemia (14 percent). One percent have severe anemia.

United States US: Prevalence of Wasting: Weight for Height: Male: % of Children Under 5 data was reported at 0.400 % in 2012. This records a decrease from the previous number of 0.500 % for 2009. United States US: Prevalence of Wasting: Weight for Height: Male: % of Children Under 5 data is updated yearly, averaging 0.650 % from Dec 1991 (Median) to 2012, with 6 observations. The data reached an all-time high of 0.800 % in 2005 and a record low of 0.400 % in 2012. United States US: Prevalence of Wasting: Weight for Height: Male: % of Children Under 5 data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s USA – Table US.World Bank: Health Statistics. Prevalence of wasting, male,is the proportion of boys under age 5 whose weight for height is more than two standard deviations below the median for the international reference population ages 0-59.; ; World Health Organization, Global Database on Child Growth and Malnutrition. Country-level data are unadjusted data from national surveys, and thus may not be comparable across countries.; Linear mixed-effect model estimates; Undernourished children have lower resistance to infection and are more likely to die from common childhood ailments such as diarrheal diseases and respiratory infections. Frequent illness saps the nutritional status of those who survive, locking them into a vicious cycle of recurring sickness and faltering growth (UNICEF, www.childinfo.org). Estimates of child malnutrition, based on prevalence of underweight and stunting, are from national survey data. The proportion of underweight children is the most common malnutrition indicator. Being even mildly underweight increases the risk of death and inhibits cognitive development in children. And it perpetuates the problem across generations, as malnourished women are more likely to have low-birth-weight babies. Stunting, or being below median height for age, is often used as a proxy for multifaceted deprivation and as an indicator of long-term changes in malnutrition.

United States US: Prevalence of Severe Wasting: Weight for Height: % of Children under 5 data was reported at 0.000 % in 2012. This stayed constant from the previous number of 0.000 % for 2009. United States US: Prevalence of Severe Wasting: Weight for Height: % of Children under 5 data is updated yearly, averaging 0.000 % from Dec 1991 (Median) to 2012, with 5 observations. The data reached an all-time high of 0.100 % in 2005 and a record low of 0.000 % in 2012. United States US: Prevalence of Severe Wasting: Weight for Height: % of Children under 5 data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s USA – Table US.World Bank: Health Statistics. Prevalence of severe wasting is the proportion of children under age 5 whose weight for height is more than three standard deviations below the median for the international reference population ages 0-59.; ; UNICEF, WHO, World Bank: Joint child malnutrition estimates (JME). Aggregation is based on UNICEF, WHO, and the World Bank harmonized dataset (adjusted, comparable data) and methodology.; Linear mixed-effect model estimates; Undernourished children have lower resistance to infection and are more likely to die from common childhood ailments such as diarrheal diseases and respiratory infections. Frequent illness saps the nutritional status of those who survive, locking them into a vicious cycle of recurring sickness and faltering growth (UNICEF, www.childinfo.org). Estimates of child malnutrition, based on prevalence of underweight and stunting, are from national survey data. The proportion of underweight children is the most common malnutrition indicator. Being even mildly underweight increases the risk of death and inhibits cognitive development in children. And it perpetuates the problem across generations, as malnourished women are more likely to have low-birth-weight babies. Stunting, or being below median height for age, is often used as a proxy for multifaceted deprivation and as an indicator of long-term changes in malnutrition.

United States US: Prevalence of Stunting: Height for Age: % of Children Under 5 data was reported at 2.100 % in 2012. This records a decrease from the previous number of 2.700 % for 2009. United States US: Prevalence of Stunting: Height for Age: % of Children Under 5 data is updated yearly, averaging 3.200 % from Dec 1991 (Median) to 2012, with 5 observations. The data reached an all-time high of 3.300 % in 2001 and a record low of 2.100 % in 2012. United States US: Prevalence of Stunting: Height for Age: % of Children Under 5 data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s USA – Table US.World Bank: Health Statistics. Prevalence of stunting is the percentage of children under age 5 whose height for age is more than two standard deviations below the median for the international reference population ages 0-59 months. For children up to two years old height is measured by recumbent length. For older children height is measured by stature while standing. The data are based on the WHO's new child growth standards released in 2006.; ; UNICEF, WHO, World Bank: Joint child malnutrition estimates (JME). Aggregation is based on UNICEF, WHO, and the World Bank harmonized dataset (adjusted, comparable data) and methodology.; Linear mixed-effect model estimates; Undernourished children have lower resistance to infection and are more likely to die from common childhood ailments such as diarrheal diseases and respiratory infections. Frequent illness saps the nutritional status of those who survive, locking them into a vicious cycle of recurring sickness and faltering growth (UNICEF, www.childinfo.org). Estimates of child malnutrition, based on prevalence of underweight and stunting, are from national survey data. The proportion of underweight children is the most common malnutrition indicator. Being even mildly underweight increases the risk of death and inhibits cognitive development in children. And it perpetuates the problem across generations, as malnourished women are more likely to have low-birth-weight babies. Stunting, or being below median height for age, is often used as a proxy for multifaceted deprivation and as an indicator of long-term changes in malnutrition.

After a dramatic population decline, Steller sea lions have begun to recover throughout most of their range. However, Steller sea lions in the Western Aleutians and Commander Islands are continuing to decline. Comparing survival rates between regions with different population trends may provide insights into the factors driving the dynamics, but published data on vital rates have been extremely scarce, especially in regions where the populations are still declining. Fortunately, an unprecedented dataset of marked Steller sea lions at rookeries in the Russian Far East is available, allowing us to determine age and sex specific survival in sea lions up to 22 years old. We focused on survival rates in three areas in the Russian range with differing population trends: the Commander Islands (Medny Island rookery), Eastern Kamchatka (Kozlov Cape rookery) and the Kuril Islands (four rookeries). Survival rates differed between these three regions, though not necessarily as predicted by population trends. Pup survival was higher where the populations were declining (Medny Island) or not recovering (Kozlov Cape) than in all Kuril Island rookeries. The lowest adult (> 3 years old) female survival was found on Medny Island and this may be responsible for the continued population decline there. However, the highest adult survival was found at Kozlov Cape, not in the Kuril Islands where the population is increasing, so we suggest that differences in birth rates might be an important driver of these divergent population trends. High pup survival on the Commander Islands and Kamchatka Coast may be a consequence of less frequent (e.g. biennial) reproduction there, which may permit females that skip birth years to invest more in their offspring, leading to higher pup survival, but this hypothesis awaits measurement of birth rates in these areas.

United States US: Prevalence of Wasting: Weight for Height: % of Children Under 5 data was reported at 0.500 % in 2012. This stayed constant from the previous number of 0.500 % for 2009. United States US: Prevalence of Wasting: Weight for Height: % of Children Under 5 data is updated yearly, averaging 0.500 % from Dec 1991 (Median) to 2012, with 5 observations. The data reached an all-time high of 0.800 % in 2005 and a record low of 0.400 % in 2001. United States US: Prevalence of Wasting: Weight for Height: % of Children Under 5 data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s USA – Table US.World Bank: Health Statistics. Prevalence of wasting is the proportion of children under age 5 whose weight for height is more than two standard deviations below the median for the international reference population ages 0-59.; ; UNICEF, WHO, World Bank: Joint child malnutrition estimates (JME). Aggregation is based on UNICEF, WHO, and the World Bank harmonized dataset (adjusted, comparable data) and methodology.; Linear mixed-effect model estimates; Undernourished children have lower resistance to infection and are more likely to die from common childhood ailments such as diarrheal diseases and respiratory infections. Frequent illness saps the nutritional status of those who survive, locking them into a vicious cycle of recurring sickness and faltering growth (UNICEF, www.childinfo.org). Estimates of child malnutrition, based on prevalence of underweight and stunting, are from national survey data. The proportion of underweight children is the most common malnutrition indicator. Being even mildly underweight increases the risk of death and inhibits cognitive development in children. And it perpetuates the problem across generations, as malnourished women are more likely to have low-birth-weight babies. Stunting, or being below median height for age, is often used as a proxy for multifaceted deprivation and as an indicator of long-term changes in malnutrition.

Our multidisciplinary team of legal, clinician, and perinatal epidemiology experts designed a study to assess the effects of state regulation of midwives on patient access to high quality maternity care in the US. We developed a novel, weighted scoring system that ranks all 50 states and DC on level of midwifery integration, and then linked state scores to maternal and newborn outcomes.

In our study we demonstrate that greater integration of midwives is associated with significantly higher rates of physiologic birth outcomes, lower rates of obstetric interventions, and fewer adverse neonatal outcomes. Our new Midwifery Integration Scoring System provides an evidenced-informed tool that can identify barriers to effective health human resource allocation in maternity care, based on population-level health outcomes data. In the current context of the Sustainable Development Goals to facilitate equitable access to skilled maternity providers, we believe that our findings will be of great interest to your readers.

We uploaded the 1) Midwifery Integration Scoring System and 2) the data set that includes all data points needed to replicate the results presented in our paper. Most of the data is for the year 2014 and comes from the CDC. Other data sources are detailed in the publication and a short data dictionary will be uploaded soon.

In 2022, the infant mortality rate in India was at about 25.5 deaths per 1,000 live births, a significant decrease from previous years. Infant mortality as an indicatorThe infant mortality rate is the number of deaths of children under one year of age per 1,000 live births. This rate is an important key indicator for a country’s health and standard of living; a low infant mortality rate indicates a high standard of healthcare. Causes of infant mortality include premature birth, sepsis or meningitis, sudden infant death syndrome, and pneumonia. Globally, the infant mortality rate has shrunk from 63 infant deaths per 1,000 live births to 27 since 1990 and is forecast to drop to 8 infant deaths per 1,000 live births by the year 2100. India’s rural problemWith 32 infant deaths per 1,000 live births, India is neither among the countries with the highest nor among those with the lowest infant mortality rate. Its decrease indicates an increase in medical care and hygiene, as well as a decrease in female infanticide. Increasing life expectancy at birth is another indicator that shows that the living conditions of the Indian population are improving. Still, India’s inhabitants predominantly live in rural areas, where standards of living as well as access to medical care and hygiene are traditionally lower and more complicated than in cities. Public health programs are thus put in place by the government to ensure further improvement.