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Low birth weight and preterm babies have been increasing in Spain since 1980, coinciding with important changes in the social and demographic structure of childbearing populations—including the contribution of a 25% of foreign mothers—and with increasing medical intervention in births. This study, based on 5,990,613 births, compares the temporary trends in reproductive patterns and birth outcomes in Spanish and foreign mothers during the period 1996–2009 and evaluates for the years 2007 to 2009 the relative contribution of mother's origin and Caesarean section to birth weight variability. Foreign mothers maintain their own reproductive pattern, whereas negative birth outcomes increase in all groups. Results from logistic regression analysis show that besides late maternity and primiparity also Caesarean section increases the risk for low birth weight. The reduction in Caesarean section rates between 2007 and 2009 might explain the reduction of low birth weight detected. A change of tendency simultaneously appears in most maternal and newborn characteristics, and in the mode of delivery in all ethnic groups since 2008. Coincidence in the timing of the change of trends points to a common factor. We suggest that the current world financial crisis could be this common cause, a hypothesis to be contrasted in future research.

While social marketing can increase uptake of health products in developing countries, providing equitable access is challenging. We conducted a 2-year evaluation of uptake of WaterGuard, insecticide-treated bednets (ITNs), and micronutrient Sprinkles in Western Kenya. Sixty villages were randomly assigned to intervention and comparison groups. Following a baseline survey (BL), a multifaceted intervention comprising social marketing of these products, home visits by product vendors from a local women's group (Safe Water and AIDS Project, or SWAP), product promotions, and modeling of water treatment and safe storage in was implemented in intervention villages. Comparison villages received only social marketing of WaterGuard and ITNs. We surveyed again at one year (FU1), implemented the intervention in comparison villages, and surveyed again at two years (FU2). At BL, <3% of households had been visited by a SWAP vendor. At FU1, more intervention than comparison households had been visited by a SWAP vendor (39% versus 9%, P<0.0001), and purchased WaterGuard (14% versus 2%, P<0.0001), Sprinkles (36% versus 6%, P<0.0001), or ITNs (3% versus 1%, P<0.04) from that vendor. During FU2, 47% and 41% of original intervention and comparison households, respectively, reported ever receiving a SWAP vendor visit (P=0.16); >90% those reported ever purchasing a product from the vendor. WaterGuard (P=0.02) and ITNs (P=0.005) were purchased less frequently by lower-SES than higher-SES households; Sprinkles, the least expensive product, was purchased equally across all quintiles.

The departure of health professionals to Europe and North America is placing an intolerable burden on public health systems in many African countries. Various retention, recall, and replacement policies to ameliorate the impact of this brain drain have been suggested, none of which have been particularly successful to date. The key question for the future is whether the brain drain of health sector skills is likely to continue and whether the investment of African countries in training health professionals will continue to be lost through emigration. This paper examines the emigration intentions of trainee health professionals in six Southern African countries. The data was collected by the Southern African Migration Program (SAMP) in a survey of final-year students across the region which included 651 students training for the health professions. The data also allows for the comparison of health sector with other students. The analysis presented in this paper shows very high emigration potential amongst all final-year students. Health sector students do show a slightly higher inclination to leave than those training to work in other sectors. These findings present a considerable challenge for policy makers seeking to encourage students to stay at home and work after graduation.

This paper assesses individual and social environment determinants of obesity in the adult Mexican population based on socioeconomic position, rural residence, and areal deprivation. Using a nationally representative health and nutrition survey, this analysis considers individual and structural determinants of obesity from a socioeconomic position and health disparities conceptual framework using multilevel logistic regression models. We find that more than thirty percent of Mexican adults were obese in 2006 and that the odds of being obese were strongly associated with an individual's socioeconomic position, gender, place of residence, and the level of marginalization (areal deprivation) in the place of residence. Surprisingly, areas of the country where areal deprivation was highest had lower risks of individual obesity outcomes. We suggest that programs oriented towards addressing the health benefits of traditional food systems over high-energy dense refined foods and sugary beverages be promoted as part of a public health program aimed at curbing the rising obesity prevalence in Mexico.

I will review the major changes in the distribution of the metropolitan population of the United States (US), as revealed by the 2010 data recently released by the US Census. These data allow us to track recent changes and provide the basis for a discussion of longer-term trends identified in previous studies of US cities (Short 2006, 2007) and the city suburban nexus (Hanlon et al. 2010). In brief summary, the paper will show the continuing metropolitanization and suburbanization of the US population. A more nuanced picture will reveal evidence of stress in suburban areas and population resurgence in selected central city areas. Overall, the story is one of a profound revalorization and a major respatialization of the US metropolis.

Through individual and group testimonies from newly arrived, 1.5 and second generation sub-Saharan Africans (For this study sub-Saharan African refers to the countries located under Northern African countries, for example, Egypt and Morocco and, includes South Africa. There are over 50 countries represented by this region; however, the most populous groups from this region in Africa in the USA are Nigerian, Ethiopian, Kenyan, Liberian, Ghanaian, Cape Verdean, South African, and Somalian.), the diversity and complexity linked to their migration and integration experiences in the USA reveal that there is a gendered and generational element to their self identity. These elements are compounded by perceptions of being African American in a racialized society and deciding whether or not to stay connected to Africa, a continent that needs their financial, political, and social resources accumulated in the USA These "new" African Americans expand the definition of blackness in the USA. Many have created a transnational relationship to Africa and the USA, which provides important implications for Africa's potential "brain gain" as well as socioeconomic, infrastructural, and political development.

This paper looks at the influence of financial factors on the labour market transitions of Canadian older workers. Also, in contrast to previous studies, the analysis focuses on transitions between full-time work, part-time work, and retirement. Sequential annual observations of employment and retirement choices are examined for samples of full-time and part-time workers, drawn from the Survey of Labour and Income Dynamics (SLID), 2001–2006. Measures of potential pension wealth and one-year and peak pension accruals are imputed using data from the Survey of Consumer Finances, 1973–1997, and the SLID, 1997–2006. Regression results indicate that financial factors influence workers to move from full-time to part-time jobs and support the evidence found in previous studies that retirement is usually a process, not a single event. Also, an increase in pension accruals increases the probability of working full-time for lower-income earners only. Among nonfinancial factors, a negative health shock increases the probability of working part-time or retiring for full-time workers but has little effect on the labour market transitions of part-time workers. Finally, these results suggest that policies to encourage phased retirement are unlikely to have a significant labour market effect since bridge employment is already a common transition process among older workers.

We seek to expose the implications of Australia's exclusionary and discriminatory disability migration provisions on the health and wellbeing of disabled children who have arrived in Australia through alternative migratory routes. By undertaking an in-depth analysis of a single case study, Ernesto, we bring to the fore the key issues facing disabled immigrant children. These children, like our case study Ernesto, are only granted visas on the proviso that their parents/primary caregivers agree to cover the full costs associated with their disability, including medical care and additional expenses such as educational inclusion. The story of Ernesto reveals the extreme impact of these discriminatory policies on this population's health and wellbeing. Further, we discuss how the state's "right to exclude" people with disabilities from the migratory process negatively affects the health and wellbeing of their siblings and parents.