Constructing a Cohort: Experience with the French Elfe Project
Claudine Pirus, Corinne Bois, Marie-Noëlle Dufourg, Jean-Louis Lanoë, Stéphanie Vandentorren, Henri Leridon and the Elfe team
The project to construct a multidisciplinary study cohort of 20,000 children to be monitored from birth to adulthood was launched in France in 2005. It was designed to address the concerns of various public bodies, especially those concerned with the environment, and researchers from a variety of disciplines. The result was the formation of the Elfe (Étude longitudinale française depuis l’enfance) longitudinal cohort of children, scheduled to commence in March/April 2011. The authors describe the origins of the project. The approach was deliberately intended to be multidisciplinary, and a large number of research teams were associated in designing the project, suggesting research questions in three major fields: social sciences, health and the links between health and the environment. To make the most of the life course approach, observations will be frequent (annually during the early years). A major place is given to fathers, who play an increasing role in children’s upbringing and socialization. The sample will be representative of births in 2011 throughout metropolitan France. The vast quantity of information to be collected and its highly personal nature require particular caution in the creation and management of data files, for which an innovative procedure will be used. The results of a pilot cohort study launched in 2007 are also presented. They cover several hundred families, whose children are now three years old.
Large Child Cohort Studies across the World
Claudine Pirus, Henri Leridon
It was in 1946 that Great Britain embarked on the world’s first ever large-scale child cohort study, designed to track participants from birth to adulthood. Half a century on, this study is still going strong and has been extended to include the second generation, namely children born to the members of the original cohort. The past fifty years have witnessed the launch of many similar initiatives worldwide, as this type of longitudinal study allows researchers to adopt a dynamic approach to child development and gain a clearer understanding of children’s long-term trajectories. This article describes the experience gained from a series of major multidisciplinary child cohort studies. It highlights the wide diversity of their themes (children’s health is the common denominator) and sampling modalities (some cohort studies rely on existing statistical sources), as well as variations in the length of time between each successive wave and the duration of follow-up, survey tools (which sometimes include biological sampling), the types of family tracking methods employed and their respective success rates. Precise data on attrition are provided for some of the studies, together with examples of scientific findings. The appendix contains detailed information about the methodology, objectives, strengths and weaknesses, institutional support and funding of twenty large-scale child cohort studies.
Mortality Patterns of Cardinals (Sixteenth - Twentieth Centuries)
Alessio Fornasin, Marco Breschi, Matteo Manfredini
This article investigates the characteristics and mortality patterns of cardinals in the Catholic Church between the sixteenth and twentieth centuries. Cardinals are high prelates who perform an essential role in the functioning of Catholic Church, and whose main duties are to elect and assist the Pope in office. Thanks to a database containing remarkably accurate and continuous biographical data on cardinals since the fifth century, some of their specific demographic characteristics can be analysed. During the study period (1586-1958), the Sacred College of Cardinals, with a maximum of 70 members, formed a fairly homogeneous group. Nearly all cardinals came from the economic elite, the majority were Italian-born and held residence in Rome. Their life expectancy levels during the seventeenth and eighteenth centuries are not dissimilar to those of "ordinary" European villagers. However, a striking observation is the subsequent absence of significant improvements in these levels from the 1830s onward; a pattern which is notably out of keeping with most of the rest of Europe. This may be due to the risks associated with the cardinals’ behaviours and lifestyles. The periods in which lower life expectancies are observed coincide with the most turbulent political times for the Church. Cardinals were nonetheless penalized throughout the eighteenth and nineteenth centuries, and it was not until the 1930s that their life expectancy started to catch up with that of the general population.
Maternal Mortality in Rural Senegal. The Experience of the New Ninéfescha Hospital
Almamy Malick Kanté, Gilles Pison
Africa continues to suffer from an acute lack of healthcare provision. Is the construction of new healthcare facilities sufficient to improve the health of the population? This is certainly a question raised when the opening of a new hospital fails to bring about any rapid improvement in health indicators. What are the reasons for the slowness of change here? Does it stem from a mismatch between supply and demand? Or from "cultural brakes" hindering the spread of modern ideas? This article investigates possible factors in the case of a modern hospital built in Bandafassi, a rural area of Senegal where facilities had previously been scarce. Data collected over several decades through demographic surveillance of the local population showed that there was no noticeable decline in maternal mortality immediately following the hospital’s opening. To identify the reasons for this failure, we conducted several surveys of local people’s health-seeking behaviour and the way they utilized this facility, notably for childbirth. Four years on, villagers were still making very little use of the hospital. Few women went there either for antenatal visits or to give birth. The hospital management ascribed this failure to the villagers themselves and, more particularly, to their traditions. These surveys, however, indicate that the heart of the problem lies in a mismatch between the services offered by the hospital and local people’s actual needs.
Male Singlehood, Poverty and Sexuality in Rural China: An Exploratory Survey
Li Shuzhuo, Zhang Qunlin, Yang Xueyan, Isabelle Attané
In China, marriage is still a highly valued social norm, and until the 1990s, practically everyone was able to marry. The situation has changed, however, and a rising proportion of men, in rural areas especially, will experience prolonged and even permanent singlehood due to the growing shortage of women on the marriage market. In the cultural context of China, singlehood is a state of frustration, and even of deprivation, for which it is difficult to find socially acceptable compensations. The lives of single men may thus be severely affected by this situation. How, and to what extent, does unwanted singlehood shape their existence? Do they find alternative means to access, among other things, a satisfactory sexual life? Are their socioeconomic characteristics different from those of married men? The data analysed in this short paper are drawn from a survey conducted in 2008 in a rural county of Anhui province. Its dual objective was to achieve a better understanding of sexual behaviours in rural China in a context of strong social and political control. This study explores the link, well documented elsewhere, between singlehood and poverty, and shows that poverty is a dual factor of exclusion in this region of rural China. Not only does it exclude men from marriage, it also excludes the poorest single men from all sexual activity.
Family Rationales behind Child Begging in Antananarivo
Jérôme Ballet, Augendra Bhukuth, Felana Rakotonirinjanahary, Miantra Rakotonirinjanahary
Child beggars form a specific category of child workers. They are generally associated with street-living children, as defined by Unicef. Analysis of begging thus generally focuses on children’s survival strategies. Using data from an exploratory survey conducted in Antananarivo in autumn 2009, this research paper shows that in the Madagascan capital, the vast majority of child beggars are in fact exploited by their family and do not live on the streets. It proposes a typology of child beggar categories based on the level of parental coercion, looking at family rationales and child beggar trajectories. Possible interpretations are discussed. The findings show that at least three categories of child beggars can be defined. They are associated with different levels of child coercion and correspond to specific age groups. The youngest children are beaten by their family to force them to beg. Above a certain age, physical violence becomes less common and, instead, the children are deprived of food. Last, for the oldest children, violence becomes psychological, with children made to feel guilty about their family’s plight so that they continue to beg on its behalf.
