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The study aimed to qualitatively explore the relationship between intimate partner violence and early marriage, focusing on the psychological and physical health issues faced by married women in rural Pakistan. Specifically, it investigated how resilience moderates the effects of early marriage, physical health problems, intimate partner abuse, and psychological issues. Using an intrinsic qualitative approach, the research involved interviews with 20 household heads, 62 husbands, and 40 wives in Sindh province. The findings indicated significant differences related to early marriage, intimate partner abuse, physical health issues, stress, anxiety, and depression. The results align with other South Asian studies, highlighting early marriage as a major risk factor for physical health issues and intimate partner violence. Additionally, the study underscores the widespread nature of violence as a social problem affecting married couples' health in Pakistan., Competing Interests: The Authors declared no conflict of interest, (African Journal of Reproductive Health © 2024.)

Leisure activities enjoyed by older married couples play an important part in creating more meaningful married lives. The study focuses on the prevalence of joint leisure activities by older couples, the factors influencing older adults' engagement in leisure activities together, and the relationship between joint participation in leisure activities and marital satisfaction of older couples. The quantitative sample included 414 married respondents aged 55 years and above from different parts of Vietnam. The leisure activities analyzed in the paper include vacation/travel, watching movies, music, karaoke singing outside the house, walking around the house, attending cultural events and festivals, watching TV, drinking tea, and doing exercise. The study results showed that the level of joint engagement in leisure activities in places near home with less cost was higher than those engaged in elsewhere. Couples with better living standards, higher education, better health, and who lived in urban areas more actively participated in leisure activities far from home. Vietnamese couples who engage in more leisure activities together had a higher level of overall satisfaction with their marriage, and greater satisfaction in several dimensions of their marital relationship than those who did not participate in leisure activities with their partners., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Forgiveness plays an important role in couple relationships, as it is essential in overcoming interpersonal offenses and related to the well-being of the relationship. To date, no valid instruments are available for Spanish populations to evaluate forgiveness within marital relationships. This study aims to adapt and evaluate the Marital Offense-Specific Forgiveness Scale (MOFS), comparing the behavior of the scale in two cultural contexts: Spain and the United States. Two studies were conducted: the first with 389 participants to evaluate the behavior of the scale and to explore the dimensionality of the Spanish version of the MOFS using exploratory factor analysis (EFA); the second study used a sample of 361 Spanish and 119 American participants, conducting a confirmatory factor analysis (CFA) and an invariance factor analysis. The EFA revealed two factors: Avoidance-Resentment and Benevolence. Using CFA, the factorial structure of the MOFS was confirmed, with results indicating that the proposed model presents a similar fit to the original version., (© 2024 American Association for Marriage and Family Therapy.)

Intermarriage between immigrants and native individuals highlights the need to study childbearing as a joint decision of couples, because fertility preferences are likely to differ for the two partners involved. This study focuses on Sweden, where the majority population holds a relative preference for daughters but many immigrants come from countries with son preferences. Using longitudinal registers for the period 1990-2009, I analyse third-birth risks according to the sex composition of previous children and type of union. Doing so allows the study of preferences from behavioural data: couples with a daughter preference, for example, are more likely to have another child if their two previous children were boys. Results show that third-birth risks tend to be higher in unions between Swedish women and immigrant men, whereas unions between Swedish men and immigrant women tend to exhibit lower third-birth risks. Son preferences are rarely realized in intermarriages.

Objectives: In the United States, the two most common interracial marriages are between Asian women and White men, and between Black men and White women. Previous research proposed that the reason for these pairings stems from White Americans' racial preferences, such that White men prefer Asian women over Black women (i.e., the group stereotyped as more feminine), whereas White women prefer Black men over Asian men (i.e., the group stereotyped as more masculine). Here, we argue that focusing solely on White Americans' preferences neglects the reality that Americans of color also have preferences (and beliefs about others' preferences) that contribute to the composition of U.S. interracial relationships., Method: We used multiple methodologies (i.e., surveys and experimental manipulations) to examine Asian, Black, and White Americans beliefs about others' preferences., Results: Across three studies ( N = 3,728), we reveal that Asian, Black, and White Americans have beliefs about others' preferences (Study 1), that those beliefs mirror their own preferences (Study 2), and that those beliefs have causal implications for their own preferences (Study 3)., Conclusion: Collectively, these findings reveal that such beliefs (and preferences) advantage White Americans, such that both Asian and Black Americans believe that they are more attractive to White Americans than to each other, which leads them to be more attracted to White Americans. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objectives: Cultural reproduction theory posits that cultural resources are transmitted across generations, suggesting early parental influences on cultural experiences in adulthood. Further, cultural resources may be transferred within the same generation-through significant others, such as spouses. This study investigates cultural engagement among middle-aged adults, focusing on individual and spousal influences of childhood cultural engagement., Methods: A sample of 1,271 couples (age 49-66) from the 2012 Korean Baby Boomer Panel Study and the Korean Forgotten Generation Study was analyzed. Each respondent reported the number of arts and cultural activities (e.g., paintings, literature, and classical music) and levels of perceived cultural engagement (i.e., cultural awareness) during childhood and at midlife. Actor-partner interdependence models (APIMs) were estimated to examine how spouses' childhood and midlife cultural engagement were linked within couples., Results: Findings showed that wives reported higher levels of activity participation and cultural awareness in childhood and midlife, compared to husbands. The APIM results indicated that beyond one's own childhood cultural engagement, spouse's childhood cultural awareness was associated with both levels of participation in arts and cultural activities (only for husbands) and cultural awareness (for both husbands and wives) at midlife., Discussion: Cultural activities and awareness can be valuable assets to enhance overall well-being in later life. Given the cross-spousal associations in cultural engagement among Korean middle-aged couples, both spouses' cultural resources need to be considered for the design of interventions and policies to cultivate cultural competence and promote cultural engagement in adulthood., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Intermarriage, defined here as the marriage between people of different races or different ethnicities, is on the rise in the United States, with one in six newlyweds intermarrying. While public opinion approval of interracial marriage is at an all-time high, racial and ethnic hate crimes are also on the rise, which can affect spouses differently based on their identity. Drawing on a 2022 Qualtrics sample of 287 spouses who intermarried and have children, authors of this article sought to learn what is related to their holding a positive view of intermarriage. Talking openly with one's spouse about differences, children initiating discussions about race, and being consciously aware of the interracial or interethnic aspect of the marriage were predictors. Implications for social work practice, which are predicated on the ability to have open communication between family members and the social worker's comfort with their own racial identity, are included for this growing population of intermarried couples., (© 2024 National Association of Social Workers.)

Background: Women who are migrants experience discrimination and face major risks, including sexual exploitation, trafficking, and violence, which affect their health and well-being. This study explored critical health incidents experienced by immigrant Thai women in marriage migration., Methods: A qualitative explorative approach with in-depth interviews was used. Forty immigrant Thai women who currently or previously had a Swedish spouse were recruited for the study. An inductive critical incident technique was used to collect and analyze the data as the first step. In a second deductive step, the Newman system model was used to categorize health dilemmas., Results: The women reported 438 critical health incidents in five main areas. Psychological health dilemmas included emotional abuse, feeling overwhelmed due to family responsibilities and the stress of leaving family behind. Sociocultural health dilemmas included transnational family duties or not performing family duties. Physiological health dilemmas included experiencing physical violence and environmental, domestic or work accidents. Developmental health dilemmas included failing health, difficulties upholding the duties expected of a spouse in the target culture and caring for an elderly husband. Spiritual health dilemmas included critical incidents in which the women perceived themselves to have failed in their hopes and duties as a wife, which intensified their dependence on faith, particularly the Buddhist concept of karma., Conclusion: Professionals in health and welfare practices in Thailand together with professionals in Western countries who work with women in marriage migration situations need to recognize the psychological, sociocultural, physiological, developmental, and spiritual health dilemmas experienced by these women. Furthermore, civil organizations that meet Thai women in foreign countries, such as Buddhist cultural associations, would benefit from the multicultural knowledge revealed by the present study. This knowledge can facilitate healthcare and welfare support for women in marriage migration situations., (© 2024. The Author(s).)

Purpose: This study aimed to investigate the experiential meaning of child-rearing for marriage immigrant women in Korea in the context of the coronavirus disease 2019 (COVID-19) pandemic., Methods: Using the hermeneutic descriptive phenomenology framework developed by Colaizzi, 10 marriage immigrant women rearing preschool and school-age children were invited through purposive and snowball sampling from two multicultural support centers in Korea. The participants were rearing one or two children, and their original nationalities were Vietnamese, Japanese, Cambodian, and Chinese. Individual in-depth, face-to-face, semi-structured interviews were conducted from September 1 to November 30, 2021. We extracted significant statements from the transcripts, transformed these into abstract formulations, and organized them into theme clusters and themes to authentically capture the essence of the participants' subjective experiences., Results: Four theme clusters with 14 themes were derived. The four theme clusters identified were "navigating child healthcare alone," "guilt for not providing a social experience," "worry about media-dependent parenting," and "feelings of incompleteness and exclusion." This study explored the perspectives of mothers raising children as marriage migrant women who experienced physical and emotional health crises due to the COVID-19 pandemic., Conclusion: The findings underscore that marriage immigrant women encountered heightened challenges in managing their children's health and well-being during the COVID-19 pandemic due to linguistic and cultural barriers limiting access to healthcare and information. Additionally, these women experienced considerable emotional stress from perceived inadequacies in providing a holistic social and developmental environment for their children under extensive social restrictions.

Despite the rising divorce rates in some immigrant communities in the US, there has been scant scholarly attention on how immigrants experience divorce, particularly on the role of culture in the divorce process. The primary goal of the present study was to explore the diverse divorce experiences of Hmong immigrants in the United States. As a patrilineal and patriarchal community, divorce is generally frowned upon, with Hmong women often experiencing shame and stigma. A narrative design with nine Hmong women was used to capture their intricate stories that highlight such experiences. Using a thematic analysis, our findings highlighted the complexity and cultural nuances the women in our sample encountered from initiating divorce to the divorce itself: (1) No wants a divorce, (2) Divorce is the "last straw", (3) Varying divorce pathways, and (4) Navigating systems as a Hmong woman. For those who have increased knowledge of both the US American court system and divorce laws along with the traditional Hmong mediations, they may be more equipped in navigating systems. Yet as Hmong divorce practices are performed by Hmong men, Hmong women may struggle with finding their voice or support needed to advocate for their divorce. In such cases, the US court system may be more appealing in assisting their cause (e.g., custody). Professionals working with such communities should be culturally aware and attuned to the different marriage and divorce practices to understand both cultural and legal barriers for those seeking a divorce., (© 2024 The Authors. Family Process published by Wiley Periodicals LLC on behalf of Family Process Institute.)

This study examined the reciprocal prospective associations between commitment, forgiveness, and different aspects of marital well-being (marital satisfaction and marital instability) among Chinese newlywed couples and the gender differences in these associations. The Vulnerability-Stress-Adaptation (VSA) model posits reciprocal associations between adaptive processes and relationship satisfaction. However, the directionality of the associations between adaptive processes and marital satisfaction may differ from the associations between adaptive processes and marital instability in Chinese societies due to the emphasis on relationship maintenance. Based on three annual waves of data from 268 Chinese newlywed couples (Mage = 29.59, SD = 3.25 for husbands; Mage = 28.08, SD = 2.51 for wives), a cross-lagged approach was used to examine the reciprocal associations between commitment, forgiveness, and marital satisfaction/instability. We found: (a) reciprocal associations between commitment/forgiveness and marital satisfaction (wives only); (b) reciprocal associations between forgiveness and marital instability (husbands only); and (c) wives' commitment at Wave 2 mediated the association between wives' commitment at Wave 1 and wives' marital satisfaction at Wave 3. Extending the VSA model, findings suggest different reciprocal associations between commitment, forgiveness, and different aspects of marital well-being among Chinese newlywed couples. Results highlight the important role of culture and gender in marital relationships and clinical practice., (© 2023 Family Process Institute.)

The transition to parenthood can be a challenging time for the relationships of new parents and result in declines in relationship satisfaction. Although a robust literature has identified characteristics that predict changes in relationship satisfaction during this period, the relationships of Black mothers postpartum remain understudied. To address this gap, we examined a set of relational, individual, and external characteristics as predictors of relationship satisfaction trajectories over the first four months postpartum. First-time Black mothers (N = 93, 22.6% married, 52.7% cohabiting, 24.7% not cohabiting) reported on relational, individual, and external characteristics at 1 week postpartum and their relationship satisfaction at 1, 8, and 16 weeks postpartum. Mothers who reported more commitment and partner support were higher in initial satisfaction, as were mothers who were married or cohabiting with a partner (relative to mothers who were not cohabiting with their partner). Mothers with clinically significant depressive symptoms at 1 week postpartum had lower initial relationship satisfaction than mothers without clinically significant depressive symptoms. Mothers' sleep difficulties and experiences of racial discrimination were associated with changes in relationship satisfaction over time; mothers experiencing more sleep difficulties and racial discrimination experienced larger declines in satisfaction. These findings offer new insights into risk and protective factors associated with relationship satisfaction among Black mothers during the early postpartum period and can inform multicomponent interventions to enhance their relationship functioning., (© 2024 The Authors. Family Process published by Wiley Periodicals LLC on behalf of Family Process Institute.)

While modern family-related ideas and behaviors have become more widely accepted in contemporary China, Chinese Muslim minorities continue to hold on to traditional religious practices. Surprisingly, data from our survey conducted in Gansu province in China's northwestern borderlands reveal that Muslims of the Hui and Dongxiang ethnicities reported much higher rates of cohabitation experience than the secular majority Han. Based on follow-up qualitative interviews, we found the answer to lie in the interplay between the highly interventionist Chinese state and the robust cultural resilience of local Islamic communities. While the state maintains a high minimum legal age of marriage, the early marriage norm remains strong in Chinese Muslim communities, where religion constitutes an alternative and often more powerful source of legitimacy-at least in the private sphere of life. Using the 2000 census data, we further show that women in almost all 10 Muslim ethnic groups have higher percentages of underage births and premarital births than Han women, both nationally and in the northwest where most Chinese Muslims live. As the once-outlawed behavior of cohabitation became more socially acceptable during the reform and opening-up era, young Muslim Chinese often found themselves in "arranged cohabitations" as de facto marriages formed at younger-than-legal ages. In doing so, Chinese Muslim communities have reinvented the meaning of cohabitation. Rather than liberal intimate relationship based on individual autonomy, cohabitation has served as a coping strategy by which Islamic patriarchs circumvent the Chinese state's aggressive regulations aimed at "modernizing" the Muslim family., Competing Interests: Competing interests statement:The authors declare no competing interest.

Background: Adolescent sexual and reproductive health (ASRH) is a major public health concern in sub-Saharan Africa (SSA). However, inequalities in ASRH have received less attention than many other public health priority areas, in part due to limited data. In this study, we examine inequalities in key ASRH indicators., Methods: We analyzed national household surveys from 37 countries in SSA, conducted during 1990-2018, to examine trends and inequalities in adolescent behaviors related to early marriage, childbearing and sexual debut among adolescents using data from respondents 15-24 years. Survival analyses were conducted on each survey to obtain estimates for the ASRH indicators. Multilevel linear regression modelling was used to obtain estimates for 2000 and 2015 in four subregions of SSA for all indicators, disaggregated by sex, age, household wealth, urban-rural residence and educational status (primary or less versus secondary or higher education)., Results: In 2015, 28% of adolescent girls in SSA were married before age 18, declined at an average annual rate of 1.5% during 2000-2015, while 47% of girls gave birth before age 20, declining at 0.6% per year. Child marriage was rare for boys (2.5%). About 54% and 43% of girls and boys, respectively, had their sexual debut before 18. The declines were greater for the indicators of early adolescence (10-14 years). Large differences in marriage and childbearing were observed between adolescent girls from rural versus urban areas and the poorest versus richest households, with much greater inequalities observed in West and Central Africa where the prevalence was highest. The urban-rural and wealth-related inequalities remained stagnant or widened during 2000-2015, as the decline was relatively slower among rural and the poorest compared to urban and the richest girls. The prevalence of the ASRH indicators did not decline or increase in either education categories., Conclusion: Early marriage, childbearing and sexual debut declined in SSA but the 2015 levels were still high, especially in Central and West Africa, and inequalities persisted or became larger. In particular, rural, less educated and poorest adolescent girls continued to face higher ASRH risks and vulnerabilities. Greater attention to disparities in ASRH is needed for better targeting of interventions and monitoring of progress.

Some evidence suggests that in sub-Saharan Africa, sexual violence is commonplace among married women, yet this problem is underresearched. Using qualitative methods and applying Heise's social-ecological model, this study examined the experiences of 15 Ghanaian women suffering sexual violence in their marriages. Results from the thematic analysis indicate several determinants of sexual violence. Whereas some participants identified macro-level and exosystem factors, including poverty, others pointed to micro-level and ontogenic factors, such as husbands' substance abuse. The results corroborate the core idea of Heise's framework, namely, that structural- and individual-level factors make women vulnerable to violence. The study concludes that Ghanaian legal and policy frameworks must be enforced and strengthened to address the etiology of sexual violence and abuse.

Background: Married adolescent girls are vulnerable to risky sexual and reproductive health outcomes. We examined the association of fertility pressure from in-laws' early in marriage with contraceptive use ever, parity, time until first birth, and couple communication about family size, among married adolescent girls., Methods: Data were taken from a cross-sectional survey with married girls aged 15-19 years (N = 4893) collected from September 2015 to July 2016 in Bihar and Uttar Pradesh, India. Multivariable regression assessed associations between in-laws' fertility pressure and each outcome, adjusting for sociodemographic covariates., Results: We found that 1 in 5 girls experienced pressure from in-laws' to have a child immediately after marriage. In-laws' fertility pressure was associated with lower parity (Adj. β Coef. - 0.10, 95% CI - 0.17, - 0.37) and couple communication about family size (AOR = 1.77, 95% CI 1.39, 2.26), but not contraceptive use or time until birth., Conclusions: Our study adds to the literature identifying that in-laws' pressure on fertility is common, affects couple communication about family size, and may be more likely for those yet to have a child, but may have little effect impeding contraceptive use in a context where such use is not normative.

Temporalities of care shape the lives of families raising children with Down syndrome in Jordan. As they age, parents grapple with the future's uncertainties and often circle back to questions of marriage. Marriage is a key symbol of adulthood, shaping futures and actualities of care by distributing gendered and generational labor among kin. Over time, children with Down syndrome depart from the normative trajectories embedded in these kinship- and marriage-based systems of care, leaving them stuck. While parents worry about care futures, they and their grown children contend with constricting opportunities in the present.

The situation of low women empowerment in household settings might influence women's attitude and ability to negotiate for protected sex in their marital relationship. This study aimed to investigate the association between women empowerment factors and the attitude for safer sex negotiation among Indonesian married women. The secondary data of 28,934 individual records of married women retrieved from the 2017 Indonesia Demographic and Health Survey (IDHS) was used. The dependent variable was the attitude for safer sex negotiation measured by women's acceptance toward a justification to ask her husband to use a condom if her husband has a sexually transmitted disease. Multivariate logistic regression analysis accounting for the complex survey design was performed. The results showed that women empowerment factors, that include higher level of education and participation in household decision-making had a positive effect on women's attitude for protected sex. Those women with higher levels of HIV knowledge and whoever talked about HIV with their husbands were also more likely to justify for protected sex. Therefore, women empowerment through education, improving socioeconomic conditions, and increasing HIV-related knowledge can help develop a positive attitude and enable women to negotiate for safer sex with their partners.

The study investigates the socio-religious factors in the propagation of genetically inherited disease of Beta thalassemia. The disorder which reportedly has a significant protraction through repeated cousin marriages results in the social maladjustment of the parents of the sick children due to constant depression, anxiety, and weak social interaction and may lead to social isolation as well. This research aims to find out the significant effect of socio-religious trends on psychosocial burden of beta thalassemia major among cousin and non-cousin couples in the province of Punjab in Pakistan. It takes a sample of 932 parents of sick children, among whom 735 were married with cousins and 197 with non-cousins, for data collection. The findings reveal that inadequate knowledge of the disease, insufficient or misdirected social support, stigmatization, and marriage breakups caused by the disease, superstitions, and misinterpretations of religion and the subsequent practices accordingly as significant predictors of psychosocial burden of beta thalassemia major among non-cousins and cousin couples. Additionally, it also finds patriarchy as only significant predictors of outcome variable among cousin couples.

Using a systematic literature review approach, this paper focused on the role of polygyny in the spread of HIV/AIDS in sub-Saharan Africa (SSA) countries. The widespread practice of polygyny is one feature of many SSA contexts that may be relevant to understanding patterns of HIV prevalence. Building on the conflicting studies on the importance of polygyny, this study investigated whether or not polygyny is a conduit for elevating HIV transmission in SSA countries. Findings showed that polygyny as an institution is perhaps less of a concern; rather the implication that men and women who are in polygamous relationships are also more likely to engage in extra-marital sex - raises secondary questions about their patterns of sexual networking and concurrent sexual partnerships. The findings however show that polygyny amplifies risky sexual behaviours such as sexual networking and concurrent sexual partnerships, all of which were found to be significantly associated with the risk of HIV transmission. This demonstrates that targeting risky sexual behaviours in a broader marital context may be more important for HIV risk reduction than targeting polygyny as an institution.

This paper presents an analysis of trends in sexual activity by marital status and age, and their associations with contraceptive use. Understanding levels of, and trends in, sexual activity is important for assessing the needs for family planning services and for analysing commonly used family planning indicators. Data were taken from 220 Demographic and Health Surveys (DHSs) and 62 Multiple Indicator Cluster Surveys (MICSs) to provide insights into sexual activity by marital status and age in a total of 94 countries in different regions of the world. The results show the sensitivity of the indicator with respect to the definition of currently sexually active, based on the timing of last sexual intercourse (during the last 4 weeks, 3 months, or 1 year). Substantial diversity in sexual activity by marital status and age was demonstrated across countries. The proportion of married women reporting recent sexual activity (sexual intercourse during the last 4 weeks) ranged from 50% to 90%. The proportion of unmarried women reporting recent sexual activity did not exceed 50% in any of the 94 countries with available data, but showed substantial regional differences: it appeared to be rare in Asia and extremely varied within Africa, Europe and Latin America and the Caribbean. Among married women, sexual activity did not vary much by age group, while for unmarried women, there was an inverted U-pattern by age, with the youngest age group (15-19 years old) having the lowest proportion sexually active. The proportion of women who reported currently using contraception and reported not being sexually active varied by the contraceptive method used and was overall much greater among unmarried women. The evidence presented in this paper can be used to improve family planning policies and programmes to serve the diverse needs, for example regarding method choice and service provision, of unmarried women.

Background: Consanguinity is a commonly recognized practice among marriages in the Middle East and may lead to an increase in the prevalence of inherited disorders. Autosomal recessive deafness is the most common form of inherited congenital hearing loss (CHL)., Objectives: Determine the association of consanguineous marriages with congenital sensorineural hearing loss (SNHL) and auditory neuropathy., Design: Descriptive and analytical cross-sectional study., Setting: Ear specialist hospital., Patients and Methods: Children with severe-to-profound congenital SNHL, who had been referred to the specialist hospital for cochlear implant were analyzed. Patients were divided into subgroups based on degree of consanguinity., Main Outcome Measure: The relative risk of having more than one child with SNHL in offspring of a consanguineous marriage., Sample Size: 189 parents and children with CHL., Results: The parents of 157 children (83.1%) were blood-related. Of those, 48 had more than one child with CHL (31.4%), while only two parents who were not blood-related had more than one child with CHL (6.25%; P =.005). Among the 189 children, 131 (69.3%) parents were direct cousins. Only 39 (20.6%) and 43 (22.8%) children had family histories of CHL on the paternal and maternal sides, respectively. There was no statistically significant difference in the prevalence of auditory neuropathy between the offspring of consanguineous and non-consanguineous marriages ( P =.648)., Conclusion: The risk of having more than one child with SNHL in the offspring from a consanguineous marriage is 3.5 times higher than that of a non-consanguineous mating., Limitation: The association of hearing loss degree with consanguinity was not studied., Conflict of Interest: None.

Background: While marriage and education help maintain older adults' health, their joint association with mortality remains unclear. This cross-national study examined the combined effect of marriage and education on the mortality of older Japanese and Finnish adults., Methods: Data on 22,415 Japanese and 11,993 Finnish adults, aged 65-74 years, were obtained from the Japan Gerontological Evaluation Study of 2010-2012 and the Finnish Public Sector Study of 2008-2009 and 2012-2013. We followed up on respondents' survival status for 5 years using public records. Marital status, educational level, and other variables in both datasets were harmonized., Results: The Cox proportional hazards model showed that unmarried men had a higher mortality risk than married men in both countries (hazard ratio [HR] 1.47; 95% confidence interval [CI], 1.21-1.79 for Japanese and HR 1.94; 95% CI, 1.29-2.91 for Finnish); no such difference was observed in women. The highest mortality risk was observed in unmarried men with tertiary education in both Japan (HR 1.85; 95% CI, 1.21-2.83) and Finland (HR 2.21; 95% CI, 1.26-3.89), when adjusted for baseline age, health-related behaviors, and illnesses., Conclusions: Our findings showed similarity in the combined effect of marriage and education between Japan and Finland, differing from observations in countries with more apparent socioeconomic health disparities. Further studies should examine the reasons for the excessive mortality risk in highly educated, unmarried men in both countries and consider whether selection bias led to underestimation of the true risk in unmarried older adults with lower education.

We examined premarital counseling services offered by Christian and Muslim lay counselors in Ghana. Participants including clergy, Islamic clerics, and laity practicing in four urban centers were interviewed. Thematic analysis showed that common issues covered include medical screening, beliefs and values, expectations, partner knowledge, roles and duties, sex, parenthood, financial management, communication, and conflicts. The findings offer important insight into religious premarital counseling in Ghana and contribute to the global literature on premarital counseling.

Family formation in the United States has changed dramatically: marriage has become less common, nonmarital cohabitation has become more common, and racial and economic inequalities in these experiences have increased. We provide insights into recent U.S. trends by presenting cohort estimates for people born between 1970 and 1997, who began forming unions between 1985 and 2015. Using Panel Study of Income Dynamics data, we find that typical ages at marriage and union formation increased faster across these recent cohorts than across cohorts born between 1940 and 1969. As fewer people married at young ages, more cohabited, but the substitution was incomplete. We project steep declines in the probability of ever marrying, declines that are larger among Black people than White people. We provide novel information on the intergenerational nature of family inequalities by measuring parental income, wealth, education, and occupational prestige. Marriage declines are particularly steep among people from low-income backgrounds. Black people are overrepresented in this low-income group because of discrimination and opportunity denial. However, marriage declines are larger among Black people than White people across parental incomes. Further, most racial differences in marriage occur among people from similar socioeconomic backgrounds. Family inequalities increasingly reflect both economic inequalities and broader racial inequalities generated by racist structures; in turn, family inequalities may prolong these other inequalities across generations.

Objectives: Caregiving does not have to be a totally negative experience for the husband caregivers of breast cancer survivors (BCS). There are growing interests in exploring the positive psychological changes (aka posttraumatic growth; PTG) among husbands of BCS. Western studies have shown that coping resources, cognitive appraisal, and coping strategies are associated with PTG among caregivers of BCS. Studies in the Chinese context are limited. This study examined the psychosocial correlates of PTG among husbands of Chinese BCS., Methods: Husbands of Chinese BCS (N = 176) were recruited from two hospitals in Weifang, China to complete a cross-sectional survey. Their levels of caregiving burden, marital satisfaction, cognitive appraisals, coping strategies, and PTG were measured., Results: After controlling for covariates, hierarchical regression results indicated that higher caregiving burden (β = .29), marital satisfaction (β = .27), challenge appraisal (β = 016), and social support seeking (β = .23) were associated with higher PTG (Ps < .05). Additionally, a significant interaction between caregiving burden and positive reframing emerged in explaining PTG (β = .17, P < .05). Positive reframing was only associated with higher PTG among those with higher caregiving burden (β = .25, P = .03), but not those with lower caregiving burden (β = -.09, P > .05)., Conclusions: Stress and coping variables significantly contributed to PTG among husbands of Chinese BCS. Our findings implied that addressing those husband caregivers' marital satisfaction, challenge appraisal toward the impact of breast cancer, and social support seeking could be intervention strategies to facilitate their PTG. Among husbands having higher caregiving burden, positive reframing may also facilitate their PTG., (© 2020 John Wiley & Sons Ltd.)

Objective This study is a comprehensive approach to psychic conflicts encountered by young women confronted with divergent cultural models. It relates the tensions experienced by Renuka, Tamil born in France, in her marital choices between cultural verticality and interbreeding. Method Renuka's matrimonial journey is explored through in-depth semi-structured interviews analyzed using Devereux's complementarist method. Results In a multicultural space, there is a difficulty of positioning. Marital choices reveal intrapsychic tensions that can be overcome by mobilizing strategies, processes and mechanisms articulating identificatory models. Conclusion This study explores the issues of marriage in a migratory context and its effects on the psychic life of individuals and relates the major issues of our mixed societies.

Background: Early Marriage is one of the global problems that undermine the personal development and the rights of women seriously. It is delicate among the developing countries such as Ethiopia. It has major consequences for public health, national security, social development, human rights, economic development, and gender equality., Methods: The analyzed data were obtained from the 2016 EDHS and 1120 samples were considered in this analysis. Both bivariate and multivariable binary logistic regression model were used to identify the determinants of early marriage practice., Results: The prevalence of early marriage practice was 48.57% in the study area. The odds of early marriage practice were 2.04(AOR=2.04, 95% CI: 1.88, 2.45) times higher among rural residents compared to urban. The odds of early marriage practice was 0.94(AOR=0.94, 95%CI: 0.57, 1.98) times lower among women who had primary education compared to uneducated women. Those who did not know the legal marital age were 1.61(AOR=1.61, 95%CI: 1.26, 2.07) times more likely to practice early marriage compared to parents who knew the legal marital age., Conclusion: Education level, family monthly income, residence, literacy level and knowledge of legal marital were significant determinants of early marriage practice., (© 2020 Tekile AK et al.)

Objectives: The incentives underlying men's hunting acquisition patterns among foragers are much debated. Some argue that hunters preferentially channel foods to their households, others maintain that foods are widely redistributed. Debates have focused on the redistribution of foods brought to camp, though the proper interpretation of results is contested. Here we instead address this question using two nutritional variables, employed as proxies for longer-term food access. We also report on broader patterns in nutritional status., Materials and Methods: We measured male hunting success, hemoglobin concentration and body fatness among bush-living Hadza. Hunting success was measured using an aggregated reputation score. Hemoglobin concentration, a proxy for dietary red meat, was measured from fingerprick capillary blood. Body fatness, a proxy for energy balance, was measured using BMI and bioelectrical impedance., Results: We find no statistically significant relationship between a hunter's success and any measure of his nutritional status or that of his spouse. We further find that: women are, as elsewhere, at greater risk of iron-deficiency anemia than men; men had slightly lower BMIs than women; men but not women had significantly lower hemoglobin levels than in the 1960s., Discussion: The absence of an association between hunting reputation and nutritional status is consistent with generalized food sharing. Null results are difficult to interpret and findings could potentially be a consequence of insufficient signal in the study measures or some confounding effect. In any event, our results add to a substantial corpus of existing research that identifies few nutritional advantages to being or marrying a well-reputed Hadza hunter., (© 2020 Wiley Periodicals, Inc.)

Marital conflict is associated with multiple negative outcomes for couples, including marital dissatisfaction and divorce. Little research, however, has examined conflict in Hispanic/Latino couples or its association with marital satisfaction, which creates an unfortunate knowledge gap for clinicians working with diverse client groups. The present study sought to examine both marital conflict and satisfaction using a sample of 231 European American (EA; n = 108) and Hispanic/Latino (H/L; n = 123) couples. Through observational coding, couples were placed into four groups based on their type of conflict management strategies: Harmonious, Withdrawn, Conflictual-Expressive, or Conflictual-Hostile. For both ethnic groups, couples in the Harmonious group were nondistressed and couples in the Conflictual-Hostile group were in the distressed range of marital satisfaction. Cross-ethnic differences emerged. EA couples experienced distress when both hostile (Conflictual-Hostile) and nonhostile conflict (Conflictual-Expressive) communication types were observed, while only hostile conflict was associated with distress for the H/L group. H/L couples reported similar levels of satisfaction in both the Harmonious and Conflictual-Expressive groups. H/L couples also fell within the distressed range when withdrawn communication patterns were observed; however, this was not the case for EA couples. These differences suggest that both types of conflict are associated with marital distress for EA couples, whereas hostile conflict and withdrawn behavior appear to be more negatively associated with marital satisfaction in H/L couples. Results provide support for the use of an observational coding system with H/L and EA couples and also suggest the importance of understanding how differences in expressions of conflict across ethnicities may relate to marital satisfaction., (© 2019 Family Process Institute.)

Improving the sexual and reproductive health of young women allows them to reap the personal, social and economic benefits through making informed decisions on their health. Restrictions on the sexual and reproductive health rights of young women are discriminatory because they relegate women to a state of being less valuable than their male counterparts. This study explore s the obstacles that women face in asserting their reproductive health rights in Zimbabwe. For this qualitative study, semi-structured interviews were conducted to collect data, which was analysed using narrative analysis techniques. The study found that polygamy and wife inheritance were among the challenges women faced that kept them from exercising their reproductive rights. Other forms of gender inequality also reduces the autonomy of women. Gender norms have an effect on the health seeking behaviour of women within the sexual and reproductive health ambit.

Although intimate partner violence (IPV) against women is prevalent in sub-Saharan Africa, studies that investigated factors associated with IPV among Gambian women are limited. In this study, we examined the prevalence and factors associated with the different forms of IPV against Gambian women. We used a sample of 3,116 currently married women age (15 ~ 49 years) from The Gambia Demographic and Health Survey 2013. Logistic regression models were used to examine factors associated with Physical Violence (PV), Sexual Violence (SV), and Emotional Violence (EV). Over 40% (n = 1,248) of women reported at least one form of IPV. The prevalence of PV, SV and EV was 20.6%, 4.3%, and 15.1% respectively. Women married at age 18 ~ 24 (adjusted Odds Ratio [aOR] SV  = 1.55), lived with 3 ~ 4 (aOR PV  = 1.69; aOR EV  = 2.10) and ≥5 (aOR PV  = 1.77; aOR EV  = 2.64) children, witnessed parental violence (aOR PV  = 1.66; aOR SV  = 2.75; aOR EV  = 2.25), partner's primary education (aOR PV  = 1.76), accused of unfaithfulness (aOR PV  = 2.42; aOR SV  = 3.62; aOR EV 4.10), and partner's alcohol consumption (aOR PV  = 2.56; OR SV  = 3.91; aOR EV  = 2.82) are more likely to report IPV. Conversely, women who lived in Kerewan area (aOR PV  = 0.43; aOR SV  = 0.38; aOR EV  = 0.50), had high income (aOR PV  = 0.65), Wolof (aOR PV  = 0.68) and Jola (aOR PV  = 0.65) ethnicity and unemployed (aOR PV  = 0.59; aOR SV  = 0.56) were less likely to report IPV. Interventions to prevent IPV should focus on education on its effects, and programs that reject sociocultural practices as determinants of IPV.

Early marriage, which is associated with a wide range of negative health and socioeconomic outcomes, may be a response to conflict and displacement. Since the onset of the Syrian conflict in 2011, there has been considerable attention to reports of high and potentially increasing rates of early marriage among Syrian refugee women. Using nationally representative survey data from Jordan in 2016 and Syria in 2009, as well as qualitative interviews with Syrian refugee youth in Jordan, we examine changes in age at marriage and drivers of early marriage. We find no evidence of an increase in early marriage rates after refugees' arrival to Jordan. Rates of early marriage among the Syrians now in Jordan were higher than preconflict national rates and have remained similar postdisplacement, although poverty and security concerns have created new drivers for accelerating marriage for young women. Other dynamics of the Syrian marriage market in displacement may act to decelerate marriage rates, including declining rates of consanguinity and inability to meet marriage costs. Analysis of early marriage in displacement must be placed within the context of change in marriage practices among refugees more broadly., (© 2020 The Population Council, Inc.)

Background: Gender inequality is a pervasive problem in sub-Saharan Africa, and has negative effects on health and development., Objective: Here, we sought to identify socioeconomic predictors of gender inequality (measured by low decision-making power and high acceptance of intimate partner violence) within heterosexual couples expecting a child in south-central Uganda., Method: We used data from a two-arm cluster randomized controlled HIV self-testing intervention trial conducted in three antenatal clinics in south-central Uganda among 1,618 enrolled women and 1,198 male partners. Analysis included Cochran Mantel-Haenzel, proportional odds models, logistic regression, and generalized linear mixed model framework to account for site-level clustering., Results: Overall, we found that 31.1% of men had high acceptance of IPV, and 15.9% of women had low decision-making power. We found religion, education, HIV status, age, and marital status to significantly predict gender equality. Specifically, we observed lower gender equality among Catholics, those with lower education, those who were married, HIV positive women, and older women., Conclusion: By better understanding the prevalence and predictors of gender inequality, this knowledge will allow us to better target interventions (increasing education, reducing HIV prevalence in women, targeting interventions different religions and married couples) to decrease inequalities and improve health care delivery to underserved populations in Uganda., (© 2020 Vrana-Diaz CJ et al.)

International migrants are one group that is vulnerable to discrimination and mental health problems. This study examined the experience of perceived discrimination and its impact on depressive symptoms among women who migrated in the specific context of marriage. Using social constructionism and the stress appraisal model, this study conceptualized perceived discrimination as a potential source of stress and hypothesized that it would negatively impact the mental health of migrant women. A survey sample of 212 Vietnamese marriage migrant women in South Korea was used for the final analysis. Perceived discrimination was measured using the adapted Everyday Discrimination Scale (EDS). Overall, approximately 62% of the sample reported having at least one discriminatory encounter based on the nine items of the EDS. The results of the multivariate analyses indicated that perceived discrimination posed a significant risk to mental health (β = 0.43, p < .001). The experience of perceived discrimination increased the amount of explained variance of depressive symptoms by 17%. Findings highlighted the adverse mental health consequences of daily unfair treatment and disrespect in interpersonal contexts and the importance of social policies and programs that promote respect for cultural diversity.

Background: Pregnancy among adolescent girls in Bangladesh is high, with 66% of women under the age of 18 reporting a first birth; this issue is particularly acute in the northern region of Bangladesh, an area that is especially impoverished and where girls are at heightened risk. Using formative research, CARE USA examined the underlying social, individual and structural factors influencing married girls' early first birth and participation in alternative opportunities (such as education or economic pursuits) in Bangladesh., Methods: In July of 2017, researchers conducted in-depth interviews of community members in two sub-districts of northern Bangladesh (Kurigram Sadar and Rajarhat). Participants (n = 127) included adolescent girls (both married and unmarredi), husbands of adolescent girls, influential adults in the girls' lives, community leaders, and health providers. All interviews were transcribed, coded and organized using Dedoose software., Results: Participants recognize the health benefits of delaying first birth, but stigma around infertility and contraceptive use, pressure from mothers-in-law and health provider bias interfere with a girl's ability to delay childbearing. Girls' social isolation, lack of mobility or autonomy, and inability to envision alternatives to early motherhood compound the issue; provider bias may also prevent access to methods. While participants agree that pursuit of education and economic opportunities are important, better futures for girls do not necessarily supersede their marital obligations of childrearing and domestic chores., Conclusions: Findings indicate the need for a multi-level approach to delaying early birth and stimulating girls' participation in economic and educational pursuits. Interventions must mitigate barriers to reproductive health care; train adolescent girls on viable economic activities; and provide educational opportunities for girls. Effective programs should also address contextual issues by including immediate members of the girls' families, particularly the husband and mother-in-law.

Attachment theory posits that in adulthood, romantic partners typically fill the role of primary attachment figure, yet few studies have examined whether these findings hold in cultures that practice arranged marriage or that emphasise collectivistic values and filial piety. In the current study, we compared attachment hierarchies in 116 Bangladeshi women engaged to be married or in the first 3 years of couple-initiated (also known as love) marriages and arranged marriages. Women in couple-initiated marriages reported greater use of their partners for the attachment functions of safe haven and secure base than women in arranged marriages. However, women in both groups were more likely to identify one of their parents than their partner as their primary attachment figure. Although replication is necessary, these findings suggest that partners may not be universally prioritised above parents in the attachment hierarchy and that attachment theory's assumptions of individuation from parents in adulthood may not apply cross-culturally. Findings are discussed in terms of cultural differences from samples previously represented in attachment research, such as kinship structures, the meaning of marriage and filial piety., (© 2019 International Union of Psychological Science.)

Knowledge of evolutionary influences on patterns of human mating, social interactions, and differential health is increasing, yet these insights have rarely been applied to historical analyses of human population dynamics. The genetic and evolutionary forces behind biases in interethnic mating and in the health of individuals of different ethnic groups in Latin America and the Caribbean since the European colonization of America are still largely ignored. We discuss how historical and contemporary sociocultural interactions and practices are strongly influenced by population-level evolutionary forces. Specifically, we discuss the historical implications of functional (de facto) polygyny, sex-biased admixture, and assortative mating in Latin America. We propose that these three evolutionary mechanisms influenced mating patterns, shaping the genetic and cultural landscape across Latin America and the Caribbean. Further, we discuss how genetic differences between the original populations that migrated at different times into Latin America contributed to their accommodation to and survival in the different local ecologies and interethnic interactions. Relevant medical and social implications follow from the genetic and cultural changes reviewed.

In this study, we synthesized findings from qualitative studies to identify the key factors that influence child marriage. We used a meta-ethnographic approach coupled with thematic synthesis. We searched literature from nine databases, which were in English language, covering areas in public health, psychology, and social science between 2008 and 2018. Twelve studies were included in the synthesis. We identified six main themes: human insecurity and conflict; legal issues; family values and circumstances; religious beliefs; individual circumstances, beliefs, and knowledge; and social norms. Our findings highlight the impact of human insecurity and conflict, as well as legal issues. In spite of global progress scaling up legislation against child marriage, the legal framework is insufficiently enforced in many settings. Most of the included studies were from the Middle East, Africa, and South Asia. Studies from other parts of the world such as Latin America and Southeast Asia, which have the highest rates of child marriage, are needed., Competing Interests: The authors have declared that no competing interests exist.

Introduction: cervical cancer is a leading cause of death among Nigerian women. Women often require spousal support before attending cervical cancer screening services. This study assessed married men´s knowledge and attitude towards male involvement in cervical cancer screening of their wives., Methods: a cross-sectional study using a mixed methods approach was conducted among 245 married men in Izzi, Local Government Area of Ebonyi State, South-East Nigeria. Quantitative data collected using structured, interviewer-administered questionnaires and qualitative data from focus group discussions were triangulated. Data analysis was done using IBM SPSS version 20. Qualitative findings were analysed using thematic analysis., Results: the mean knowledge of cervical cancer was 2.06±0.55. Only 2.9% of the respondents had adequate knowledge of risk factors for cervical cancer. Up to 89.8% were willing to approve screening for their spouses. Majority (76.3%) considered screening important in cervical cancer prevention, while 91.4% were willing to pay for the screening test. Most of them exhibited patriarchal tendencies and insisted that their wives must obtain their consent before screening as depicted by the statement "It is what I tell her that she will do". Previous spousal screening was a predictor of good knowledge (OR = 10.94, 95% CI = 2.44-48.93; P=0.002)., Conclusion: married men in this study had poor knowledge of cervical cancer. However, they were willing to support cervical cancer screening conditional on their pre-information and consent. Awareness creation activities on cervical cancer screening should incorporate active engagement of husbands in order to promote screening uptake by their wives., Competing Interests: The authors declare no competing interests., (Copyright: Ijeoma Nkem Okedo-Alex et al.)

In this paper, we analyze the family level and socio-demographic factors affecting women's decision-making ability over access to reproductive health care services in rural communities of Balkh province, Afghanistan. A questionnaire survey was conducted with a total of 176 married women. Using logistic regression analysis, we found that four out of seven variables significantly influenced women's decision-making ability over access to Reproductive Health Care Services (RHCS): extended family structure (OR = 14.31, p  < 0.01), husbands accompanying their wives to RHCS (OR = 4.12, p  < 0.05), discussing issues related to reproductive health with partner (OR = 3.57, p  < 0.05), and distance from home to a health facility (OR =0.86, p  < 0.01). Therefore, some policies or programs designed to improve husband-wife communication, in particular fostering discussions related to reproductive health and encouraging husbands to accompany their wives to health centers, are recommended to improve women's decision-making ability over access to RHCS.

In mainland China, HIV prevalence among men who have sex with men (MSM) has risen sharply in the past decade. However, few HIV studies have directly addressed the female spouses' (tongqi) experiences, a population estimated at 14 million [Cheng, F. K. (2016). I want to come forward: Voices from Chinese tongqi. Cogent Social Sciences, 2(1), 1158343. doi:10.1080/23311886.2016.1158343; Zhu, J. (2018). "Unqueer" kinship? Critical reflections on "marriage fraud" in mainland China. Sexualities, 21(7), 1075-1091. doi:10.1177/1363460717719240]. We conducted this exploratory qualitative study to understand tongqi's attitudes toward same-sex sexuality and HIV risk as well as their sexual history. Semistructured interviews were conducted with 24 tongqi between October 2015 and September 2016. Data were coded and analyzed using thematic analysis. We identified four primary themes: (a) surprise, initial disbelief, and negative attitudes toward their husbands' same-sex sexuality; (b) maintenance of regular sexual contact, particularly before pregnancy; (c) unprotected sex with marital and extramarital partners; and (d) low perception of HIV risk. Strategies to increase HIV knowledge and testing uptake are urgently needed among these vulnerable women but must be implemented with caution to avoid exacerbating high levels of homophobia.

Background: With the introduction of the prolonged grief disorder (PGD) in the ICD-11 and most likely in the future DSM-5-TR, there is clinical need to examine cultural variations in grief phenomenon. We tested whether grief symptoms differ cross-culturally by examining the prevalence rates and predictors of PGD among French and Togolese bereaved individuals., Methods: The sample comprised 235 widowed persons (73 French and 162 Togolese participants). They all completed the Prolonged Grief Scale-11 items. There were no statistically significant differences between both groups in terms of sociodemographic information (except for education). However, they differed on loss-related characteristics. We used two different symptom-diagnostic tests to estimate the prevalence rates., Results: We found that French and Togolese bereavers reported almost similar PGD prevalence rates (21.9% [95% CI 0.13, 0.36] and 15.4% [95% CI 0.10, 0.23], respectively for the first test, 26% [95% CI 0.16, 0.41] and 17.3% [95% CI 0.12, 0.25], respectively for the second test). Through regression analyses, PGD severity was predicted by low education, being unemployed, long duration of a marital relationship, and traumatic death in the French sample, whereas it was predicted by being male and highly educated in the Togolese sample. Both groups only shared a recent bereavement period as a common risk factor., Conclusions: Even though French and Togolese widowed persons reported almost similar prevalence rates of PGD, etiology, risk, and protective factors are culturally distinctive. It is critical to consider cultural and individual differences when conducting research on diagnosis and intervention in cases of prolonged grief.

Background: Intimate partner violence (IPV) is a multi-national problem with many health consequences. Some research suggests that reducing rates of child marriage can improve gender norms and health outcomes related to IPV. Here, we examine whether changes in national child marriage laws can improve attitudes about domestic violence and reduce intimate partner violence at scale., Methods: Data on attitudes towards violence and violence experienced were obtained from the Demographic and Health Surveys (DHS) and longitudinal data on child marriage policy from WORLD and MACHEquity databases (1995-2012). Treatment countries were included if they improved their national child marriage policies from harmful (under 18) to more protective and control countries were included if they had a constant child-marriage policy that allowed girls to marry under the age of 18. Our final data set included 5 treatment and 14 control countries for women's outcomes, 2 treatment and 9 control countries for men's outcomes and 2 treatment and 7 control countries for IPV outcomes (for which fewer countries collect data). We combined individual level responses to five questions on attitudes about domestic violence to create a scale from 0 (always unacceptable) to 5 (always acceptable). All analyses employed a difference-in-differences approach adjusting for individual and country level predictors., Results: Data were available for 532 255 women, of which 96 414 also completed the domestic violence modules, and 104 704 men. National changes to a protective child marriage policy were associated with improved attitudes towards violence among women (-0.21 points, 95% confidence interval (CI) = -0.28, -0.14) and men (-0.98 points, 95% CI = -1.13, -0.83). Additionally, the risk of women experiencing physical and sexual abuse reduced by a greater proportion in treatment compared to control countries (odds ratio OR = 0.65, 95% CI = 0.50, 0.84; OR = 0.63, 95% CI = 0.45, 0.88, respectively)., Conclusions: Our large multi-national study is the first of its kind to critically evaluate the role of national policy on attitudes towards and experiences of IPV among both men and women, and finds that these laws have protective outcomes. Our results are consistent with the hypothesis that gender egalitarian laws positively influence norms and health at the national level., Competing Interests: Competing Interests: The authors completed the ICMJE Unified Competing Interest form (available upon request from the corresponding author), and declare no conflicts of interest., (Copyright © 2020 by the Journal of Global Health. All rights reserved.)

Background: Leukocyte telomere length (LTL), an indicator of aging, is influenced by both genetic and environmental factors; however, its heritability is unknown. We determined heritability and inheritance patterns of telomere length across three generations of families., Methods: We analyzed 287 individuals from three generations of 41 Korean families, including newborns, parents, and grandparents. LTL (the ratio of telomere repeat copy number to single gene copy number) was measured by quantitative real-time PCR. We estimated heritability using the SOLAR software maximum-likelihood variance component methods and a pedigree dataset. With adjustment for age and length of marriage, Pearson's partial correlation was performed for spousal pairs., Results: Heritability of LTL was high in all participants (h 2  = 0.64). There were no significant differences in correlation coefficients of telomere length between paternal and maternal lines. There was a positive LTL correlation in grandfather-grandmother pairs (r = 0.25, p = 0.03) but not in father-mother pairs. After adjusting for age and length of marriage, the relationship between telomere lengths in grandfathers and grandmothers disappeared. There were inverse correlations between spousal rank differences of telomere length and length of marriage., Conclusions: LTL is highly heritable without a sex-specific inheritance pattern and may be influenced by a shared environment.

A cross-sectional study was performed to identify the factors associated with health-related quality of life (HRQoL) among 1,236 married Turkish women aged 15-49 years, in the urban area of Sivas, between January and July 2017. Multiple logistic regression analyzes showed that being unemployed [adjusted odds ratio (AOR) = 1.73, 95% confidence interval (CI) = 1.18-2.25], and having an unsatisfying sexual life (AOR = 1.54, 95% CI = 1.17-2.03), a chronic illness (AOR = 1.66, 95% CI = 1.27-2.17), more than three children (AOR = 1.38, 95% CI = 1.03-1.86), and experienced domestic violence (AOR = 2.15, 95% CI = 1.55-2.98) were associated with worse mental HRQoL. Having less than a high school education (AOR = 2.00, 95% CI = 1.33-3.02), a chronic illness (AOR = 2.49, 95% CI = 1.88-3.30), a history of abortion (AOR = 1.59, CI = 1.09-2.31), and experienced domestic violence (AOR = 1.71, 95% CI = 1.21-2.40) were associated with worse physical HRQoL. These findings suggest that health care providers or policy makers should pay special attention to unemployed women who are less educated, have more than three children and those having unsatisfied sexual lives, chronic illness, domestic violence experience and abortion history to enhance their HRQoL.

Background: The persistently high prevalence of girl-child marriage remains a public health and developmental concern in Nigeria. Despite global campaign against the practice and policy efforts by Nigerian government, the prevalence remains unabated. This study investigates the prevalence and the influence of ethnicity and religious affiliation on the girl-child marriage among female adolescents in Nigeria., Methods: Data of 7804 girls aged 15-19 years extracted from the 2013 Nigeria Demographic and Health Survey were used. Ethnic groups were classified into five: major Northern ethnic group (Hausa/Fulani); Northern ethnic minorities; two major Southern ethnic groups (Yoruba and Igbo), and Southern ethnic minorities. The prevalence of girl-child marriage was determined for the five ethnic groups and individually for each ethnic minority group. Relationships between ethnicity and religious affiliation on girl-child marriage were explored using Cox proportional hazard regression models, adjusting for residence, education and wealth quintile., Results: Child marriage was higher for the Northern majority ethnic group of Hausa/Fulani (54.8%) compared to the two major Southern ethnic groups (3.0-3.6%) and aggregated Northern ethnic minorities (25.7%) and Southern minorities (5.9%). However, overall, the less known Northern ethnic minority groups of Kambari (74.9%) and Fulfude (73.8%) recorded the highest prevalence. Compared to the major Southern ethnic group of Yoruba, the adjusted hazard ratio (AHR) of child marriage was significantly higher for Northern ethnic minorities (AHR = 2.50; 95% C.I. = 1.59-3.95) and Northern major ethnicity (AHR = 3.67, 95% C.I. = 2.33-5.77). No significant difference was recorded among Southern ethnic groups. Girls affiliated to other religions (Muslim and traditionalist) had higher child-marriage risks compared to Christians (AHR = 2.10; 95% C.I. = 1.54-2.86)., Conclusion: Ethnicity and religion have independent associations with girl-child marriage in Nigeria; interventions must address culturally-laden social norms that vary by ethnic groups as well as religious-related beliefs.

Background: This study explores a series of processes in which marriage immigrant women achieve positive mental health status after experiencing various marriage- and migrant-related difficulties through the framework of resilience theory. As marriage immigrant women face greater barriers to public health services than non-immigrant women, it is necessary to understand the related factors, process, and context to address these barriers and strengthen available assets., Methods: A qualitative case study design was used with the phenomenological approach. Eleven mental health promotion program managers and 12 marriage immigrant women from who experienced resilience were recruited from four public-funded multicultural community centers in Seoul and Gyeonggi-do, South Korea, between December 2015 and March 2016. Using data from in-depth semi-structured face-to-face interviews, the author applied theme analysis informed by the resilience theory in order to identify factors that affect resilience and its development process., Results: Findings indicated that the process of resilience follows enduring difficulties, collapse of stability, access to professional help, professional and social support, and experience of growth. A combination of the staged process of growth, absence of partner support, children as a driving force for change, the need for economic activity, factors affecting difference in growth: satisfaction levels of women's need for recognition, respect, and reward, and level of spousal support were identified as factors affecting marriage immigrant women's resilience., Conclusions: Spouses, children, and economic activity play key roles in resilience in positive and negative ways. The existing information barrier should be addressed at a structural level to improve the mental health of marriage immigrant women, and the optimum time for intervention is suggested within 2 years post-migration. Efforts to build supportive relationships with Korean spouses and meet the women's needs for recognition, respect, and reward may also help promote these women's resilience.

Objectives: How soon an ever-married woman falls a victim of domestic violence after marriage is not documented in Africa. This study sought to assess the timing of first domestic violence (FDV) against women after marriage and determined the factors associated with the timings in Nigeria, Kenya, and Mozambique., Study Design: This is a cross-sectional study., Methods: Data of 29,793 ever-married women of reproductive age consisting of 21,564, 4237 and 3992 from Demographic and Health Survey conducted in Nigeria (2013), Kenya (2014) and Mozambique (2011), respectively, were used. The timing of FDV was the time interval between marriage date and date of the FDV for those with reported violence but censored as the time interval between marriage date and the survey date for those without domestic violence. Survival analysis techniques were used to assess the timing and the factors influencing the timing at (P = 0.05)., Results: The lifetime prevalence of domestic violence among the ever-married women in Nigeria, Kenya and Mozambique was 15.4%, 39.0% and 31.0%, respectively. The overall median time to FDV was 3 years. The risk of FDV was twice higher in Kenya (adjusted hazard ratio (aHR) = 1.934; 95% confidence interval (CI): 1.729-2.132) and 15% higher in Mozambique (aHR = 1.156; 95% CI: 1.156-1.223) than in Nigeria. The hazard of domestic violence was significantly higher among separated/divorced women across the three countries (aHR = 1.326; 95% CI: 1.237-1.801). Other factors associated with the timing of FDV against women were respondents' education, age at first marriage, region and location of residence, religion, ethnicity, employment status, wealth quintile, spouse consuming alcohol and husbands' educational attainment., Conclusions: Domestic violence against married women by their intimate partners is prevalent across Mozambique, Nigeria and Kenya, with earlier occurrences in Kenya and Mozambique. Age at first marriage, education factors, religion, ethnicity and region of residence in each country affected the timing of the first incidence of domestic violence., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)