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European Journal of Population

, Volume 32, Issue 4, pp 543–573 | Cite as

Ready, Willing, and Able: Contraceptive Use Patterns Across Europe

  • Rozemarijn Dereuddre
  • Bart Van de Putte
  • Piet Bracke
Article

Abstract

An “East–West” divide in contraceptive use patterns has been identified across Europe, with Western European countries characterized by the widespread use of modern contraception, and Central and Eastern European countries characterized by a high prevalence of withdrawal, the rhythm method, or abortion. Building on the Ready–Willing–Able framework, this study aims to gain more insight into the micro- and macro-level socioeconomic, cultural, and technological determinants underlying contraceptive use. Data from the Generations and Gender Survey (2004–2011) covering four Western and seven Central and Eastern European countries are used, and multinomial multilevel analyses are performed. Results reveal that individuals who intend to delay parenthood are more likely to use any contraceptive method, whereas holding more traditional values and having a lower socioeconomic status are associated with a higher likelihood of using no or only traditional methods. Regional reproductive rights and gender equality interact in complex ways with these associations. At minimum, our results underline the complexity of the processes underlying the persistent difference in contraceptive use across Europe.

Keywords

Contraception East–West divide Europe Comparative research 

References

  1. Acock, A. C. (2005). Working with missing values. Journal of Marriage and Family, 67(4), 1012–1028.Google Scholar
  2. Adsera, A. (2006). Religion and changes in family-size norms in developed countries. Review of Religious Research, 47(3), 271–286.Google Scholar
  3. Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211.Google Scholar
  4. Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  5. Allison, P. D. (2002). Missing data. California: Sage.Google Scholar
  6. Anderson, J. E., Jamieson, D. J., Warner, L., Kissin, D. M., & Nangia, A. K. (2012). Contraceptive sterilization among married adults: National data on who chooses vasectomy and tubal sterilization. Contraception, 85, 552–557.Google Scholar
  7. Balbo, N., Billari, F. C., & Mills, M. (2013). Fertility in advanced societies: A review of research. European Journal of Population, 29(1), 1–38.Google Scholar
  8. Bauer, G., & Kneip, T. (2013). Fertility from a couple perspective: A test of competing decision rules on proceptive behaviour. European Sociological Review, 29(3), 535–548.Google Scholar
  9. Becker, G. S. (1960). An economic analysis of fertility. In National Bureau of Economic Research (Ed.), Demographic and economic change in developed countries (pp. 209–240). Princeton, NJ: Princeton University Press.Google Scholar
  10. Bentley, R., & Kavanagh, A. (2008). Gender equity and women’s contraception use. Australian Journal of Social Issues, 43(1), 65–80.Google Scholar
  11. Blumberg, R. L. (1984). A general theory of gender stratification. Sociological Theory, 2, 23–101.Google Scholar
  12. Blumberg, R. L., & Coleman, M. T. (1989). A theoretical look at the gender balance of power in the American couple. Journal of Family Issues, 10(2), 225–250.Google Scholar
  13. Carlson, E., & Lamb, V. (2001). Changes in contraceptive use in Bulgaria, 1995–2000. Studies in Family Planning, 32(4), 329–338.Google Scholar
  14. Centers for Disease Control and Prevention and ORC Macro. (2003). Reproductive, maternal and child health in Eastern Europe and Eurasia: A comparative report. Atlanta, GA and Calverton, MD.Google Scholar
  15. Clark, R. (2006). Three faces of women’s power and their reproductive health: A cross-national study. International Review of Modern Sociology, 32(1), 35–52.Google Scholar
  16. Clarke, P. (2008). When can group level clustering be ignored? Multilevel models versus single-level models with sparse data. Journal of Epidemiology and Community Health, 62(8), 752–758.Google Scholar
  17. Cliquet, R., & Lodewijckx, E. (1986). The contraceptive transition in Flanders. European Journal of Population, 2(1), 71–84.Google Scholar
  18. Coale, A. (1973). The demographic transition reconsidered. In International Population Conference: Liege 1973 (Vol. 1, pp. 53–72). Liege: IUSSP.Google Scholar
  19. Coleman, L. M., & Testa, A. (2008). Sexual health knowledge, attitudes and behaviours: Variations among a religiously diverse sample of young people in London, UK. Ethnicity & Health, 13(1), 55–72.Google Scholar
  20. Dalla Zuanna, G., De Rose, A., & Racioppi, F. (2005). Low fertility and limited diffusion of modern contraception in Italy during the second half of the twentieth century. Journal of Population Research, 22(1), 21–48.Google Scholar
  21. Del Boca, D. (2002). The effect of child care and part-time opportunities on participation and fertility decisions in Italy. Journal of Population Economics, 15(3), 549–573.Google Scholar
  22. Diehl, C., Koenig, M., & Ruckdeschel, K. (2009). Religiosity and gender equality: Comparing natives and Muslim migrants in Germany. Ethnic and Racial Studies, 32(2), 278–301.Google Scholar
  23. Dommermuth, L., Klobas, J., & Tappegard, T. (2011). Now or later? The theory of planned behavior and the timing of fertility intentions. Advances in Life Course Research, 16(1), 42–53.Google Scholar
  24. Easterlin, R. A. (1975). An economic framework for fertility analysis. Studies in Family Planning, 6(3), 54–63.Google Scholar
  25. Eeckhaut, M. C. W., & Sweeney, M. M. (2013). Gender, class, and contraception in comparative context: The perplexing links between sterilization and disadvantage. Paper presented at the 2013 Annual Meeting of the Population Association of America, New Orleans, USA.Google Scholar
  26. EU, GEPLAC, and Georgian Economic Trends. (2004). Georgian economic trends. Quarterly Review, No. 4.Google Scholar
  27. Eurostat. (2015a). Employment by full-time/part-time, sex and NUTS 2 regions. http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=lfst_r_lfe2eftpt&lang=en. Accessed April 22, 2015.
  28. Eurostat. (2015b). Involuntary part-time employment as percentage of the total part-time employment, by sex and age. http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=lfsa_eppgai&lang=en. Accessed April 22, 2015.
  29. Eurostat. (2015c). NUTS classification. The hierarchical categorisation of EU territories and regions. https://www.destatis.de/Europa/EN/Methods/Classifications/OverviewClassification_NUTS.html. Accessed April 22, 2015.
  30. Fehring, R. J., & Ohlendorf, J. (2007). The influence of religiosity on contraceptive use and abortion in the United States. Life and Learning, XVII, 399–414. http://epublications.marquette.edu/cgi/viewcontent.cgi?article=1051&context=nursing_fac. Accessed May 15, 2014.
  31. Ferge, Z. (1997). Women and social transformation in Central-Eastern Europe. The ‘old left’ and the ‘new right’. Czech Sociological Review, 5(2), 159–178.Google Scholar
  32. Ferrera, M. (1996). The southern model of welfare in social Europe. Journal of European Social Policy, 1(1), 17–37.Google Scholar
  33. Fishbein, M., & Ajzen, I. (1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley Publishing Company.Google Scholar
  34. Fisher, K. (2000). Uncertain aims and tacit negotiation: Birth control practices in Britain, 1925–50. Population and Development Review, 26(2), 295–317.Google Scholar
  35. Frejka, T. (2008). Birth regulation in Europe: Completing the contraceptive revolution. Demographic Research, 19(5), 73–84.Google Scholar
  36. Frejka, T., & Sobotka, T. (2008). Fertility in Europe: Diverse, delayed and below replacement. Demographic Research, 19(3), 15–46.Google Scholar
  37. Frejka, T., & Westoff, C. F. (2008). Religion, religiousness and fertility in the US and in Europe. European Journal of Population, 24(5), 5–31.Google Scholar
  38. Gakidou, E., & Vayena, E. (2007). Use of modern contraception by the poor is falling behind. PLoS Medicine, 4(2), 381–389.Google Scholar
  39. Goldscheider, C., & Mosher, W. D. (1991). Patterns of contraceptive use in the United States: The importance of religious factors. Studies in Family Planning, 22(2), 102–115.Google Scholar
  40. Grady, W. R., Klepinger, D. H., & Billy, J. O. G. (1993). The influence of community characteristics on the practice of effective contraception. Family Planning Perspectives, 25(1), 4–11.Google Scholar
  41. Grady, W. R., Klepinger, D. H., Billy, J. O. G., & Cubbins, L. A. (2010). The role of relationship power in couple decisions about contraception in the US. Journal of Biosocial Science, 42(3), 307–323.Google Scholar
  42. Gribaldo, A., Judd, M. D., & Kertzer, D. I. (2009). An imperfect contraceptive society: Fertility and contraception in Italy. Population and Development Review, 35(3), 551–584.Google Scholar
  43. Gustafsson, S. (2005). Having kids later. Economic analyses for industrialized countries. Review of Economics of the Household, 3(1), 5–16.Google Scholar
  44. Hoffman, L. W., & Hoffman, M. L. (1973). The value of children to parents. In J. T. Fawcett (Ed.), Psychological perspectives on population (pp. 19–76). New York: Basic Books.Google Scholar
  45. Hoffman, L. W., Thornton, A., & Manis, J. D. (1978). The value of children to parents in the United States. Journal of Population, 1(2), 91–131.Google Scholar
  46. Hox, J. J. (2010). Multilevel analysis. Techniques and applications (2nd ed.). New York: Routledge.Google Scholar
  47. International Planned Parenthood Federation European Network Regional Office. (2012). Key factors influencing contraceptive use in Eastern and Central Asia. http://countryoffice.unfpa.org/kazakhstan/drive/Rep_Keyfactorsinflcontractusein7ctries_Dec2012.pdf. Accessed May 12, 2014.
  48. International Planned Parenthood Federation European Network Regional Office. (2013). Barometer of women’s access to modern contraceptive choice in 10 EU countries. http://www.ippfen.org/sites/default/files/Barometer_Apr2014.pdf. Accessed May 16, 2014.
  49. Janevic, T., Pallas, S. W., Ismayilova, L., & Bradley, E. H. (2012). Individual and community level socioeconomic inequalities in contraceptive use in 10 newly independent states: A multilevel cross-sectional analysis. International Journal for Equity in Health, 11, 69.Google Scholar
  50. Janta, B. (2014). Caring for children in Europe. How childcare, parental leave and flexible working arrangements interact in Europe. http://europa.eu/epic/studies-reports/docs/rr-554-dg-employment-childcare-brief-v-0-16-final.pdf. Accessed April 22, 2015.
  51. Johnson, S., Pion, C., & Jennings, V. (2013). Current methods and attitudes of women towards contraception in Europe and America. Reproductive Health, 10, 7.Google Scholar
  52. Johnson-Hanks, J. (2002). On the modernity of traditional contraception: Time and the social context of fertility. Population and Development Review, 28(2), 229–249.Google Scholar
  53. Klijzing, E. (2000). Are there unmet family planning needs in Europe? Family Planning Perspectives, 32(2), 74–81, 88.Google Scholar
  54. Kramer, M. R., Hogue, C. J. R., & Gaydos, L. M. D. (2007). Noncontracepting behavior in women at risk for unintended pregnancy: What’s religion got to do with it? Annals of Epidemiology, 17(5), 327–334.Google Scholar
  55. Kusunoki, Y., & Upchurch, D. M. (2011). Contraceptive method choice among youth in the United States: The importance of relationship context. Demography, 48(4), 1451–1472.Google Scholar
  56. Langdridge, D., Sheeran, P., & Connolly, K. (2005). Understanding the reasons for parenthood. Journal of Reproductive and Infant Psychology, 23(2), 121–133.Google Scholar
  57. Lesthaeghe, R. (2000). Europe’s demographic issues: Fertility, household formation and replacement migration. Paper presented at the UN Expert Group Meeting on Policy Responses to Population Decline and Ageing, New York.Google Scholar
  58. Lesthaeghe, R., & Surkyn, J. (2002). New forms of household formation in Central and Eastern Europe: Are they related to newly emerging value orientations? In Economic Commission for Europe & J. Surkyn (Eds.), Economic Survey of Europe 2002 No. 1 (pp. 197–216). Geneva: United Nations.Google Scholar
  59. Lesthaeghe, R., & van de Kaa, D. (1986). Twee demografische transities? In R. Lesthaeghe & D. van de Kaa (Eds.), Bevolking: Groei en krimp (pp. 9–24). Deventer: Special issue Mens en Maatschappij, Van Loghum Slaterus.Google Scholar
  60. Lesthaeghe, R., & Vanderhoeft, C. (2001). Ready, willing and able: A conceptualization of transitions to new behavioral forms. In J. B. Casterline (Ed.), Diffusion processes and fertility transition: Selected processes (pp. 240–264). Washington, DC: National Academy Press.Google Scholar
  61. Liefbroer, A. C. (2005). The impact of perceived costs and rewards of childbearing on entry into parenthood: Evidence from a panel survey. European Journal of Population, 21(4), 367–391.Google Scholar
  62. Mannan, H. R., & Beaujot, R. (2006). Readiness, willingness and ability to use contraception in Bangladesh. Asia-Pacific Population Journal, 21(1), 45–64.Google Scholar
  63. Manning, W. D., Flanigan, C. M., Giordano, P. C., & Longmore, M. A. (2009). Relationship dynamics and consistency of condom use among adolescents. Perspectives on Sexual and Reproductive Health, 41(3), 181–190.Google Scholar
  64. McQuillan, K. (2004). When does religion influence fertility? Population and Development Review, 30(1), 25–56.Google Scholar
  65. Miller, W. B. (1994). Childbearing motivations, desires, and intentions: A theoretical framework. Genetic, Social, and General Psychological Monographs, 120(2), 223–258.Google Scholar
  66. Miller, W. B., Rodgers, J. L., & Pasta, D. J. (2010). Fertility motivations of youth predict later fertility outcomes: A prospective analysis of national longitudinal survey of youth data. Biodemography and Social Biology, 56(1), 1–23.Google Scholar
  67. Mills, M., Präg, P., Tsang, F., Begall, K., Derbyshire, J., Kohle, L., et al. (2014). Use of childcare services in the EU Member States and progress towards the Barcelona targets. http://ec.europa.eu/justice/gender-equality/files/documents/140502_gender_equality_workforce_ssr1_en.pdf. Accessed April 23, 2015.
  68. Mood, C. (2010). Logistic regression: Why we cannot do what we think we can do, and what we can do about it. European Sociological Review, 26(1), 67–82.Google Scholar
  69. Moreau, C., Bouyer, J., Gilbert, F., & Bajos, N. (2006). Social, demographic and situational characteristics associated with inconsistent use of oral contraceptives: Evidence from France. Perspectives on Sexual and Reproductive Health, 38(4), 190–196.Google Scholar
  70. Moreau, C., Trussell, J., & Bajos, N. (2013). Religiosity, religious affiliation, and patterns of sexual activity and contraceptive use in France. European Journal of Contraception and Reproductive Health Care, 18(3), 168–180.Google Scholar
  71. Mosher, W. D., & Jones, J. (2010). Use of contraception in the United States: 1982–2008. Vital and Health Statistics, 23, 1–54.Google Scholar
  72. Neyer, G., & Andersson, G. (2008). Consequences of family policies on childbearing behaviour: Effects or artifacts? Population and Development Review, 34(4), 699–724.Google Scholar
  73. Oddens, B. J., Vemer, H. M., Visser, A. P., & Ketting, E. (1993). Contraception in Germany: A review. Advances in Contraception, 9(2), 105–116.Google Scholar
  74. Oddens, B. J., Visser, A. P., Vemer, H. M., & Everaerd, W. T. A. M. (1994a). Contraceptive use and attitudes in reunified Germany. European Journal of Obstetrics & Gynecology, 57(3), 201–208.Google Scholar
  75. Oddens, B. J., Visser, A. P., Vemer, H. M., Everaerd, W. T. A. M., & Lehert, P. (1994b). Contraceptive use and attitudes in Great Britain. Contraception, 49(1), 73–86.Google Scholar
  76. Organisation for Economic Co-operation and Development. (2015). Incidence of involuntary part time workers. https://stats.oecd.org/Index.aspx?DataSetCode=INVPT_I. Accessed May 19, 2015.
  77. Pascall, G., & Manning, N. (2000). Gender and social policy: Comparing welfare states in Central and Eastern Europe and the former Soviet Union. Journal of European Social Policy, 10(3), 240–266.Google Scholar
  78. Pickett, K. E., & Pearl, M. (2001). Multilevel analyses of neighbourhood socioeconomic context and health outcomes: A critical review. Journal of Epidemiology and Community Health, 55(2), 111–122.Google Scholar
  79. Reproductive Health Survey (RHS). (2015). http://ghdx.healthdata.org/series/reproductive-health-survey-rhs. Accessed June 16, 2015.
  80. Robinson, W. C. (1997). The economic theory of fertility over three decades. Population Studies, 51(1), 63–74.Google Scholar
  81. Rostosky, S. S., Wilcox, B. L., Wright, M. L. C., & Randall, B. A. (2004). The impact of religiosity on adolescent sexual behavior: A review of the evidence. Journal of Adolescent Research, 19(6), 677–697.Google Scholar
  82. Rubin, D. B. (1996). Multiple imputation after 18+ years. Journal of the American Statistical Association, 91(434), 473–489.Google Scholar
  83. Sandor, E. (2011). Part-time work in Europe. Luxembourg: European Foundation for the improvement of Living and Working Conditions.Google Scholar
  84. Sandström, G. (2012). Ready, willing and able. The divorce transition in Sweden 19151974 [Doctoral dissertation]. Umea: Umea Universitet.Google Scholar
  85. Santow, G. (1993). Coitus interruptus in the twentieth century. Population and Development Review, 19(4), 767–792.Google Scholar
  86. Santow, G., & Bracher, M. D. (1999). Traditional families and fertility decline: Lessons from Australia’s Southern Europeans. In R. Leete (Ed.), Dynamics of values in fertility change. Oxford: Oxford University Press.Google Scholar
  87. Schafer, J. L. (1999). Multiple imputation: A primer. Statistical Methods in Medical Research, 8(1), 3–15.Google Scholar
  88. Schenker, J. G., & Rabenou, V. (1993). Contraception: Traditional and religious attitudes. European Journal of Obstetrics & Gynecology and Reproductive Biology, 49(1–2), 15–18.Google Scholar
  89. Sedgh, G., Henshaw, S. K., Singh, S., & Drescher, J. (2007). Legal abortion worldwide: Incidence and recent trends. International Family Planning Perspectives, 33(3), 106–116.Google Scholar
  90. Serbanescu, F., Goldberg, H., & Morris, L. (2004). Reproductive health in transition countries in the European context. Paper presented at the European Population Forum, Population Challenges and Policy Responses, Geneva.Google Scholar
  91. Serbanescu, F., Imnadze, P., Bokhua, Z., Nutsubidze, N., Jackson, D. B., & Morris, L. (Eds.). (2005). Reproductive Health Survey Georgia 2005. Final report. Atlanta, GA: US Department of Health and Human Services.Google Scholar
  92. Serbanescu, F., Morris, L., Stupp, P., & Stanescu, A. (1995). The impact of recent policy changes on fertility, abortion, and contraceptive use in Romania. Studies in Family Planning, 26(2), 76–87.Google Scholar
  93. Serbanescu, F., & Seither, R. (2003). Contraceptive knowledge and use. In Centers for Disease Control and Prevention and ORC Macro (Eds.), Reproductive, maternal and child health in Eastern Europe and Eurasia: A comparative report (pp. 51–71). Atlanta, GA and Calverton, MD.Google Scholar
  94. Singh, S., Sedgh, G., & Hussain, R. (2010). Unintended pregnancy: Wordwide levels, trends, and outcomes. Studies in Family Planning, 41(4), 241–250.Google Scholar
  95. Skouby, S. O. (2004). Contraceptive use and behavior in the 21st century: A comprehensive study across five European countries. The European Journal of Contraception and Reproductive Health Care, 9(2), 57–68.Google Scholar
  96. Sobotka, T. (2008). The diverse faces of the Second Demographic Transition in Europe. Demographic Research, 19(8), 171–224.Google Scholar
  97. Sobotka, T., & Adigüzel, F. (2003). Religiosity and spatial demographic differences in The Netherlands. SOM Research Report 02F65, University of Groningen. http://som.eldoc.ub.rug.nl/FILES/reports/themeF/2002/02F65/02F65.pdf. Accessed May 15, 2014.
  98. Spinelli, A., Talamanca, I. F., & Lauria, L. (2000). Patterns of contraceptive use in 5 European countries. American Journal of Public Health, 90(9), 1403–1408.Google Scholar
  99. Srikanthan, A., & Reid, R. L. (2008). Religious and cultural influences on contraception. Journal of Obstetrics and Gynaecology, 30(2), 129–137.Google Scholar
  100. Stark, R. (1996). Religion as context: Hellfire and delinquency one more time. Sociology of Religion, 57(2), 163–173.Google Scholar
  101. Starke, K., & Visser, A. P. (1994). Sexuality, sexual behavior and contraception in East Germany. Patient Education and Counseling, 23(3), 217–226.Google Scholar
  102. Stegmueller, D. (2013). How many countries for multilevel modeling? A comparison of frequentist and bayesian approaches. American Journal of Political Science, 57(3), 748–761.Google Scholar
  103. Sundström, A., & Wängenerud, L. (2013). Women’s political representation in the European regions: The impact from corruption and bad governance. QoG Working Paper Series, 9.Google Scholar
  104. Thomson, E. (1997). Couple childbearing desires, intentions, and births. Demography, 34(3), 343–354.Google Scholar
  105. Troitskaia, I., Avdeev, A., Badurashvili, I., Kapanadze, E., & Tretjakova, V. (2009). Etude comparative des pratiques contraceptives: France, Géorgie, Lithuanie et Russie. Revue d’études comparatives Est-Ouest, 40(3–4), 241–272.Google Scholar
  106. United Nations. (2013). World contraceptive patterns 2013. New York: United Nations.Google Scholar
  107. United Nations, Department of Economic and Social Affairs, Population Division. (2012). World contraceptive use 2012. Survey-based observations: Unmet need for family planning. http://www.un.org/esa/population/publications/WCU2012/WCP_2012/Country_survey.html. Accessed June 16, 2015.
  108. United Nations Economic Commission for Europe. (2000). Family and Fertility Survey standard tables. http://www.unece.org/pau/ffs/ffstab.html. Accessed June 16, 2015.
  109. United Nations Economic Commission for Europe. (2005). Generations & Gender Programme: Survey instruments. New York and Geneva: United Nations.Google Scholar
  110. Van Bavel, J. (2010). Choice of study discipline and the postponement of motherhood in Europe: The impact of expected earnings, gender composition, and family attitudes. Demography, 47(2), 439–458.Google Scholar
  111. van de Kaa, D. J. (1997). Options and sequences: Europe’s demographic patterns. Journal of the Australian Population Association, 14(1), 1–29.Google Scholar
  112. Van de Velde, S., Huijts, T., Bracke, P., & Bambra, C. (2013). Macro-level gender equality and depression in men and women in Europe. Sociology of Health & Illness, 35(5), 682–698.Google Scholar
  113. Vikat, A., Spéder, Z., Beets, G., Billari, F. C., Bühler, C., Désesquelles, A., et al. (2007). Generations and Gender Survey (GGS): Towards a better understanding of relationships and processes in the life course. Demographic Research, 17(14), 389–439.Google Scholar
  114. Wang, G. (2004). Reproductive health in the context of economic and democratic development. Comparative Sociology, 3(2), 135–162.Google Scholar
  115. Wang, G. (2007). Testing the impact of gender equality on reproductive health: An analysis of developing countries. The Social Science Journal, 44(3), 507–524.Google Scholar
  116. Wang, G., & Pillai, V. K. (2001). Women’s reproductive health: A gender-sensitive human rights approach. Acta Sociologica, 44(3), 231–242.Google Scholar
  117. Westoff, C. F. (2005). Recent trends in abortion and contraception in 12 countries. DHS Analytical Studies, 8. Google Scholar
  118. Westoff, C. F., & Ryder, N. B. (1977). The contraceptive revolution. Princeton: Princeton University Press.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  • Rozemarijn Dereuddre
    • 1
  • Bart Van de Putte
    • 1
  • Piet Bracke
    • 1
  1. 1.Health and Demographic Research, Department of SociologyUniversity of GhentGhentBelgium

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