Latin American and Border Demography
For over 40 years, the PRC has been a leading center for research in Latin American demography, and led by Joseph Potter and Bryan Roberts, we continue to focus a great deal of our work in this area. Recently, the PRC has been involved in some major collaborative research projects on Mexico, Brazil, other South American countries, as well as the US-Mexico border. These efforts will be further bolstered by the recent hiring of Emily Skop and Andres Villareal to the faculty. The center is now extending its existing work on population issues in Latin America in two new directions. The first is to coordinate research on migration and urbanization through our Center for Migration and Urbanization in Developing Countries, funded by the Mellon Foundation. The second is to develop a more explicit social policy focus in research on Latin American population issues through cooperation with the Center for Latin American Social Policy of the Lozano Long Institute of Latin American Studies, the Urban Affairs Institute of the University and the LBJ School of Public Affairs.
Area Projects
Border Contraceptive Access Study (BCAS)
Principal Investigator: Joseph E. Potter
Additional Investigators: Kristine Hopkins, Co-Investigator
Daniel Powers, Co-Investigator
Jon Amastae, Principal Investigator, University of Texas-El Paso Subcontract
Daniel Grossman, Principal Investigator, Ibis Reproductive Health Subcontract
Consultants: Michele Shedlin, Leticia Fernández, Sandra Garcia, Linda Potter, Carolyn Westhoff
Funded by: Eunice Kennedy Shriver National Institute of Child Health and Human Development
Oral contraceptives (OCs) are one of the most effective, safe and widely-used contraceptive methods available to women worldwide. The US differs from many other countries in that women still need a healthcare provider's prescription, often requiring an examination, to purchase OCs. Policy debate about the prescription requirement has focused on whether women could safely and effectively use oral contraceptives without mandatory contact with a healthcare provider. Specifically, questions remain as to whether women can screen themselves for contraindications; the degree to which the prescription requirement dissuades OC candidates from starting or continuing OC use; and whether written or other forms of information are an effective substitute or improvement on clinician contact.
This interdisciplinary study will be fielded along the heavily traversed US-Mexico border separating Ciudad Juarez, Mexico and El Paso, Texas. The study setting provides a unique "natural experiment" environment in which to address these unanswered questions due to the fact that El Paso residents can, and frequently do, cross the border to purchase OCs in Mexican pharmacies, where prescriptions are not required.
The first aim is to assess whether women are as capable of screening themselves for contraindications to OC use as health professionals. To this end, we will recruit a convenience sample of women from the general population in El Paso and make use of a simple checklist of contraindications as well as nurse's clinical assessment. Second, by comparing women recruited when they purchase OCs at pharmacies in Ciudad Juarez to controls recruited from family planning clinics in El Paso, the study will explore: women's motivations for buying OCs at each location, and the relation between procurement location and women's knowledge about OCs. Also, using a randomized controlled design, we will investigate the role of a simple written instruction leaflet about OCs in conveying information to women obtaining pills in Mexican pharmacies. Finally, a large prospective cohort of OC users recruited from Mexican pharmacies and the El Paso family planning clinics will be followed quarterly for nine months to assess whether their baseline decisions about OC procurement source are associated with satisfaction, compliance, continuation and unintended pregnancy.
Our research will answer important questions regarding the appropriate role of medical supervision in OC provision and the factors influencing compliance and continuation. Additionally, it will add substantially to the slim literature on the increasingly important area of Hispanic fertility and contraceptive practice.
Unmet Demand for Surgical Sterilization among Mexican Origin Women
Principal Investigator: Joseph E. Potter
Additional Investigators: Kristine Hopkins, Co-Investigator
Jon Amastae, Principal Investigator, University of Texas-El Paso Subcontract
Consultants: Daniel Grossman, Michele Shedlin
Funded by: The Society of Family Planning
This project will assess the unmet demand for female sterilization in a sample of Mexican origin oral contraceptive users, as well the factors underlying that demand and the availability of this method of contraception in El Paso, Texas. It will build on the research findings and infrastructure of the project “Border Contraceptive Access Study,” (J. E. Potter, PI) in its fourth of five years. Preliminary results of 1046 pill users in El Paso, Texas show three surprising findings: a high proportion of these pill users want no more children and large proportions of them want to be sterilized and wish they had been sterilized at the time of their last delivery. In this project, we will identify what motivates women to want to be sterilized in favor of reversible methods, and their perceptions about the accessibility of sterilization in El Paso through semi-structured interviews with a subsample of prospective study participants. We will also explore men’s perceptions of prevailing community norms about who makes reproductive decisions, and men’s beliefs about male and female sterilization through focus groups with male partners of prospective study participants. In addition, we will assess the way that the local health care service context in El Paso affects women’s use of sterilization vs. reversible methods by conducting interviews with health care providers in El Paso. Together, the information gathered from multiple perspectives of women, their partners, and sterilization providers will provide a comprehensive basis for exploring the finding of substantial unmet demand for female sterilization in our study population. It will also lay the basis for a future collaborative project on female sterilization among underserved Hispanic women in other parts of the country.
Demographic Change and Economic Wellbeing at the Local Level in Mexico and Brazil
Principal Investigator: Joseph E. Potter
Additional Investigators: Daniel Hamermesh, Eduardo Rios-Neto, Francisco Alba
Funded by: MacArthur Foundation
This project is investigating the influence of shifts in the age distribution on local labor markets and economic growth in Mexico and Brazil, and assessing policy options available to government and civil society in those countries so as to take advantage of the opportunities and alleviate the problems presented by their rapidly shifting age distributions. The researchers will exploit a wealth of survey and census data with statistical analysis to extract lessons about how population growth, the changing age distribution, and relative cohort size have affected labor force outcomes, educational enrollments, and migration at the local level. Additionally, they wll inventory existing policies related to equipping present and future youth cohorts with the capital (human and financial) to find productive employment, and assess the possibilities for expanding such policies, or creating new ones.
Texas Teen Opportunity Project (T-TOP)
Principal Investigator: Kristine Hopkins
Additional Investigators: Catherine Cubbin and Kari L. White, Co-Investigators
Funded by: Texas Department of State Health Services
Teen fertility has generally been declining in the United States over the past 15 to 20 years and these declines have been especially pronounced for African Americans. This general good news is tempered somewhat by the fact that declines have been much smaller among Hispanics than among Anglos or African Americans. Whereas the decline in the teen fertility rate between 1990 and 2005 was about 50% for African Americans and Anglos, it was only about 33% among Latinas. What factors lead Latina adolescents to become pregnant? If and how are they different from other race/ethnic groups? This is a particularly important issue in Texas, a state where the Latino population is especially large and growing at a fast rate. To address this question, the project will conduct 48 race/ethnic-specific focus group interviews with young women, young men, and the parents of adolescents. The researchers will focus particularly on the a) Motivations for/against pregnancy; b) Knowledge about conception and contraception; c) Access to contraception, and d) Attitudes about contraception.
