This paper presents a new data collection method, called the Neighborhood History Calendar, desig... more This paper presents a new data collection method, called the Neighborhood History Calendar, designed to collect event histories of community-level changes over time. We discuss the need for and the uses of this method. We describe issues related to the design of instruments, collection of data, and data entry. We provide detailed examples from an application of this method to the study of marriage, contraception, and fertility in rural Nepal. The paper addresses applications of this same technique to other settings and research problems. We also extend the technique to collection of other forms of contextual-history data, including school histories and health service histories. Finally, we discuss how Geographic Information System (GIS) technology can be used to link together multiple sources of contextual-history data.
Theories of family stability and change, demographic processes, and social psychological influenc... more Theories of family stability and change, demographic processes, and social psychological influences on behavior all posit that parental attitudes and beliefs are a key influence on their children’s behavior. Though we have evidence of these effects in Western populations, there is little information regarding this social mechanism in non-Western contexts. Furthermore, comparisons of mothers’ and fathers’ independent roles in these crucial intergenerational mechanisms are rare. This paper uses measures from a ten-year family panel study featuring independent interviews with both mothers and fathers in rural Nepal to investigate these issues. We test the association of specific attitudes, rather than broad ideational domains, about childbearing and old-age care with sons’ subsequent marriage behavior. Our results indicate that both mothers’ and fathers’ attitudes have important and independent influences on sons’ marriage behavior. Simultaneous study of both parents’ attitudes reveals that gender-specific parenting contexts can shape the relationship between parental attitudes and children’s behaviors. This crucial mechanism of intergenerational continuity and change is strong in this non-Western setting, with substantial implications for studies of intergenerational influences on behavior in all settings.
Do timing attitudes—subjective evaluations of particular ages as good ages to marry—influence ent... more Do timing attitudes—subjective evaluations of particular ages as good ages to marry—influence entrance into marriage? To address this question, we formulated an intergenerational model of how parents’ and children’s timing attitudes influence children’s marriage behavior. We theorized that both parents’ and children’s timing attitudes influence expectations of when children will marry. In turn, both parents’ and children’s marital expectations would influence children’s actual entrance into marriage. We tested the model using intergenerational panel data from Nepal collected in 2008–2014. Timing attitudes of young people and their parents did influence expectations, as well as entrance into marriage. Young people’s own attitudes were more influential than their parents’ attitudes in determining children’s expectations, but not behavior. Further, while the influence of parents was relatively even, mothers appear slightly more influential than fathers.
AimsTo measure the independent consequences of community‐level armed conflict beatings on alcohol... more AimsTo measure the independent consequences of community‐level armed conflict beatings on alcohol use disorders (AUD) among males in Nepal during and after the 2000–2006 conflict.DesignA population‐representative panel study from Nepal, with precise measures of community‐level violent events and subsequent individual‐level AUD in males. Females were not included because of low AUD prevalence.SettingChitwan, Nepal.ParticipantsFour thousand eight hundred seventy‐six males from 151 neighborhoods, systematically selected and representative of Western Chitwan. All residents aged 15–59 were eligible (response rate 93%).MeasurementsMeasures of beatings in the community during the conflict (2000–2006), including the date and distance away, were gathered through neighborhood reports, geo‐location and official resources, then linked to respondents' life histories of AUD (collected in 2016–2018) using the Nepal‐specific Composite International Diagnostic Interview with life history calenda...
Journal of Ethnic and Migration Studies, Oct 16, 2019
Migration of men has important influences on reshaping family and gender roles in left-behind wiv... more Migration of men has important influences on reshaping family and gender roles in left-behind wives. However, it is unclear whether husbands’ out-migration increases the burden on or creates autonomy for left-behind wives. Using new data from Nepal, we examine the associations of husband’s out-migration and remittance status with the work burden and autonomy of left-behind wives’. Results of our multi-level multivariate analyses show that the number of months a husband migrated internationally during the last year is significantly associated with an increase in participation in farming activities for the left-behind wives. Husband’s out-migration and remittance status is also associated with an increase in wives’ number of daily activities outside the home, and leisure activities and media use. In sum, husbands’ out-migration might be good and bad for women, by increasing the burden on wives while also promoting their freedom of movement, leisure activities and media use. Importantly these findings are net of wives' individual background characteristics, household characteristics and community context measures.
BackgroundAlcohol use is a leading cause of disease. Although low- and middle-income countries (L... more BackgroundAlcohol use is a leading cause of disease. Although low- and middle-income countries (LMICs) have lower per capita alcohol consumption, the alcohol-attributable disease burden is high in these settings with consumption increasing. LMICs are also experiencing unprecedented levels of internal migration, potentially increasing mental stress, changing social restrictions on drinking, and increasing alcohol availability. We assessed the relationship between internal migration, opportunity to drink, and the transition from first use to regular alcohol use and alcohol use disorders (AUD) in Nepal, a low-income, South Asian country.MethodsA representative sample of 7435 individuals, aged 15–59 from Nepal were interviewed in 2016–2018 (93% response rate) with clinically validated measures of alcohol use and disorders and life history calendar measures of lifetime migration experiences. Discrete-time hazard models assessed associations between migration and alcohol use outcomes.Resu...
Importance Individual-level social support protects against major depressive disorder (MDD) among... more Importance Individual-level social support protects against major depressive disorder (MDD) among adults exposed to trauma. Little is known about the consequences of community-level interventions in the general population. Objective To determine the potential consequences of neighborhood social infrastructure on incident MDD in a high-risk general population. Design, Setting, and Participants This longitudinal, multilevel study estimated associations between a neighborhood-level program in a case-control design and subsequent individual outcomes across 10 years (2006-2015) in a cohort of young adults. Exogenously placed social programs simulate natural experiment conditions in a high-poverty population experiencing armed conflict (1998-2006). The western Chitwan valley in Nepal has a general population at high risk of MDD, with neighborhoods exposed to interventions to improve social support. From a random sample (response rate 93%) selected to represent the general population in 2016, participants aged 25 to 34 years in 2006 were studied. These individuals resided within 149 neighborhoods that varied in their availability of active social support programs. The analyses were conducted between October 2020 and November 2021. Exposures The Small Farmers Development Program (SFDP) uses shared, joint liability financial credit among neighbors to build social capital and cohesion within neighborhoods. Main Outcomes and Measures Onset of DSM-IV MDD after the conflict, assessed by the Nepal-specific, clinically validated World Mental Health Composite International Diagnostic Interview with a life history calendar. The hypothesis tested was that exposure to SFDP reduced adult onset of MDD. Results Of the 1917 survey participants, 886 (46.2%) were women, and 856 (44.7%) were of Brahmin or Chhetri ethnicity. Of the 149 neighborhoods, 21 had an active SFDP group, and 156 of 1917 (8.1%) participants experienced MDD between 2006 and 2015. Discrete-time hazard models showed participants living in neighborhoods with an SFDP experienced incident MDD at nearly half the rate as others (odds ratio = 0.55; 95% CI, 0.30-1.02; P = .06). A multivariate, multilevel matching analysis showed the incidence of MDD among adults living in neighborhoods with an SFDP was 19 of 256 (7.4%), compared with 33 of 256 (12.9%) in the matched sample with no SFDP (z = 2.05; P = .04). Conclusions and Relevance Living in a neighborhood with community-level social support infrastructure was associated with reduced subsequent rates of adult-onset MDD, even in this high-risk population. Investments in such infrastructure may reduce population-level MDD, supporting clinical focus on potentially unpreventable cases.
The study was designed to investigate the influence of changing social contexts on family formati... more The study was designed to investigate the influence of changing social contexts on family formation behaviors, marriage, childbearing, and contraceptive use. The research investigates the extent to which changes in the community produce changes in family formation behavior, and whether the family organization of individual life courses produces these changes in behavior. The study used a combination of ethnographic and survey research methods to gather 171 neighborhood histories, 142 school histories, 118 health service histories, 20 bus route histories, household farming practices, family planning histories, and household composition in Western Chitwan, Nepal. Personal histories were gathered from the 5,271 individuals ages 15-59 years living in these neighborhoods using a semi-structured Life History Calendar and a highly structured survey questionnaire. The sample neighborhoods for this study were chosen to represent the five major ethnic groups inhabiting the area: high caste Hi...
The study was designed to investigate the influence of changing social contexts on family formati... more The study was designed to investigate the influence of changing social contexts on family formation behaviors, marriage, childbearing, and contraceptive use. The research investigates the extent to which changes in the community produce changes in family formation behavior, and whether the family organization of individual life courses produces these changes in behavior. The study used a combination of ethnographic and survey research methods to gather 171 neighborhood histories, 142 school histories, 118 health service histories, 20 bus route histories, household farming practices, family planning histories, and household composition in Western Chitwan, Nepal. Personal histories were gathered from the 5,271 individuals ages 15-59 years living in these neighborhoods using a semi-structured Life History Calendar and a highly structured survey questionnaire. The sample neighborhoods for this study were chosen to represent the five major ethnic groups inhabiting the area: high caste Hi...
Tropical Medicine & International Health, 2021
ObjectivesTo understand COVID‐19 worries and how they influence COVID‐19 mitigation behaviours, e... more ObjectivesTo understand COVID‐19 worries and how they influence COVID‐19 mitigation behaviours, especially in communities prior to case surges, in Nepal.MethodsData related to COVID‐19 impacts on life disruptions were collected from households in the Chitwan Valley Family Study, a 25‐year community panel study, during February–April 2021. COVID‐19 worry was measured by the extent of respondent concern for themselves or household members getting COVID‐19 in the prior 2 weeks. 11 items examined COVID‐19 mitigation behaviours. Logistic regression models assessed associations between socio‐demographic characteristics and COVID‐19 worry and then the influence of worry on any mitigation behaviour and behaviour type adjusting for age, education, sex, ethnicity and COVID‐19 exposure, accounting for neighbourhood clustering.ResultsOf 2,678 households with a responding adult, ages 18–88, 394 (14.7%) reported moderate‐to‐extreme COVID‐19 worry and 1,214 (45.3%) engaged in three or more mitigat...
We hypothesize that developmental ideas and models concerning family life have been disseminated ... more We hypothesize that developmental ideas and models concerning family life have been disseminated widely around the world where they have become forces for both ideational and behavioral change. In this paper we examine the ways in which marriage has been influenced by these ideas of development in Nepal a country that has historically practiced young age at marriage arranged marriage taboos against intercaste marriage polygamy and almost no divorce as recently as the 1950s. Using qualitative and quantitative data from recent face-to-face interviews we demonstrate that large fractions of Nepalis now endorse marriage behavior similar to that found in the West. The evidence suggested that preferred age at marriage has risen tolerance for intercaste marriage has increased divorce has become more permissible young people are more likely to be involved in their spousal choice and polygamy has greatly decreased. Further analyses examine potential mechanisms such as education and media expo...
This paper presents a new data collection method, called the Neighborhood History Calendar, desig... more This paper presents a new data collection method, called the Neighborhood History Calendar, designed to collect event histories of community-level changes over time. We discuss the need for and the uses of this method. We describe issues related to the design of instruments, collection of data, and data entry. We provide detailed examples from an application of this method to the study of marriage, contraception, and fertility in rural Nepal. The paper addresses applications of this same technique to other settings and research problems. We also extend the technique to collection of other forms of contextual-history data, including school histories and health service histories. Finally, we discuss how Geographic Information System (GIS) technology can be used to link together multiple sources of contextual-history data.
Theories of family stability and change, demographic processes, and social psychological influenc... more Theories of family stability and change, demographic processes, and social psychological influences on behavior all posit that parental attitudes and beliefs are a key influence on their children’s behavior. Though we have evidence of these effects in Western populations, there is little information regarding this social mechanism in non-Western contexts. Furthermore, comparisons of mothers’ and fathers’ independent roles in these crucial intergenerational mechanisms are rare. This paper uses measures from a ten-year family panel study featuring independent interviews with both mothers and fathers in rural Nepal to investigate these issues. We test the association of specific attitudes, rather than broad ideational domains, about childbearing and old-age care with sons’ subsequent marriage behavior. Our results indicate that both mothers’ and fathers’ attitudes have important and independent influences on sons’ marriage behavior. Simultaneous study of both parents’ attitudes reveals that gender-specific parenting contexts can shape the relationship between parental attitudes and children’s behaviors. This crucial mechanism of intergenerational continuity and change is strong in this non-Western setting, with substantial implications for studies of intergenerational influences on behavior in all settings.
Do timing attitudes—subjective evaluations of particular ages as good ages to marry—influence ent... more Do timing attitudes—subjective evaluations of particular ages as good ages to marry—influence entrance into marriage? To address this question, we formulated an intergenerational model of how parents’ and children’s timing attitudes influence children’s marriage behavior. We theorized that both parents’ and children’s timing attitudes influence expectations of when children will marry. In turn, both parents’ and children’s marital expectations would influence children’s actual entrance into marriage. We tested the model using intergenerational panel data from Nepal collected in 2008–2014. Timing attitudes of young people and their parents did influence expectations, as well as entrance into marriage. Young people’s own attitudes were more influential than their parents’ attitudes in determining children’s expectations, but not behavior. Further, while the influence of parents was relatively even, mothers appear slightly more influential than fathers.
AimsTo measure the independent consequences of community‐level armed conflict beatings on alcohol... more AimsTo measure the independent consequences of community‐level armed conflict beatings on alcohol use disorders (AUD) among males in Nepal during and after the 2000–2006 conflict.DesignA population‐representative panel study from Nepal, with precise measures of community‐level violent events and subsequent individual‐level AUD in males. Females were not included because of low AUD prevalence.SettingChitwan, Nepal.ParticipantsFour thousand eight hundred seventy‐six males from 151 neighborhoods, systematically selected and representative of Western Chitwan. All residents aged 15–59 were eligible (response rate 93%).MeasurementsMeasures of beatings in the community during the conflict (2000–2006), including the date and distance away, were gathered through neighborhood reports, geo‐location and official resources, then linked to respondents' life histories of AUD (collected in 2016–2018) using the Nepal‐specific Composite International Diagnostic Interview with life history calenda...
Journal of Ethnic and Migration Studies, Oct 16, 2019
Migration of men has important influences on reshaping family and gender roles in left-behind wiv... more Migration of men has important influences on reshaping family and gender roles in left-behind wives. However, it is unclear whether husbands’ out-migration increases the burden on or creates autonomy for left-behind wives. Using new data from Nepal, we examine the associations of husband’s out-migration and remittance status with the work burden and autonomy of left-behind wives’. Results of our multi-level multivariate analyses show that the number of months a husband migrated internationally during the last year is significantly associated with an increase in participation in farming activities for the left-behind wives. Husband’s out-migration and remittance status is also associated with an increase in wives’ number of daily activities outside the home, and leisure activities and media use. In sum, husbands’ out-migration might be good and bad for women, by increasing the burden on wives while also promoting their freedom of movement, leisure activities and media use. Importantly these findings are net of wives' individual background characteristics, household characteristics and community context measures.
BackgroundAlcohol use is a leading cause of disease. Although low- and middle-income countries (L... more BackgroundAlcohol use is a leading cause of disease. Although low- and middle-income countries (LMICs) have lower per capita alcohol consumption, the alcohol-attributable disease burden is high in these settings with consumption increasing. LMICs are also experiencing unprecedented levels of internal migration, potentially increasing mental stress, changing social restrictions on drinking, and increasing alcohol availability. We assessed the relationship between internal migration, opportunity to drink, and the transition from first use to regular alcohol use and alcohol use disorders (AUD) in Nepal, a low-income, South Asian country.MethodsA representative sample of 7435 individuals, aged 15–59 from Nepal were interviewed in 2016–2018 (93% response rate) with clinically validated measures of alcohol use and disorders and life history calendar measures of lifetime migration experiences. Discrete-time hazard models assessed associations between migration and alcohol use outcomes.Resu...
Importance Individual-level social support protects against major depressive disorder (MDD) among... more Importance Individual-level social support protects against major depressive disorder (MDD) among adults exposed to trauma. Little is known about the consequences of community-level interventions in the general population. Objective To determine the potential consequences of neighborhood social infrastructure on incident MDD in a high-risk general population. Design, Setting, and Participants This longitudinal, multilevel study estimated associations between a neighborhood-level program in a case-control design and subsequent individual outcomes across 10 years (2006-2015) in a cohort of young adults. Exogenously placed social programs simulate natural experiment conditions in a high-poverty population experiencing armed conflict (1998-2006). The western Chitwan valley in Nepal has a general population at high risk of MDD, with neighborhoods exposed to interventions to improve social support. From a random sample (response rate 93%) selected to represent the general population in 2016, participants aged 25 to 34 years in 2006 were studied. These individuals resided within 149 neighborhoods that varied in their availability of active social support programs. The analyses were conducted between October 2020 and November 2021. Exposures The Small Farmers Development Program (SFDP) uses shared, joint liability financial credit among neighbors to build social capital and cohesion within neighborhoods. Main Outcomes and Measures Onset of DSM-IV MDD after the conflict, assessed by the Nepal-specific, clinically validated World Mental Health Composite International Diagnostic Interview with a life history calendar. The hypothesis tested was that exposure to SFDP reduced adult onset of MDD. Results Of the 1917 survey participants, 886 (46.2%) were women, and 856 (44.7%) were of Brahmin or Chhetri ethnicity. Of the 149 neighborhoods, 21 had an active SFDP group, and 156 of 1917 (8.1%) participants experienced MDD between 2006 and 2015. Discrete-time hazard models showed participants living in neighborhoods with an SFDP experienced incident MDD at nearly half the rate as others (odds ratio = 0.55; 95% CI, 0.30-1.02; P = .06). A multivariate, multilevel matching analysis showed the incidence of MDD among adults living in neighborhoods with an SFDP was 19 of 256 (7.4%), compared with 33 of 256 (12.9%) in the matched sample with no SFDP (z = 2.05; P = .04). Conclusions and Relevance Living in a neighborhood with community-level social support infrastructure was associated with reduced subsequent rates of adult-onset MDD, even in this high-risk population. Investments in such infrastructure may reduce population-level MDD, supporting clinical focus on potentially unpreventable cases.
The study was designed to investigate the influence of changing social contexts on family formati... more The study was designed to investigate the influence of changing social contexts on family formation behaviors, marriage, childbearing, and contraceptive use. The research investigates the extent to which changes in the community produce changes in family formation behavior, and whether the family organization of individual life courses produces these changes in behavior. The study used a combination of ethnographic and survey research methods to gather 171 neighborhood histories, 142 school histories, 118 health service histories, 20 bus route histories, household farming practices, family planning histories, and household composition in Western Chitwan, Nepal. Personal histories were gathered from the 5,271 individuals ages 15-59 years living in these neighborhoods using a semi-structured Life History Calendar and a highly structured survey questionnaire. The sample neighborhoods for this study were chosen to represent the five major ethnic groups inhabiting the area: high caste Hi...
The study was designed to investigate the influence of changing social contexts on family formati... more The study was designed to investigate the influence of changing social contexts on family formation behaviors, marriage, childbearing, and contraceptive use. The research investigates the extent to which changes in the community produce changes in family formation behavior, and whether the family organization of individual life courses produces these changes in behavior. The study used a combination of ethnographic and survey research methods to gather 171 neighborhood histories, 142 school histories, 118 health service histories, 20 bus route histories, household farming practices, family planning histories, and household composition in Western Chitwan, Nepal. Personal histories were gathered from the 5,271 individuals ages 15-59 years living in these neighborhoods using a semi-structured Life History Calendar and a highly structured survey questionnaire. The sample neighborhoods for this study were chosen to represent the five major ethnic groups inhabiting the area: high caste Hi...
Tropical Medicine & International Health, 2021
ObjectivesTo understand COVID‐19 worries and how they influence COVID‐19 mitigation behaviours, e... more ObjectivesTo understand COVID‐19 worries and how they influence COVID‐19 mitigation behaviours, especially in communities prior to case surges, in Nepal.MethodsData related to COVID‐19 impacts on life disruptions were collected from households in the Chitwan Valley Family Study, a 25‐year community panel study, during February–April 2021. COVID‐19 worry was measured by the extent of respondent concern for themselves or household members getting COVID‐19 in the prior 2 weeks. 11 items examined COVID‐19 mitigation behaviours. Logistic regression models assessed associations between socio‐demographic characteristics and COVID‐19 worry and then the influence of worry on any mitigation behaviour and behaviour type adjusting for age, education, sex, ethnicity and COVID‐19 exposure, accounting for neighbourhood clustering.ResultsOf 2,678 households with a responding adult, ages 18–88, 394 (14.7%) reported moderate‐to‐extreme COVID‐19 worry and 1,214 (45.3%) engaged in three or more mitigat...
We hypothesize that developmental ideas and models concerning family life have been disseminated ... more We hypothesize that developmental ideas and models concerning family life have been disseminated widely around the world where they have become forces for both ideational and behavioral change. In this paper we examine the ways in which marriage has been influenced by these ideas of development in Nepal a country that has historically practiced young age at marriage arranged marriage taboos against intercaste marriage polygamy and almost no divorce as recently as the 1950s. Using qualitative and quantitative data from recent face-to-face interviews we demonstrate that large fractions of Nepalis now endorse marriage behavior similar to that found in the West. The evidence suggested that preferred age at marriage has risen tolerance for intercaste marriage has increased divorce has become more permissible young people are more likely to be involved in their spousal choice and polygamy has greatly decreased. Further analyses examine potential mechanisms such as education and media expo...
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Papers by Dirgha Ghimire