The Link: Economic Decline and Fertility Rates

Fact Sheet: The Decline in U.S. Fertility

by Mark Mather

(July 2012) In the United States and other developed countries, fertility tends to drop during periods of economic decline. U.S. fertility rates fell to low levels during the Great Depression (1930s), around the time of the 1970s "oil shock," and since the onset of the recent recession in 2007 (see Figure 1). The U.S. total fertility rate (TFR) stood at 2.0 births per woman in 2009, but preliminary data from the National Center for Health Statistics show that the TFR dropped to 1.9 in 2010—well below the replacement level of 2.1.¹ A similar decline—or leveling off—of fertility rates has been reported in Ireland, Italy, Spain, Sweden, and several other European countries.

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Figure 1
The U.S. Fertility Rate Has Fallen During Periods of Economic Decline

* Estimated by PRB.
Source: National Center for Health Statistics

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This recent fertility decline may be just a short-term response to high unemployment rates, or it may signal a longer-term drop in lifetime fertility. Most recessions have had relatively minor effects on fertility rates—often lasting two to five years. Recessions generally affect the timing of fertility but not the overall number of children that women will have in their lifetimes.² Longer-term trends in fertility are determined by broader societal factors, including trends in marriage; economic development; cultural norms; and women’s education, employment, and access to contraception. Although fertility rates bottomed out during the Great Depression, the birth rate had been declining throughout the 1920s—a period of rapid economic growth—as more couples used birth control to limit family size.³
The U.S. fertility rate is edging closer to TFRs in Europe, where many countries are grappling with very low birth rates (averaging 1.6 children per woman) and potential labor shortages.

Fertility Rates Converge for Different Racial/Ethnic Groups

Fertility rates in the United States have fallen since 1990 among all major racial/ethnic groups (see Figure 2). The Latina fertility rate dropped sharply in recent decades, from 3.0 births per woman in 1990 to 2.4 births per woman in 2010; and for black women from 2.5 to 2.0. Fertility rates among white and Asian women have also dropped, but at a slower pace, resulting in similar fertility rates among different racial and ethnic groups.

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Figure 2
Fertility Rates for Latinas and Black Women Are Approaching Those of White and Asian Women.

* Preliminary data.
Source: National Center for Health Statistics.

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Relatively high unemployment rates among African Americans and Latinos may have played a role in the recent fertility decline—especially among those with less education and lower incomes.⁴ But increasing college attendance, especially among women, is another potential factor. Education affects the timing of marriages and first births, typically delaying both. Thus, the U.S. fertility rate may drop further if the share of women attending and completing college continues to increase. Among 18-to-24-year-olds, more women than men are enrolled in college in every racial and ethnic group.⁵
A prolonged decline in African American and Latina fertility rates will affect the future racial and ethnic composition of the United States. The Census Bureau recently reported that over half of all U.S. infants are racial/ethnic minorities.⁶ The U.S. population is currently projected to reach "majority-minority" status (the point at which less than half of the population is non-Hispanic white) in 2042. For several decades, immigration has been the driving force behind rapid racial/ethnic change in the United States, but a sustained drop in fertility rates could slow the pace of growth of the country’s minority population.

Young Adults in U.S. Postpone Childbirth

The decline in U.S. fertility has been driven primarily by a trend among young adults to postpone having children. Forty years ago, birth rates among women in their 20s were significantly higher than those of women in their 30s. In 1970, there were 168 births per 1,000 women ages 20 to 24, compared with 73 births per 1,000 women ages 30 to 34. However, this gap has steadily narrowed over time. By 2009—for the first time in U.S. history—birth rates among women ages 30 to 34 (97.5 births per 1,000 women) exceeded those for women ages 20 to 24 (96 births per 1,000 women). In 2010, the birth rate among teens dropped to 34 births per 1,000 girls ages 15 to 19—the lowest level ever recorded in the United States.
This recent drop in births among young adults could be linked to the recession. In Europe, high rates of unemployment and low levels of economic security are strongly associated with declines in fertility among young adults.⁷ The economic downturn may have had a similar effect on young adults' fertility in the United States.
However, longer-term fertility trends may depend on future trends in women's employment and earnings relative to men.⁸ Women outnumber men in college and make up a growing share of the labor force. The recession hit male-dominated jobs the hardest, contributing to a growing share of women who now outearn their husbands.⁹ As more women become primary breadwinners, fertility decisions are more likely to hinge on women’s earnings than they did in previous decades. A growing reliance on women’s employment and earnings could further dampen U.S. fertility rates in the coming decades.

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Mark Mather is associate vice president of Domestic Programs at PRB.

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References

1. The total fertility rate estimates the number of births a woman is expected to have during her lifetime based on current age-specific fertility rates. Replacement level fertility is the level of fertility at which a couple has only enough children to replace themselves, or about 2.1 children per couple.
2. Tomáš Sobotka, Vegard Skirbekk, and Dimiter Philipov, "Economic Recession and Fertility in the Developed World," Population and Development Review 37, no. 2 (2011).
3. U.S. Centers for Disease Control and Prevention, "Achievements in Public Health, 1900-1999: Family Planning," accessed on June 26, 2012.
4. Gretchen Livingston, "In a Down Economy, Fewer Births," accessed on June 7, 2012.
5. Linda A. Jacobsen and Mark Mather, "A Post-Recession Update on U.S. Social and Economic Trends," Population Bulletin Update (December 2011).
6. U.S. Census Bureau, "Most Children Younger Than Age 1 Are Minorities," accessed on June 7, 2012.
7. Wolfgang Lutz, Vegard Skirbekk, and Maria Rita Testa, "The Low Fertility Trap Hypothesis," in Vienna Yearbook of Population Research, ed. Dimiter Philipov, Aart Liefbroer, and Francesco Billari (Vienna: Vienna Institute of Demography, 2006); Lisa Bell et al., "Failure to Launch: Cross-National Trends in the Transition to Economic Independence," Luxembourg Income Study Working Paper Series 456; and Christian Schmitt, "Gender-Specific Effects of Unemployment on Family Formation: A Cross-National Perspective," SOEP 127 (2008).
8. Diane J. Macunovich, "Using Economics to Explain U.S. Fertility Trends," in "What Drives U.S. Population Growth?" Mary M. Kent and Mark Mather, Population Bulletin 57, no. 4 (2002).
9. Richard Fry and D’Vera Cohn, "New Economics of Marriage: The Rise of Wives," accessed on June 7, 2012.

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Have You Had Your Iodine Level Checked? Here's Why You Might Want To

Today's research took me to an area of health that grabs my attention almost as much as the realm of hormone balance.  I personally realized that I was a bit iodine deficient after testing my levels about 1 year ago.  I then started doing some restoration therapy to address it.  The testing was super simple to perform (an at home urine kit) and quite affordable at a cost of $75. Today's blog is just to share some key facts about iodine and it's importance to the body in health and prevention of disease.  I know your time is as limited as mine, so I will keep this blog in "bullet points" for easy-breezy access to the nuts and bolts of information.  So, here goes....

*Iodine is a member of halogen family which also includes fluorine, chlorine, bromine, and astatine. 

*Every cell in the body contains and utilizes iodine which is concentrated in the glandular system

*The thyroid gland contains the largest amount of iodine although it can also be found in breast tissue, salivary glands, parotid glands, pancreas, CSF, brain, stomach, skin, and other places.

*The absence of iodine is known to be a promoter of cancer

*IoDIDE is a salt.  Breast tissue, prostate tissue and the stomach prefer iodINE, whilst the thyroid, salivary glands and the skin prefer ioDIDE. In other words, the body needs both.

*Iodine is essential for the normal growth and development of children.  In fact, researchers have established that a baby's IQ is set by the age of 2, and iodine is what sets the IQ.  (Interesting huh?)

*A deficiency of iodine can result in cretinism, mental deficiency, deafness, and delayed development. 

*In Japan the average person eats 13.8mg/day of iodine.  In America, 168mcg (huge difference)

*The U.S. has the highest breast cancer incidence in the world, while Japan has the lowest.

*In the U.S., there are 7 deaths per 1000 live births, in Japan it is 3.5, the lowest in the world.

*We are taking the iodine out of bread, milk, and salt.  Half of our cooking salts contain no iodine.

*With high blood pressure, the first point of therapy is to remove salt from the diet.  (Think about it)

*Iodine deficiency results in fibrocystic breast disease and dysplastic changes of the breast.

*Low iodine levels leads to a high estrogen state. 

*Researchers connect an increased prevalence of Attention Deficit  (500% in 5-6yrs) to so many pregnant women who are iodine deficient.

*Researchers connect iodine deficiency to Fibrocystic Breast Disease, Polycystic Ovaries, cysts, and ovarian cancer. 

*Our environment has competitive inhibitors of iodine.  Do a "google" search of halides and the impact on iodine status and thyroid health.

*I recently came across a set of prescriptions from the 1950's and 60's.  In them, I couldn't help but notice all of the Rx's for Iodine Supplementation.  We don't see that very much at all today.

*Possible symptoms of iodine deficiency: thyroid disease, goiter, weight gain, infertility, memory loss, emotional instability, breast cancer, fibrocystic breasts, prostate cancer, cold hands and feet, swelling, low energy, indigestion, heart palpitations, brain fog, dry skin, hair loss, fatigue, constipation, intolerance to heat, menstrual disorders, A.D.D., and sleep disorders. 

This blog (hopefully) gives compelling evidence that iodine levels should be checked out in the "health-care" approach to longevity and in the prevention of disease.  I am a provider of an at-home testing kit that will allow you to do a personal check of your iodine status.  Give our team a call and we can walk you through the process.

To your good iodine health,
Dr. Sonja

No Link: Testosterone Therapy & Heart Attack Risk

No Link: Testosterone Therapy & Heart Attack Risk | Worldhealth.net Anti-Aging News

One Size Does NOT Fit All

When you are heading into the clothing store you might find something with the label One-size-fits-all.  That's great if you are buying sunglasses, a hat, or even some styles of clothing, but when it comes to medicine and the individual needs of a person, it's often not the best way.  One of the questions that I often respond to is, "Dr. Sonja, what is it that you actually do?"  Well, in a nutshell, I design custom medicines!  Creative Medicines!!  And "I" is not even the way I should respond.  I have a staff surrounding me that really know how to make things happen under my direction and supervision.  I get phone call after phone call, in a days time, from physicians, practitioners, and patients from all over the country asking me what possibilities exist for their specific concerns. 

......What kind of concerns?

I just wanted to share some of the neat things that we were able to intervene on in recent weeks so that you have an understanding of what it means to customize medicine.

Patient 1: Hemorrhoids!  Yep, a patient with the horrible problem of hemorrhoids.  I received the call and was happy to share that I could design a suppository formulation with multiple ingredients that would heal his problem.  His case also happened to be higher in the rectum area causing fissures and tears.  No problem.  We can design medicine for any area of the body and any need.  We also make a cream that's magical for hemorrhoids.  NO kidding.  GI Doctors write for it all the time. 

Patient 2: Fertility and Miscarriages A woman with fertility issues and a history of lost pregnancies.  We tested her hormone levels, and I worked with her OB/Gyn to help her get into a normal menstrual cycle pattern.  We also created progesterone suppositories that helped her sustain a pregnancy.  Love that!!  I especially love baby pictures 9 months later. 

Patient 3:  Profuse Sweating A young teenager with horrible sweating causing embarrassment and irritation.  I designed a deodorant formulation that will dry up the sweating and stop the rash.  Yes we have dispensing units that allow us to make deodorant like you see in the stores.  It's really "cool" to be able to provide this treatment.  We've used it and put it to the test over and over in patients.  The patients always come back.

Patient 4:  Autism A child with autism who requires a small dose of medicine and needs a specific flavor for palatibility issues.  No problem!

Patient 5:  Shingles A patient with shingles who had intense stinging and burning pain along with a rash caused by this terrible disease.  On her, we were able to customize a medicine with 3 ingredients that put a halt to the pain and allowed healing.  Yeah!! 

Patient 6:  Vaginal Dryness A woman with a condition called Lichen Sclerosus who has suffered for 8 years before finding us. She also had hormone deficiencies resulting is significant vaginal dryness. Thankfully a referral was made by her provider to me and YES I had a formulation that we started about 4 weeks ago with her.  She reports that she is improved and regaining some of her life back.

Patient 7: Menopause A woman with horrible symptoms of menopause.  Sweating, depression, fatigue, irritability, and the whole gammet.  I consulted with her privately, tested her hormone levels, and designed a formulation specificially to her need by collaborating with her personal physician.  This is the majority of our business. Bio-Identical Hormone Replacement. It's the future of medicine now and women in our care are doing great.  It's spreading like wildfire. 

Patient 8:  Psoriasis A man with psoriasis who did not like to wear shorts or short sleeves because of the embarrassment of the patches and silvery areas on his elbows and knees.  No problem.  We again had a multi ingredient recommendation that cleared him up wonderfully and even added a shampoo for his scalp too.  He's doing great!

Patient 9:  Diaper Rash A baby with horrible diaper rash.  We actually intervene a lot to provide Happy Hiney's.  Our magic BUTT Paste will do the trick.   Our pediatricians and providers write for it all the time to soothe bottoms for our little patients. 

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Patient 10:  Animal Care A cat with hyperthyroidism.  Yes, we do veterinary work too.  We make a special medicine that can be rubbed into the non-hairy pat of a cats ear to fix it's thyroid disease.  It's a pretty common formulation for us to make.  We also help animals with anxiety, wetting, and allergies.   Years ago, I made medicine for sharks.....and a sick elephant.....oh, and lets not forget the Llama.  No kidding.  :)

Patient 11:  Restless Leg Syndrome  This morning I'm working with a physician on a patient with plantar fasciitis, horrible insomnia, and restless leg syndrome.  She wants to go a natural approach.  My research gives compelling evidence that there are often neurotransmitter deficiencies that can be evaluated with targeted therapies to restore those levels to norm.  Her physician and I have worked through her medical history, failed therapies, concerns, and symptoms and will give her the TLC that is necessary to figure out where the problem exists.


Here's some other needs that have come up just in the last couple of weeks:  Fibromyalgia, Anxiety, Depression, Alzheimer's Disease, Low Testosterone (Andropause), Weight Gain, Autoimmune Disease, Thyroid Disease, Acne Treatments, Scar Therapy, and I'm now providing agents for Medical Spas to use in Anti-Aging Procedures.  The list could go on, and on, and on. 

So to say that I have the coolest job in the world is TRUE.  I never know what's coming in a days time, but with some years (cough....cough...actually almost 25) of experience and knowledge behind me, I can now make some great recommendations to heal whatever ails.  It really is amazing to make "Creative Medicines" for a living.  I've met a lot of great people who felt trapped by their physical need but who fortunately made the phone call to see if there was a better way.  Trust is not taken lightly because I have to calculate percentages, and determine if certain medicines can be added together, and figure out a way to make it the most effective to the need.  It's really quite intense at times, but we have great resources, libraries, and consultants available to us.  

The cost of customized medicine is always a concern for people.   No joke, I can often design a medicine for the same price that you would pay on your insurance copay.  Really?  Yes! And often cheaper.  Truth!!

If you are struggling with something, ANYTHING, please don't hesitate to call.  I would love to help you out and share some options.  Let's get you FIXED!! 


To your good health,
Dr. Sonja

The Problem with Plastics: Baby Bottles, Plastic Bottles, and Food Containers

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A Common Hormone Link: Infertility, Osteoporosis, and Cancer

Infertility, Osteoporosis, Cancer, and Natural Progesterone

Natural PROGESTERONE, which has many beneficial functions that are described in a new book* by John R. Lee, MD,

• is a precursor of other sex hormones, i.e., estrogen and testosterone
• maintains secretory endometrium (the inner secretory lining of the uterus)
• protects against breast fibrocysts
• is a natural diuretic
• helps use fat for energy
• is a natural antidepressant
• helps thyroid hormone action
• normalizes blood clotting
• restores libido
• helps normalize blood sugar levels
• normalizes zinc and copper levels
• restores proper cell oxygen levels
• protects against endometrial cancer
• helps protect against breast cancer
• stimulates osteoblast-mediated bone building
• is necessary for survival of embryo and fetus throughout gestation
• is a precursor of cortisone synthesis by the adrenal cortex.

On the other hand the various synthetic progestins are not precursors of the adrenal hormones or the sex hormones and cannot be easily broken down by the liver. Dr. Lee mentions many side effects from synthetic progestins, including that they may

• increase the risk of birth defects such as heart and limb defects if taken during the first four months of pregnancy . . .
• cause fluid retention, epilepsy, migraine, asthma, cardiac or renal dysfunction . . .
• cause or contribute to depression . . .
• decrease glucose tolerance; diabetic patients must be carefully monitored.

In this review of Dr. Lee's book the effects of natural progesterone in combating female infertility, osteoporosis, and cancer will be outlined. .
Infertility
In the menstrual cycle at the crucial time—right after ovulation— low levels of progesterone in relation to estrogen can result in female infertility. Progesterone is the natural hormone that makes possible the survival of the fertilized egg; It is produced by a special tissue (corpus luteum) formed by the follicle from which the matured ovum emerges. Progesterone is essential for the proper development of the uterine lining so that it can receive and nourish a fertilized ovum. As the placenta develops, it assumes and progressively increases the production of progesterone for the duration of the gestation period, i.e., until birth of the baby. During the third trimester, progesterone is produced at the rate of more than 300 milligrams per day, an astounding level of hormone production which, for other hormones, is usually measured in micrograms per day. . . . Progesterone (unlike estrogen and testosterone) is devoid of secondary sex characteristics. Thus, its effects in promoting the development of the fetus are independent of the baby's gender. The fetus is allowed to develop according to its own DNA code and not be affected by the hormones of the mother.
Osteoporosis
Bones are living tissue and, unlike teeth, they can grow as the body grows, mend when broken, and continually renew themselves throughout life. Bone can be thought of as mineralized cartilage. . . . Bone forming cells (osteocytes) differentiate into osteoclast and osteoblast varieties. Osteoclast cells continually travel through bone tissue looking for older bone previously mineralized and in need of renewal. Osteoclasts resorb (dissolve away) such bone leaving tiny unfilled spaced (lacunae) behind. Osteoblasts then move into these spaces and produce new bone. This astounding process of continual resorption (by osteoclasts) and new bone formation (by osteoblasts), called remodeling, is the mechanism for the remarkable repair abilities and the continuing strength of our bones.
At any stage in life, one's bone status is a product of the balance between these two functions of bone resorption and new bone formation. . . .

• Estrogen retards osteoclast-mediated bone resorption
• Natural progesterone stimulates osteoblast-mediated new bone formation
• Some progestins [synthetic forms of progesterone, which can be patented, used profitably in birth control pills, and which have many deleterious side effects] may also stimulate new bone formation to a lessor degree.

Many factors are involved in osteoporosis. Exercises, particularly weight-bearing ones, and appropriate nutrition are absolutely essential for avoiding osteoporosis.
Mineralized bone (hydroxyapatite) is a crystalline structure and, as such, will respond to physical stress just as other crystalline structures do. In particular, any force tending to distort the crystalline arrangement generates an electric voltage, called the piezoelectric effect, producing a small electric current (discovered by Pierre Curie in 1883). This also happens in mineralized bone and may explain the wondrous ability of osteoclast and osteoblast action in constructing and reinforcing bone trabeculae along lines best suited for maximum strength and physical efficiency. When viewed microscopically, trabeculae remind one of the vaulted chambers and flying buttresses of the best Gothic churches.
Dr. Lee deals with many factors in the treatment of postmenopausal osteoporosis and summarizes as follows:
Since calcium is the predominant mineral in bone building, it is helpful to follow the chain of events that facilitate its bone use from ingestion to incorporation into bone.
facilitating factors
Ingested calcium
gastric hydrochloric acid (HCl) and vitamin D
Absorbed calcium
exercise, progesterone (stimulates osteoblasts), estrogen (restrains osteoclasts), magnesium, micronutrients. Avoid excess protein, diuretics, antibiotics, fluoride, and metabolic acidosis.
Bone incorporation
Natural progesterone is effectively absorbed through the skin. Dr. Lee. has had excellent success increasing the bone density of osteoporotic patients who used progesterone cream, not constantly but as prescribed, along with a diet emphasizing leafy green and other vegetables (Over 5000 plants contain progesterone-like substances.plus supplements, and appropriate exercise.
Interestingly, a comparison of patients younger than 70 years of age with those over 70 showed no difference in the bone response to progesterone. Further, patients who are now well up in their 80's continue to enjoy strong bones without evident bone loss while continuing their use of natural progesterone. Age is not the cause of osteoporosis; poor nutrition, lack of exercise, and progesterone deficiency are the major factors.
Cancer
Breast cancer and uterine cancer are promoted by some and controlled by other gonadal hormones, namely, the estrogens and progesterone. The three principal estrogens produced by our bodies are estradiol, estrone, and estriol. The latter is particularly high during pregnancy. In the Journal of the American Medical Association; in 1966;it was reported that women with breast cancer excreted 30 to 60 per cent less estriol than non-cancer controls; and that remission of cancer in patients receiving endocrine therapy occurred only in those whose estriol quotient rose. On the other hand, estradiol and estrone are known promoters of uterine cancer. Specifically, among the three major natural estrogens, estradiol is the most stimulating to breast tissue, estrone is second, and estriol by far the least.
What about progesterone? Breast cancer and uterine cancer tend to occur when estrogen levels are high relative to progesterone. Dr. Lee calls this &estrogen dominance.
In the case of breast cancer, consider the following observations:

• Breast cancer is more likely to occur in premenopausal women with normal or high estrogen levels and low progesterone levels. . . . it also occurs after menopause when women are given estrogen supplements without progesterone.
• Among premenopausal women, breast cancer recurrence or late metastases after mastectomy for breast cancer is more common when surgery had been performed during the first half of the menstrual cycle (when estrogen is the dominant hormone) than when surgery had been performed during the latter half of the menstrual cycle (when progesterone is dominant). . . .
• Treatment of males with estrogen (for prostatic cancer or after trans-sexual surgery) is associated with an increased risk of breast cancer
• Recently, industrial pollutants having potent estrogenic effects, called xenoestrogens, are being recognized as a pervasive environmental threat, likely to be a contributing factor in the incidence of breast cancer. . . .

The cancer protective benefit of progesterone is clearly indicated by the prospective study in which premenopausal women with low progesterone levels were found to have 5.4 times the risk of developing premenopausal breast cancer and a 10-fold increase in deaths from all malignant neoplasms compared to those with normal progesterone levels. . . .
Thus, the evidence is strong that unopposed estradiol and estrone are carcinogenic for breasts, and both progesterone and estriol, the two major hormones throughout pregnancy, are protective against breast cancer.
Dr. Lee asks why the natural and beneficial hormones progesterone and estriol are not prescribed for women rather than the deleterious synthetic estrogens and progestins. He answers by pointing out that the synthetic forms, which are never found in any living creature, can be patented and sold profitably and that many doctors, who get advertisements for the synthetic products from the pharmaceutical companies, are not aware that the natural hormones, progesterone and estriol are also available.
[Editor's note: I thoroughly enjoyed reading Dr. Lee's book. It is delightfully written and most informative.]

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Natural Progesterone: The Multiple Roles of a Remarkable Hormone , BLL Publishing, P.O. Box 2068, Sebastopol, CA 95473; 99 pages, paperback.
Article from NOHA* NEWS, Fall 1994
*The American Nutrition Association was formerly known as the Nutrition for Optimal Health Association [NOHA].