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COMMITTEE ON POPULATION AND DEMOGRAPHY Report No. 23 . The Determinants of Brazil's Recent Rapid Decline in Fertility lhomas WO Memck ~~ Berquo Panel on Fordlity Determinants Committee on Pop~a~don and Demography Confusion on Behavioral and Social Sciences and Education National Research Council NATIONAL ACADEMY PRESS Washington, D.C. 1983

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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn 'from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the co''unittee responsible for the report were chosen for their special competences and with regard for appropr late balance. This report has been reviewed by a group other than the authors according to procedures approved by a Repor t Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The National Research Council was established by the National Academy of Sciences in 1916 to associate the broad con munity of science and technology with the Academy' s purposes of furthering knowledge and of advising the federal government. The Council operates in accordance with general policies determined by the Academy under the authority of its congressional charter of 1863, which establishes the Academy as a private, nonprofit, self-governing membership corporation. The Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in the conduct of their services to the government, the public, and the scientif ic and engineering communities. It is administered jointly by both Academies and the Institute of Medicine. The National Academy of Engineering and the Institute of Medicine were established in 1964 and 1970, respectively, under the charter of the National Academy of Sciences. Available from NATIONAL ACAD - tY PRESS 2101 Constitution Avenue, N.W. Washington, D.C. 20418 Printed in the United States of America

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PANEL ON FERTILITY DETERMINANTS W. PARKER MAULDIN (Chair), The Rockefeller Foundation, New York ELLA BERQUO, Centro Brasileiro de Analise e Planejamento, Sao Paulo, Brazil WILLIAM BRASS, Centre for Population Studies, London School of Hygiene and Tropical Medicine DAVID R. BRILLINGER, Department of Statistics, University of California, Berkeley V.C. CHIDAMBARAM, World Fertility Survey, London JULIE DAVANZO, Rand Corporation, Santa Monica RICED A. EASTERLIN, Department of Economics, University of Southern California, Los Angeles JAMES T. FAWCETT, East-West Population Institute, East-West Center, Honolulu . RONALD FREEDMAN, Population Studies Center, University of- Michigan DAVID GOLDBERG, Population Studies Center, University of Michigan RONALD GRAY, School of Hygiene and Public Bealth, The Johns Hopkins University , Baltimore PAULA E. HOLLERBACE, Center for Policy Studies, The Population Council, New York RONALD LEE, Graduate Group in Demography, University of California ~ Berkeley ROBERT A. DEVIL:, Graduate School of Education, Earvard University SUSAN C.M. SCRIMSHAW, School of Public Bealth, University of California, Los Angeles ROBERT WILLIS, Department of Economics, State University of New York, Stony Brook ROBERT JO LAEBAM, Study Director

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COMMITTEE ON POPULATION AND DEMOGRAPHY ANSLEY J . COALE (Chair ), Of f ice of Population Research, Pr inceton Univer sity WILLIAM BRASS, Centre for Population Studies, London School of Hygiene and Tropical Medicine LEE-JAY CHO, East-West Population Institute, East-We~t Center, Honolulu RONDO FREED - N. Population Studies Center, University of Michigan NATHAN KEYFITZ, Department of Sociology, Harvard University LESLIE RISE, Institute for Social Research, University of Michigan W. PARSER MAULDIN, Population Division, The Rockefeller Foundation, New York JANE MENl~l, Office of Population Research, Princeton University SAMUEL PRESTON, Population Studies Center, University of Pennsylvania WILLIAM SELTZER, Statistical Office, United Nations CONRAD TAEIJBER, Kennedy Institute, Center for Population Research, Georgetown University ETTENNE VAN DE ~~ Population Studies Center, University of Pennsylvania ROBERT J. LAPEAM, Study Director . NOTE: Members of the Committee and its panels and working groups participated in this project in their individual capacities; the listing of their organizational affiliation is for identification purposes -only, and the view" and designations used in this report are not necessarily those of the organizations mentioned. iv

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CONTENTS LIST OF TABLES LIST OF FIGURES PREFACE SAY INTRODUCTION Background, 12 Geography and Population Distribution, 12 Political and Economic Bistory, 15 Recent Demographic Trends, 18 Population Trends, 18 National and Regional Trends in the Total Fertility Rate, 20 Expectation of Life at Birth, 22 Income Class Differences in Fertility and Mortality, 23 Purpose and Structure of This Report, 25 PART I FERTILITY DETERMINANTS AT t!~ NAT TONAL LEVEL 1 THE PROXIMATE DETERMINANTS OF ~uKTILITY Marital Status and Mean Age at Marriage, 30 v ix xiv x 1 12 29

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Mar ital Fertility, 35 Decompos ition of Change in Bir th Rates, 4 1 Role of the Proximate Variables, 42 Contraceptive Use, 44 Abortion, 49 Breastfeeding/Postpartum Amenorrhea, 54 A Speculative Overview of Trends in the Proximate Determinants of Total Fertility Rates, 1970-80, 56 Coracles ions, 5 8 2 SOCIOECONOMIC DIFF~TIALS IN FERTILITY Education and Fertility Decline, 61 Family Income, 67 The Regional Dimension of Income Differences, 73 Conclus ions, 77 60 3 DETERMINANTS OF BRAZIL ' S RECENT FERTILITY DECLINE 79 Hypotheses Linking Socioeconomic Conditions to Fertility Decline, 80 Increased Access to Fertility Control' 84 Socioeconomic Factors, 90 Socioeconomic Factors and Fertility Decline Among Urban and Rural Women, 96 Currently Married Urban Women, 97 Currently Married Rural Women, 106 Conclus sons, 113 4 ARALYSIS OF FERTILITY DETERMINANTS AT Am; NATIONAL LEVEL Urban Women, 116 Analysis of Urban CEB Differentials in 1970 and 1976, 122 Sources of Change in CEB frown 1970 to 1976, 127 Rural Women' 133 ~1 115

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Analysis of Rural CEB Differentials in 1970 and 1976, 136 Changes in Rural CED from 1970 to 1976, 142 Concl~ signs, 14 2 PART I I FERTILITY DETERMINANTS AT Tar: LOCAL LEVEL , 5 Ted: NIHR: PURPOSE AND METHODOLOGY 6 TEE TOTAL E ERTILITY RATI:: I~:VELS AND TRENDS 7 NUPTIALITY Type of Union, 156 D istr ibution of Types of Union, 156 The Role of Concensual Unions, 16 8 Type of Union and Fertility, 172 Age at Marriage, 174 8 MARITAL f-liKTILITY 9 ARE PROX=AU: VARIAB~:S Contraceptive Use, 183 Contraceptive Prevalence, 183 Contraceptive Methods, 186 Bongearts' Index of Contraception, 189 Postpartum Infecundability, 191 Abortion, 194 10 SOCIOECONOMIC FACTORS: 11 CONCLUSIONS FAMILY INCOME Decomposition of General Fertility Rates, 202 Decomposition of Total Fertility, 204 F indings at the National/State and Local Levels, 205 NOTES APPENDIX: "E NIER CONTEXTS REFERENCES V11 145 151 156 178 181 196 202 208 209 235

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LIST OF TABLES 10 16 1 Components of Population Growth, 1940-80 2 Total Fertility Rates ~ 1950-80 3 Expectation of Life at Birth, l9S0-76 4 Income Class Dif ferences is Total Fertility Rates and the Expectation of Life at Birth, 1970 Reported Percent Distribution of Women by Mar ital Status and Age, 1950-80 6 Percent of Single Women Who Report Having Mad a Child, by Age, 1950-76 7 Singulate Mean Age at Marriage (SMAM), by Region, 1950-76 8 Age-Specific And Total Marital Fertility Rate Calculations, 1960, 1970, and 1976 9 Decomposition of Change in General Fertility Rate, 1960-76 Decomposition of Change in Crude Birth Rate, 1960-76 11 Contraceptive Prevalence, Summary of Survey Data 1 2 Components of Index of Contraception (Cc ), 1970 , 1976, and 1980 Reported Abortions, Sugary of Survey Data Reported Breastfaeding, Sugary of Survey Data 13 14 15 Estimates of Proximate Determinants of Total Fertility Rate, 1970-80 Total Fertility Rates by Years of Schooling, 1970-76 17 Total Fertility Stem by Family Income Level (multiples of monthly minimum salary), 1970 and 1976 18 Total Fertility Rates by Family Income Deciles, 1970-76 ix 18 20 23 24 31 32 34 36 41 42 4S 48 52 55 56 63 67 70

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72 20 21 22 23 24 25 26 27 19 Percent [Distribution of All Women Aged 15-49 by Income Deciles, Years in School, and Rural-Urban Residence, 1970 and 1976 Unadjusted Total Fertility Rate by PNAD Region and Income Dec ile, 1970 and 19 7 6 Percent Distribution of Women Aged 15-49 by PNAD Region and Income Deciles, 1970 and 1976 Percent Distribution of Marr fed Women Aged 15-44, by Contraceptive Use Status and Household Income Contraceptive Prevalence Survey Data on Percent of Currently Married Women Aged 1S~44 Using Contraceptives, by Education Source of Family Planning Supplies and Services Currently Married Women Aged 15-44, CPS Data by State Percent of Women Reported as Having No Schooling, by Age, 1960-80 Percent Distribution of All Women Aged 20-44 by Age and Years of Schooling, 1970 and 1976 Percent of Women Reported as Working, by Age and Years of Schooling, 1970 and 1976 28 Mean and Standard Error (S)a of Number of Children Ever Born, Currently Married Urban Women, by Age and Educational Attainment, 1970 and 1976 29 Percent Working and Percent Migrants Among Currently Married, Urban When, 1970 and 1976 30 Distribution of Currently Married Women Aged 20-44 by Occupation, Work Status, and Educa- tional Attainment, 1970 and 1976 31 Percent of Currently Married' Urban Women Living in Households Reporting Ownership of a Tele- vision, by Age and Education, 1970 and 1976 Average Number of Children Ever Born for Cur- rently Married, Urban Women, by Age, Education, 74 75 88 90 91 93 94 95 97 99 101 102 and Current Employment Status, 1970 and 1976 103 Average Number of Children Ever Born for Migrant and Nonmigrant Women, by Age and Educational Attainment, 1970 and 1976 Mean dumber of Children Ever Barn for Currently Married, Rural Women by Region, Educational Attainment, and Age, 1970 and 1916 Percent of Currently Married, Rural Women in Proletarian Households, Percent Working, and Percent Migrant, by Age and Region, 1970 and 1976 x 104 108 109

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36 37 40 41 43 44 AS 46 4t 48 49 Mean Number of Children Ever Born for Currently Married, Rural Women Aged 20-44, by Region and Proletarian Status, 1970 and 1976 Mean Number of Children Ever Born for Currently Married, Rural Women Aged 20-44, by Region and Work Status, 1970 and 1976 112 38 Variable Labels and Definitions, Urban Women 118 39 Means (standard deviations) of Variables Used in Analysis of Differences in Average Parity for Urban Women, 1970 and 1976 Regression Analysis, Average Number of Children Ever Born (CEB), Married Urban Women' 1970 Regression Analysis, Average Number of Children Ever Born (CEB), Married Urban Women, 1976 42 Changes in Contribution of Independent Variables to Levels of COB, 1970 and 1976 Regression Analysis and Test for Interactions, Merged 1970 and 1976 Data Files Decomposition of Changes in Average Parity from 1970 to 1976 Using Regression Coefficient for Merged Data Percent of Women with GAP Greater than One Standard Deviation from Mean, 1970 and 1976 Variable Labels and Definitions, Rural Women Means (standard deviations) of Variables Used in Analysis of Differences in Average Parity for Rural Women, 1970 and 1976 Regression Analysis, Average Number of Children Ever Born (CUR), Married Rural Women, 1970 140 Regression Analysis, Average Number of Children Ever Born (CEB), Married Rural Women, 1976 141 111 121 124 125 50 Nine Contexts Defined in Terms of Modes of Produc" tion and Type of Involvement in the Development Process Total Fertility Rates, Nine Contexts, 1965, 1970, and 1975 52 Mean Parity 1/2 (P2S-29 + P30-34)' 1965, 1 and 1975 Percent Distribution of Ever-Married Women, by Type of Marital Union, Nine Contexts, 1960, 1970, and 1975 Percent Distribution of Ever-Married Women, by Type of Marital Union, 1960, 1970, and 1978 Distribution of Unions According to Order and Type 53 54 55 129 130 131 133 137 138 148 X1 153 155 158 160 161

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Distribution of Ever-Married Women by Type of First Union, for Three Marriage Cohorts: A (until 1960), ~ (1961-70), and C (1971-76), and for Nine Contexts 57 Distribution of Ever-Married Women by Type of First Union, for Three Marriage Cohorts: A (until 1960), B (1961-70), and C (1971-76), and for Five Urban and Four Rural Contexts Distribution of Ever-Married Women According to Type of First Union, for Three Marriage Cohorts: A (until 1960), B (1961-70), and C (1971-76), Nine Contexts Distribution of Consensual Unions by Different Types, Nine Contexts 60 Distribution of Consensual Unions, by Type for Three Marriage Cohorts, Recife Mean Number of Children Ever Born Alive by Ever-Married Women, by Type of Marital Union, Nine Contexts, 1975 62 Mean Number of Children Ever Born' for Currently Married Women (first marriage), by Type of Union and Three Marriage Cohorts, Nine Contexts Estimates for Nuptiality Parameters Using - Coale's Method, Nine Contexts Mean Age at Marriage (Bajnal method}, Nine Contexts Total Marital Fertility Rates, Nine Contexts, 1970 and 1975 Values for the Fertility Control Measure (m) Estimated by C^=le's Method, 1970 and 1975 Currently Married Women Aged 15-49 Currently Using Contraception, by Types of Methods, Nine Contexts Currently Married Women Aged 15-49 Currently Using Contraception, Nine Contexts Age Distribution of Currently Married, Sterilized Women Aged 15-49, Nine Contexts 70 Estimates (in percent) for Use Efficiency of Contraceptives (e), for Currently Married Women, Nine Contexts Index of Contraception, Nine Contexts Percent of Breastfed Children at 4 Months of Age, by Various Studies Values of ~ i ~ and Ci, Nine Contexts Total Abortion Rates (EM) and Bongsarts' Abortion Rate (Ca), Nine Contexts xii 163 164 166 170 L72 173 174 17S 176 179 180 182 184 187 190 191 192 194 195

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Percent Distribution of Women Aged 15 and Over, by Per Capita Monthly Income (in fractions of one minimum wage), Five Urban Contexts, at Time of Survey Average Number of Children Born to Ever-Married Women Aged 15 and Over, by Per Capita Monthly Income (in fractions of one minimum wage), Five Urban Contexts 77 Changes in General Fertility Rates Due to Age Structure, Marital Status, and Marital Fertility, Nine Contexts, 1970-75 78 Proximate Determinants of Total Fertility, Nine Contexts, 1975 Dynamics of the Population of Parnaiba (municipality), 1940-70 A.2 Dynamics of the Population of Cachoeiro do Itapemirim (municipality), 1940-70 Dynamics of the Population of Sao Jose dos Campos (municipality), 1940~70 A.4 Dynamics of the Population of Sertaozinho (municipality), 1940-70 Ao5 Dynamics of the Population of Santa Cruz do Sul (municipality), 1940-70 Dynamics of the Population of Recife (municipalityJ, 1940-70 . . . x`~z 197 199 203 206 214 217 221 228 231 234

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LIST OF FIGURES 1 Total Fertility Rater by Urban-Rural Residence, 1950-80 - 2 2 Total Fertility Rates by Region, 1950-80 3 3 Changes in Selected Reproductive Measures Based on Bongearts ' Model, 1970-80 7 Percent of Married Women Aged 15-44, Currently Using Contraception, by Household Income for Specif fed Years 8 5 Age-Specific Fertility Rates, 1975 37 6 Age~Specif ic Marital Fertility Rates, (ASMER25029 = L00), Six Contexts 40 7 Total Fertility Rate by Years of Schooling, 1970 and 1976 6 5 8 Distribution of Women Aged 15-49 by Region and Income Group, 1976 76 9 National and Regional Trends in Commercial Distribution of Contraceptive Pills, 1965-81 86 x~v

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PREFACE Fertility and its determinants have been urgent topics for research in recent decades with the rapid expansion in world population. Attempts to control population growth have focused on reducing fertility, with some apparent effect. The peak rate of growth in the world's population has now been passed, but growth is still at a high level in almost all the developing countries. In absolute numbers, the increase in the world's population continues to rise; according to United Nations medium projections, more people will be added each year for the next 50 years than were added in 1980. This report is one of a series of country studies of fertility determinants carried out by the Panel on Fertility Determinants of the Committee on Population and Demography. The Committee on Population and Deacgraphy was established in April 1977 by the National Research Council in response to a request by the Agency for International Development (AID) of the U.S. Department of S tate . The causes of the reductions in fertility- whether they are the effect primarily of such general changes as lowered infant mortality, increasing education, urban rather than rural residence, and improving status of women, or of such particular changes as spreading knowI- edge of and access to efficient methods of contraception or abortion--are strongly debated. There are also diver- gent views of the appropriate national and international policies on population in the face of these changing trends. The differences in opinion extend to different beliefs and assertions about what the population trends really are in many of the less-developed countries. Because births and deaths are recorded very incompletely in much of Africa, Asia, and Latin America, levels and xv

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trends of fertility and mortality must be estimated, and disagreement has arisen in some instances about the most reliable estimates of those levels and trends. It was to examine these questions that the committee was established within the Commission on Behavioral and Social Sciences and Education of the National Research Council. It was funded for a period of five and one-half years by AID under Contract No. AID/pha-C-1161 and Grant No. AIO/DSPE-G-0061. Chaired by Ansley J. Coale, the committee has undertaken three major tasks: 1. To evaluate available evidence and prepare estimates of levels and trends of fertility and mortality in selected developing nations; 2. To Improve the technologies for estimating fer- tility and mortality when only incomplete or inadequate data exist (including techniques of data collection); 3. To evaluate the factors determining the changes in birth rates in less-developed nations. Given the magnitude of these tasks, the committee concentrated its initial efforts on the first two tasks. This work is detailed in a series of country and methodological reports from the National Academy Press, and the demographic estimation methodology developed for the country studies is laid out in a volume issued by the United Nations. Altogether, come 170 population specialists, including 94 from developing countries, have been involved in the work of the committee as members of panels or working groups. The committee, the commission, and the National Research Council are grateful for the unpaid time and effort these experts have been willing to g ive. The committee initiated work on the third task in October 1979 when the separately funded Panel on Fertility Determinants was established. Research on the determi- nants of fertility change has been carried out by scholars from several disciplines, and there is no comprehensive accepted theory of fertility change to guide the evalua- tion. Because of this state of knowledge of the causes of reductions in fertility and the difficulty of the task, the Panel on Fertility Determinants includes scholars from anthropology, demography, economics, epidemiology, psychology, sociology, and statistics. Three committee members serve on the panel. The work program of the panel includes the preparation of a report that attempts to summarize and integrate scientific knowledge about the xvi

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determinants of fertility "Academic Press, 1983) as well as a few illustrative cross-national analyses and studies of several developing countries (see inside back cover). This report is the fourth panel country study. It has been prepared by Thomas W. Merr ink, director, Center for Population Research, Georgetown University, and Elza Be~quo, research scholar, Centro Brasileiro de Analise e Planejamento, Sao Paulo, Brazil, and a member of the panel. Although it is self~contained, the study is in part a companion ho the report of the committee's Panel on Brazil, Levels and Recent Trends in Fer Utility and Mortality in Brazil, published earlier this year, which examines some of the demographic estimates that are incorporated in this report. Thomas Merrick served as a member of the Panel on Brazi 1. The work on this study we'; carried out at Georgetown University and at the Centro Bras~leiro de Analise e Planejamento. During its preparation, each author spent time at the other's institution and at the committee office. Both of the authors' institutions provided logistical support, and, more important' each institution essentially supported each author during the time they devoted to the preparation of thin report. The panel and the committee are grateful to these institutions for all of this support. Partial f inancial support for research assistance and computer use also was provided through an award from the Rockefeller and Ford Foundations' Research Program on Fertility, Mortality, and Development Interrelations. For Part ~ of this report, Mahesh Sharma provided capable programming and statistical assistance, and Pamela Nall made valuable contributions to the preparation of tables and in typing mater ial for the repot t. For Par t }I, Marcelo Cesar Gouveia and Ivaldo Olimpio da Silva assessed an programming, Rebecca de Sousa e Silva provided statistical assistance in preparing tables, and Oneida Maria Borges deserves credit for typing draft material for the report. Jose Alberto Magno de Carvalho, Hania Zlotnik, and Leo Morris provided comments and technical advice at various stages. Brazil's IPPF aff iliate, BEMFAM, and the U. S. Centers for Disease Control were particularly helpful in providing information and advance copies of tables from the Contraceptive Prevalence Surveys cited in the report. An early version of the draft report was discussed at a country studies workshop organized by the panel in . Hi i

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January 1982 with f inancial assistance from the Rockefeller Foundation. Finally, panel and co''unittee reviewers provided advice and suggestions. Several members of the panel and committee staff assisted in the preparation of this report. On the production side appreciation is expressed to Elaine McGarraugh of the panel staff for handling the production edi ting details, to Solve ig Padilla and Irene Mar tines for helping type the text and tables, and to Ron a Briere f or edi ~ ing then repor t. WO PARKER MAULDTN' Chair Panel on Fertility Determinants . . XY1\ 1 \