Populations

As Populations completes its inaugural volume, we pause to reflect on what has been achieved during the journal’s formative year and anticipate the intellectual directions that will shape its next phase [...]

Infertility affects 10–30% of couples globally, with significant psychological and social impacts in sub-Saharan Africa, where fertility is closely tied to identity and social status. To explore how couples’ understanding of infertility causes influences their treatment-seeking behaviours and healthcare decision-making processes in Ghana, this cross-sectional qualitative study used in-depth interviews with 24 married participants (nine dyads and six individuals) experiencing current or past infertility in Greater Accra, Ghana, from August to October 2023. Data were analysed using thematic analysis with NVivo version 15. Couples demonstrated comprehensive knowledge of infertility causes spanning medical, spiritual, cultural, and lifestyle factors, although they lacked knowledge of clinical diagnostic criteria. Three main treatment pathways emerged: medical/orthodox, herbal, and spiritual interventions, pursued either sequentially or concurrently. Decision-making was influenced by internal factors (treatment effectiveness, financial constraints, and safety concerns) and external factors (family influence and peer testimonials). Four distinct navigation strategies were identified: informed notification, trial periods and evaluation, parallel relationship management, and strategic sequencing. Couples experiencing infertility are sophisticated healthcare consumers who skilfully navigate pluralistic healthcare systems through strategic decision-making. Rather than representing non-compliance, their multimodal approaches reflect rational responses to structural constraints and cultural values. Healthcare systems should recognise and accommodate these navigation strategies to improve therapeutic relationships and outcomes.

Recent policy reports and state briefs continue to highlight the trend of out-migration from California. This outflow has been pronounced over the last three years, revealing a substantial net loss (i.e., net migration) of approximately 740,000 residents. However, there has been comparatively less emphasis on new residents moving to California. Over the past decade, California has attracted substantial in-migration from both domestic and international sources with annual inflows often exceeding 300,000 individuals. As such, studying in-migration is noteworthy as it shapes economic, political, and social landscapes. In-migration can alter the demographic profiles of regions, thereby impacting community dynamics, cultural diversity, and the provision of social services. Using pooled data from the American Community Survey (ACS) from 2021 to 2023 and employing a two-way fixed effects regression framework, I study how temporal changes in racial and ethnic composition, age structure, educational attainment, and economic indicators influence in-migration rates per 1000 residents at the public use microdata level (PUMA). The analysis reveals that higher proportions of Asian and Hispanic populations, as well as an increased share of college-educated residents, are positively associated with in-migration. Notably, higher supplemental poverty rates are also associated with greater in-migration, a counterintuitive finding that may reflect mobility toward affordable housing markets. These findings emphasize the importance of recognizing demographic and intra-regional variability, which can aid policymakers and planners in assessing and delivering public services.