Abstract

In many demographic behaviors (e.g., those relating to marriage, contraception, migration, and health), people change among multiple statuses through time, sometimes leaving and then returning to the same status. Data on such behaviors are often collected in surveys as censored event histories. The multistate life table (MSLT) can be used to properly describe, in a single analysis, these complex transitions among multiple states measured in such data, but MSLT is rarely applied in the demographic literature because practical guidance is lacking on how to compute MSLTS with such data. We provide methods for computing MSLT quantities using censored event-history data: namely, transition intensities and probabilities, “state occupancy” probabilities and standard errors, average time spent in specified states, and average number of visits to specified states. Applying these methods to contraceptive use, we find high levels of switching back and forth, particularly between barrier methods and non-use, resulting in high rates of unintended pregnancy.

This content is only available as a PDF.

References

Aalen, O., & Johansen, S. (
1978
).
An Empirical Transition Matrix for Non-homogeneous Markov Chains Based on Censored Observations
.
Scandinavian Journal of Statistics
,
5
,
141
50
.
Abma, J., Chandra, A., Mosher, W., Peterson, L., & Piccinino, L. (
1997
).
Fertility, Family Planning, and Women’s Health: New Data From the 1995 National Survey of Family Growth
Vital Health Statistics
.
Hyattsville, MD
:
National Center for Health Statistics
.
Anderson, P.K., Borgan, O., Gill, R.D., & Keiding, N. (
1993
).
Statistical Models Based on Counting Processes
.
New York
:
Springer
.
Anderson, P.K., & Keiding, N. (
2002
).
Multistate Models for Event History Analysis
.
Statistical Methods in Medical Research
,
11
,
91
115
. 10.1191/0962280202SM276ra
Chiang, C.L. (
1968
).
Introduction to Stochastic Processes in Biostatistics
.
New York
:
John Wiley & Sons, Inc.
.
Commenges, D. (
1999
).
Multistate Models in Epidemiology
.
Lifetime Data Analysis
,
5
,
315
27
. 10.1023/A:1009636125294
Cox, D.R. (
1972
).
Regression Models and Life Tables (With Discussion)
.
Jurnal of the Royal Statistical Society Series B
,
34
,
187
220
.
Datta, S., & Satten, G.A. (
2001
).
Validity of the Aalen-Johnson Estimators of Stage Occupation Probabilities and Nelson Aalen Integrated Transition Hazards for Non-Markov Models
.
Statistics and Probability Letters
,
55
,
403
11
. 10.1016/S0167-7152(01)00155-9
Fix, E., & Neyman, J. (
1951
).
A Simple Stochastic Model of Recovery, Death, and Loss of Patients
.
Human Biology
,
23
,
205
41
.
Gill, R.D. (
1992
).
Multistate Life-tables and Regression Models
.
Mathematical Population Studies
,
3
,
259
76
. 10.1080/08898489209525345
Grady, W.R., Billy, J.O.G., & Klepinger, D.H. (
2002
).
Contraceptive Method Switching in the United States
.
Perspectives on Sexual and Reproductive Health
,
34(3)
,
135
45
. 10.2307/3097712
Grady, W.R., Hayward, M.D., Billy, J.O.G., & Florey, F.A. (
1989
).
Contraceptive Switching Among Currently Married Women in the United States
.
Journal of Biosocial Science
,
11
,
117
32
.
Guo, G. (
1993
).
Event-History Analysis of Left-Truncated Data
.
Sociological Methodology
,
23
,
217
43
. 10.2307/271011
Hammerslough, C.R. (
1984
).
Characteristics of Women Who Stop Using Contraceptives
.
Family Planning Perspectives
,
16
(
1
),
14
18
. 10.2307/2135118
Hougaard, P. (
1999
).
Multi-state Models: A Review
.
Lifetime Data Analysis
,
5
,
239
64
. 10.1023/A:1009672031531
Hougaard, P. (
2000
).
Analysis of Multivariate Survival Data. Statistics for Biology and Health
.
New York
:
Springer
.
Islam, M.A. (
1994
).
Multistate Survival Models for Transitions and Reverse Transitions: An Application to Contraceptive Use Data
.
Journal of the Royal Statistical Society
,
157
,
441
55
. 10.2307/2983530
Kaplan, E.L., & Meier, P. (
1958
).
Nonparametric Estimation From Incomplete Observations
.
Journal of the American Statistical Association
,
53
,
457
81
. 10.2307/2281868
Koo, H.P. 1995. “Who Chooses Norplant and Why?” Paper presented at the annual meeting of the Population Association of America, April 6–8, San Francisco.
Laditka, S.B., & Wolf, D.A. (
1998
).
New Methods for Analyzing Active Life Expectancy
.
Journal of Aging and Health
,
10
,
214
41
. 10.1177/089826439801000206
Land, K.C., Guralnik, J.M., & Blazer, D.G. (
1994
).
Estimating Increment-Decrement Life Tables With Multiple Covariates from Panel Data: The Case of Active Life Expectancy
.
Demography
,
31
,
297
319
. 10.2307/2061887
Land, K.C., & Rogers, A. (
1982
).
Multidimensional Mathematical Demography
.
New York
:
Academic Press
.
Lièvre, A., Brouard, N., & Heathcote, C. (
2003
).
The Estimation of Health Expectancies From Cross-Longitudinal Surveys
.
Mathematical Population Studies
,
10
,
211
48
. 10.1080/713644739
Meira-Machado, L., De Una-Alvarez, J., & Cadarso-Suarez, C. (
2006
).
Non-Parametric Estimation of Transition Probabilities in a Non-Markov Illness-Death Model
.
Lifetime Data Analysis
,
12
,
325
44
. 10.1007/s10985-006-9009-x
Meira-Machado, L., De Una-Alvarez, J., Cardarso-Suarez, C., & Anderson, P.K. (
2006
).
Multistate Models for the Analysis of Time to Event Data. Research Report
.
Denmark
:
Department of Biostatistics, University of Copenhagen
.
Namboodiri, K., & Suchindran, C.M. (
1987
). Winsborough, H.H.
Life Table Techniques and Their Applications. Studies in Population
.
Orlando, FL
:
Academic Press
.
Palloni, A. (
2000
).
Increment-Decrement Life Tables
. In Preston, S.H., Heuveline, P., & Guillot, M. (Eds.),
Demography: Measuring and Modeling Population Processes
(pp.
256
72
).
Oxford, England
:
Blackwell
.
Putter, H., Fiocco, M., & Geskus, R.B. (
2007
).
Tutorial in Biostatistics: Competing Risks and Multistate Models
.
Statistics in Medicine
,
26
,
2389
430
. 10.1002/sim.2712
Rajulton, F. (
1992
).
Life History Analysis in Demography: Implications for Teaching and Research
.
Canadian Studies in Population
,
19
(
1
),
1
16
.
Rajulton, F. (
2001
).
Analysis of Life Histories—A State Space Approach
.
Special Issue on Longitudinal Methodology—Canadian Studies in Population
,
28
,
341
59
.
SAS OnlineDoc 9.1.3
. (
2006
).
Cary, NC
:
SAS Institute Inc.
.
Schoen, R. (
1975
).
Constructing Increment-Decrement Life Tables
.
Demography
,
12
,
313
24
. 10.2307/2060768
Schoen, R. (
1988
).
Modeling Multigroup Populations
.
New York
:
Plenum
.
Singer, B., & Spilerman, S. (
1976
).
The Representation of Social Processes by Markov Models
.
American Journal of Sociology
,
82
(
1
),
1
54
. 10.1086/226269
Trussell, J., & Vaughan, B. (
1999
).
Contraceptive Failure, Method-Related Discontinuation and Resumption of Use: Results From the 1995 National Survey of Family Growth
.
Family Planning Perspectives
,
31
(
2
),
64
72
. 10.2307/2991641