Re: 'the association between living through a prolonged economic depression and the male:female birth ratio-A longitudinal study from cuba, 1960-2008' and 'invited commentary: Natural versus unnatural sex ratios-a quandary of modern times'

摘要

The heightened boy/girl birth ratio in Cuba in the mid-1990s, reaching 1.18 in 1996 before falling back below 1.08 by 2001, was not due to sex-selective abortion as Wilcox and Baird (1) wondered in their commentary on the paper by Fernandez et al. (2). It was indeed due to economic depression in Cuba, but not through its impact on any biologic process as claimed by Fernandez et al. (2). The causal process was ordinary but tells of the ways of our world. The immediate cause was a lack of glue. I can explain.Russia's breaking of economic trade agreements with Cuba in 1990 was followed by a tightening embargo on trade from the US government. The impact of the resulting "special period" of severe economic hardship was discussed well by Fernandez et al. (2). The worst impacts on Cuban health outcomes were avoided, but the plummeting trade also had an impact on the administrative and statistical infrastructure of the Cuban health service. As one specific example, there were insufficient funds to continue to import a gummed 2-page form that accurately replicated writing onto a copy. This form had been used to record birth details in hospitals, where over 99% of births in Cuba occurred throughout this period.