Analysis reveals global challenges may influence reproductive health outcomes and public health interventions affecting the secondary sex ratio.
The secondary sex ratio (SSR), defined as the ratio of male to female live births in a population, is a crucial indicator of reproductive and public health. External factors, such as lifestyle, natural disasters, environmental chemicals and infections, have been examined as potential trendsetters of the SSR. Several global challenges have emerged in recent years, such as climate change, wars, terrorist attacks and stressful political events. These aspects can potentially impact reproductive health outcomes, fertility rates, and the overall well-being of individuals. With respect to this, they may also affect the SSR. Through an in-depth examination of the existing literature, this manuscript elucidates the complex interconnections between global challenges and the SSR. Indeed, terrorist attacks and stressful political events have been linked to a decrease in the SSR. In contrast, high temperatures and warfare have shown a propensity to elevate the SSR in numerous scenarios. However, these associations require further validation through additional studies. The precise mechanisms through which these determinants exert their influence need to be elucidated. Understanding the unseen influences of global challenges on the SSR is crucial for understanding population trends and ensuring effective public health interventions.
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Axarloglou et al. (2025) studied this question.
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