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Topic 4 – Population Policy. A – Fertility Policies B – Mortality Policies. A. Fertility Policies. 1. Population Policy 2. Fertility Enhancement 3. Fertility Decline 4. Family Planning 5. Missing Female Population. 1. Population Policy. Context Fairly recent phenomenon.

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topic 4 population policy

Topic 4 – Population Policy

A – Fertility Policies

B – Mortality Policies

fertility policies

A

Fertility Policies
  • 1. Population Policy
  • 2. Fertility Enhancement
  • 3. Fertility Decline
  • 4. Family Planning
  • 5. Missing Female Population
population policy

1

Population Policy
  • Context
    • Fairly recent phenomenon.
    • Few nations had formal population policies prior to the 1950s:
      • Developed and developing world alike.
      • India was the first country to have a family planning policy in 1951.
      • Still today the place where the needs are among the most urgent.
    • Became an issue with the population explosion.
    • The world undertook a reproductive revolution.
    • About 80% of the population of developing countries is subject to population policies.
    • Most of them are words without meaning.
population policy1

1

Population Policy
  • Definition
    • Official government strategy.
    • Set of guidelines specifically intended to affect:
      • Size of the population.
      • Rate of growth of a population: fertility (enhance or reduce).
      • Distribution.
      • Composition (ethnic).
  • Population program (direct policies)
    • Means to make to policy operational.
    • Public or private initiatives.
    • Services, information, persuasion or legitimation.

Government

Policy

Intentional

Program

Impacts

Population

population policy2

1

Population Policy
  • Indirect policies
    • Economic and social programs can have an impact on population.
    • Taxation (credits and deductions for children).
    • Health and education.
    • Welfare.
  • Migration
    • Either promote emigration or immigration.
    • Often related to the labor market.
    • Becoming a very sensitive issue in several developed countries:
      • The United States and Europe facing migration pressures.
population policy4

1

Population Policy
  • Labor force
    • Population in age of working:
      • On average between 15-65.
    • Composition and quality are two major concerns.
    • Substantial changes forthcoming:
      • More workers and they will be better educated.
      • More minorities and more women.
      • Older retirement age.
  • Size of the labor force
    • Size of the working age population:
      • Determined by the population’s age structure.
      • How many people fall between the ages of 15 and 65.
    • Rate of labor force participation:
      • Participation rates are affected by many factors.
      • The role of women in the society in general.
fertility enhancement

2

Fertility Enhancement
  • Pro-natal policies
    • Exist in many European nations currently experiencing population decline or ZPG.
    • Policies:
      • Generous welfare benefits.
      • Liberal maternity / paternity leave programs.
      • Substantial investment in child day care facilities.
      • Free education through University level.
    • Sweden:
      • 12 months maternity leave.
      • At least 1 month paternity leave.
      • Payments of $160 per month through age 16 (1st and 2nd child).
      • $240 per month (3rd and 4th child).
fertility decline

3

Fertility Decline
  • Context
    • Lower the number of new children.
    • Policies and programs oriented toward fertility decline have been increasingly common during the past 30 years.
    • Controlling population growth is often a politically controversial issue.
    • Third World Nations:
      • Attained the 3rd stage of the Demographic Transition.
      • The promotion of birth control policies for Third World nations has often been viewed as racist.
family planning1

4

Family Planning
  • Concept
    • Designed to help families achieve a desired size.
    • 1/3 of the population growth in the world is the result of incidental or unwanted pregnancies.
    • 210 million pregnancies in the world per year, of which 100 million are unwanted pregnancies (47%).
    • 46 million abortion per year.
    • 500,000 women die each year from unsafe abortions.
    • 49% of pregnancies in the US are unwanted.
    • If women could have only the number of children they wanted, the TFR in many countries would fall by nearly to 1.
family planning2

4

Family Planning
  • Contraceptive use
    • Significant increase in the 1960s and 1970s.
    • From 10% to 50% in the 1990s.
  • Traditional methods
    • Abstinence.
    • Withdrawal.
    • Douche.
  • Modern methods
    • Oral contraceptives.
    • Intra Uterine Devices (IUD; e.g. diaphragm)
    • Injectables and implants.
    • Male and female condoms.
    • Spermicides.
    • Emergency contraception (day after pill).
    • Voluntary sterilization.
    • Abortion.
family planning3

4

Family Planning
  • US view on family planning
    • Contributes between 40 and 50% of international FP aid.
    • Characterized by paradoxes:
      • Between the religious ethics of the leaders and a liberal urban society.
    • Strongly supportive of FP in the 1960s and 1970s.
    • Change in the 1980s:
      • Reagan stopped support to the United Nations Population Fund.
      • Revoked by Clinton in 1993.
    • Current policies:
      • Anti-abortion and increasingly anti-family planning (anti-contraception) domestic policies.
      • Promote a conservative moral and religious agenda.
      • First action of President Bush in 2001 was to ban funding to international agencies promoting abortion (and thus FP).
      • Growing violence against family planning and abortion clinics.
family planning4

4

Family Planning
  • Controlling population growth
    • Natural increase:
      • Biggest factor in population growth in most countries.
      • Reducing this component will require substantial progress in social and economic development.
    • Empowerment of women:
      • Guarantee of their human rights:
        • No jobs, no education, no money,
        • Equal access to nutrition, health care and education
        • Unable to own land or inherit property
      • Right to reproductive and sexual health.
    • Reproductive health services:
      • Family planning.
      • Contraception.
      • Abortion.
family planning5

4

Family Planning
  • Family Planning programs
    • Still considerable unmet demand for reproductive health services.
    • Require financing.
    • Must be equitable:
      • Disparity between accessibility to the poor and the wealthy.
      • Better access in cities.
    • Fertility levels among the poor are generally higher:
      • In rural areas, unwanted fertility reduces the ability to provide for the children.
      • Put stress on local resources and local environments.
      • Help push people into migration.
family planning6

4

Family Planning
  • Efficient Family planning activities
    • Strong government support.
    • Must be medically, economically and culturally acceptable.
    • Counseling ensures informed consent in contraceptive choice.
    • Provision of contraceptives.
    • Training of staff and education of public.
    • Monitoring the results.
    • Research for new or improved methods.
    • Privacy and confidentiality are ensured.
  • Impact
    • Much evidence to support the idea that family planning programs have been having a great affect.
    • Economic development and socioeconomic transformations are a necessary precondition for family planning programs to have an impact?
family planning7

4

Family Planning
  • Family planning in the United States
    • Birth control use:
      • 20% of sexually active U.S. teens reported using no birth control
      • 4% in Great Britain, 6.5% in Sweden, 12% in France and 13% in Canada.
      • Between 50% and 70% of girls in other countries used birth control pills, only 32% did so in the United States.
    • Different attitudes of developed countries:
      • Accepting attitude about teen-age sexual relationships.
      • Clearer expectations for responsible sexual behavior.
      • More accessible reproductive health services.
      • The U.S. is the only country with a formal policy promoting abstinence only.
      • One-third of school districts teaching sex ed mandate as an abstinence-only program.
missing female population

5

Missing Female Population
  • Missing female population
    • About 100-135 million females are missing from the world population.
    • Normal ratio at birth is about 100 girls to 105 boys.
    • Boys are weaker and the ratio evens out after 5 years.
    • Since 1900 the ratio has been declining, especially after 1990.
    • Particularly the case for China and India (0-4 age group):
      • China accounts for about 60 million missing females; India for 25 million.
      • 1990: 110 boys per 100 girls.
      • 1995: 118 boys per 100 girls.
      • 2000: 119 boys per 100 girls.
      • Ratios even higher for second and third child.
    • Problems exacerbated by declining fertility and growing standards of living.
missing female population1

5

Missing Female Population
  • Missing female population in India
    • Sex determination tests outlawed (1994):
      • Nobody ever convicted of infringing the law.
      • Ultrasound for “abdominal cyst”: 500 rupees ($11).
      • Abortion: 2,000 rupees ($44).
    • 25% of all female deaths between the age 16 and 24 are due to “accidental burns”.
    • Between 5,000 and 12,000 “dowry deaths” per year.
    • Sex ratio is still declining:
      • 962 girls for 1000 boys (1981).
      • 945 girls for 1000 boys (1991).
      • 927 girls for 1000 boys (2001).
      • Can go as low as 770 in some regions.
missing female population2

5

Missing Female Population
  • Gender roles and the missing female population
    • Sons are perceived as an asset:
      • Farm work.
      • Security for old age (no social security in several countries).
      • Take over the family name.
      • Sons get better health care, food and schooling.
      • 100% of them must find a bride and produce an heir.
      • In China, the birth of a boy is labeled as “big happiness” while the birth of a girl is labeled as “small happiness”.
    • Daughters are perceived as a liability:
      • Marry and leave home to provide labor to another family.
      • Dowries are often to be paid.
missing female population3

5

Missing Female Population
  • Causes of the missing female population
    • High female mortality in infancy or childhood:
      • Preferential treatment for boys; better food and health care.
      • Infanticide.
    • Excess female mortality in utero:
      • Sex-selective abortion.
      • 500,000 and 750,000 unborn Chinese girls are aborted every year after sex screening.
    • Net out-migration of female children:
      • International adoptions.
      • Abandon; Orphanage are strictly populated by girls.
      • In some cases 90% of the girls in orphanages will die.
    • Sex-selective undercount of children:
      • Daughters are not declared.
      • No education provided by the state.
      • “Sold” / “rented” as a factory worker, wife or prostitute.
missing female population4

5

Missing Female Population
  • Consequences of the missing female population
    • Demographic “backlash”:
      • May help achieve demographic stability.
      • Fast decline in fertility.
      • Fast decline of population growth and then of absolute population.
    • Social consequences:
      • Limit the advancement of women in society.
    • The “value” of females will increase considerably in the future:
      • Millions of men will not be able to find a wife.
      • Changes in the economics of marriage.
      • Inverted dowry; “Bride prices” are becoming more common (about $4,000 in China).
      • Daughters increasingly an asset for industrial work.
mortality control

B

Mortality Control
  • 1. Context
  • 2. Major Epidemics
  • 3. Human Health
  • 4. Genocide
context

1

Context
  • Mortality control
    • Goal of most governments.
    • Seek to improve the health standards and life expectancy of their populations.
    • Expenditures for such health programs are often diminished by conflicting priorities for limited government funds:
      • Health programs lose out to military spending.
      • Grandiose infrastructure development programs whose benefits accrue to a small minority of the overall population.
      • Surveys have shown that small investments over the most threatening causes of death lead to significant increase in health.
    • More accepted (culturally and socially) than fertility control.
context1

1

Context
  • Health
    • Key component of human development.
    • Broad indicators of human health show that significant progress has been made over the past few decades.
    • Globalization has enabled new threats of diffusion.
    • Conditions in many Third World countries remain difficult, especially for the poorest groups.
    • Health conditions in Third World countries are not necessarily related to climate, but mostly to poverty.
  • Density issues
    • Human densities favor the diffusion of diseases.
    • Strong urbanization can be linked with declining health conditions.
context2

1

Context
  • Endemic
    • Many diseases exists in a state of equilibrium within a population.
    • Many develop an immunity.
    • Saps energy, lowers resistance, shortens lives.
  • Epidemic
    • Sudden outbreak at local, regional scale.
    • Generally short lived.
  • Pandemic
    • Worldwide spread.
major epidemics

2

Major Epidemics
  • Black Death
    • Europe, 14th century (the Plague)
    • Bacteria originating in Asia.
    • Moved through the trade routes.
    • Entered Europe in 1347.
    • Transmission by rats and coughing and sneezing.
    • 90% death rate of those infected.
    • 25 million deaths; 25-33% of the European population.
    • 75 million deaths in Eurasia out of a population of 300 million.
major epidemics1

2

Major Epidemics
  • Smallpox
    • New World, 16th Century.
    • Virus introduced by Spanish conquistadors and European colonists.
    • Spread through respiratory system and physical contact.
    • Between 10 and 20 million killed.
    • Decimation of the Inca, Aztec and Native American civilizations.
    • Was officially eradicated in 1977.
major epidemics2

2

Major Epidemics
  • Influenza
    • Global, 1918-1919 (Spanish Flu).
    • Virus brought by troops.
    • Spread through transport routes all over the world.
    • Transmission through respiratory channels.
    • Between 25 and 40 million killed (1.2-2.2 % of the global population).
    • WWI (1914-1918) killed 9 million people.
major epidemics3

2

Major Epidemics
  • HIV/AIDS
    • Global (Pandemic), 1980 to present.
    • Originated in Africa.
    • Mutation of a primate virus to infect humans.
    • Transmission by body fluids.
    • 28 million deaths so far.
    • 68 million infected (0.5% of the global population).
    • 14,000 new infections per day.
    • More than 20% of the population infected in several African countries.
global estimates of cumulative hiv aids infections and deaths worldwide 1980 2002 in millions

2

Global Estimates of Cumulative HIV/AIDS Infections and Deaths Worldwide, 1980-2002 (in millions)
place of death 2001

3

Place of Death, 2001
  • Deaths per year
    • 56 million deaths.
    • 12 million in developed countries.
    • 44 million in developing countries.
    • In the poorest regions, 1 in 5 children will die before their 5th birthday.
  • Contribution to mortality (world)
    • Tobacco use : 6% (4 million).
    • Hypertension: 5.8%.
    • Inadequate water and sanitation: 5.3%.
    • STDs: 2.2%.
    • Alcohol use: 1.5%.
  • Contribution to mortality (USA)
    • Smoking: 18%
    • Poor diet and physical activity: 17%
    • Alcohol-related: 4%
human health

3

Human Health
  • Major infectious diseases (2001)
    • Respiratory infections:
      • 3.9 million deaths.
      • Pneumonia affects mainly children under 5.
      • Mainly linked to deteriorating air quality.
    • Tuberculosis:
      • 1.6 million deaths.
      • 30% of humanity carry the TB bacteria.
      • Growing resistance to antibiotics.
    • Diarrheal diseases:
      • 2.0 million deaths.
      • Improper sanitation of drinking water.
      • Mainly affect young children.
    • AIDS:
      • 2.8 million deaths (see case study 3).
human health1

3

Human Health
    • Malaria:
      • 1.1 million deaths.
      • Growing because of resistance to antimalarial drugs and to insecticides.
      • Related to mosquito prevalence.
      • Linked to urban areas (stagnant water).
  • Obesity
    • 300 millions adults obese in the world (“Globesity”)
    • Increase risk of heart attack, stroke, diabetes and cancer:
      • Could reduce life expectancy by 2 to 5 years.
    • United States:
      • About 97 million adults, or 55% of people over 20, are overweight or obese.
      • $33 billion a year on weight-loss products and services.
      • $70 billion estimated annual health-related costs of treating obesity.
human health2

3

Human Health
  • Environmental factors
    • 25% of deaths related to environmental factors.
    • 1.4 billion people exposed to polluted air:
      • Relationship between air pollution and hearth attacks.
    • Urbanization.
    • Infectious and parasitic diseases:
      • Accounted for 43% of the 40 million deaths in developing countries.
      • Almost 40% were due to chronic diseases such as circulatory diseases, cancers and respiratory diseases.
      • Mosquito is public enemy number 1.
genocide

4

Genocide
  • Definition
    • Killed more people than war.
    • Intent to destroy, in whole or in part, a national, ethnical, racial or religious group as such (UN 1948 Convention).
    • Killing members of the group, causing serious bodily or mental harm to its members.
    • Deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part.
    • Forcibly transferring children of the group to another group.