The Congo Needs to be on Our Radar Screen

Uganda is opening up new camps for refugees from violence in the Democratic Republic of the Congo, according to BBC News. Violence is not a new thing in DR Congo, of course, but neither does it show any sign of going away.

Tens of thousands of Congolese have fled over the years - and the country is struggling to recover from the civil conflict that claimed an estimated three million lives.
The BBC's Ignatius Bahizi visited the camps where 6,000 people have arrived since July. Recent arrivals told him of killings, abductions and rape by unknown armed men.
The UN's refugee agency says the recent movement of people is "not a massive flight yet".
"It is not so much the number but the fact that they are not safe in their country and that they need assistance," UNHCR's Fatoumata Lejeune-Kaba told the BBC.

The reason that this instability is important to all of us is that the population in the DR Congo is growing at an explosive rate. The UN Population Division estimates that the 70 million people currently living there (which makes it already the 18th most populous country in the world), will double to 150 million by 2050, surpassing the population of Mexico by that time. Yet, what do most of us know about this emerging demographic behemoth? Not much.

DR Congo is rich in minerals such as gold, diamond and coltan, which is used in mobile phones.
But years of conflict and mismanagement mean it recently came bottom of a survey of living standards around the world.

I guarantee you that a resource-rich country that is nonetheless desperately poor and rapidly increasing in its population cannot stay off our radar screen for very long.

Demographic Squeeze in Belize

My son, Greg, and I have discussed the concept of a "demographic fit" as it relates to the dents in the age structures of rich countries being filled in by migrants from the bulges in the age structures in developing countries [check out our book on Irresistible Forces for more details]. The Economist reports on an emerging situation in Belize that sounds more like a demographic squeeze than a fit. 

BELIZE has long been a country of immigrants. British timber-cutters imported African slaves in the 18th century, and in the 1840s Mexican Mayans fled a civil war. More recently, North American sun-seekers and retired British soldiers have discovered its coast. Light- and dark-skinned men stand side by side on the country’s flag.The latest migration is from elsewhere in Central America. Thousands of Salvadoran refugees arrived in the 1980s. More recently, Guatemalans have come seeking land. Of Belize’s 300,000 people, 15% are foreign-born. Thanks to higher birth rates, mestizos have overtaken creoles (of mixed African ancestry) to become the biggest group, making up half the population.

Belize has always been a bit of an outlier in the region--a predominantly English-speaking country sandwiched along the Caribbean coast next door to Mexico, Guatemala, and Honduras, with El Salvador not far away. The country is about the same geographic size as El Salvador but has only about 300 thousand people, compared to El Salvador's 6 million, Guatemala's 14 million, Honduras's 8 million, and of course, Mexico's 114 million. Belize has a slightly lower TFR than either Guatemala or Honduras, and a higher life expectancy than those neighbors. But, like its neighbors, it has a young age structure and its long-term net outmigration rate suggests that its residents are not always able to find work at home. 

Migrants are also redrawing the map of the country. While in the rest of Central America people are moving from the countryside to cities, since 2000 the urban share of Belize’s population has fallen from 47% to 44%, as immigrants have set up border towns. In Cayo 7,000 new households have sprung up. Many are in Salvapan, a Salvadorean district complete with tortilla shops on the edge of the capital. It is likely to grow further: land stretching miles into the jungle has already been divided into lots.The population boom brings relief and strain. Most migrants are of working age, and keep the sugar, banana and citrus industries competitive by toiling for low wages in harsh conditions. But with almost a quarter of Belizeans telling census officials they are unemployed, not all locals welcome the new arrivals. And as Spanish becomes more important, monolingual creoles are losing service jobs.
Along the border, Guatemalans poach game and plants from Belize’s national parks. Last month Belizean soldiers killed a Guatemalan while he harvested palm leaves. The state has had to build roads to remote migrant outposts in the jungle.

So, the picture really looks like one in which Belize's neighbors are spilling over, quite literally, into it. Their demographic pressure is able to let off a little steam by squeezing into Belize. It's not  guaranteed that this will have a happy ending.

Re-Imagining American Suburbs

Since I'm in New York City, I went today to MOMA (the Museum of Modern Art) to see a new exhibit that explores how suburbs can be rethought in the wake of the housing bust and the subsequent foreclosures that have pounded the suburbs. This is a project from a team at Columbia University.

Foreclosed: Rehousing the American Dream is an exploration of new architectural possibilities for cities and suburbs in the aftermath of the recent foreclosure crisis. During summer 2011, five interdisciplinary teams of architects, urban planners, ecologists, engineers, and landscape designers worked in public workshops at MoMA PS1 to envision new housing and transportation infrastructures that could catalyze urban transformation, particularly in the country’s suburbs. Responding to The Buell Hypothesis, a research report prepared by the Buell Center at Columbia University, teams—lead by MOS, Visible Weather, Studio Gang, WORKac, and Zago Architecture—focused on a specific location within one of five “megaregions” across the country to come up with inventive solutions for the future of American suburbs.

The ideas underlying the project are drawn from SMART growth strategies that have been developed to stem the tide of urban sprawl. But this project also dips into important issues related to the demographic change in the structure of neighborhoods that needs to be taken into account. For example, the case of Cicero, Illinois, emphasizes the role of immigration from Mexico in changing the sociodemographic structure of this Chicago suburb. In fact, they even name the Mexican states of Jalisco, Colima, and Michoacan as being major sources of the area's residents. It's a complicated story, of course, but two things that I did not see in the exhibit (despite the apparent emphasis on their importance) were references to where jobs are and what transportation systems exist to get people from these re-imagined communities to their jobs--whatever and wherever they may be.

The Sludge Report

It is often complained, even in rich countries, that infrastructure has no constituency. We take for granted that someone is going to provide us with clean water and good sewerage and we give it little thought--except to perhaps complain about high taxes. But if we don't recognize that these amenities are not a natural-born right, they will deteriorate and our health and quality of living will suffer. There is no better example of what can happen, and how people try to respond to this, than cities of developing countries, where the tax base simply does not exist to provide infrastructure to the local population. A recent story about Accra, the capital of Ghana, in West Africa, illustrates this sad point.

Accra, Ghana, is a tropical capital on the Gulf of Guinea, but almost no one swims in the ocean here. If you are not turned off by the mounds of trash the ocean continuously heaves onto the beach, the water’s unnatural brownish color hints something is awry. The city’s open sewers empty straight into the ocean. And then, of course, there is Lavender Hill.
Every day, just past a lighthouse on Accra’s western edge, trucks dump more than 250,000 gallons of human feces directly onto the beach and into the ocean at Lavender Hill.

“That's over 100 trucks dumping continuously, day in and day out, where the sludge is channeled down the beach and into the sea,” says Ashley Murray, the 32-year old founder and CEO of Waste Enterprisers, a Ghana-based business with the mission to improve urban sanitation.
 In sub-Saharan Africa, Murray says, such practices are par for the course. More 85 percent of the human waste generated in Ghana and in sub-Saharan Africa is dumped into the environment without any treatment, according to the World Water Assessment Program. This results in an ongoing public health disaster: The World Health Organization reports that diarrheal disease amounts to an estimated 4.1 percent of the total global disease burden and is responsible for the deaths of 1.8 million people every year.

So, the government simply does not have the resources to deal with this problem. Can private industry fill the gap?

Instead of charging people to have their septic tanks and pit latrines emptied, Murray wants to pay them for the waste—or at least take it for free—then process or convert it into a product that will sell. She wants to reinvest some of the profits back into the sanitation sector. “We want to show that we can do good and be a profitable company,” Murray says.
So far, Waste Enterprisers, along with research and funding partners including Columbia University, the Gates Foundation, and the Swiss Federal Institute of Aquatic Science and Technology, has numerous plans to process human feces. They want to turn our crap into an industrial fuel used in cement kilns, turn stagnant sewage treatment ponds into profitable fish farms, and finally, build the world’s first ever fecal-sludge-to-biodiesel plant, which will be funded by the Bill and Melinda Gates Foundation.

It is still early days with this project, but we have to hope that this works and calls attention to the key role of infrastructure in creating a liveable, sustainable urban environment.

Republicans Coping (or not) with Undocumented Immigration

Greg Weeks has posted two excellent items on undocumented immigration in the past couple of days, and I can't do better than to direct you to them. The first looks at the truly incredible hypocrisy in the policies put forth by the leading contenders to be the Republican nominee for president. The second is a little "quiz" that deals with the idea that what goes around, comes around when you're talking about immigration from Mexico.

Trying to Get a Handle on Poverty in India

Poverty in India often gets overlooked in the West, where the emphasis tends to be on rising middle class in that country. Because of its size and continued population growth (India adds more people each day to the planet than any other country), it is possible to have both a rising middle class and a rising number of people below the poverty level. On February 23rd, the Population Reference Bureau is going to (or will have, depending upon when you are reading this) host an online web discussion about "What Does 'Poverty' Really Mean in India?" It will be hosted by PRB's senior demographer, Carl Haub. Here is the setup for the discussion:

The past few years have seen much hype regarding the economic progress in India, much of it extolling the country's "rising incomes" and "exploding" middle class. Entrepreneurs in the country seem to have believed this, resulting in an overbuilding of glitzy malls and the rapid expansion of the number of domestic airlines. Although there has been definite economic progress in India, who exactly benefits?
The number of people living in poverty is often ignored. India's official poverty measure has long been this: People below the poverty line have a daily diet of less than 2,400 kilocalories in rural areas and less than 2,100 kilocalories in urban areas.
What do measures of wealth such as "middle class" and "poverty" mean in India, compared to countries such as the United States or those in Europe? Estimates of the number of people in poverty in the country vary wildly, as Carl Haub wrote in a 2010 PRB web article with co-author O.P. Sharma, and even the slightest changes in the definition of poverty can change the number of the poor in India by millions. India is on track to become the world's largest country about 10 years from now, despite declining fertility. How will it manage the population growth in its very large and very poor states?

While this discussion is taking place, I'll be on a plane to New York City to attend the annual meeting of the Association of American Geographers, but those of us who miss it in real time can pick it up later on the PRB website.

Undocumented Immigrants Are Also Taxpayers

It is not uncommon for people to assume that undocumented immigrants to the US take more than they give when it comes to government services. Indeed, that is frequently the excuse for making sure that they are excluded from the receipt of local services. However, the American Immigration Council has generated a set of estimates suggesting that undocumented immigrants contribute a tremendous amount of taxes.

Collectively, these households paid $11.2 billion in state and local taxes.  That included $1.2 billion in personal income taxes, $1.6 billion in property taxes, and $8.4 billion in sales taxes.  The states receiving the most tax revenue from households headed by unauthorized immigrants were California ($2.7 billion), Texas ($1.6 billion), Florida ($806.8 million), New York ($662.4 million), and Illinois ($499.2 million).

These are potentially important calculations in states such as Alabama that have tried deliberately to get undocumented immigrants to "self-deport." For the time being, at least, the limited evidence available suggests that Hispanics have departed Alabama for other states in the US, rather than deporting themselves out the of the US. This at least keeps their tax revenue within the country. Remember that a large proportion of undocumented immigrants pay Social Security taxes on their earnings, but since their names are unlikely to match up with a valid Social Security number, those tax payments wind up in the Social Security Administration's "earnings suspense file"--which is essentially a government slush fund since those people will never be eligible to draw upon Social Security benefits.

The World According to Air Traffic

The nighttime lights satellite images from NOAA have provided powerful images of where people actually live in the world--at least those with access to electricity at night. I recently was pointed to a YouTube site in which air traffic in the world is modeled for a 24-hour period. This provides a glimpse of the demographic networking in those parts of the world with enough money to fly in planes. Check it out.

Trying to Balance Diet and Development

The UN's Food and Agriculture Organization (FAO) estimates that out of the seven billion humans alive right now, three billion of us are eating badly--one billion have too little to eat, another billion have enough calories but not good nutrition, and a third billion are malnourished in the sense that they eat too much and are obese. The Economist this week has a lengthy summary of the global situation, and it is neither a pretty nor a terribly hopeful picture.

Malnutrition is attracting attention now because the damage it does has only recently begun to sink in. The misery of lacking calories—bloated bellies, wasted limbs, the lethargy of famine—is easy to spot. So are the disastrous effects of obesity. By contrast, the ravages of inadequate nutrition are veiled, but no less dreadful.
More than 160m children in developing countries suffer from a lack of vitamin A; 1m die because they have weak immune systems and 500,000 go blind each year. Iron deficiency causes anaemia, which affects almost half of poor-country children and over 500m women, killing more than 60,000 of them each year in pregnancy. Iodine deficiency—easily cured by adding the stuff to salt—causes 18m babies each year to be born with mental impairments.
Malnutrition is associated with over a third of children’s deaths and is the single most important risk factor in many diseases. A third of all children in the world are underweight or stunted (too short for their age), the classic symptoms of malnourishment [note that these data come mainly from the Demographic and Health Surveys].

A major part of the problem is that nutrition is very complex and we humans are very good at preferring food that is not necessarily very good for us. To be sure, there are many projects underway to change the latter, especially, but it is not easy to imagine things changing very quickly.

Out-of-Wedlock Births Add Diversity to Households in the US

Today's New York Times leads with a story that draws on a report from Child Trends last November which itself draws especially upon birth data from the US National Center for Health Statistics. Among women under 30 in the US today, a majority of births are now to unmarried women.

Large racial differences remain: 73 percent of black children are born outside marriage, compared with 53 percent of Latinos and 29 percent of whites. And educational differences are growing. About 92 percent of college-educated women are married when they give birth, compared with 62 percent of women with some post-secondary schooling and 43 percent of women with a high school diploma or less, according to Child Trends.
Almost all of the rise in nonmarital births has occurred among couples living together. While in some countries such relationships endure at rates that resemble marriages, in the United States they are more than twice as likely to dissolve than marriages. In a summary of research, Pamela Smock and Fiona Rose Greenland, both of the University of Michigan, reported that two-thirds of couples living together split up by the time their child turned 10.

One of the lines in the story that really got to me was the following:

Amber Strader, 27, was in an on-and-off relationship with a clerk at Sears a few years ago when she found herself pregnant.

When she "found herself pregnant"? Hello, we know how this happens, and this is why methods of birth control need to be available to both men and women (and I'm not talking about the Bayer aspirin regimen). 

An important theme in the story is that women no longer need the financial support of men and so they are more readily able to manage on their own. I agree with that whole-heartedly, but we usually think of that in terms of women being able to delay or avoid having children who will set them back financially and in many other ways. Indeed, Melissa Harris-Perry was just today discussing on her new TV show the "side-effects" of birth control being the ability of women to get an education and have a career. 

Bayer Aspirin is NOT a contraceptive!

This falls under the category of you couldn't make this up: Today on MSNBC, Foster Friess (and, no, I'm not making up that name, either), who is a big financial supporter of Republican presidential hopeful Rick Santorum, said this to reporter Andrea Mitchell: 

"This contraceptive thing, my gosh, it's so... inexpensive. Back in my days, they used Bayer aspirin for contraceptives."
"The gals put it between their knees, and it wasn't that costly," he told MSNBC's Andrea Mitchell.Mitchell was visibly taken aback by the suggestion.
"Excuse me, I'm just trying to catch my breath from that, Mr. Friess, frankly," she said, after a pause.

This is perhaps a male chauvinist take on Nancy Reagan's idea that young people should "just say no" to drugs, violence and premarital sex. As Dr. Phil would say, "How's that working for you?"

Will You Still be Alive for Your 50th HS Reunion?

My wife and I were high school sweethearts and our 50th high school reunion is coming up this year. A member of the reunion committee just sent us a sobering list of classmates who had died since we all graduated from high school and our first reaction was shock at the number--43 out of a graduating class of 412--10 percent. Being a demographer, I then checked the life tables to see what we should have expected. The latest single-year-of-age life tables for the US are available from the National Center for Health Statistics of the US Centers for Disease Control. These data refer to 2007 and so the numbers will be very conservative because my classmates and I were born into a world with a lower life expectancy (71 years at birth) than prevailed in 2007 (81 years at birth). Our high school was predominantly white, so I have used the life tables for that group. It turns out that a white male graduating from high school in 1962 had a 21 percent chance of dying before that 50th reunion, while for females it was a 13 percent chance. Among our classmates, 12 percent of females have thus far died and that number is not statistically significant different from the expected value of 13 percent. However, among males, only 9 percent have thus far died (although one of them was murdered in a very high profile case), and that is statistically significant lower than expected. Of course, it may well be that more males have died and we just don't know about them--are males more likely to "disappear" from view than females? Perhaps. In all events, it was sobering to realize that the initial number of dead classmates was not higher than we should have expected.

Redistricting Will Change the Demographics of California's Congressional Delegation

For the first time in state history, California this year did its congressional (and state legislative) redistricting with an independent commission, rather than having the Legislature do it, as still happens in most states. The New York Times reports that the results appears to have been what voters actually wanted--a shakeup of the California congressional delegation--but with some unintended consequences.

California’s Congressional delegation, the largest and most influential in the nation, is undergoing a major upheaval, the result of reapportionment and retirements, threatening the state’s influence in Washington next year and forcing members to scramble to withstand what is emerging as a generational wave.A quarter of the state’s 53-member delegation to Washington could be newcomers in the new Congress, analysts said, the result of at least 6 members retiring and strong contests in 10 other districts. By contrast, only one seat changed hands between parties in the course of 255 Congressional elections in California over the past 10 years.

This is what voters had in mind in creating the independent commission through a ballot initiative two years ago, even if no one was contemplating a loss of clout for the state. Of some interest is the fact that the redistricting in California seems likely to benefit Democrats.

While the full impact of redistricting is beginning to clarify in California, to the benefit of Democrats, the national battle over the process — done every decade in all the states, based on the most recent census — continues to churn. There are several court battles over it, particularly in Texas, which at 32 members has the next biggest delegation and where elections have been put on hold as the courts rule on various conflicting maps.

Smart Growth Rides the New Demographics of the US

The concept of smart growth has been around for a long time, but got shoved to the background with the housing bubble that focused on building up new suburban areas. Smart growth may be making a comeback, however, as the San Diego Union reported today. The story followed up on the New Partners for Smart Growth Conference, held here in San Diego this past weekend. The paper interviewed Geoffrey Anderson, president and CEO of Smart Growth America:

Geoffrey Anderson: Smart growth is gaining traction, particularly if you look over a 15-to-20-year perspective. If you think back to the mid-’90s when cities were almost assumed to be dead — relics of a past age that were overtaken by the domination of auto-oriented suburbs — the contrast between that view of walkable neighborhoods, of smart growth and what we see today, is striking by any measure, and nowhere more so than how the market views it. There was a lot of skepticism among the private sector that this was something people wanted, and now it’s practically a given by a lot of the development community.Q: What’s driving this change?Anderson: We’d be fools to discount the impact of changing demographics. The difference between the 1960s, when half the households had kids and today’s (is that) it’s 30 percent and headed downward — you can’t overstate that difference in the population. We’ve built up a regulatory, financial and development infrastructure to serve that market. Look away for a second and it’s changed, and we forgot to change with it.
Q: Are NIMBYs (“not in my backyard” opponents to growth) totally in charge in neighborhoods?Anderson: The places people hate the most are abandoned brownfields ... and strip retail. They want something. This is one of the new phenomena we’re seeing. We’re seeing places generating YIMBYs (yes in my backyard) and I think it is because of our success in demonstrating the success of smart growth.

So, the big demographic driver of smart growth is seen to be household diversity, which is associated with the changing age structure, as noted by Bill Fulton, vice president of Smart Growth America:

The two biggest market drivers are retiring baby boomers (born between 1946 and 1964) and millennials (1979 to 2000). They’re bigger than any other portion.

Families Evolving--The Saga of Education and Marriage for Women

With the approach of Valentine's Day thoughts naturally turn to romance, and the New York Times has a good story by Stephanie Coontz tracing the evolution of marriage among educated women in the western world. We no longer live in a world where men are routinely better educated than men. Indeed, that worm has turned:

TODAY women earn almost 60 percent of all bachelor’s degrees and more than half of master’s and Ph.D.’s. Many people believe that, while this may be good for women as income earners, it bodes ill for their marital prospects.

She goes on to note that it was once true that intelligent, well-educated women had more limited marital opportunities than their less-educated cousins. But that is all changing.

The sociologist Christine B. Whelan reports that by 2008, men’s interest in a woman’s education and intelligence had risen to No. 4, just after mutual attraction, dependable character and emotional stability.The result has been a historic reversal of what the economist Elaina Rose calls the “success” penalty for educated women. By 2008, the percentage of college-educated white women ages 55 to 59 who had never been married was down to 9 percent, just 3 points higher than their counterparts without college degrees. And among women 35 to 39, there was no longer any difference in the percentage who were married.
ONE of the dire predictions about educated women is true: today, more of them are “marrying down.” Almost 30 percent of wives today have more education than their husbands, while less than 20 percent of husbands have more education than their wives, almost the exact reverse of the percentages in 1970.
But there is not a shred of evidence that such marriages are any less satisfying than marriages in which men have equal or higher education than their wives. Indeed, they have many benefits for women.

In particular, Coontz notes that educated women have a different idea in mind of the kind of man to marry than might have been true in the past.

The most important predictor of marital happiness for a woman is not how much she looks up to her husband but how sensitive he is to her emotional cues and how willing he is to share the housework and child-care. And those traits are often easier to find in a low-key guy than a powerhouse.

This personality-trait theme is also the centerpiece of a new book just published by Susan Cain called "Quiet: The Power of Introverts in a World that Can't Stop Talking." I am in the middle of reading it right now and thoroughly recommend it.

Problem at the US-Mexico Border is More About Drugs Than People

Over the past few years violence has escalated along the northern border of Mexico, in roughly the 200 mile zone south of the US-Mexico border. The violence has almost nothing to do with undocumented immigrants coming to find work in the US, and almost everything to do with undocumented drugs coming to be consumed by people in the US. An Associated Press story reveals some of the bizarre consequences of this drug-inspired violence.

Max Pons is already anticipating the anxiety he'll feel when the heavy steel gate shuts behind him, leaving his home isolated on a strip of land between America's border fence and the violence raging across the Rio Grande in Mexico.
For the past year, the manager of a sprawling preserve on the southern tip of Texas has been comforted by a gap in the rust-colored fence that gave him a quick escape route north in case of emergency. Now the U.S. government is installing the first gates to fill in this part of the fence along the Southwest border, and Pons admits he's pondering drastic scenarios.
Pons' concerns illustrate one of the complications in the government's 5-year-old effort to build a secure barrier along the border that would keep out illegal activity from Mexico without causing worse problems for the people living in the region.
In this lush area, the Rio Grande's wide floodplain precluded building the fence right on the border so it was set back more than a mile in places, running behind the levees. The result is a no-man's-land of hundreds of properties, and the people who work on them, on the wrong side of the divide.

The United States has long had a strange relationship with our Latin American neighbors. We have perpetuated an embargo on trade with Cuba, despite the evidence that it has only hardened the resolve of the Castro regime, rather than destroying it. Most people I know have the view that free trade and interaction with Cuba would be the quickest route to changing the island's economic and political situation. The same is true with drugs coming north from Latin America into the US. We have long pretended that the problem lies in Latin America, whereas it is obvious to anyone who thinks about the situation for even 30 seconds that the problem lies squarely with the large market for these drugs in the US. If the demand didn't exist, there wouldn't be a supply and there wouldn't be cartels controlling the supply by whatever violent means they choose. And the same is true with undocumented immigrants. If there weren't jobs in the US, people would not risk their lives trying to cross the border to work in those jobs. We really need some kind of wake-up call on these issues.

The Geography of Politics and Religion in the US

The western mountain states of the US are moving demographically in the direction of more liberal politics--specifically more sympathetic to the Democratic party. At least that is the conclusion drawn by David Damore of the Brookings Institution in a recent report. The idea is that two key demographic trends--increasing diversity and urbanization--are changing the political boundaries after the 2010 census and these changes will lead to an increase in the likelihood that Democrats will win elections.

Between 2000 and 2010 population growth in all six Mountain West states outpaced the national average of 9.7 percent and the region contains the four states that experienced the largest percent population increase in the country (Nevada = 35.1 percent; Arizona = 24.6 percent; Utah = 23.8 percent, and Idaho = 21.1 percent). As a consequence, Nevada and Utah each gained their fourth seats in the House of Representative and Arizona was awarded its ninth. Beginning with the 2012 election, the Mountain West will have 29 U.S. House seats (Idaho has two House seats, New Mexico has three, and Colorado has seven) and 41 Electoral College votes.
Across the Mountain West, population growth was concentrated in the region’s largest metropolitan statistical area (MSA). Most notably, the Las Vegas metro area is now home to nearly three out of four Nevadans — the mostly highly concentrated space in the region.
In addition to further urbanizing the region, the prior decade’s growth continued to transform the region’s demographics as all six Mountain West states are now more ethnically diverse as compared to a decade ago. The largest changes occurred in Nevada where the minority population increased by over 11 percent and now better than 45 percent of Nevadans are classified as non-white. While the bulk of this growth was among Hispanics, whose share of the population increased by 7 percent and are now 26.5 percent of all Nevadans, the Silver State also recorded large increases among Asian and Pacific Islanders. Arizona experienced similar increases as that state’s minority population mushroomed from 36.2 percent to 42.2 percent with Hispanics now constituting 30 percent of the population. In Colorado, the minority population increased by 3.5 percent to 30 percent. Nearly all of this change was caused by an increase in Hispanics, who now constitute 20.7 percent of the state’s population. 

One cannot argue with those numbers, but we might wish to temper the conclusion that the region is going to become more friendly to Democrats. In the first place a large percentage of the Hispanics are not citizens, and so they won't participate politically, even if their presence helped to shape political boundaries. Secondly, data from the Pew Research Forum show that Hispanics are predominantly Catholic, but at the same time heavily evangelical. It is not yet clear how this religious perspective plays out politically. And finally, we can note that other data from Pew show that 53 percent of all Mormon adults in the US live in the Mountain West states. Since Mormons are generally quite conservative politically, even though generally urban, their presence may moderate the liberalizing tendency of the region.

Should Politics Trump Women's Health?

The last few days have been full of news about attempts by members of the Republican Party in the US to trample on the reproductive health rights of women. The Susan B. Komen Race for the Cure organization had to back down on their decision to defund Planned Parenthood, and their newly installed vice-president who had promulgated that policy wound up resigning. The latest issue has to do with the yet-to-be-implemented health care laws known colloquially as "Obamacare." I happen not to be much of a fan of this new health policy largely because I think all of the evidence from rich countries with higher life expectancy than ours (and most rich countries have a higher life expectancy than the US) is that you either have to have a national health insurance scheme or, like Switzerland, a mandate that everyone buy health insurance from a private provider. Neither approach puts the burden on the employer, and this latter issue is why the Obama administration is now in trouble with the right-wing over the way in which reproductive health benefits will be provided to women. In the United States most health insurance is purchased through a person's employer, and this puts the employer in the position of judging for its employees what might or might not be acceptable in the health care realm. The New York Times has the story.

Facing vocal opposition from religious leaders and an escalating political fight, the White House sought on Tuesday to ease mounting objections to a new administration rule that would require health insurance plans — including those offered by Catholic universities and charities — to offer birth control to women free of charge.As the Republican presidential candidates and conservative leaders sought to frame the rule as showing President Obama’s insensitivity to religious beliefs, Mr. Obama’s aides promised to explore ways to make it more palatable to religious-affiliated institutions, perhaps by allowing some employers to make side insurance plans available that are not directly paid for by the institutions.
But White House officials insisted the president would not back down from his decision last month that employees at institutions affiliated with religious organizations receive access to contraceptives.

The reason that this is more of a political issue than a religious one is that data suggest that Catholic women--who would be most likely to be the ones working in a religious-based organization opposed to birth control--are just as likely as any other group of women in America to be using contraception. This is not an issue that women are raising. Rather, it is an issue that others are raising that would, in essence, deny them the same level of reproductive health care that other women would be receiving. There may be a way out for the Obama administration, however, based on current practice in Hawaii:

Administration officials say one avenue for resolution might be to look at how Catholic institutions in the 28 states with similar laws have dealt with the issue. One possible compromise might be to emulate Hawaii, where the rule is in effect, but where employees at religious institutions that do not offer free contraception can get birth control through side benefits, which the employees nominally pay for but which often end up being free.

What's Your Label? South African Style

Under apartheid in South Africa, the government (meaning, of course, government bureaucrats who looked at you) decided that a person belonged in one of four racial categories: black, coloured (yes, with the extra 'u' in there because this is British English), Indian/Asian, or white. The Economist reports that this four category system is still in operation, with the only difference that people now self-report (as is done in almost every other country in the world). But the wrinkle seems to be that the "coloured" category has slipped to the bottom of the hierarchy over time.

Given that coloureds were formerly regarded as racial misfits, once dismissed by the wife of former president F. W. de Klerk, Marike, as “non-persons…the leftovers”, one might have expected the number of South Africans wishing to describe themselves as such to plummet. But since the end of apartheid in 1994 the coloured population has in fact grown by almost a third, to 4.5m.
Most live in Cape Town and the Western Cape region, where they originated some 350 years ago after the arrival of the first Dutch settlers. Given the dearth of European women at the time, the Dutch—soon to be followed by French, German and English settlers—often took the pale-skinned indigenous Khoisan or, later, imported Asian and African slaves as their wives and mistresses.
But unlike in America, where a mixed-race president describes himself as an African-American, South Africa’s coloureds have tended to reject their African heritage, preferring to adopt the language, culture, religion and even family names of their former white persecutors. Most coloureds speak Afrikaans (a creolised Dutch) and worship in the Dutch Reformed Church.
Better educated and traditionally better treated than blacks, the coloureds worry about being disadvantaged under ANC rule—perhaps rightly.
Economic-empowerment and affirmative-action laws are supposed to benefit all previously disadvantaged groups, but coloureds claim that blacks often get priority. They also fret over their loss of status. Second from last in South Africa’s old racial pecking order, they now find themselves right at the bottom. Trevor Manuel, the country’s most senior coloured politician, recently complained that “worst-order racism” has “infiltrated the highest echelons of government”.

This is all a very sad reminder that whatever can be used against us (or that we can against others), will be, when it comes to social relations. Differences are so often not seen simply as differences, but rather as a sign of inferiority or superiority. The argument is often made that labels should be made illegal because having the labels reinforces their importance. The counter-argument, though, is that if you get rid of the labels, discrimination will still exist, but it will be harder to know about because the data won't exist on who's who.

Malaria May Be a Bigger Global Load Than We Thought

Chris Murray and his colleagues at the Institute of Health Metrics and Evaluation at the University of Washington have just published a paper in The Lancet suggesting that the number of deaths from malaria may be double what we thought it was. The Washington Post picks up the story:

The number of people who die annually of malaria is roughly double the current estimate, with a huge overlooked death toll in adults who, according to conventional teaching, rarely die of the tropical disease. That’s the conclusion of a new study that, if widely accepted, could affect billions of dollars of charitable spending and foreign aid in the developing world. The new estimate is likely to spur increased competition for global health spending, which has stalled in the economic downturn.According to the new calculations, global malaria deaths peaked in 2004 at 1.81 million but by 2010 had fallen to 1.24 million. That year, 524,000 people age 5 or older died of the disease — about 42 percent of the global toll.
In contrast, the World Health Organization estimates that 655,000 died of malaria in 2010, with 91,000 — 14 percent — being people age 5 and older. The WHO agrees that malaria deaths peaked in 2004.
Malaria was eliminated from the United States in 1951 and from Europe in 2009. More than 90 percent of deaths from the infection now occur in sub-Saharan Africa, where children are at highest risk.

These data are consistent with our own work in Accra, Ghana where we find that malaria continues to be a big concern among residents. We know, for example, that malaria accounted for 38 percent of health clinic outpatient visits in Greater Accra in 2005, and 43 percent of women in the our recently completed Women's Health Survey of Accra, Wave II, reported having malaria in the prior year. Our focus groups have also revealed that people name malaria as the number one health issue for them.

Has War Been Good for the Health of Afghans?

Health levels in Afghanistan have for many years been among the very worst in the world. The Population Reference Bureau's 2011 World Population Data Sheet shows a life expectancy there of 44 years (compared to the world average of 70), an infant death rate of 131 deaths in the first year of life per 1000 live births (compared to the world average of 44), and a total fertility rate of 6.3 children per woman (compared to the world average of 2.5). This latter figure is also associated with a very high maternal mortality rate--often acknowledged to be the highest in the world. There is, however, a new US-sponsored health survey that seems to challenge these figures--which has of course led to the results of the survey being challenged. NPR has reported on the story.

A U.S.-sponsored mortality survey released last year announced huge improvements in health across Afghanistan. But the gains are so great that experts are still arguing about whether it's correct.
During three decades of war, Afghanistan remained a black hole of health information. The few mortality studies looked at a small slice of the population and then extrapolated.
Enter last year's $5 million Afghanistan Mortality Survey, which was funded by the U.S. Agency for International Development with a contribution from the U.N. Children's Fund. Officials say the new survey provides the most accurate snapshot ever of health in Afghanistan — and it delivered shockingly good news.
Afghan surveyors in all 34 provinces brought back data suggesting that life expectancy at birth is now 62 years. Child mortality under age 5 dropped to 10 percent. Of 100,000 live births, the maternal mortality number was down to 327.
"We were all surprised," says Susan Brock, health adviser with USAID in Kabul. "That's what led to additional review and much more analysis."

Some experts who worked on the survey still think it shows too much of a leap forward to be credible. Dr. Kenneth Hill, a Harvard University demographer and technical adviser on the survey, says there are too many anomalies.
"If the results had come out closer to expectations, they would have been hugely valuable, I think," Hill says. "But because there are still huge question marks hanging over the estimates, I'm not sure there is an enormous value in the data."

But defenders of the study say people can't believe the numbers because they've become accustomed to thinking of Afghanistan as hopeless.
Dr. Mohammad Rasooly, with the Afghan Ministry of Public Health, was the lead technician from the Afghan side of the survey. He says health care in his country is improving dramatically, and in many different ways.
"If we consider only the example of midwives, 10 years back we had only 400 midwives at the national level. So, today we have more than 3,000. This is very important for maternal care," Rasooly says.
Now, new paved roads mean that a journey to one of the thousands of newly built clinics takes hours instead of days in rural areas, says Rasooly. Widespread mobile phones have helped save the lives of people who in the past had no way to call for help. And there is little doubt that women have much more access to health care.

My own view is that if Ken Hill is skeptical, then so am I. There is probably no one in the world who knows demographic data of this kind better than he does. Still, I can understand the hope for progress that exists within these numbers, and can appreciate that there are many who really want to believe that this is true (and, of course, it might be--only another survey will be able to tell us for sure).

Women's Reproductive Health Under Attack

The news has been full of the genuinely incredible saga of the Susan B. Komen for the Cure decision to stop funding breast cancer education and screening at Planned Parenthood clinics. The decision was clearly a political one. The founder of the organization, the sister of Susan B. Komen whose death from breast cancer was the inspiration for the organization, is known to be a staunch Republican supporter, and the Republican Party in the US has increasingly moved into the anti-choice camp with respect to abortion. Since a small portion of the work that Planned Parenthood does is legal, safe, induced abortion (thereby keeping a woman from seeking an unsafe abortion), this has led to Planned Parenthood being targeted, as happened last year in Congress. The decision to defund Planned Parenthood seemed to come not long after Komen added a solidly pro-life former candidate for Governor of Georgia to its board, although the specific decision was cloaked in the excuse that Planned Parenthood was "under investigation." In fact, as the Associated Press notes, "Komen had adopted criteria excluding Planned Parenthood from future grants for breast-cancer screenings because it was under government investigation, citing a probe launched by a Florida congressman at the urging of anti-abortion groups." So, the investigation itself was politically motivated.

After two tumultuous days in which a Komen executive resigned in protest, several Komen chapters around the country revolted, and a torrent of support for Planned Parenthood came forward, Komen reversed its decision.

"We will amend the criteria to make clear that disqualifying investigations must be criminal and conclusive in nature and not political," Komen said Friday. "That is what is right and fair."

As a result, Komen said, "we will continue to fund existing grants, including those of Planned Parenthood, and preserve their eligibility to apply for future grants."

Unfortunately for Komen, it has been caught in the middle of the abortion debate, even though breast cancer has nothing to do with abortion.

Buried in the crush of news about the Komen issue was a statement put out by Speaker of the House John Boehner, a Catholic, that the new health care law requiring health care plans to cover birth control might be unconstitutional.

Under President Barack Obama's health care overhaul law, most employers and insurance plans will have to cover birth control free of charge as preventive care for women. Churches and houses of worship do not have to follow that requirement, but administration officials recently announced that many religious-affiliated institutions such as hospitals, colleges and charities must comply after a year's phase-in period."I think this mandate violates our Constitution," Boehner, R-Ohio, said Thursday. "I think it violates the rights of these religious organizations. And I would hope that the administration would back up and take another look at this."At issue is a provision of the health care law that requires insurance plans to cover preventive care for women free of charge to the employee. Last year, an advisory panel from the respected Institute of Medicine recommended including birth control on the list, partly because it promotes maternal and child health by allowing women to space their pregnancies.

So, once again, the reproductive health of women is under threat not for public health or medical reasons, but for political reasons.

What's Your Label--Brazilian Style

Brazil is one of the world's most diverse societies, built on a history of Portuguese taking over land from the indigenous population, Africans imported as slaves, Japanese immigrants, and many others arriving over time, especially from various parts of Europe. People are, of course, conscious of skin color. Indeed, the question on the 2010 Brazilian census asked "Your color or race is: (1) white (2) black (3) yellow (4) brown," and color charts exist if you aren't sure where you fit into the rainbow. The country has prided itself in recent years as a "racial democracy" but the Economist reports on recent cracks in that perception.

In the 2010 census some 51% of Brazilians defined themselves as black or brown. On average, the income of whites is slightly more than double that of black or brown Brazilians, according to IPEA, a government-linked think-tank. It finds that blacks are relatively disadvantaged in their level of education and in their access to health and other services. For example, more than half the people in Rio de Janeiro’s favelas(slums) are black. The comparable figure in the city’s richer districts is just 7%.
Brazilians have long argued that blacks are poor only because they are at the bottom of the social pyramid—in other words, that society is stratified by class, not race. But a growing number disagree. These “clamorous” differences can only be explained by racism, according to Mário Theodoro of the federal government’s secretariat for racial equality. In a passionate and sometimes angry debate, black Brazilian activists insist that slavery’s legacy of injustice and inequality can only be reversed by affirmative-action policies, of the kind found in the United States.
Their opponents argue that the history of race relations in Brazil is very different, and that such policies risk creating new racial problems. Unlike in the United States, slavery in Brazil never meant segregation. Mixing was the norm, and Brazil had many more free blacks. The result is a spectrum of skin colour rather than a dichotomy.

That doesn't mean that skin color doesn't matter. It seems to matter less in Brazil than in the United States, but it seems still to influence a person's life chances.

Many Brazilians simply assume blacks belong at the bottom of the pile. Supporters of affirmative action are right to say that the country turned its back on the problem. But American-style policies might not be the way to combat Brazil’s specific forms of racism. A combination of stronger legal action against discrimination and quotas for social class in higher education to compensate for weak public schools may work better.