This blog is intended to go along with Population: An Introduction to Concepts and Issues, by John R. Weeks, published by Cengage Learning. The latest edition is the 13th (it will be out in January 2020), but this blog is meant to complement any edition of the book by showing the way in which demographic issues are regularly in the news.

You can download an iPhone app for the 13th edition from the App Store (search for Weeks Population).

If you are a user of my textbook and would like to suggest a blog post idea, please email me at:

Tuesday, March 31, 2015

Sustainable Development Goals Seem Out of Control

The United Nations' Millennium Development Goals (MDGs) were targeted to 2015, and this year they are being replaced by a new set of Sustainable Development Goals (SDGs). Let's set aside the question of whether there is really such a thing as sustainable development (I discuss this in Chapter 11 of my text). Do the goals make any sense? They are scheduled to be finalized in September of this year. This week's Economist notes, however, that at the moment there are 17 overarching goals and 169 targets, compared with only 8 MDGs. 
The MDGs were mainly about the poor; their successors are supposed to go far beyond that, with goals proposed for urbanisation, infrastructure, standards of governance, income inequality and climate change. The MDGs, says Homi Kharas of the Brookings Institution, who helped draft an early version of the SDGs, were about reducing poverty; the new goals are about creating peaceful and inclusive societies.
And how did the world do with the 8 MDGs in terms of targets for 2015? The Economist also summarizes the record there. Only 6 of the 8 are readily measurable and the world hit 3 of the 6 targets. Here's the tally:

1. Reduce extreme poverty (living on less than $1.25 per day) by half compared to 1990. This was achieved, although the record is a bit sketchy if you take inflation into account and look at the fraction living on less than $2 per day.
2. Increase gender equality in eduction compared to 1990--yes, that was accomplished.
3. Halve the proportion of population without improved drinking water compared to 1990--yes, that was accomplished, although we still have a lot of people without such access.
4. Reduce child mortality by two-thirds compared to 1990--Not quite, but progress was made.
5. Reduce maternal mortality by three-quarters compared to 1990--Not quite, progress was made.
6. Universal primary education--not quite, but we're getting closer.
7. Ensure environmental sustainability--not yet!
8. Develop a global partnership for development--not yet!!

It remains disheartening that there is so little emphasis on slowing population growth beyond its current levels. If we cannot achieve our goals with 7 billion people, how can we possibly achieve even more ambitious goals with 9 or 10 billion? Come on, folks, let's get real!

Monday, March 30, 2015

We Can All Agree That Families Matter, Right?

One of the major themes of the inequality literature is the fact that children raised in two-parent families (especially if the parents have a college education) have a much greater chance of success in modern society than those raised by a single parent. This idea that marriage matters has been pushed along by strong research from social scientists including Andrew Cherlin at The Johns Hopkins University and Linda Waite at the University of Chicago. Both of them are Past Presidents of the Population Association of America and have strong academic credentials. Thus, when Dr. Cherlin authored an op-ed in today's NYTimes, we need to pay attention. His major point is that in the United States both conservatives and liberals seem to be on the same page with respect to families--they matter and we need to help them. The helping mechanisms on offer may not always be in sync, but we have a start. Here are some key points:
Liberals now seem to acknowledge the downsides of the retreat from marriage. A report on strengthening families that was released in January by the liberal Center for American Progress recommended not only economic assistance but also social support, such as couples’ counseling services and visits by specially trained nurses and other professionals to the parents of young children. 
The growth of legal same-sex marriage has made it possible for liberals to endorse the importance of marriage without feeling that they have abandoned their commitment to equality. Same-sex couples are seizing the opportunity to marry in large numbers: According to American Community Survey data analyzed by the demographer Gary J. Gates of the Williams Institute at the University of California, Los Angeles, School of Law, 34 percent of all same-sex couples in the Northeast in 2013 were married. Far from undermining heterosexual marriage, as its opponents warned, same-sex marriage has broadened support for marriage beyond its conservative base. 
A tougher test of the truce would be whether anyone can summon broad support for providing paid parental leave. Current federal law requires large employers to offer 12 weeks of unpaid family leave, which few low-income workers can afford to take. Conservatives often say that they favor programs that encourage work, and paid family leave would most likely do that: In wealthy countries with paid leave, women are more likely to be in the work force, although they tend to work part-time more than American women do.
The policy-relevance of these issues--of helping families who then more successfully raise the next generation--is obvious. And it is very hopeful, as Cherlin notes, that there is at least enough bipartisan on that point that we may be able to make some progress legislatively. 

Sunday, March 29, 2015

The Solution to Inequality in America is Simple--Getting There Not So Much

Inequality in the United States (and in other rich countries) has grown large enough that politicians on both sides of the aisle agree that it is a problem. We have been through this before over the past 150 years, as Thomas Piketty has reminded us in great detail. The answer is simple--redistribution of income from those with a lot to those with not enough. I am not a Marxist who believes that there should be a leveling of income. All of the evidence in the world suggests that such schemes rob society of the kind of innovation and enterprise that we need in order to promote societal welfare. But I am a social scientist who recognizes that we live in a society that depends upon sharing and cooperation for social and economic survival. If the rich share too little then that also shuts off innovation and enterprise. Aristotle's idea of a happy medium, of all things in moderation, still resonates. Indeed, it is a shame that modern Greeks have forgotten the lessons of their predecessors. A new Pew Research poll shows that many American are more interested in the fairness of the tax system than in the actual amount of taxes they are paying. But there is an increasing political divide on the issue and that's where the problem lies:
Today, Republicans are 20 points more likely than Democrats to say they are paying more than their fair share in taxes (50% vs. 30%). In the 2011 survey, nearly identical percentages of Republicans (37%) and Democrats (38%) said they were paying more than their fair share.
A story in today's New York Times lays out the problem in a very straightforward manner: the wealthy resist paying more in taxes and since they are now in a position to fund the election campaigns of members of Congress, they have the advantage (one might call it a corrupt advantage) when it comes to reforming the tax system. The wealthy have a tendency to take all the credit for their success and to blame lack of success on those who don't succeed. Sometimes that it probably correct, but mostly we humans live in social groups where others provide opportunities for us, and where others can also keep us down, no matter who we are. Human capital, rather than just financial capital, is necessary for success. Scandinavians have figured out that modest (not drastic) redistribution is not only fair, but it is economically beneficial. That is the simple answer to inequality, but politically hard to implement in this country. 

Thursday, March 26, 2015

Education is the Answer

Since I'm a college professor, it would be easy to scoff at my solution to the Anthropocene and demography problem--more education. I thought of that today because this week's Economist has a cover story on the increase in university education throughout the world. I like the Economist, but in this case the story is too much like many real-world economists--only thinking about the dollar value of an investment, not what it means for society. A college degree is not necessarily the same as an education. Take Ted Cruz (please!)--he's a smart, Harvard-degreed person, but the Economist calls him dangerous and he isn't educated in the way that I mean it. We need to become educated so that we can go beyond superstition and bigotry and make real progress in tackling the problems that we humans are creating for ourselves.

Educating women, in particular, empowers them to delay marriage, choose the number of children they want (which is almost always fewer than a less educated husband would prefer), and make contributions to science and to improving the economy in potentially sustainable ways. Indeed, by including projections of education by age and sex into their population predictions, demographers at IIASA in Vienna believe that the world will reach its peak population sooner than projected by the United Nations demographers. Sooner is better, of course!

While more education is, in my view, the answer to the future, it is a two-edged sword because knowledge and the personal power that it imbues can be employed for purposes other than what we might wish. For many years now, Steve Ruggles, the current President of the Population Association of America, has placed a notice on the website of the IPUMS project at the Minnesota Population Center. When you download data from their website you have to agree to Use it For Good, Not Evil. If we keep that in mind in all things, we may have a shot at the future.

Wednesday, March 25, 2015

If You Want to Save the Planet, Read This Book (and it's free)

I have recently blogged about the Anthropocene and demography and we have just been gifted with a huge contribution to the discussion. My SDSU colleague, Professor Stuart Hurlbert, today linked me to a new book--Overdevelopment, Overpopulation, Overshoot, published by Global Population Speakout, which is a project of the Population Media Center, The Population Institute, and the Foundation for Deep Ecology. I am not familiar with the latter organization, but the first two have William Ryerson in common. He has been working on population-related issues all of his life, and he wrote the introduction to the book. 
If you care about people, you must care about what we are doing to the planet. If you care about what we are doing to the planet, you must also care about human numbers. Given a planet with infinite space and resources, population growth could, arguably, be a blessing. We do not live on such a planet. However, there was a time when the Earth and its resources appeared boundless. Some people still adhere to that anachronistic belief. If nothing else, the photographs in this book should shatter that illusion.
Given the central role that population dynamics will play in determining the welfare of future generations, what the world needs today is a wake-up call. This book is that wake-up call. The photographs to follow are emotionally jarring; they are deeply provocative. But that is the nature of wake-up calls. The way that human numbers and behavior are transforming the Earth, undermining its ability to support the human family and the rest of life, is apparent for all to see. The reality of this urgent moment calls us to think, to care, and to act.
The photographs are, to be sure, truly amazing and disturbing. But the story is exactly the same one that I have been telling in my book (see especially Chapter 11) for a long time. Indeed, this book--either the published version (coffee table style) or the free online version (slide show style)--should be required reading not only for every student reading my Population text, but for every human now alive.

Tuesday, March 24, 2015

Latinos in the U.S. South

A few years ago, my son, Greg, and I published a book on Irresistible Forces: Latin American Migration to the United States and Its Effects on the South. We used census and other data to show that the New South was new not just because African-Americans were heading back that way, but because immigrants from Latin America were also heading that way. Many of those migrants are undocumented, but most of the children have been born in the U.S., and this is changing the entire demographic of southern states. We picked up on this theme in a chapter in a book just out this week, published by Springer. Here's the abstract:
In the South, as in much of the United States, the demographic train has left the station. For over a decade the region has been attractive to migrants leaving either a Latin American country or areas of the United States with weaker economies and/or higher costs of living. Our projections going out to 2040 show continued growth under virtually all assumptions, signaling a permanent shift in what had traditionally not been a destination for Hispanics. Using U.S. Census data and other sources to develop projections, the core of our argument is that as the cohort of older (65 years and over) Latinos grows in North Carolina, there will be concomitant political shifts. Children who are citizens will eventually become eligible to vote, legislative districts will be transformed, and Hispanic adults will be taking care of a growing elderly population.
The U.S. Census Bureau no longer makes projections of the population by age and ethnicity at the state level, so we undertook the task ourselves, with results that show that "the train has left the station," (and thanks to Irene Tienda Rumbaut for that title!) by which we mean that the demographics of the South are in the process of being changed forever, whether the South likes it or not!

Monday, March 23, 2015

Birth Control and Family Success

A tweet from the Population Council today sent me to a US News and World Report story summarizing the important work that they have done, and are continuing to do, to create ever better contraceptives. 
Currently, contraceptive rings like the NuvaRing offer women monthly protection against pregnancy. Every month, a woman inserts the ring – which releases low, continuous doses of the hormones estrogen and progestin – into her vagina. Before her period, she takes out the ring; afterwards, she replaces it with a fresh one.
The Population Council – a nonprofit that conducts biomedical and public health research – recently finished two Phase 3 clinical trials on a new contraceptive that is effective for one year of use.
But the ring isn’t just long lasting; it confers other benefits as well. This ring doesn’t need to be refrigerated, unlike its counterparts – meaning it’s ideal for women who might not have constant access to electricity, says Diana Blithe, program director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development’s Contraceptive Discovery and Development program, which helps fund the project.
If approved by regulatory authorities, this contraceptive ring will be the first long-lasting, reversible contraceptive that’s completely under a woman’s control.
The story discusses other contraceptive innovations in the works, including improved condoms for females, so that they don't have to rely on a male partner. As I read the story, I could only think of the difference that careful use of contraception can make in people's lives. In many ways, that is the sub-text (at least in my mind) of the new book by Robert Putnam--Our Kids: The American Dream in Crisis--which was reviewed in this week's Economist:
Among the educated elite the traditional family is thriving: fewer than 10% of births to female college graduates are outside marriage—a figure that is barely higher than it was in 1970. In 2007 among women with just a high-school education, by contrast, 65% of births were non-marital. Race makes a difference: only 2% of births to white college graduates are out-of-wedlock, compared with 80% among African-Americans with no more than a high-school education, but neither of these figures has changed much since the 1970s. However, the non-marital birth proportion among high-school-educated whites has quadrupled, to 50%, and the same figure for college-educated blacks has fallen by a third, to 25%. Thus the class divide is growing even as the racial gap is shrinking.
These differences in outcomes do not happen by chance. It is the choices that people make about the timing of children that drives the future success of those children. Contraceptives are key to all of this. 

Sunday, March 22, 2015

World Water Day--Welcome to the Anthropocene

Today is World Water Day, as proclaimed by the United Nations, and promoted by USAID. We humans cannot survive without water, including especially clean drinking water. I have blogged about this numerous times over the years, most recently only three weeks ago. It is obviously so important that it should never be far from our minds. Here are some background numbers from USAID:
Currently, 748 million people lack access to improved drinking water, and about 2.5 billion lack access to proper sanitation, putting them at risk of disease. For families around the world, waterborne illnesses mean lost income, malnourishment, or the death of a child.
The direct linkage of clean water to health is very important, and is central to much of my own research. Indeed, in Accra, the capital city of Ghana, where my colleagues and I have been conducting research for more than a decade, the 2010 census showed that less than half of the city's residents have water piped into the house, and even that water is not guaranteed to be drinkable because of the leakage in pipes en route from the treatment plant (where the water does start out to be good) to homes. Thus, even among people with piped water in their house, one-third spend extra money to buy sachet water for drinking.

More broadly, though, we need water to grow food for the ever growing human population. Agriculture actually consumes most of the world's fresh water, and human-induced climate change (the Anthropocene), induced in part by the vast increase in agriculture, is shifting weather patterns and rainfall levels. Here in California we are in a severe drought, although the stories that we are about to run out of water are a bit exaggerated. Still, in San Diego County we import 90 percent of our water (mainly from the Colorado River), and a rain-fed lake near our house is more mud than water. The UN correctly links water to sustainability, and we need to be collectively very careful with this precious resource.

Friday, March 20, 2015

Anthropocene from a Demographic Perspective

Nature News recently highlighted a story from the journal Nature about the growing movement to add a new period of geological time called The Human Age--Anthropocene. Now, to be sure, this is a classification scheme developed by geologists, not by demographers or other social scientists. But let's face it--the only reason why most people are going to be interested in geological time is because it relates back to human existence in some way or another. Andrew Revkin also takes up the issue in his NYTimes blog because, as he notes, he is "on the Anthropocene Working Group of the international geological organization that is pondering the official scientific question and because I proposed we were entering a “geological age of our own making” back in 1992." This latest proposal published in Nature suggests that the Anthropocene began in 1610:
Simon L. Lewis and Mark A. Maslin of University College London* point to the year 1610, marked by, of all things, a sharp but brief dip in carbon dioxide concentrations (revealed in ice cores). The greenhouse-gas decline, they say, is thought to have been the result of the implosion of civilizations in the Americas as European-carried diseases killed off tens of millions of inhabitants of the “New” World. The collapse of agriculture would have resulted in enormous regrowth of forests, and thus the uptake of CO2.
I get it that geologists have their own rules of the game, but from a "real" perspective, the impact of humans began with the scientific discoveries leading to a fall in the death rate, and thus to the startling increase in the number of human beings living on the planet. Those same scientific discoveries--emanating generally from the European Enlightenment--are also at the core of innovations that have allowed us to change the earth's atmosphere in very measurable ways, and the layers of the planet beneath the surface in ways that are less readily measurable, but no less real in their consequences (e.g., water and mineral extractions). The mid-19th century is when these changes became readily apparent and they have been essentially unstoppable since then. 

Another candidate for the beginning of the Anthropocene might be the year the world hit 2 billion people--estimated to be 1927. Why? Because multiple studies suggest that the world could sustain a population of no more than 2 billion people at the current level of living of the US and other rich nations. 

A quick Google search of the term "anthropocene" shows that its use is spreading and that it resonates with a lot of people. It may or may not resonate with geologists, but I have a hunch the term is here to stay and with luck it will help to call attention to what we're doing to the planet before it's too late to save the human species.

Thursday, March 19, 2015

Latinos and the Future of America

I was traveling all of last week and so it has taken me some time to catch up with my reading, such as the front page story (with a whole special section) in last week's Economist, about the role of Latinos in the future of America. It's all good, no matter what the older, predominantly non-Hispanic white population may think. The children of immigrants will fuel the future of America and, in The Economist's view, keep the country at the forefront. I was especially pleased to see demographers highlighted in the story:
In a recent book, “Diversity Explosion”, William Frey of the Brookings Institution, a think-tank, makes an impassioned call to celebrate America’s new demographics. In just a few years, his numbers show, there will be as many whites over 65 as white children. Among non-whites, children outnumber the old by four to one. Take away Hispanics and other fast-growing minorities, and America’s numbers look like those for Italy, a country full of pensioners with a shrinking labour force. As things stand, however, America’s working-age population is expected to grow at a healthy clip.
But there's still work to do:
Steve Murdock of Rice University, a former boss of the US Census bureau, recently published a paper warning Texans that Hispanics are not getting enough advanced degrees and qualifications to replace highly educated whites retiring from their state’s workforce. By 2050, his study predicts, Hispanic workers will outnumber white ones in Texas by almost three to one, but without a change in education policy the state will be poorer and less competitive.
Despite the challenges, the broad base of children in the US (see accompanying graph) bodes well for the country's future. Contrast that with the story in this same issue of The Economist pointing out that Japan has pulled up the drawbridge against refugees.
AROUND 9m people have fled their homes in Syria. Over 3m have taken refuge in neighbouring countries. But thousands more have fanned out across the world, some to as far away as Japan. There, they have found the drawbridge up. The world’s third-largest economy has yet to grant asylum to a single Syrian.
The treatment meted out to Syrians is consistent with Japan’s stingy record on sheltering people fleeing conflicts of all kinds. In the decade to 2013, the country gave asylum to just over 300 refugees. In 2014, the number fell to 11.

Wednesday, March 18, 2015

Demography and the Israeli Election

The victory of Benjamin Netanyahu's Likud Party over the Zionist Union party led by Yitzhak Herzog was a comeback victory that had clear demographic roots. As a group, Jews comprise 75 percent of the Israeli population, according to data from Israel's Central Bureau of Statistics, but the most rapidly growing segment of the Jewish population is the Ultra-Orthodox population which tends to be politically very conservative and least likely to back a two-state solution to the Israeli-Palestinian conflict. Arabs comprise 20 percent of the population, and among them almost 90 percent are Muslim (most of the rest of the Arabs are Christian). They, of course, are most likely to back a two-state solution and that was a policy promoted by Herzog during this election campaign, as it had been by Netanyahu in earlier times. The remaining 5 percent of Israel's population consists primarily of non-Arab Christians and Druze and people with no religious affiliation. It is probable that they too are more liberal than conservative in their political attitudes. 

The problem that Israel faces down the road is that, as I have mentioned before, the groups at the political extremes--Ultra-Orthodox Jews on the one hand, and Arab Muslims on the other--are growing more quickly than the rest of the population. This demographic clearly emerged in this election, when Netanyahu was able to mobilize the right to vote by raising fears of a high turnout among Arabs. Demographic trends suggest that these problems are only going to get worse, not better, and we have to hope that policy-planners for the region are taking that dynamic into account.

Friday, March 13, 2015

The Demographic Mess in the Middle East

I have often blogged about the mess in the Middle East, and I discuss this in some detail in the first chapter of my text. Abu Daoud linked me to a story that also tries to put many of these demographic pieces together, and with some historical context. 
As Islamic State (IS) and Shi’a militias backed by Iraq and Iran continue their missions to create “pure” sectarian enclaves, changing demographics throughout the region could be a harbinger of more conflict to come. Large flows of refugees and disparate birth rates not only have the propensity to prolong violence in Iraq and Syria, but could drastically reconfigure the make-up of strong states like Turkey and Israel. Lebanon’s perennially fragile sectarian balance is also at risk.
It seems possible that one of the major outcomes of all this could be the creation of a Kurdish state in northern Iraq that would have ties to the Kurdish population in Turkey. There, the battle for independence from Turkey seems to be evolving into a realization that demographic trends are leading to Kurds being an ever larger share of the Turkish population:
The affluent Turks in the west of the country have similar birth rates to Western Europe, whereas rates in the poorer and underdeveloped Kurdish areas of the south-east are much higher. President Tayyip Erdogan responded to this news by admonishing Turkish women for committing the “treason of birth control … seeking to dry up our bloodline”.
But there are signs that the Kurds may be willing to adopt a new strategy of cooperation and integration with the rest of Turkey might be a better route than independence. The Kurdish state in northern Iraq almost certainly depends, of course, on their ability to battle ISIS. Success against ISIS would augur well for establishing independence.

Israel, in the meantime, is facing the fact that the right-wing Orthodox population is growing at a much faster rate than the rest of the Israeli population. All the while, the continued creation of Jewish settlements in the West Bank has created a demographic mess there that will not admit of an easy solution. We may know more about the future direction of that country after next week's elections.

Tuesday, March 10, 2015

The Time For Political Demography is Now

We leave in the morning for Charlotte and then Charleston, where my son, Greg, and I will be presenting our research on the effects of the age structure on socialism in Latin America at the annual meeting of the Southeastern Council of Latin American Studies. Greg is a past president of the organization and also edits the organization's journal--The Latin Americanist. The topic is clearly about political demography (although we define socialism in terms of an economic system, not a political system per se). Greg and I also had a political demography focus in our co-authored book on Irresistible Forces: Latin American Migration to the United States and Its Effects on the South, and Debbie Fugate and I had a distinctly political demography focus in our book on The Youth Bulge.

So, with all that as prelude, you won't be surprised that I was very pleased by a blog post suggesting that political demography is coming of age. The report was inspired by sessions at this year's International Studies Association, which opened up a new section on political demography just a few short years ago.
“Political demography is a discipline whose time has come,” said Rob Odell of the National Intelligence Council at a gathering of demographers and researchers in New Orleans. “You can sense this inherent dissatisfaction” with a lot of analytical and predictive tools in international relations, he said, and “political demography provides policymakers a way to think about long-term trends.”
The Arab Spring, with its images of youthful mass protest, has helped popularize demographic terms, like “youth bulge.” And in Europe and East Asia, fears over aging – its effects on welfare, labor force, even military power – are routinely addressed by senior policymakers, said George Mason University’s Jack A. Goldstone. “Why? Because they’re concerned about demographic decline.” 
Besides the fundamental rights-based argument for gender equality, political demography also illuminates a colder calculus. “We can say, ‘look at how impossible it is to get to a modern nation state without doing these things for women,’” said Wilson Center Global Fellow Richard Cincotta, referring to things like access to education, health care, and agency for women. “Political demography screams these things.”
There are very few courses on political demography in universities, so it is not a field that has a lot of visibility yet. The insights from demography are just too important to ignore, however, and so we have to keep working on increasing awareness among policy-makers, in particular. Indeed, that is the exact point of the paper that Greg and I will be presenting in Charleston.

Sunday, March 8, 2015

Save the Butterflies--Plant Milkweed

Perhaps the only insects that humans love are butterflies, especially the magnificently beautiful Monarch butterfly. But the modern world of population growth and industrial agriculture needed to grow food for that population has inadvertently been wiping out the butterfly population by destroying the one plant in the world that Monarch caterpillars require to grow into a butterfly--milkweed. The National Wildlife Federation posted a useful story yesterday about six ways to save the butterflies, and generated this alarming set of estimates of the Monarch butterfly depopulation:

Now, to be sure, these numbers are based on wintering in Mexico. Where I live here in southern California, we have Monarchs year-round because, I assume, they don't need to go to Mexico to winter.  There are really two important things to do for Monarchs, as I have noted before: (1) plant milkweed; and (2) don't spray insecticides around your yard, because that will kill the eggs and caterpillars. If you have ants, as we do, just use those ant stakes you can buy at the store. They deal with the ants, but don't harm the butterflies. For more on this, take a look at a very good commentary from a midwestern farmer that aired this morning on CBS Sunday Morning. Our experience is that the butterflies reward you not only with their beauty, but their friendliness. They really do seem to love humans and will join you in the yard as you make life better for them.

Saturday, March 7, 2015

Global Dietary Patterns--Generally Getting Worse Not Better

Historical data suggest that improving diets--especially more calories--helped raise life expectancy in Europe up to about 40 years at the beginning of the 19th century. Public health improvements such as clean water, sewerage, validation of the germ theory, and vaccinations, helped push life expectancy up into the 60s. It takes medical advances to get much beyond the 60s and we are headed that way globally, except for the fact that diets are now holding us back. This idea was first put forward by Barry Popkin at UNC Chapel Hill and his colleagues as the natural consequence of the nutrition transition. Finding data to track trends has not been easy, however, which is why the paper just published in The Lancet Global Health is so informative (this is open access so it is available to everyone). A group of researchers associated with the Global Burden of Diseases Nutrition and Chronic Diseases Expert Group tracked down every national level survey they could find that included dietary intake data collected at the individual levels. This way they could evaluate differences not only by country, but also by age and sex. The results suggested that age and sex were less important than overall national differences, based especially on overall levels of income.
Nations with higher incomes had larger improvements in diet patterns based on healthy items than did nations with lower incomes; for example, by 2·5 points (95% UI 0·5–4·6) comparing high-income to low-income countries. By contrast, middle-income nations showed the largest worsening in diet patterns based on unhealthy items: compared with high-income nations, greater worsening by 2·5 points (95% UI 0·5–4·5) and by and 2·8 points (95% UI 0·9–4·8) was noted in upper-middle nations and lower-middle income nations, respectively. Although most world regions showed modest improvements in dietary patterns between 1990 and 2010 on the basis of more healthy items, such improvements were generally not noted in the poorest regions, including in sub-Saharan Africa and the Andean states of Latin America. Conversely, most regions of the world showed substantial declines in diet quality based on increased consumption of unhealthy items. The exceptions included many of the wealthiest regions including the USA and Canada, western Europe, Australia, and New Zealand, where consumption of these unhealthy items modestly decreased. Of note, for these world regions and nations, this improvement was superimposed on a poor starting score in 1990 (appendix pp 47–49 figure S24). Thus, despite some improvement by 2010, dietary scores for unhealthy items in wealthy countries remained among the worst in the world.
The map below shows the global pattern when good and bad dietary elements are balanced against one another. The best diets at the moment are actually in the poorer countries that have not yet moved into the income categories where they can afford the less healthy, but obviously desirable, diets. We have to hope that we can alter that trajectory and keep them on better diets even as incomes improve.

Thursday, March 5, 2015

Drought and the Syrian Crisis

If you've read the 12th edition of my text, or read my blog post from nearly two years ago, you'll be familiar with the argument that one of the likely causes of the current crisis in Syria was a major drought that sent a lot of farmers to cities looking for work. They were rebuffed and the rest, as they say, is history. A paper recently published in the Proceedings of the National Academy of Sciences goes even further, to suggest that the drought was likely caused by human-induced climate change. The New York Times covered the story.
The drought was the worst in the country in modern times, and in a study published Monday in Proceedings of the National Academy of Sciences, the scientists laid the blame for it on a century-long trend toward warmer and drier conditions in the Eastern Mediterranean, rather than on natural climate variability.
The researchers said this trend matched computer simulations of how the region responds to increases in greenhouse-gas emissions, and appeared to be due to two factors: a weakening of winds that bring moisture-laden air from the Mediterranean and hotter temperatures that cause more evaporation.
Colin P. Kelley, the lead author of the study, said he and his colleagues found that while Syria and the rest of the region known as the Fertile Crescent were normally subject to periodic dry periods, “a drought this severe was two to three times more likely” because of the increasing aridity in the region.
Some social scientists, policy makers and others have previously suggested that the drought played a role in the Syrian unrest, and the researchers addressed this as well, saying the drought “had a catalytic effect.” They cited studies that showed that the extreme dryness, combined with other factors, including misguided agricultural and water-use policies of the Syrian government, caused crop failures that led to the migration of as many as 1.5 million people from rural to urban areas. This in turn added to social stresses that eventually resulted in the uprising against President Bashar al-Assad in March 2011.
To be sure, the refugees from drought would not have had to elicit the kind of response that they did from President Assad of Syria. So, drought is not the immediate cause of the conflict. But demographic change--in this case an unwelcome influx of rural people into urban areas--is something that societies must always deal with. As it turned out, the Syrian government did not deal well with it, and the result has been a vastly larger disaster than the drought itself.

Wednesday, March 4, 2015

The Hidden Threat of Dengue Fever in West Africa

Ebola is obviously the headline-catching disease in West Africa and we must continue to take it seriously, in order to avoid new flareups. At the same time, malaria is still a bigger killer in the region, so we cannot take our eyes of prevention efforts for malaria. But, wait! It turns out that a significant fraction of children in Ghana who are diagnosed with malaria also have dengue fever. This tells us that dengue fever (transmitted by mosquitos, albeit a different species than carries the malaria parasite) is also prevalent in West Africa, despite the fact that few physicians are looking for it when they treat sick patients. These were the surprising findings of a paper just published by Justin Stoler of the University of Miami and associates of his in Ghana in the American Journal of Tropical Medicine and Hygiene. The article is behind a subscription, but Justin was interviewed today on Voice of America, where his findings were summarized.
“The best data we have is from Accra, Ghana’s capital. And we see there roughly 40 to 45 percent of all outpatient visits – anyone presenting at a hospital, a healthcare facility – for any reason – are walking out of there with a presumptive malaria diagnosis, which is a staggering number in and of itself. Now, what we’re just starting to learn in the last few years is that when you actually do confirmatory blood tests -- and you look at who really has malaria -- typically it’s less than 10 percent of that group, who’s presumed to have malaria,” he said.
So, if those figures are correct, what diseases could the rest actually have?
“Well, we started with dengue because it’s widespread across the tropics. It’s recognized. It’s something many people have heard of. But in reality it’s probably just a small piece of the pie. There are bacterial infections, other viral fevers, viral infections – things like influenza – fungal diseases, other parasitic infections…really a whole menu of things that people are dealing with on a regular basis,” said Stoler.
Stoler said the findings have the potential to cause donors to re-think their anti-malaria strategies. The Roll Back Malaria Global Action Plan estimates nearly $6 billion a year is spent to fight malaria.
“At least in parts of rapidly urbanizing Africa, maybe malaria is not their biggest problem. I don’t mean to undermine the importance of fighting malaria in sub-Saharan Africa and around the world, in general. But malaria has traditionally been a rural disease and that’s probably still where most of the burden exists. But really all the action is in urban places and there a lot of other things that people are dealing with there,” he said.

Tuesday, March 3, 2015

We Need More Saving, Not More Spending

One of the major concerns in richer, aging societies is how will the older population be supported in its dotage. The assumption is made that people will live an ever longer number of years in retirement and that they will not have saved enough money for that retirement, so the younger generation will have to begrudgingly support them. The solution to this problem is really very straightforward, as I have pointed out before: (1) keep people in the labor force longer (so that the number of retirement years is consistent with increasing life expectancy at the older years); and (2) make sure everyone is saving for their retirement (so that they are not totally reliant on intergenerational transfers from younger people).

These ideas seem so simple, but the problem is that in the short term economists want people to spend money, while in the long term economists want people to save for their old age. It's very hard to have it both ways, and I was thinking about this as I read in today's New York Times that the drop in oil prices over the past few months has not produced the kind of boom in consumer spending that some economists were expecting.
While few outside of Texas and North Dakota are complaining about this huge savings that consumers have enjoyed since energy prices began falling last summer, economists have been stumped recently trying to figure out exactly what consumers are doing with the windfall. 
They have not gone on a shopping spree at the mall or online. Results at many retail chains have been mixed, and some stores that are middle-class fixtures, like Sears and J.C. Penney, continue to struggle. 
One hint at what consumers might be thinking came Monday, when new government data on the economy showed a healthy gain for wages and salaries in January, even as spending by consumers inched lower for the second month in a row. As a result, the savings rate ticked upward to 5.5 percent, the highest level in just over two years.
If this is really true, we can only say "thank goodness"! The future may look brighter than we thought. Let's see if we can keep this up. 

Sunday, March 1, 2015

Don't Drink the Water--Chinese Style

We humans need water to survive. And clean water at that, because polluted water is bad for your health. Indeed, as Justin Stoler has detailed in his research, "pure" water sold in sachets throughout West Africa may well prevent children from getting diarrhea which can lead to an early death. Now, I admit that whenever I travel outside the U.S. I routinely buy bottled water because I'm never sure where the local water might be coming from, but I was still amazed to read in this week's Economist that there is a huge demand for bottled water in China due to concerns about water quality.
Hygiene and health concerns among China’s rising middle class have stoked demand as more migrate to cities, where water is more polluted and the bottled sort more common (typically, 19-litre barrels installed in homes). In 2009 the World Bank said water problems cost the country over 2% of GDP every year—mostly due to damage to health. In 2013 thousands of rotting pigs’ carcasses were found in the Huangpu river, which supplies four-fifths of tap water to Shanghai, China’s most populous city. Last April, in the industrial city of Lanzhou in the north-west, a leak from an oil company’s pipeline poisoned tap water for 2.4m locals with carcinogenic benzene. And even if water meets drinking standards at source, it can be harmful by the time it reaches the tap after coursing through decaying pipelines.
Yikes! That really is disgusting. Of course, if the Chinese went back to more vegetables and fewer pigs, things might start to improve. Still, the article points out that China has 20% of the worlds' population, but only 7% of the global freshwater supply. That doesn't sound sustainable to me. The article suggests that one of the penalties of higher urban incomes in China is going to be the cost of daily consuming imported bottled water. Now, if they could just import cleaner urban air...