Lessons From Blue Zones on How to Increase Healthy Life Expectancy

The concept of a "blue zone" was put out there more than a decade ago by demographer Michel Poulin at the University of Tallinn in Estonia. These are places of validated extraordinary longevity of people, measured in terms of the likelihood of people born in a place making it to age 100 (e.g., what percentage of people alive at age 60 are still alive at age 100). They are called Blue Zones simply because researchers circled the places in blue on a map! Poulin and his colleagues have focused especially on a mountainous area on the Italian island of Sardinia. Another demographer, Luis Rosero-Bixby, and his colleagues have investigated the Nikoyan region of Costa Rica. Other investigated and validated Blue Zones include the Greek island of Ikaria, the Japanese island of Okinawa, and perhaps most surprisingly, the community of Loma Linda, California. Academic papers describing the first four of these places can be found in the 2013 Vienna Yearbook of Population Research, published by the Vienna Institute of Demography. There is an especially good introductory paper to this special issue on longevity by Graziella Caselli and Marc Luy.

These places offer an interesting opportunity to figure out the explanations for people being able to survive in greater proportions, and presumably in better health, than most of us can currently expect to do. Genetics probably explains about one-third of this, as Caselli and Luy note, but are there lessons beyond "choosing your parents well" that can benefit the rest of us? Dan Buettner has become a successful writer of NYTimes bestseller books by trying to answer that question and his latest book, The Blue Zones Solution, offers the recipes (both figuratively and literally):

No one thing explains longevity in the Blue Zones. It's really an interconnected web of factors--including what we eat, our social network, daily rituals, physical environment, and sense of purpose--that propels us forward and give life meaning. But food is at the center of that ecosystem, and food may be the best starting point for anyone seeking to emulate the health, longevity, and well-being found in the world's Blue Zones.

Buettner then summarizes those major components of health and well-being and provides what amounts to a cookbook of 77 recipes (and, no, I don't think that there is any magic in that number!) that emphasize a diet that is largely, but not necessarily exclusively, vegetarian, emphasizing things like beans, lentils, and nuts--along with a glass or two of wine with dinner. This is essentially what we typically call a "Mediterranean diet."

Diet is an important thing to change in our lives, but there are other elements to this potentially healthier lifestyle, as described by Buettner. His list of the "Power Nine" includes (1) moving naturally (natural exercise, rather than a forced workout at a gym), (2) having a sense of purpose in life, (3) trying to limit stress in your life [and see this piece in today's Washington Post for more on this topic], (4) stop eating when you are 80 percent full, (5) have a diet with a "plant slant", (6) have one or two (but no more than that) glasses of wine in the evening with friends and/or food, (7) choose your friends carefully (you can do that, even if you couldn't choose your parents) because friends reinforce both good and bad behavior, and (8) commit to a life partner and have them come first in your life. In a very real sense, these are words to live by.

Your Health Literacy Can Improve Your Healthy Life Expectancy

Chris Murray and his group at the Institute of Health Metrics at the University of Washington have repeatedly shown that while global life expectancy is increasing (i.e., we are dying at ever older ages), the number of healthy years we live is not increasing as quickly. This week they released their latest Global Burden of Disease study in The Lancet, and Reuters picked up the story.

People around the world are living longer, but many are also living sicker lives for longer, according to a study of all major diseases and injuries in 188 countries.

General health has improved worldwide, thanks to significant progress against infectious diseases such as HIV/AIDS and malaria in the past decade and gains in fighting maternal and child illnesses.

"The world has made great progress in health, but now the challenge is to invest in finding more effective ways of preventing or treating the major causes of illness and disability," said Theo Vos, a professor at the Institute of Health Metrics and Evaluation at the University of Washington who led the analysis.

The study's main findings were that global life expectancy at birth for both sexes rose by 6.2 years -- from 65.3 in 1990 to 71.5 in 2013. Healthy life expectancy at birth rose by 5.4 years -- from 56.9 in 1990 to 62.3 in 2013.

One of the problems is an increasingly less nutritious diet around the globe, as these same researchers pointed out earlier this year.  But a broader issue that actually encompasses the changing diet is that of health literacy. I thought about this last week when I saw a National Academy Press report on this topic. The volume is a bit dry (albeit literate), but the topic is huge. Think about the people who don't understand the importance of vaccines, or cultures whose practices dealing with dead bodies contributes to the spread of disease (e.g., ebola in west Africa), or the lack of appreciation for the value of condoms in casual sexual intercourse. In our own research in Accra, the capital of Ghana, we  found that adults in the city were not always sure how malaria is transmitted nor how best to protect themselves and their children from it. That is only a small step from those people who don't follow a prescribed medical regimen because they really aren't sure why they should--this is mainly what the National Academy of Sciences workshop report was about. We readily take for granted the things that others do for us that keep us healthier, but we aren't always so good at figuring out what is best for ourselves. In short, if we all became more health literate we would almost certainly close the gap between actual and healthy life expectancy.

Europe's Migrant Culture Clash and Mash

Over the past two years or so, I have blogged increasingly often about the undocumented migrant situation facing Europe. This is largely a result of the economic and political mess in the Middle East and Africa, but it is aided in some ways by the limited willingness or inability of at least some European nations to take in refugees. Today's news brought two very contrasting reactions to these migrants. In Hungary, the government is thinking about deploying troops to deal with the migrant crisis, as reported by the Financial Times.

Janos Lazar, a senior Hungarian minister, said the government had discussed a possible military build-up following police reports that more than 2,500 migrants had penetrated the country’s border with Serbia on Tuesday. One official said the numbers were the highest in the country’s history.

Unfortunately, not all those migrants heading north from Serbia (as I discussed a couple of days ago) were still alive when they made it north. CCTVAfrica posted a photo of a truck in which 50 migrants had been found dead in Austria. They had been trapped in the back of the truck and suffocated during the journey. The driver abandoned the truck and is now being sought.

At a press conference in Eisenstadt, Interior Minister Johanna Mikl-Leitner said it demonstrated “the despicable methods used by Mafia traffickers in all their ugliness in Austria”. “Today is a dark day,” she added and vowed there would be zero tolerance shown towards any that were caught.

A different approach to dealing with migrants is being tried at least in a small way in Italy, where OZY reports that families are taking in refugees and providing them with an informal introduction to Italian language and culture. Families receive a monthly stipend for doing this, much as foster families do in the U.S. for caring for children who have been abandoned by their parents. It's not clear that this will catch on in a big way, but it is a step in the direction of coping with the cultural differences that exist between sending and receiving nations and which are almost certainly the biggest challenges anywhere in the world to the issue of migration.

UPDATE: Foreign Policy reports that:

In the Austrian case, three people in Hungary have been arrested in connection to the truck deaths. Authorities believe a Bulgarian-Hungarian trafficking ring is responsible. The victims are believed to be Syrian, police said.

Are "Anchor Babies" Really a Problem?

As I've noted before, Donald Trump has stirred up the immigration pot with his racist rhetoric aimed especially at undocumented immigrants from Mexico. Note, by the way, that not all undocumented immigrants are from Mexico--check out the infographic I referenced a few days ago). Note also that a large fraction of undocumented immigrants arrive on planes, rather than crossing the U.S.-Mexico, as my son, Greg Weeks, pointed out today. One of the issues raised once again by Trump is the fact than anyone born in the U.S. is automatically a U.S. citizen. The 14th Amendment to the Constitution was passed after the Civil War to make sure that former slaves would not be denied U.S. citizenship. Since U.S. laws also allow U.S. citizens to apply for legal admission for their close relatives (the "family preference" provisions of U.S. immigration laws), it means that eventually a child born in the U.S. could apply to bring their parents legally into the U.S. But the key here is "eventually." The child will have to be at least 21 years old when they make the application (as a result of laws passed during the Jimmy Carter administration) and it will likely take many years for an entry visa to be issued because they are subject to annual limits. So, even if an undocumented woman did choose deliberately to have her baby born in the U.S. in order to "link" her to a U.S. citizen, she will probably have to wait a minimum of three decades for that to come about. For a good background on these issues, I recommend Leo Chavez's 2008 book, The Latino Threat: Constructing Immigrants, Citizens, and the Nation.

In the meantime, however, the fuss is not really about anchor babies or even about undocumented immigrants. Eric Posner of the University of Chicago has a very good op-ed piece in Slate in which he argues that the issue that Trump has raised is about differences in culture. That's what this is all about--a classic case of xenophobia. Every immigrant group coming to the U.S. has been discriminated against and bullied by the "mainstream" until finally making it into the mainstream--and changing American culture in the process. Think about it--Ben Franklin was worried about German immigrants more than two hundred years ago. Now, the census data show that more Americans claim some German heritage than any other ethnic origin. They became part of the mainstream along with the Irish, Italians, Poles, Chinese, Vietnamese, Koreans, and--increasingly--Mexicans (and, of course, I've left lots of cultural backgrounds off the list for sake of brevity). Posner very cogently concludes that "...defenders of immigration might do best to thread their way through the minefield of culture—to argue that immigration does not harm American culture and probably enriches it—rather than pretend that these concerns do not exist.

Anchor babies are not the problem--fear of cultural differences is the problem, and every human society has this same problem. We need to talk about it, so we can deal with it.

Learning to Manage Demographic "Shrinkage"

The Financial Times has recently had a string of articles highlighting the demographics of low fertility European countries, as I noted recently with respect to Portugal. Yesterday they turned to Germany, highlighting a northern German town that is trying to attract immigrants in order to keep its schools open.

When the quiet village of Ottenstein, in northern Germany, was faced with its school closing for lack of children, Manfred Weiner, its mayor, hit upon a novel way of attracting young families. Instead of renting out village land to farmers, he is giving it away for free to people willing to move to the picturesque hamlet. Successful applicants will be awarded a building plot on one condition: that they have young children and, preferably, intend to have more. About 30 couples have responded.

This is not quite as novel as the FT might think. Let's go back to Dayton, Ohio, just a couple of years ago, as reported by the NYTimes:

Fighting back from the ravages of industrial decline, this city adopted a novel plan two years ago to revive its economy and its spirits: become a magnet for immigrants.Other struggling cities are trying to restart growth by luring enterprising immigrants, both highly skilled workers and low-wage laborers. In the Midwest, similar initiatives have begun in Chicago, Cleveland, Columbus, Indianapolis, St. Louis and Lansing, Mich., as well as Detroit, as it strives to rise out of bankruptcy.

In many ways, this is all about "managing shrinkage," as the FT article noted:

[A]s a rich country with a highly- educated population, Germany has the opportunity to become an innovator in how to manage an ageing population. “Demographic change need not be a catastrophe. The question is how to react,” says Reiner Klingholz, director of the Institute for Population and Development. “Governments are all used to managing growth. They must now learn how to manage shrinkage. We need a complete rethink in our societies.”

And how is another rich, well-educated country, Japan, coping? At the moment, Tokyo is dealing with a growing number of abandoned homes.

These ghost homes are the most visible sign of human retreat in a country where the population peaked a half-decade ago and is forecast to fall by a third over the next 50 years. The demographic pressure has weighed on the Japanese economy, as a smaller work force struggles to support a growing proportion of the old, and has prompted intense debate over long-term proposals to boost immigration or encourage women to have more children.

I'm betting on the idea that these unoccupied homes will be demolished, and probably at public expense. That's a lesson in shrinkage management. Tearing down an unoccupied home is a lot cheaper than raising children or integrating immigrants.

Explaining Low Fertility in Taiwan

Few countries on earth have fertility levels as low as Taiwan (TFR of 1.06), although several Pacific Asian neighbors (especially China, Japan, and Korea) are also way down there. A very nice paper just published by Stuart Basten and Georgia Verropoulou in PLOS ONE helps to explain the phenomenon, while simultaneously throwing cold water on any idea that fertility might rise any time soon. The introduction to the paper is an especially good review of the literature on low fertility and the paper is worth a read on that account alone. In particular, what we see in Taiwan is a country that has empowered women to become educated and have a career and choose the number of children that they are having. The culture does not empower women to be equal to men at home (and probably not in many other sectors, as well), and so the domestic demands on women who marry and have one or more children are enormous. Under similar circumstances, most of would make the same decision as do women in Taiwan to avoid or delay marriage and, within, marriage, to limit the number of children we were having. These very same phenomena are at work in low fertility countries in East Asia and Southern and Eastern Europe.

Now, why don't Basten and Verropoulou expect fertility to be going up? Because recent surveys have asked Taiwanese women how many children they intend to have, as opposed to their ideal family size. Ideal family size has remained fairly constant at around two children. But, when women with one child already were asked if they intended to have another one, most said no. Sadly, the ones more likely to say they intended to have another child were those whose first child was a girl. Thus, son preference is clearly influencing fertility. Even though the effect of son preference on fertility is "positive" in a statistical sense, the reality is that fertility in all of these low fertility countries would almost certainly be higher if women were given overall societal equality to men. Could that happen? The survey data offer a glimmer of hope that younger Taiwanese men may lean in that direction.

 

More Migrant Messiness in Europe

The news about migrants heading into Europe shifted geographic focus this weekend from the English Channel to the eastern side of Europe, where refugees heading north from Greece were initially stymied in their attempt to cross into and through Macedonia. The NYTimes has the story:

Hours after several hundred migrants bypassed a line of baton-wielding police officers on Saturday to enter Macedonia from Greece, nearly all those remaining on the Greek side of the border were allowed in, according to video footage and human rights activists at the scene. By Saturday evening, only around 200 people were left behind a fenced area on the line that separates the two countries.

Some of the people who entered continued their trip north, toward the Serbian border, via taxis and private buses. But most headed toward the train station about three miles away in the border town of Gevgelija, joining more than 2,000 people there waiting for a train to Serbia and Hungary, and then on toward wealthier European countries.

Just north of Hungary is Slovakia and it has made it very clear that it wants only Christian migrants, as CNN reports:

As Europe grapples with an unprecedented wave of migrants, many fleeing the brutal conflict in Syria, Slovakia announced Thursday that it only wanted to take in Christians. Slovakian Interior Ministry spokesman Ivan Netik told CNN his country's approach did not result from discrimination. Instead, he said, it stemmed from concern over whether the migrants would stay in Slovakia for the long term. Slovakia has only a tiny Muslim community, Netik said, and there are no mosques, making it hard for Muslims to integrate.

By which Slovakia is saying--go somewhere else. Like Germany, which CNN reports is expecting 800,000 asylum seekers this year--four times the number last year. Given the political and economic uncertainty in the Middle East, Western Asia, and Africa generally, it is hard to see when this will end.

Can We Feed These Folks?

New population projections from the UN and PRB have reminded us that we are still a long way from the peak of population growth. The UN thinks we could have 9.7 billion by 2050 and 11 billion people (4 billion more than we have right now) by the end of this century, and PRB thinks we could have 9.8 billion by mid-century (2.5 billion more than at present). How are we going to feed these people? A group of researchers in the UK has been looking for answers and, as BBCNews notes, the conclusion is that the future is a bit risky on this score.

Climate change is increasing the risk of severe 'food shocks' where crops fail and prices of staples rise rapidly around the world. 

Researchers say extreme weather events that impact food production could be happening in seven years out of ten by the end of this century. 

The authors argue that an over reliance on global trade may make these production shocks worse.

The impacts are most likely to be felt across Africa and the Middle East.

The UN's Food and Agriculture Organisation says that increasing population will drive demand for food up by 60% by 2050 in any case, so there is going to be significant pressure on food production.

In a separate but closely related study, global warming has been blamed for making the drought in California even worse than it would otherwise be. Perhaps the only good news for the world this week was that China may not be polluting the atmosphere quite as bad as earlier estimates had suggested. It is still the world's biggest polluter, though (with the US a close second). The sooner we transition to renewable solar and wind energy, the more likely it is that we can sustainably feed the expected new billions of people. 

Coping with Migrants at the English Channel Tunnel

One of the many ramifications of undocumented migration from Africa and the Middle East to Europe has been the encampment of people near Calais, France, trying to slip into the UK via the English Channel Tunnel. BBCNews reports that France and the UK have reached an agreement to try to cope with the problem. A centerpiece of the agreement is the pledge of money by both governments to go after the human traffickers that are largely responsible for the migrants having made it there in the first place.

The UK and France have signed an agreement on new measures including a "control and command centre", to help alleviate the migrant crisis in Calais. The centre will be jointly run by British and French police and will "relentlessly pursue" people-smuggling gangs, Home Secretary Theresa May said...She said the new command centre would "relentlessly pursue and disrupt the callous criminal gangs that facilitate and profit from the smuggling of vulnerable people, often with total disregard for their lives".

Other measures include funding more police to better protect the entrance to the tunnel, money to airlift undocumented migrants back to their country of origin (a practice also employed by the U.S.), and measures to help other countries, especially Greece and Italy, who are already dealing with vastly more migrants than they can handle, since the UK-France agreement will likely shift more migrants their way. Indeed, the BBC article notes the scale of the problem:

The situation in Calais is part of a wider migration crisis in Europe - caused largely by people fleeing war and oppression in countries such as Syria, Afghanistan and Eritrea
More than 240,000 migrants have crossed the Mediterranean already this year, arriving on the shores of Greece and Italy. [And this doesn't include the hundreds who have died trying...]

Most European nations--like most nations--are already relatively averse to taking in many legal migrants, so their reaction to the flow of undocumented immigrants has mirrored much of the negative talk that circulates in the U.S. regarding undocumented immigrants.

Who and Where are Undocumented Immigrants in the US?

Donald Trump has trumpeted a truly idiotic immigration reform, as others, including Greg Weeks, have pointed out. It is basically a two-parter: deport all "illegals" and then build an impenetrable wall, and send the bill for the wall to Mexico. There are a guzillion problems with this idea, but two are particularly important: (1) the border is already well defended and, as Doug Massey pointed out in an Op-Ed in Foreign Policy, the wall mainly serves to keep people in the US once here; and (2) Mexico is no longer the sender of immigrants that it once was. I reminded you of this recently, but it is also well documented in a report just out from the Migration Policy Institute. Drawing on data from the American Community Survey and the Survey of Income and Program Participation, they show both the range of places from which undocumented migrants come, and the changes in origin that have taken place over time. This is a complex picture, which is one of many reasons that immigration reform is so difficult and controversial. 

Along with the report is a very nice interactive map that allows you to see the number and origin of undocumented immigrants in each state and major county in the U.S. Check it out:

2015 PRB World Population Data--Get 'em While They're Hot

It's been a busy few days for population data. First the UN Population Division came out with its new set of population projections, and today the Population Reference Bureau released its latest set of world population data (don't leave home without them!). This year the overall theme of their data analysis is the empowerment of women, which is a key to future demographic success in the world. They have also added a new interactive data map that actually can be embedded in your own website, if you'd like to treat your readers to that. BloombergBusiness did an interesting job of covering the data release, including the graph below.

After America dominated the 20th century, a view formed that Asia would be the next to lead the world in economic and cultural influence. Africa may have something to say about that before the century is out.

The continent will claim three of the world's 10 most populous countries in 2050, according to projections released Tuesday by the Population Reference Bureau in Washington. The largest of those, Nigeria, will be just 1 million people shy of the U.S.'s size, with Democratic Republic of the Congo and Ethiopia entering the list. They replace Russia and Mexico, with the former's exit leaving Europe with no country on the top 10 list.

Key to the countries' growth? Babies. While the U.S. and other developed countries struggle to adapt their labor forces to an aging population, African countries are experiencing a baby boom. Niger, South Sudan, Democratic Republic of the Congo, Somalia and Chad have the highest fertility rates in the world.

"The population gains are also due to a decline in mortality rates due to improvements in public health," said Peter Goldstein, vice president with the PRB, who oversaw production of its 2015 World Population Data Sheet. "Africa is going to be a key driver in population growth over the next few decades."

No doubt about that. 

Are Blacks Being Deliberately Excluded From Juries in Southern States?

The Sixth Amendment to the U.S. Constitution lays down the principle of a trial by a jury of your peers. This doesn't mean that jurors have to be just like you; rather, they should be representative of the community in which the crime was committed. Over the years the U.S. Supreme Court has ruled that this largely means that jury pools should have roughly the same proportions of persons by race/ethnicity as does the community from which jurors can be drawn (adult citizens, in general, with some states adding residency or other requirements). Over the years I have been involved as an expert witness in more than 100 murder cases--mostly in California--in which the demographics of the jury pool have been challenged. Sometimes we have found that there are problems, and sometimes not. Sometimes when there are problems, the Court seeks to fix them, sometimes not. 

One of the items that is never on the table in the cases in which I have been involved, however, is the demographic makeup of the people who are actually selected for the jury. The Supreme Court's rulings have focused on the pool of people available to sit on the jury--not the final group selected for trial. However, as a lengthy story in the NYTimes points out, the constitutional ability of attorneys for either side in a case to use a certain number of peremptory challenges of jurors means that the demographics of the jury may in fact wind up being skewed. Indeed, in several southern states, there is evidence that peremptory challenges are being used by prosecutors to lower the number of blacks who serve on juries. The Supreme Court has ruled that there cannot be racial bias in peremptory challenges, but it appears that the Court has a lot of tolerance for "stupid" reasons that sidestep racial issues.

In Louisiana’s Caddo Parish, where Shreveport is the parish seat, a study to be released Monday [today] has found that prosecutors used peremptory challenges three times as often to strike black potential jurors as others during the last decade.

That is consistent with patterns researchers found earlier in Alabama, Louisiana and North Carolina, where prosecutors struck black jurors at double or triple the rates of others.

In Georgia, prosecutors excluded every black prospective juror in a death penalty case against a black defendant, which the Supreme Court has agreed to review this fall. 

“If you repeatedly see all-white juries convict African-Americans, what does that do to public confidence in the criminal justice system?” asked Elisabeth A. Semel, the director of the death penalty clinic at the law school at the University of California, Berkeley [and a person with whom I have worked].

This is just a reminder that we have to continue our vigilance (to quote Jon Stewart on the last day of "The Daily Show") if we are to somehow, sometime, rid ourselves of racial/ethnic bias.

By the way, the article references a North Carolina judge who has been active in dealing with these cases. His name is Greg Weeks, but he is not the same Greg Weeks of North Carolina who is my son, although I'm sure the two men share the same perspective on this issue.

Does Beijing Have a Population Problem or Not?

Last month I commented on a NYTimes story indicating that the Chinese government was on track to create a 130 million person megapolis centered on today's 7 million person city of Beijing. A more recent story in Slate does not mention the megalopolis plan, but instead focuses only on the role that Beijing itself is expected to play in that plan.

The government of the capital said in July that it planned to move the bulk of its agencies from downtown areas to the less populated Tongzhou District in the east over the next several years, a move authorities hope will shift 1 million people out of crowded downtown areas. The authorities have also been moving factories and major wholesales markets to the city’s outskirts or to neighboring Tianjin [site of that deadly chemical explosion two day ago!!] and Hebei provinces to comply with an order from the central government for Beijing to shed some functions that do not match its status as the capital. [note that this is part of the megapolis plan]

In a more controversial move, city authorities have in the past two years tightened requirements for children from migrant families to enroll in public schools. This is an apparent effort to rein in the growth in the number of migrant workers in Beijing. The capital had 8.82 million migrant workers—38 percent of the total population—at the end of 2014.

However, as with every plan, there are detractors. Slate found one here in the U.S:

Huang Wenzheng, a demographer at Johns Hopkins University in Baltimore [well, sort of, he received his PhD in biostatistics from there in 1998, but he does not appear to be a member of the faculty there, nor is he a member of the Population Association of America], wrote in an article published on Caixin’s Chinese website that the city’s population density ranked only 138th out of 224 cities around the world with populations of at least 2 million people.

The Chinese capital is more crowded than big cities in most developed countries, such as Tokyo, Paris, and New York, but is less cramped than cities in developing countries, including Brazil’s Sao Paulo and Ankara, in Turkey. “From a global perspective, it’s untenable to claim Beijing has too many people,” Huang wrote.

In other words, there are not too many people--there is too little infrastructure. This is all relative, of course, and it seems that the central government has decided that it is cheaper to move people than to build infrastructure.  Keep in mind, though, that the lack of infrastructure out in the suburbs was, sadly, one of the very things mentioned in the NYTimes story about the future of the megalopolis plan. This story and the previous suggest some tough times ahead in Beijing. 

Will Portugal Survive?

Yesterday the Financial Times had a pretty positive view of demographic events--at least as long as businesses paid attention to low fertility and the underlying demand for immigration in order to avoid population decline in rich countries. Today's Financial Times (and thanks to my older son, John Weeks, for this link) has a more dire story about the demographic situation in one of those richer places in the world--Portugal--calling it the "perfect demographic storm."

Portugal’s fertility rate — the average number of children in the population for every woman of child-bearing age — has been falling, from three in 1970 to 1.21 in 2013. This is the lowest level in Europe, with only South Korea having a lower rate among the 34 mostly wealthy nations in the OECD.

“The high rate of youth employment and a precarious job market are critical factors in deterring young couples from having children,” says Maria Filomena Mendes, a sociology professor and president of the Portuguese Demographic Association. “At the same time, many young people are emigrating at an age when they might otherwise have been starting families in Portugal.”

It is not clear that Portugal will flourish in the modern environment. Indeed, it has been a source of emigration for a long time. Here in San Diego the Portuguese fishing community has a long and rich history (along with immigrant Italian fisherman), but that was based on people leaving Portugal in search of a life elsewhere. Nothing really seems to have changed and the FT article does not offer any real hope for improvements in the economy that would alter the demographic decisions that Portuguese have been making for a long time--have fewer kids and move somewhere else. The idea that more children will solve the problem is a bit ephemeral and it is clear that the average person in Portugal doesn't buy that argument.

The Glass is Half Full Response to New UN Population Projections

The new set of UN population projections has received a lot of media attention, as I noted recently--and that's a good thing. Now, to be honest, my own reaction to each new set of UN projections is to see what they might say about future policy issues in the world. In other words, are we going to be OK? So, it was in some ways a bit refreshing to see a nicely nuanced very positive approach to the projections from Robin Harding at the Financial Times. Her basic message is that there is money to be made by businesses that adapt to the changing demographics. Focusing largely on the decline in birth rates, she argues that:

For business, that will mean a huge demographic dividend, as working age populations with spare cash swell in these countries.

But it also means the seemingly inexhaustible pool of cheap global labour actually has an end in sight. Countries with falling populations will soon be common. Companies will have to learn to navigate these declining markets. 

Finally, the end of population growth almost everywhere else will make Africa a hugely tempting market and manufacturing centre. More than that, however, lower fertility opens the prospect of truly tackling extreme poverty, with the chance of an accelerator effect as falling fertility elsewhere frees up resources to help the poorest.

My only complaint about this article is its title: "The End of the Malthusian Nightmare:  Falling fertility opens a new stage in human history, with greater control of our destiny." To be fair, we are not yet sure that we will be able to sustain 9-10 billion people indefinitely. When we get to that point, the "nightmare" will be over. And, it isn't exactly that falling fertility increases our control of destiny--it is really quite the opposite: gaining control of our destiny (as we have been doing over the past 200 years) is why fertility is falling.

We're Getting More Sophisticated at Keeping Infants Alive

For all animals species of which I am aware, the first year (or species equivalent thereof) of life is the most critical to the survival of the species. Our ability to keep human infants alive is one important reason that the world's population has gone from 1 billion to more than 7 billion in just two hundred years. Human infants are especially prone to die from dehydration due to diarrhea, which can be caused by almost anything. So, when oral rehydration therapies (ORT) were introduced globally only a half-century ago, they ushered in a new era of rapid decline in infant mortality and, of course, population growth. Indeed, ORT is new enough that one of its founders, Dr. Richard Cash, is still active on the faculty at the Harvard School of Public Health.

Medicine has progressed beyond ORT to look at what the causes are of diarrhea so that the child can be appropriately treated. The Bill and Melinda Gates has been instrumental in this effort and an article in today's NYTimes illustrates some of the complexities of diagnosis and treatment.

More than 40 pathogens — viruses, bacteria and parasites — cause diarrhea in children in developing countries. According to decades-old guidelines from the World Health Organization, these children should receive oral rehydration; intravenous rehydration if they cannot keep fluids down; and a zinc supplement.

The guidelines also say that children should receive antibiotics only when there is blood in their stool. At the time the recommendations were written, the best science indicated that blood was a sign of bacterial infection, and bacterial diarrhea is usually the most dangerous.

But bacterial causes are more common than had been realized, recent studies have found, and blood is not always present. And because many children with diarrhea do not receive antibiotics under W.H.O. guidelines, some experts say, many die or end up stunted by persistent infections that could have been cured.

The problem, though, is that some physicians are worried about giving out antibiotics unnecessarily, in order to avoid problems of building up immunities to its effects. Others argue (and I would agree) that if it could be a bacterial infection (even if you can't prove it), give the child the medicine! As the story points out, that's what we adults do when we travel. I wouldn't travel abroad without my antibiotics in case of diarrhea. Why should we deny that to a child?

All the time, though, we need to remember that as we more effectively keep children alive, we need to more effectively make sure that the parents have access to contraception. Those two things go together.

A Billion People in Poverty--Just Like 200 Years Ago!

Max Roser has done it again! He's put together a great analysis of global poverty over the past 200 years, focusing on "absolute poverty." This is roughly equivalent to the current World Bank idea of poverty as representing the equivalent of living on $1.25 per day. In colloquial terms, we would call this dirt poor. He makes the excellent point that if we go back 200 years (in this case to 1820, for which a data series of estimates exists), almost everyone was poor. Indeed, his estimates are that 94 percent of humans were in poverty as the modern industrial enlightened age began. That meant that there were 1 billion poor people in the world. As you can see in the graph below, that number hit its peak in the late 1960s--just as Paul Ehrlich published The Population Bomb. Since then the number of people living in absolute poverty has dropped back down to "only" one billion, but fortunately that now represents only 14 percent of the world's population. The global community has devoted a lot of time and energy to raising people out of the bottom of the pit, but now the question turns to how we are going to sustain that effort. There is obviously a lot of concern that economic growth has come about in ways that have been using resources faster than they can be regenerated. A key to the future will be our ability to transition quickly to renewable energy sources, as I have discussed before.

There Are Lots of Africans in Europe's Future

The UN's new population projections have generated a number of good stories in the press, and one of the better ones is a piece by Ross Douthat in the NYTimes. He picks up on two themes: (1) the population of Africa is growing faster than that in other region of the world, as I noted a few days ago; and (2) people are risking their lives to get from Africa to Europe, as I have also discussed. These two trends suggest a "Eurafrican" future, for which Europe is badly unprepared.

Already the desire for immigration sovereignty is behind Britain’s possible referendum on a “Brexit” from the European Union. It’s behind Denmark’s experiment with reimposing border controls. It’s behind the rise of the National Front in France, and Euroskeptical parties the continent over. It’s adding to Europe’s already-significant north-south divisions, since (poorer) southern European countries are receiving the bulk of recent migrants and (richer) northern European countries would prefer the new arrivals remain in Italy or Spain. 

And these pressures are only likely to increase, because of the second difference between immigration in Europe and America: Namely, the scale of the migration that may be coming to Europe over the next fifty years.

Today there are 738 million Europeans (500 million of them in the E.U.) and just under 1.2 billion Africans. In 2050, according to the latest U.N. projections, Europe’s population will have dipped to (an aging) 707 million, while Africa’s population will be 2.4 billion. By 2100, there will be 4.4 billion Africans – two of every five human beings overall — and Europe’s population will be just 646 million.

Douthat notes--correctly in my view--that migration will be driven not just by refugees, but by people looking for a better life in Europe. That has been happening for a long time, and it is likely only to increase over time, given the "Irresistible Forces" at work (as my son, Greg, and I have written about with respect to migration to the US from Latin America).  

Immigration "Ideas" Among Republican Candidates for President

Last night was the first "debate" (really, a Q&A, not a debate) among the candidates leading the polls in the quest for the Republican nomination for US President. To be fair and balanced about it, the Fox News moderators, led by Megan Kelly, actually did a pretty good job of framing questions and trying to put candidates on the spot. I was pleasantly surprised on that score. I was unpleasantly unsurprised, however, about the response to questions about immigration and immigration reform. Donald Trump continued to spout his vitriol about migrants from Mexico, again suggesting that the Mexican government was sending over criminals on purpose [as Castro did a few decades ago]. If you want the fact-checking on that, go to a brand new analysis of ACS data on immigration put together by my long-time friend at UT-San Antonio, Rogelio Saenz (and thanks to other long-time friend Rubén Rumbaut for linking me to this). The reality is that the SES of recent migrants from Mexico is going up, not down--almost certainly in response to people in Mexico fleeing the cartel violence there if they have the means to do so.

And, speaking of violence, the idea that immigrants from Mexico are criminals and so we have to make sure that we "shut the door" just isn't true, as Professor Rumbaut has convincingly shown us in his research.

The person on last night's panel who seemed to know most about the current undocumented migration situation was Marco Rubio, who correctly noted that migration from Mexico is way down compared to a few years ago, whereas migration from violence-prone areas of Central America has been rising. He did not, however, draw the important conclusion--these people are fleeing violence at home, they are not contributing to it in the U.S. Nor does anyone want to talk about the fact that at least some of the violence in Central America is caused by people learning how to be violent while living in the U.S., and then exporting that back to Central America. This is a complicated situation and simple ideas will not prevail, no matter how much we wish they might.

What is Education Good For?

As we approach the start of a new academic year, the value of education rises to the surface as a topic for discussion. Education is a key demographic characteristic, of course, and I can guarantee you that it is one of the more frequently mentioned items in this blog (click on "search" and see for yourself). Two stories today emphasized why that's true, and they both go well beyond the idea that education is just a commodity that you buy because it is useful to you. Rather, it is an investment in yourself and, ultimately, in your children as well. For the former, we have a piece in the Washington Post by a former professor and university president, focused on the value of a college education:

If we are going to treat college as a commodity, and an expensive one at that, we should at least grasp the essence of its economic nature. Unlike a car, college requires the “buyer” to do most of the work to obtain its value. The value of a degree depends more on the student’s input than on the college’s curriculum.

The ultimate value of college is the discovery that you can use your mind to make your own arguments and even your own contributions to knowledge, as do many students pursuing research in college. That too is a new sensation, and a very good one. Yes, it generally leads to higher career earnings. But it is the discovery itself that is life-changing.

Education is important because it allows us to see the world differently, to challenge existing assumptions, and to work to make the world a better place. That is scary for traditionalists, but it is precisely the recipe for bringing down the death rate, bringing down the birth rate, and having people migrate to places that can best use their skills and talents.

Now, as to your children, research just out in the journal Pediatrics demonstrates that parents who read to their children from the earliest days of the babies' lives can actually influence the brains of their children.

The researchers saw that, when the young children were being told a story, a number of regions in the left part of the brain became active. These are the areas involved in understanding the meaning of words and concepts and also in memory. These same brain regions have been found to be active when older children listen to stories or read.

Even more interesting, according to Horowitz-Kraus, is how the brain activity in this region was higher among the children whose parents reported creating a more literacy-friendly home. "The more you read to your child the more you help the neurons in this region to grow and connect in a way that will benefit the child in the future in reading," she said.

Obviously, a parent has to have some education in order to be able to read to their child, but that education can then be used, among other things, to stimulate their own children--a true upward spiral. 

Dogs Are People Too

I wrote in February about the death of our beloved German Shepherd, Max. He was a genuine member of the family, loved by my wife and I, our kids, grandkids, and everyone else who ever met him. His death left a genuine void in our lives, but a few days ago, when four of our grandchildren were in town, we all picked out a new member of the family. He is a one year old German Shepherd, saved from an early death by Coastal German Shepherd Rescue of San Diego, and we are very lucky indeed to have him. He is very well mannered and wants to please--a good boy in every way--but also very smart and energetic. We named him Larry, after the lifetime friend who told us about the rescue program and so put us in our Larry's path. 

I think we have all experienced that oxytocin rush that we now know is experienced by both dogs and people in the bonding process, as described in a research article in Science a few months ago:

If you think of your dog as your “fur baby,” science has your back. New research shows that when our canine pals stare into our eyes, they activate the same hormonal response that bonds us to human infants. The study—the first to show this hormonal bonding effect between humans and another species—may help explain how dogs became our companions thousands of years ago.

Dogs are already renowned for their ability to interact with humans. It’s not just the walks and the Frisbee catching; canines seem to understand us in a way that no other animal does. Point at an object, for example, and a dog will look at where you’re pointing—an intuitive reading of our intentions (“I’m trying to show you something”) that confounds our closest relatives: chimpanzees. People and dogs also look into each other’s eyes while interacting—a sign of understanding and affection that dogs’ closest relatives, wolves, interpret as hostility.

It is thus very hard to understand how someone could essentially "throw away" any animal, but then we think of stories of human parents who for a whole range of reasons abandon their children either deliberately or through neglect, and we are reminded to love our dogs and other children that much more.

Germans Need Immigrants--It's That Simple.

Thanks to Justin Stoler for linking me to an NPR story yesterday about Arab asylum seekers in Germany. 

German officials have struggled with the arrival of a record number of refugees and asylum-seekers this year who are draining local resources and prompting calls for increased deportations. But German businesses and labor officials see an opportunity in these newcomers to ease a chronic shortage of skilled workers.

A frantic search for hires is common in Germany, says Herbert Brücker, an economist with the Institute for Employment Research in Nuremberg. 

"We have shortages in the labor market," Brücker says. "My assessment is that asylum-seekers and refugees might be both an important resource for the labor market in the high-skilled segment as well as in the less-skilled segment, for example, in agriculture, in hotels and restaurants, in health care."

This is what happens in a rich society with a low birth rate and substantial social welfare programs on the books--you need people to do the work. And, because of the general principal of migration selectivity, people who have a legitimate claim to legal status to be in the country are likely to have salable skills. Germany's future depends on these people, no matter how much Germans may say they don't want immigrants (and they do say that!). Sadly, this migrant drain is going to make it that much harder for Syria, Iraq and other countries in the Middle East to rebuild when (and I optimistically say when, not if) the violence ends.

We Don't Actually Know Cause of Death for Millions of Humans

About 60 million humans will die this year, but 40 million of them will die without having a death certificate filled out for them in which a cause of death is listed. We can make some pretty good guesses about why they died, of course, but we could make better health progress if we knew for sure. This is the situation laid out by Dr. Alan Lopez, Director of the Global Burden of Disease Group at the Melbourne School of Population and Global Health, University of Melbourne and a long-time associate of Dr. Chris Murray and his Global Burden of Disease Group at the University of Washington. The story came to us via Ozy.com, and it made even my head turn.

“Policy is very weak because countries don’t have any evidence” for what’s killing populations, says Alan Lopez, one of the studies’ lead authors and laureate professor at the University of Melbourne’s school of population and global health. Without a cause of death and other basic demographic information, aka civil registration and vital statistics, it makes trying to prevent premature death a Goliath task. The series of studies, published in The Lancet, also found that another 40 million births a year, approximately one-third of the world’s total, also go unrecorded.

The births that go unrecorded are perhaps less important from a health perspective, but they do matter to the people who don't have a birth certificate because in modern society that means that you don't "count" in any official way. Your presence on the planet is estimated, but not officially acknowledged.

Our estimates of the causes of death come from limited sets of questions in surveys and censuses, as well as what are known as "verbal autopsies", in which a respondent tells an official what they think was the causes of death for a family member who died recently (typically in the past year). Lopez and others are trying to kickstart a movement to improve the registration of births and deaths.

Lopez and his team say they are starting to gain traction in making the recording of basic death and birth statistics a priority for global health movers and shakers. In partnership with Bloomberg Philanthropies, which is putting in $100 million, and a number of other groups, Lopez is leading a four-year push to improve death and birth registration systems in 20 countries. The initiative, called Data for Health, will look to use mobile and other technology to collect data faster and more efficiently.

A regular system of civil registration is very expensive, so there is almost no point in trying to move in that direction. On the other hand, cell phone penetration is now so deep in most developing countries, that verbal autopsies via cell phone text message makes a lot of sense.