Population Boom in Ghana--More Contraceptives Needed

This past Saturday was World Contraceptive Day--as important a day from a global perspective as you can imagine. This was highlighted by news from Ghana (and thanks to Population Matters for the heads-up on this) that the population continues to grow at a pace faster than the economy can handle. 

Dr Patrick Aboagye, Director of the Family Health Division of the Ghana Health Service (GHS), said currently, the country had a young population of age 0-14, which represented approximately 41.0 percent of the total population.

He said the youthful population had an in-built momentum for further rapid growth when they reached their reproductive ages.

To contain the rate of population growth, the President of the National House of Chiefs, Professor Naa John S. Nabila, appealed to traditional rulers to join hands in the education of the youth about sexuality.

He indicated that since the youth were already sexually active, there was the need to educate them on the right use of condoms and the other contraceptive choices that they had in order to help curb the population boom that was looming in the country.

It is estimated that Ghana needs GH¢906m to carry out a vigorous family planning campaign in the next five years to help curb population growth.

Keep in mind that Ghana already has one of the slower rates of population growth in West Africa, and its economy is helped along by the relatively recent discovery of off-shore oil in the Gulf of Guinea. So, if Ghana is worried about its ability to maintain a good reproductive health system that will keep pushing the birth rate down, you can imagine what is happening in the neighboring countries...

Integration of Immigrants into American Society

Two days ago I noted that the National Academy of Sciences was holding a briefing on immigration to celebrate the 50th anniversary of the current immigration law in the U.S. The briefing highlighted a new report published by the National Academy Press called "The Integration of Immigrants into American Society," edited by Mary Waters and Marisa Gerstein Pineau. In a nutshell (and from their introduction), the panel found that:

Overall, the panel found that current immigrants and their descendants are integrating into U.S. society. This report documents the course and extent of integration and the report’s chapters draw 18 formal conclusions with regard to integration. Across all measurable outcomes, integration increases over time, with immigrants becoming more like the native-born with more time in the country, and with the second and third generations becoming more like other native-born Americans than their parents were.  

For the outcomes of educational attainment, occupational distribution, income, residential integration, language ability, and living above the poverty line, immigrants also increase their well-being as they become more similar to the native-born and improve their situation over time. Still, the well-being of immigrants and their descendants is highly dependent on immigrant starting points and on the segment of American society—the racial and ethnic groups, the legal status, the social class, and the geographic area—into which they integrate. There are three notable outcomes where well-being declines as immigrants and their descendants converge with native-born Americans: health, crime, and the percentage of children growing up with two parents.

The bottom line, then, is that the descendants of immigrants eventually become "Americans" but that isn't always good for their health and well-being. But, being an immigrant can also be hard on your health, as we were reminded today on NPR's "The California Report." The issue here is that an increasing fraction of migrants (usually undocumented) from Mexico are from the southern states of Mexico, where Spanish is not the first language. [Note that Piotr Jankowski, Justin Stoler and I analyzed this trend in a paper we published a few years ago.] These migrants often speak only native languages such as Mixteco or Triqui, and there are no translators to help health providers understand their health problems. Here at San Diego State University we have a program to work with members of these linguistic communities, but the obvious goal has to be to bring them into English proficiency so that they can better navigate the host society.

Celebrating the 50th Anniversary of Major Changes to US Immigration Law

Fifty years ago this week President Lyndon Johnson signed into law a set of major changes to the U.S. Immigration and Nationality Act. As my son, Greg Weeks, and I summarize in our book Irresistible Forces, the changes were dramatic (p.53):

In 1965, amendments to the Immigration and Nationality Act (which in 1952 had brought all existing immigration laws under one piece of legislation) raised the total number of immigrants who could enter each year from all countries, from 150,000 to 290,000, and eliminated the numerical restrictions (the “quota system”) established in 1921 that had strictly limited immigration from most non-Western European countries (the vast majority of immigrants thus came from Great Britain, Ireland, and Germany). Under the new legislation, for example, a ceiling for the eastern hemisphere was set at 170,000, and no more than 20,000 could come from any single country. In that era of civil rights activism, the idea was to end the blatant discrimination that existed in the immigration policies. For the western hemisphere, 120,000 could enter with no ceiling on any specific country, but there were no restrictions on family members of legal immigrants.

Canada had recently rid itself of the racist quotas and the U.S. followed suit. In signing the bill, President Johnson made the following assessment:

This bill that we sign today is not a revolutionary bill. It does not affect the lives of millions. It will not reshape the structure of our daily lives, or really add importantly to either our wealth or our power.

Oh boy, was he ever wrong! And a new Pew Research Center report authored by Mark Hugo Lopez, Jeffrey Passel, and Molly Rohal, tells the story about the massive changes wrought in American society by the shift in immigration policy. There are two headlines making the rounds: (1) the percentage of the US population that is foreign-born is almost back to where we were at the beginning of the 20th century (but you already knew that if you've read my book); and (2) in the past few years, Asians (largely from China and India) have surpassed Latin Americans (largely from Mexico) as the majority of migrants entering the country. That's the beauty of migration--it never stops surprising us.

UPDATE: GO HERE FOR A VERY INTERESTING AND USEFUL VIDEO ON THE CELEBRATION THAT TOOK PLACE AT THE MIGRATION POLICY INSTITUTE THIS WEEK.

Migration on our Minds

Thanks to my son, John Weeks, for pointing me to a very interesting podcast on migration by Dan Carlin, who is a former radio show host, and now a very successful podcaster, focusing on issues of the day, but from a broad historical perspective with a bit of common sense thrown in (ergo the names of his podcasts--Hardcore History and Common Sense). The podcast is an hour long, but it is very thought-provoking and worth the time. Think of it is as a good guest lecture.

Migration will also be on the minds of people attending a briefing tomorrow (28 September) at the National Academy of Sciences in Washington, DC, on the topic of "The Integration of Immigrants into American Society." The briefing is sponsored by the NAS Committee on Population.

And, you'll want to read about a new study just released by researchers at Germany's Max Planck Institute for Demographic Research (MPIDR) comparing the fertility in Germany of Turkish origin women born in Turkey compared to those born in Germany. 

Katharina Wolf distinguishes between migrants of the “second generation” who were born to Turkish parents in Germany and migrants of the “1.5 generation” who were born in Turkey and moved to Germany before they were 17. While in the 1.5 generation 86 percent of all women already had a first child by 35, the percentage was only 77 for the second generation. It was even lower for Western German non-migrants of whom only 63 percent had become mothers by age 35. For comparison, among women living in Turkey nine out of ten have at least one child by the same age. (This number, 90 percent, is not a result of the MPIDR paper but stems from an earlier Turkish study). 

The migrants born in Turkey (1.5 generation) were the youngest to have their first child. Half of them had already become a mother by 24. For women born to Turkish parents in Germany this age was 27, while it was highest for non-migrants in Western Germany at 31 years.

These results confirm the key role of culture as a factor in fertility levels among migrants, as does a recent paper published in Demographic Research comparing fertility among different immigrant groups in the Lombardy region of Italy.

Moroccans are characterized by a strong interrelation effect between fertility and migration. Moroccans and Albanians are the national groups with the highest risk of having a first child during the years shortly after migration. Migration does not seem to have any effect on the fertility behavior of Romanians, who have a lower risk of having a child regardless of their migration status.

This brings us gets us back to the main point of Dan Carlin's podcast, which is to emphasize how complex this whole migration business is.

UN Approves Sustainable Development Goals

Today the United Nations General Assembly officially approved the set of 17 Sustainable Development Goals (SDGs) that replace the 8 Millennium Development Goals (MDGs) put in place just prior to the new millennium. The MDGs focused on improving health and raising incomes, and the SDGs follow those themes, but with various alterations and additions. Indeed, as a commentary in Nature noted, there are probably too many goals, especially since each goal has multiple targets within it (169 in all!):

Ambitious and broad, these Sustainable Development Goals (SDGs) would, if met, greatly improve human welfare. But some experts fear that the goals are too numerous and vague to have practical value. “I’m a little worried that there are too many of them,” says Steven Radelet, director of the Global Human Development Program at Georgetown University in Washington DC. “They may fall prey to the old adage that if every­thing is a priority, then nothing is a priority.”

Lurking in the shadows, but never out on the table, are goals related to slowing down the global rate of population growth. Indeed, as with the MDGs, the explicit goals are to make people healthier and live longer. No one can argue with that. But, sadly, people do argue with the idea that everyone should have access to voluntary methods of effective birth control so that they can have only the number of children they want and can afford (i.e., responsible parenthood). To be sure, the goals of improving the status of women and making sure that everyone, including girls, have access to more and better education, will move things in that direction (the motivational part). And, hidden within some of the targets are measures regarding reproductive health (the implementation part), as noted recently by an analysis in The Lancet:

There are two targets in the SDGs that explicitly mention sexual and reproductive health. Target 3.7, under the health goal, states: “By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.” Target 5.6, part of the gender goal, aims to “Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.”

My guess is that the contradictions embedded in the targets, and the multiplicity of goals, will make it way too easy for governments and NGOs to pick and choose the ones they want--avoiding especially the controversial ones like population growth. Without that, however, none of the other goals are likely to be accomplished--certainly not in a sustainable fashion.

Muddling Toward a Syrian Refugee Solution

It seems reasonable to me that the current flood of refugees and other migrants to Europe would not have occurred were we not now in the 4th year of a civil war in Syria. Yes, there would be many migrants heading to Europe, as there have been for many years now, but the current crisis is largely a result of the mess in Syria. As I have noted before, this could be a demographic boon for Germany (and other European countries on the precipice of population decline). But, as the NYTimes and everyone else notes today, there is no real consensus in Europe about how to proceed--especially how many to let in, and where will they go? For receiving countries, this will not be an easy project--a surge of immigrants never is. Abu Daoud provided a link to a very interesting Op-Ed piece about "Germany's Coming Demographic Revolution" that speaks to this issue.

Before 2015, Germany’s Muslim population was around 5 percent of the whole, potentially rising to 7 percent or so by 2030 [Note--see the Pew/IIASA projections that came out earlier this year]. If the present wave of migrants and refugees continues, that figure could well be 15 or 20 percent by the 2030s, and it would be rising fast. For the first time ever, we would seriously be looking at something like the Islamization of Europe that has been a nativist nightmare for a generation. And in the German context, that process would be squeezed into just a couple of decades. That is radically destabilizing.

Personally, I don’t believe that the presence of Islam in Europe need of itself be harmful or even negative, nor that it would necessarily lead to violence. But I am quite certain that numerical changes on this scale do portend a cultural and social revolution without precedent.

Shouldn’t the Germans, and other Europeans, at least be allowed to discuss this openly?

I think that this is a reasonable point. Not all of the refugees are Muslim, of course, and while that shouldn't matter, the point I've often made is that "differences" matter when it comes to immigrants, whether it's language, religion, status of women, or anything else. These issues need to be out in the open in order to promote accommodation, adaptation, and integration, rather than discrimination and ghettoization.

Pope Francis's Views on Not Breeding Like Rabbits

With Pope Francis's arrival here in the US, there are a lot of stories on the news. In particular, CNN has been playing a nicely done biography of the Pope, hosted by Chris Cuomo. This program brought  up the tweet from the Pope this past January that Catholics (well, everyone, really) should not breed like rabbits, but should rather practice "responsible parenthood." The National Catholic Reporter had this to report:

Moments earlier, Francis had signaled his approach to the vexed birth control issue when, with equally quotable verve, he said the contraception ban "does not mean that the Christian must make children in series."

He noted that during a parish visit some months ago, he even "rebuked" a woman who was pregnant again after having seven children, all delivered by Caesarean section. "But do you want to leave seven orphans?" Francis told her. "That is to tempt God!"

The idea of responsible parenthood is a bit vague, but to me it recalls Malthus, who firmly believed in what he called "moral restraint"--that no man (and, yes, of course, he was a sexist back there in the late 18th century) should get married until he knows that he can afford to raise all of the children that God will then provide. This naturally assumed abstinence before marriage and no birth control (which was very primitive in those days) during marriage.

But Malthus was right in the sense that the motivation to avoid children is the key to responsible parenthood. Back in the early 1980s I received a grant from the US Office of Population Affairs to analyze data from a fertility awareness clinic ("Responsible Parenthood of San Diego") at one of the Catholic parishes here in San Diego. The director of the clinic contacted me about this, and what we found was that this enhanced method of the rhythm method--relying on close scrutiny of temperatures and a lot of self-control--had a failure rate of 13.2 pregnancies per 100 woman years of exposure to intercourse. I published the results in the Journal of Biosocial Science where I noted that among highly motivated couples (and that's the key!!) the method "is not quite as effective as the pill or IUD, but it is as effective as barrier methods such as the condom, diaphragm, or spermicidal foams or jellies." Maybe that was too effective--the local diocese closed down the program a long time ago...

Are We Sure About Essure as a Permanent Contraceptive?

Essure is the only nonsurgical, permanent birth control method that the US Food and Drug Administration has ever approved. and it did this back in 2002. A story today on NPR indicates that the FDA is about to convene a panel to assess its overall safety. Essure is a small coiled device that a physician places in the fallopian tubes, where it causes scarring that blocks sperm from reaching eggs. Since there is no surgery, there are no potential surgical complications, but there apparently are other complications experienced by at least some women, not to mention that the method may actually fail among at least 10% of women.

After their third son was born, Tisha Scott and her husband decided they were done having kids. So Scott, 34, of Drakesville, Iowa, decided to get her tubes tied. "As old married people, neither of us was really interested in using condoms for the rest of our life," Scott says. "So that was the decision that we made because we knew that our family was complete."

But instead of undergoing surgical sterilization, Scott's doctor urged her to try something called Essure — the only available, nonsurgical permanent birth control option approved by the Food and Drug Administration. Essure is a device comprising two tiny coils made of nickel-titanium alloy. Scott's doctor inserted one into each of her fallopian tubes to permanently block them. Since Essure doesn't require surgery, he said it would be a lot easier, quicker and safer.

But almost immediately after the procedure Scott started getting an excruciating burning pain in her back and pelvis. "All of a sudden it hurt to have to move my body to get out of bed, to do anything," she says. The pain got worse and spread all over her body. Despite two operations and many tests and exams, Scott says she still lives in constant pain.

Now, what struck me about this story is that Tisha Scott's husband apparently never considered having a vasectomy. It is a quick and easy procedure and millions of men all over the world have done this. So, that scenario looks decidedly sexist. Then, I noticed that the Vice President for Women's Health Care of the Bayer Company, which makes Essure, is a man! What? Come on--the Germans know better than that.

Spatial Demography Lessons from Mexico

This week's Economist has a wide-ranging, but generally optimistic assessment of changes taking place in Mexico. They point out, though, that there are two Mexicos: the modernized, industrialized, higher income states and residents (a minority of the population), and the poor Mexico (the majority), with people living without infrastructure and working in the informal sector. They divide this roughly into the north and south, but even their own map shows that, while the north/south divide does exist in Mexico, the country is more complex than that. Part of the complexity is a factor that the Economist ignores--demography. Life expectancy is nearly as high in Mexico as in the United States (despite the fact that that the average Mexican pays far less for health care than the average American--according to OECD data) and fertility is dropping to levels nearly as low as in the U.S. According to data from the Mexican government, the average woman in Mexico in 2013 (the most recent data) was giving birth to only 2.2 children (just barely above replacement level)--a drop from 2.6 in 2000. Indeed, fertility has been below replacement level in Mexico City for a number of years. The drop in fertility, of course, helps to explain the dramatic slowdown in migration from Mexico. There are fewer young people and that helps the economy, and the better economy increases the chances of finding a job in Mexico, rather than having to cope with the increasingly dangerous and expensive undocumented migration to the U.S.

But the birth rate is not evenly low throughout Mexico, even though it is lower in every state now than it used to be. I created a state-by-state map of the TFR in Mexico for 2000 from the INEGI data, and you can see that fertility is very low in Mexico City and especially in states closer to the US-Mexico border. I used data for 2000 instead of 2013 for the map because these data will reflect the youth population of today--the group of people needing to be absorbed by the Mexican economy. The state of Guerrero, just to the south of Mexico City (albeit over the mountains), and the state of Coahuila, bordering south Texas, had the highest fertility levels in 2000 (as they do still now). So, proximity to the engines of modernization (i.e., Mexico City and the US) does not ensure low fertility. At the same time, the lowest levels of fertility are generally found in Mexico City and its surrounding areas, and along the rest of the US-Mexico except for Coahuila. But you can also see that fertility is below average in the Yucatan peninsula. As the Economist rightly notes, it is the combination of geography and culture that matters, and that is the essence of spatial demography.

What If There Were No Planned Parenthood?

One of the more obnoxious issues on display at the recent Republican presidential candidates debate was the vicious set of attacks on Planned Parenthood. This echoes the feelings of many right-wing members of Congress who want to shut down the government rather than provide any funding to Planned Parenthood, despite the fact that no federal funding goes for abortions. As she usually does, Gail Collins hits the nail on the head in an Op-Ed in today's NYTimes.

This leads us to an important question about the Planned Parenthood debate: Are the people who want to put it out of business just opposed to the abortions (which don’t receive federal funds), or are they against family planning, period?

“I’m telling you, it’s family planning,” House Minority Leader Nancy Pelosi said in a phone interview. “They decided that was their target long ago.”

Sara Rosenbaum, a professor of health law and policy at George Washington University, studied what happened when Texas blocked Planned Parenthood grants and tried to move the money to other providers. Even when there were other clinics in an area, she said, “they were overbooked with their own patients. What happened in Texas was the amount of family planning services dropped. And the next thing that happened, of course, was that unplanned pregnancies began to rise.”

Unplanned pregnancies increase the chances of a woman having a child that cannot be easily afforded, potentially increasing the demands on welfare--which right-wing Republicans also resent paying for. Collins reminds us, as I've noted before, that the best way to get rid of the demand for abortions is to make sure that all women and men have excellent access to birth control. And, even if you are a pronatalist, you surely must understand that a planned family does not necessarily mean a smaller family. Rather, it implies a family of parents and children that are loved and well cared for. I really think that most of us aspire to that kind of society. Getting rid of Planned Parenthood would move us in the other direction.

Why Do We Have to Keep Fact-Checking Vaccination Stories?

The Republican presidential candidate's debate last night brought us back to the subject of vaccinations. People love conspiracies, I guess, and some people just cannot accept facts. So, one more time, we needed a responsible person to remind the world that vaccinations save lives! That's what they do! And they don't cause autism. Aaron Carroll, a professor of pediatrics at the University of Illinois filled the role of explainer-in-chief on today's NYTimes' Upshot blog. 

Questions about vaccines and autism were asked not only of Donald Trump, but also of the two physicians taking part: Ben Carson, a neurosurgeon, and Rand Paul, an ophthalmologist. The doctors, at least, should know better.

Here are the facts:

Vaccines aren’t linked to autism.
The number of vaccines children receive is not more concerning than it used to be.
Delaying their administration provides no benefit, while leaving children at risk.
All the childhood vaccines are important.

Carroll laments the fact that the subject of vaccinations has to keep coming up for discussion because every time it does it undoubtedly cements the idea in various believing brains that some of this bologna is really true. 

Guest Workers and Putting Americans to Work

As I write this, the second Republican candidates debate is still playing on CNN (it is a three-hour extravaganza). The immigration issue is not the single most important topic in the discussion, but it has come up. Among the salad bowl of ideas floating around are: (1) we don't need amnesty for undocumented immigrants, but we do need a guest worker program; and (2) we need to create more jobs for Americans, although that should not be accompanied by a higher minimum wage. Don't these ideas clash with each other? We ended our major guest-worker program with Mexico (the Bracero program), just before the massive new immigration law was enacted in 1965 that increased the legal quota of immigrants from the western hemisphere, as from most other places in the world. The idea was that we were no longer going to need a guest worker program. That immediately turned workers crossing the border to work in the US from legal guest workers to undocumented immigrants. We have continued to need those workers, however, because US-born workers tend not to want to do the jobs that the immigrants are taking. Part of this is because the jobs are hard and crummy, and also because wages in these jobs are so low--they are exploitative.

At the same time, many jobs--especially manufacturing jobs--in the US have gone "off-shore" because global population increase since WWII means that there are a lot of people elsewhere in the world who will work for a lot less than the current US minimum wage, even as low as it is. And that is why we are able to buy so many things--our standard of living has risen because we can afford to buy things that are made by people who work for very low wages. So, we have to reckon with the fact that a rise in wages will increase our cost of living, and implicitly lower our standard of living. Now, the first people who feel this effect of a mandatory rise in wages are the owners of businesses. Oftentimes, however, they are making so much more money than their workers that the resultant income inequality is also a major societal problem.

These are issues that have evolved over the past several decades, and they are not amenable to easy answers. Anyone who has an easy answer simply hasn't thought this through.

Measles, Dengue, and Cholera--Still out to get us!

The news from the Democratic Republic of the Congo (formerly the Belgian Congo and then Zaire) is that there is an outbreak of measles in an area that is remote and thus hard for vaccinators to reach. The NYTimes reports that:

More than 23,000 people, mostly children, have been infected with measles in the Katanga region of the Democratic Republic of Congo. More than 400 have died, according to United Nations agencies and Doctors Without Borders.

The news from India, via BBC News, is that there is a huge new outbreak of dengue fever. While this is common at the end of the monsoon season, this year is worse than most:

The Indian capital, Delhi, is in the grip of the worst outbreak of dengue fever in five years, officials say. 

More than 1,800 cases have been recorded in recent weeks, compared to 1,695 cases for all of 2010. Five deaths have been reported so far.

The mosquito that carries the dengue virus breeds in containers with clear, stagnant water.

The government in Delhi has ordered 1,000 extra bed in hospitals to treat dengue patients after the suicide of a couple whose seven-year-old son died from the tropical illness after being allegedly refused treatment at a number of city hospitals.

That part of the story is almost too awful to contemplate. Meanwhile, in the western hemisphere, it is also hard to contemplate how deeply affected Haiti has been by the cholera epidemic that followed on the heels of the major earthquake there almost five years ago. As I noted at the time, cholera was introduced into the country by UN peacekeepers from Nepal, and a paper recently published in the Annals of the Association of American Geographers suggests that the country doesn't expect to rid itself of the disease until 2022 (no, that's not a typo). The authors--Matthew Smallman-Raynor, Andrew Cliff and Anna Barford, note that in the first four years after the disease first appeared in the country more than 700,000 people have been infected, of whom nearly 400,000 were hospitalized and nearly 9,000 died. 

As measured by morbidity, the Haitian epidemic is the largest reported outbreak of the disease since the nineteenth century, and it has occurred in a country with no previous recorded history of disease.

These stories are just reminders that you have to always be careful out there...something is always right around the corner waiting to get you if you aren't paying attention. That's not paranoia--that's just the real world.

New Australian PM is Demographically Aware

Australia's Parliament elected a new Prime Minister today, with Malcolm Turnbull ousting Tony Abbot. Admittedly, I wouldn't have given this much thought were it not for Nick Parr's tweet highlighting Turnbull's first speech to Parliament after being elected back in 2004. After talking about his own background, Turnbull moves to the subject of demography, noting first that Europe and East Asia are aging rapidly, and offering the clear opinion that this is not a good thing. Then he says:

Demography is indeed destiny. America's global leadership is reinforced by its strong population. The Economist has estimated that by 2050 the US population will not only have overtaken that of Europe but that the median age of Europeans will be 53—17 years older than Americans and 10 years older than Americans and 10 years older than Australians. These changes to our population and their consequence of very substantially increased demands on government for health and aged care will preoccupy this parliament and its counterparts in other nations for the rest of this century. Australia is well prepared to deal with these challenges, as we have seen laid out in the Treasurer's groundbreaking Intergenerational Report of 2002. More than the leadership of any other developed country, the Howard government has not only recognised these demographic changes and their implications but moved to meet them. There is, however, no room for complacency. The demographic storm is coming. How hard it blows and how well our children weather it will depend in large measure on the decisions we take today and our maintaining the courageous and determined leadership of the last 8 1/2 years. A strong Australia in a changing world will be one committed to enterprise, self-reliance, economic growth and, above all, high productivity. It will be an Australia that recognises that we have a vital interest in strengthening, promoting and defending marriage and family life.

Australia has, in fact, been following in the path of the US and Canada with respect to accepting immigrants, including an increasing fraction of Asian immigrants. According to data from the Migration Policy Institute, Australia is now the 9th most "popular" destination for international migrants (well, those data predate the current onslaught in Europe).

In addition to his demographic awareness, there appear to be other things to like about Turnbull. He is a champion of women's rights, and his wife was the first female Lord Mayor of Sydney. He is in favor of gay rights, and supports actions to battle climate change. He also has a dog blog...

Road Kill in China

Life is a fragile thing to begin with. You only have to look at infant, child, and maternal mortality rates to get a feel for that. But we as humans figure out an amazingly large number of ways to kill ourselves deliberately or accidentally. One of the more silent killers is road deaths. The World Bank published a report on this type of "other non-communicable causes of death" a couple of years ago, focusing on sub-Saharan Africa, where traffic deaths are especially prevalent. This is due to bad roads, old cars, poor driving, and too much congestion amongst pedestrians, cycles, and cars. The Washington Post also did a story on this last year:

It has a global death toll of 1.24 million per year and is on course to triple to 3.6 million per year by 2030. 

In the developing world, it will become the fifth leading cause of death, leapfrogging past HIV/AIDS, malaria, tuberculosis and other familiar killers, according to the most recent Global Burden of Disease study.

The victims tend to be poor, young and male.

In one country — Indonesia — the toll is now nearly 120 dead per day; in Nigeria, it is claiming 140 lives each day. 

This global killer is our most necessary accessory, the essential thing that gets us from here to there: the motorized vehicle. 

But the most amazing story along these lines came from Slate just a few days ago as they explained why drivers in China intentionally kill the pedestrians they hit.

It seems like a crazy urban legend: In China, drivers who have injured pedestrians will sometimes then try to kill them. And yet not only is it true, it’s fairly common; security cameras have regularly captured drivers driving back and forth on top of victims to make sure that they are dead. The Chinese language even has an adage for the phenomenon: “It is better to hit to kill than to hit and injure.”

Most people agree that the hit-to-kill phenomenon stems at least in part from perverse laws on victim compensation. In China the compensation for killing a victim in a traffic accident is relatively small—amounts typically range from $30,000 to $50,000—and once payment is made, the matter is over. By contrast, paying for lifetime care for a disabled survivor can run into the millions. The Chinese press recently described how one disabled man received about $400,000 for the first 23 years of his care. Drivers who decide to hit-and-kill do so because killing is far more economical. Indeed, Zhao Xiao Cheng—the man caught on a security camera video driving over a grandmother five times—ended up paying only about $70,000 in compensation.

This IS genuinely crazy--you couldn't make this up. 

Child Mortality Declining Globally--But MDG Goal Not Hit

The fourth of the Millennium Development Goals (MDGs) approved by the United Nations (in cooperation with the World Bank) back in 2000 was to reduce child mortality to only 1/3 of the 1990 level as of 2015. The good news is that a report out yesterday published in The Lancet confirms that the global rate of child mortality has declined. The sobering news is that the MDG goal has not yet been met, as BBCNews reports:

Child mortality has fallen by more than 50% since 1990, a report by the World Health Organization and UN children's agency Unicef says.
It says that 25 years ago 12.7 million children under five died, but this year the figure is projected to drop below six million for the first time.
But aid agencies warn that huge challenges remain.
They point out that the UN target of reducing child mortality by two-thirds between 1990 and 2015 will not be met.

To put the decline into perspective, the report estimates that in 1990, when the world's population was 5.3 billion, there were 12.7 million children under age 5 dying during the year. By this year, with a world population of 7.3 billion, "only" 5.9 million children are expected to die. The lowest rates of child mortality tend to be in northwestern Europe and Scandinavia, while the highest rates are in sub-Saharan Africa. However, the single biggest contributor to child deaths is India, which accounts for one out of every five child deaths in the world [Note: country level data are available in the online UN version of the report]. A recent report from India, reported by CNN, indicates that "[B]esides neonatal health conditions, widespread illiteracy, poverty, poor sanitation and nutrition have also been identified as contributors to high rates of child mortality in the world's second most populous nation." In the meantime, the world's most populous nation, China, has reduced its child mortality rate to only 1/5 what is was in 1990. This has certainly been aided by the low fertility in the country.

Growing Older in China Isn't What it Used to Be

Respect for one's elders is embedded as a cultural value in nearly all human societies. In China, the concept of filial piety has a long history and refers to the Confucian "virtue of respect for one's father, elders, and ancestors." I took that quote from Wikipedia and one can note the gender bias, in particular. I mention in my book, however, that older people have not fared well in recent years in China. They are often neglected and abused, and laws have had to be passed to protect them. You would think that in a culture with that Confucian ethic, with communism layered over it (an ideology of sharing society's resources) that this wouldn't be happening. But it is, and a story in yesterday's NYTimes suggests that things could be a lot better for China's elderly.

By 2050, as many as one-third of China’s projected population of about 1.5 billion may be 60 or older, a situation so far found only in Japan, a “hyper-aged” nation where 33 percent of people fall into that category. So how are older Chinese doing compared with their counterparts in other countries?

“Moderately,” according to the Global AgeWatch Index 2015, a survey released on Wednesday by HelpAge International, a nongovernmental organization. The country “faces significant challenges,” but has “made progress on age-friendly policies,” the group said in a statement.

It is not clear how well the government is providing for the elderly in China--the article suggests that they are twice as likely to be in poverty as other people in a given region. Families used to be responsible for the elderly, but of course that was much easier when people had only a slim chance of reaching old age in the first place, and in all events there was more than one child who might be available to provide help if needed. Demographic dynamics have changed everything.

Is Germany Securing its Demographic Future?

Germany has announced that it expects to accept 800,000 refugees by the end of this year, and around 500,000 per year for "several years," Vice Chancellor Sigmar Gabriel has said, as reported by CNN. This is clearly an enormous humanitarian effort and, despite the publicized xenophobia, Germans appear to be generally supportive of the government's actions. A story in the Sydney Morning Herald reported that, despite anti-immigrant protests:

...such incidents have been drowned out in recent days by the numerous accounts and images of ordinary Germans turning out in droves to help the newcomers in their midst. 

In Munich, such efforts shifted into high gear at a donation bank, where half a dozen people sorted through heaps of clothing, toys, bicycles and bedding earmarked for refugees. The welcoming attitude was particularly noteworthy in a city that has long had to live with the stigma of being the birthplace of the Nazi Party. 

"This is the nicer side of Germany you are seeing," said retired banker Eddie Lauer, 64.

Germany is currently a country with 81 million, so we are talking about new migrants accounting for less than 1% of the total each year. Small enough to be absorbed by a country that has nonetheless had a fairly large immigrant population (including Turks, Afghans, Vietnamese, and many others) for a long time. But also large enough to make a demographic difference in an otherwise aging society. The UN's latest population projections suggest that by 2050 Germany's population could be down to 75 million, and then down to 63 million by the end of the century. So, you can see where we're going with this. On its own, Germany would not likely have upped the number of immigrants that it accepted, no matter what the long-term benefit might be. But, under these unusual humanitarian circumstances they are taking people in. These are largely people of working and reproductive age. They are obviously highly motivated and creative--think of what it must take to find the money to pay human traffickers and find the courage to make a genuinely perilous journey as an alternative to the peril of not doing so. 

Even at this moment, I can imagine John Wilmoth and his group at the UN's Population Division rethinking those projections for Germany...

Can Europe's Migrant Mess Get Messier? You Bet!

The surge of migrants into Europe has been constantly in the news, as well it should be. European countries, along with the US, have played a huge hand in creating the stresses generating the flow out of the Middle East and Africa. The NYTimes has a detailed summary of recent events:

Thousands of migrants continue to flow through the Balkans toward Hungary every day, rapidly approaching its southern border with Serbia, government officials said. Two Greek ferries carrying more than 4,000 migrants were scheduled to land Sunday in Athens, a first stop on the migrant trail through the Balkans.

On Sunday, Pope Francis called upon Catholic parishes and religious communities to take in refugees. And Germany has called for a quota system to distribute the migrant population evenly throughout Europe. 

But the European Union remains deeply divided over what should be done, a debate that has strained relations and threatened the 28-nation bloc’s proud policy of open borders.

In the midst of all this, it turns out that not all migrants heading out of Serbia towards Germany are fleeing the Middle East or Africa. Today the Economist reported that Serbians are themselves part of the migrant flow.

Aleksandar Vucic, Serbia’s prime minister, trumpets his country’s kindness to those in transit; he can afford to be generous, because none want to stay in hard-up Serbia. A bigger problem is that 42% of those applying for asylum in Germany are from the southern ex-Yugoslav states and Albania. Almost all of them are economic migrants, fleeing poverty, not the persecution their countries’ temporary guests have escaped.

As you can see in the map below, the flow of refugee migrants is north from Greece, through Macedonia, and then through Serbia towards Hungary, then Austria and Germany. In Serbia a lot of people are joining the growing group, and this is getting messier by the day.

Working Mothers--the Key to Japan's Demographic Future

I've noted before that Japan is the land of the rising sun, but only the son rises. Japanese women are well educated and are active in the labor force, but they are much less likely to rise occupationally than are men, and they are very likely to be discriminated against at work if they become pregnant. Prime Minister Shinzo Abe promised at the beginning of this year that he would work on these issues, and this week's Economist has what might be called a report card on his progress.

“ABENOMICS is womenomics,” Japan’s prime minister declared, marrying two atrocious words in a single phrase, at a glamorous shindig called WAW!, or the “World Assembly for Women in Tokyo”, on August 28th-29th. Before an international audience of high-powered female leaders and businesswomen, Shinzo Abe promised to help women “shine” at work as a way to boost Japan’s talent pool and economy. As the conference opened, the Diet (parliament) passed a long-awaited law calling on companies to find ways to promote more women.

Yet such grand visions are beside the point for most working women. Sayaka Osakabe, founder of a new non-profit outfit called Matahara Net, which campaigns for the rights of pregnant women at work, says that before “shining” women just need to be allowed to work without being harassed. Matahara, (a contraction of “maternity” and “harassment”), is illegal but rife.

The problem is that there is a lot of opposition within society to these reforms. They won't come easily. In the meantime, Japan's birth rate remains very low and this lack of gender equality in the workplace (and at home) is almost certainly the primary reason, as it is in Taiwan.

Lots of People in the South Knocking on Northern Doors

The migrant mess continues almost unabated in Europe, as people south of the Mediterranean stream north. In the meantime, violence and economic uncertainty south of Mexico is fueling a continued stream of people heading north. A key change in that dynamic, however, is that Mexico has been stepping up its program of apprehension and deportation of Central American migrants as they come north across Mexico's southern border. This is detailed in a new report by the Migration Policy Institute titled "Migrants Deported from the United States and Mexico to the Northern Triangle: A Statistical and Socioeconomic Profile."

Amid increasingly muscular enforcement by Mexico, U.S. apprehensions of Central Americans for fiscal 2015 to date have fallen by more than half compared to the prior year. Many of those who previously would have made it to the U.S. border and been apprehended by the Border Patrol now are being intercepted by Mexican authorities.

The report also offers a profile of deportees to the Northern Triangle, finding that the majority are young males with low educational attainment levels, most having experience in low-skilled jobs but with nearly 40 percent reporting they were unemployed in the 30 days before setting off on their journey.

And contrary to the stereotype that many young Central American migrants are gang members, the MPI researchers report that the majority of deportees do not have a criminal background. Ninety-five percent of child deportees and 61 percent of adult deportees had never been convicted of a crime. For those with a criminal record, 63 percent had been convicted of immigration or traffic offenses or other non-violent crimes. Twenty-nine percent of those with criminal convictions had committed violent offenses and 9 percent drug offenses.

The report also discusses the myriad policy issues embedded in these statistics. People in Central America have a strong local incentive to get out of there. Gang violence in El Salvador means that it is about to pass Honduras as the country with the highest murder rate in the world, and Guatemala's president was just forced to resign (although at least he did do that). 

Are We Running Out of Room on the Planet?

It is not a good visual. No one who has ever traveled can readily absorb the idea that there are more humans than the planet can handle. There just seems to be so much space out there, right? The problem, of course, is that most of the planet is not fit for human habitation, and we are, indeed, using almost all of the useful land to sustain ourselves. This is the idea behind the ecological footprint and it is the subject of two different stories in today's news.

From BBCNews comes the story with the exact title of "Is the World Running Out of Space?" This is a good overview of population growth with quotes from a lot of familiar people.

“Virtually all population growth between now and the end of the century will be in cities,” says Joel Cohen, head of the Laboratory of Populations at Rockefeller University and Columbia University, and author of a book called How many people can the Earth support? “It boils down to more than one million additional people living in cities every five to six days from now until 2100.”

“People can live at much higher population densities – it is possible,” says John Wilmoth, director of the Population Division of the United Nations. “As someone who lives in Manhattan, I have to say that it’s not awful.”

“The Africa projections are really scary,” says John Bongaarts, vice president and distinguished scholar at the Population Council, a non-profit research organisation based in New York City. “A large proportion will end up in urban slums, which is not a recipe for happy living.”

“I’d say there’s no threat of the world’s rainforests all being taken over by cities,” says Karen Seto, a professor of geography and urbanisation at Yale University. “The bigger threat is the indirect impact of urbanisation on those landscapes.” Indeed, cities require wood for creating buildings and furniture, agricultural land for growing food, space to dispose of tonnes of rubbish produced on a daily basis – and much more.

Karen Seto's concern is echoed by a new report from Negative Population Growth on the replacement of good agricultural land in the US by the spread of cities out into the countryside.

Part of the reason that growth is unsustainable is because it is devouring the land it needs to feed itself, sawing off the limb it stands on. Eventually that limb will snap. But we’re smarter than that – one hopes.

Even if you don't feel very crowded where you are, rest assured that the increasing number of us--all clamoring for a higher standard of living--is crowding the planet.

Migrant Journeys Last a Lifetime

For many years, Rubén Rumbaut and his colleagues have been studying the processes by which immigrants adapt to and, eventually, assimilate into their new home country. This is a slow and cross-generational process, with a thousand possible bumps in the road. I was thinking of this today as two pieces of news came across my screen. The first is the latest iteration of the European migrant crisis, as Hungary loaded a bunch of people onto a train and sent them on to Germany--which is where they want to go because it is a big country with a big economy. The New York Times, among many others, has noted that this crisis has really put Europe's open border policy to the test. It wasn't designed to deal with a bunch of people arriving without documentation, but hoping to be granted refugee status so that they can stay in Europe for a better life than they would have had wherever they came from.

It seems very likely that, once settled, their lives will in fact, be better than before. It could certainly take a while to get to that point, however. The people who may wind up suffering most from the new place will be the children. A report out just today from the Migration Policy Institute reviews the evidence about discrimination against immigrant children in the United States, but it is reasonable to expect that this could happen in Europe as well:

Report author Christia Spears Brown, an associate professor of developmental psychology at the University of Kentucky, examines the literature on discrimination in school settings. Studies show that by elementary school, children of immigrants report being treated unfairly by teachers, receiving verbal insults, being excluded from activities or being threatened with physical harm by peers. By their teen years, immigrants’ children report that they have been graded unfairly, discouraged from joining advanced-level classes and disciplined excessively for the same behaviors as other children.

So, the point is that the trauma for immigrants doesn't end when they are finally settled in a place. The cultural problem of dealing with differences, as I've noted before, is going to be an issue for some time to come. It may not be until the third generation--some 50 years from now--that the descendants of these immigrants will finally be part of the "mainstream." In the meantime, there will need to be many kinds of adjustments on the part of immigrants and the host society. With luck, immigrants and the host society collectively will be better off as a result, but it won't be easy.