Bill Gates' Letter

Like me, you may have received an email today from Bill Gates:

I am writing to share my fifth annual letter about the work our foundation and its partners are doing. From time to time we should step back and celebrate the way that the right goals and smart innovation have done so much to improve the lives of people. In previous annual letters, I’ve focused on the power of innovation to reduce hunger, poverty, and disease. But any innovation—whether it’s a new vaccine or an improved seed—can’t have an impact unless it reaches the people who will benefit from it. That’s why in this year’s letter I discuss how innovations in measurement are critical to finding new, effective ways to deliver these tools and services to the people who need them most.

You can read my letter at billsletter.com.

Well, in fact I did read his letter (and watched him on TV, as well, where he described himself as a bigger geek than Steve Jobs). In fact, it is pretty amazing what one couple with nearly unlimited money can do for the world. Here's one of the excerpts from his "letter" that particularly caught my eye:

There are now just three countries that have never eliminated polio: Nigeria, Pakistan, and Afghanistan. I visited Northern Nigeria four years ago to try to understand why eradication is so difficult there. I saw that routine public health services were failing: Fewer than half the kids were getting vaccines regularly, and there were no reliable figures for how many children lived in each area. Also, the normal process of quality monitoring done as part of each polio campaign was not working. Statistics about the quality of coverage varied greatly. We decided we needed to invest heavily in another layer of quality monitoring to understand what was going wrong. This involved picking random locations on the map and randomly checking children in those places to see if they had been vaccinated. The work required specially trained staff working independently of the people implementing the vaccination campaigns. That impartiality was crucial....The measurement systems put in place by the eradication initiative will be invaluable for other health care activities, including routine vaccination of infants, which means the legacy of polio eradication will live beyond stopping a disease that once paralyzed over 400,000 children every year.

Obviously he does this with the help and cooperation of a broad range of national and international organizations, but I still find this to be very impressive.

It Takes a Village

In response to my note yesterday about education and health, someone led me to a story from the Christian Science Monitor suggesting that communities needed to work together to "save the family" by encouraging young couples with children to stay together, and they followed up with this question:

Do you think this is correct? That the USA must save families to prevent poverty? I feel this sort of message discriminates against single parents and makes them feel they are in some way failures. I can't see how this sort of article can be published in a country where all are equal. This sort of article will make single parents feel inferior and thus has no place in the American press.

The reality is that children growing up in poverty do not have as good a set of life chances as those who grow up in families with more resources per person. Currently in the United States, one in five children lives in a family with income at or below the poverty level and nearly half live in low-income families (at or below twice the poverty level). One of the major issues is that a large proportion of children living in low-income families are living in a single-parent household:

32 percent of all children with married parents – 15.5 million – live in low-income families.
69 percent of all children with a single parent – 16.4 million – live in low-income families.

This cannot bode well for the future of the country and a natural policy question is:  What can we do about this? The article that inspired the comment suggests that communities should be doing all they can to make it easier for couples to stay together--noting that at the time of birth most mothers are still in a relationship with the child's father. Two incomes instead of one clearly improves the situation economically. If there are other ways to improve the economic circumstances of each child--if the village can step up in other ways--then they too could be implemented, but these other things are harder to define and implement.

How Important is Education to Your Health?

My thanks to Shoshana Grossbard for pointing me to an interesting article just published in the Journal Population Economics that examines the health impact of educational attainment. The study examines twins included in the Midlife in the United States survey, which included a national sample of 1,900 twin pairs. Using these latter data, Swedish researcher Pettor Lundborg was able to conclude that a twin who completed high school was healthier than the sibling who did not, but other returns to education were negligible. These somewhat vague findings are a reminder that our health (and the chance of death more generally) is driven by factors that operate at several different scales. The single most important is the country in which we are born because that puts us in a particular physical and cultural infrastructural framework that influences all aspects of health. Life expectancy is more about where we live than who we are. At the other extreme is the gene pool with which we are born, which can affect the probability of good health and long life relative to those around us, regardless of whether we live in a high or low mortality society. In between are the sociocultural influences over which we might have some individual control, such as education. Even if a bit vague, the results are still consistent with the idea that, all other things being equal, education is good for your health--but I'm sure you never doubted that.

A First Step Toward Immigration Reform

Members of the US Congress have been unusually swift in generating a bipartisan proposal for comprehensive immigration reform. As the BBCNews notes, this is probably pushed along by the realization among at least some Republicans that they cannot afford to continue alienating the country's fastest growing demographic group. The proposal includes elements that have been on the table for some time--a path to citizenship for at least some of the current undocumented immigrants, a renewed effort at border security, and increased scrutiny of employers who might be hiring undocumented immigrants. Of course many of these elements are similar to the Immigration Reform and Control Act (IRCA) signed into law by President Ronald Reagan in 1986. 

A cynic might suggest that since the average length of generation is about 25-27 years, it appears that each generation has to have a bill like this. But, the important point raised by everyone is that we cannot continue to exploit and discriminate against a large group of people whose only real crime is to come to the US to do the work that legal residents won't do for the wages on offer. Of course these jobs will still be there after the current crop of undocumented immigrants starts on the path to citizenship, which is why the proposal also includes ideas about guest-worker programs.

There are lots of details to be worked out--and it is not yet clear whether they can be worked out. But, in the meantime, we must keep in mind that an increasing fraction of future voters and taxpayers will be the children of immigrants (both legal and undocumented) from Latin America, especially Mexico. My view is that all of us will be better off if the parents of these young citizens are legal residents who can thus be making more concrete contributions to American society. In the short term the immigrants contribute to the fact that the US population continues to grow despite low fertility levels, but in the long term it is the children of the immigrants who will make the largest demographic contribution.

More on China's Age Transition

This week's Economist, like yesterday's New York Times, has a story on China's population, based on a new set of data released by China's National Bureau of Statistics that emphasizes the fact that the working age population is starting to decrease in size. While this reporting raises the question of whether or not China will re-think its One-Child Policy, it also references the same research that I do in my book by S. Philip Morgan (recently named Director of the Carolina Population Center) and his colleagues suggesting that fertility is unlikely to rise much in China even if the government completely got rid of the One-Child Policy. Furthermore, at this point it would be another 15-20 years before that would make a difference in the labor force, even if that were to happen.

The demographic dividend that China has enjoyed in recent decades has kept wage rates low and saving rates high. With fewer children per worker, China has enjoyed a higher income per head, a large chunk of which it has been able to save and invest. The shrinking of the working-age population will put downward pressure on the saving rate and upward pressure on wages, as coastal factories have already found. According to Mr Laurent [of Global Demographics], the number of 15- to 24-year-olds will shrink particularly quickly, dropping by 38m, or 21%, over the next ten years.

Optimists argue that urbanisation can trump demography. Because 47% of China’s population still resides in the countryside, China’s urban workforce still has room to grow at rural China’s expense. Louis Kuijs of the Royal Bank of Scotland points out that urban employment increased by 12m in 2012 even as rural employment fell by 9m.

The point here, and it seems to me like a good one, is that the age transition has been an economic boon to China, but the country has not yet fully exploited its working age population. If those in rural areas can be effectively recruited into the manufacturing labor force, then "disaster" will be postponed. That assumes, of course, that the rural population is sufficiently well educated for these jobs, and that there are not major problems with the household registration system that currently turns rural migrants to cities into "illegal" migrants.