Demographic Vulnerability--Looking Forward

Yesterday I looked back at the countries of the Middle East to show that the most rapidly growing countries 25 years ago are, with few exceptions, the ones in which we today see the greatest level of violence and instability. That prompted Steve Kent at the Population Institute in Washington, DC to point me to an excellent report that they have just published on "Demographic Vulnerability: Where Population Growth Poses the Greatest Challenges." You can see the top 20 in the map below and the details for each country are provided in the report, which also has a lot of other good discussion and analysis. Indeed, I will say that I did not see a single thing with which to disagree. As the press release for the report indicates:

Robert Walker, president of the Population Institute and the principal author of the report, noted that, “Some of the countries profiled in this report—such as Afghanistan, Iraq, Somalia, South Sudan, and Yemen—are ‘headline’ countries commonly recognized as ‘fragile’ states, though demographic pressures are seldom acknowledged. Others—such as Niger, Malawi, and Mozambique—don’t get much press coverage, but the challenges they face are no less daunting.”

World population is projected to increase from 7.3 billion today to 9.6 billion or more by 2050. Virtually all that growth will be in the developing world, and much of that increase will occur in countries struggling to alleviate hunger and severe poverty. Many countries with rapidly growing populations are threatened by water scarcity or deforestation; others are struggling with conflict or political instability. While progress is not precluded, population growth in these countries is a challenge multiplier.

I too have tried repeatedly to remind us all that the "population problem" is not "solved" just because rates of population growth are low in the richest countries. Population growth in these other countries is a storm headed our way, and we need to act now to help them and ourselves create a better future, not a worse one.

Population Growth in the Middle East: A Look Back

I just happened quite serendipitously to come across the material from a Senate Breakfast Briefing at the Senate Office Building in Washington, DC, in which I participated in 1991. The topic was "Population Trends and the Middle East: Implications for Long-Term Stability," and the briefing took place shortly after the end of the first Gulf War. The meeting was co-sponsored by Senators Tim Wirth of Colorado and Nancy Kassebaum of Kansas and was organized by Jane DeLung of the Population Resource Center in cooperation with the Population Association of America. Joining me were Nazli Choucry of MIT and John Waterbury of Princeton (who went on to become President of the American University of Beirut). My first slide is shown below. It really tells the story of what has come since in terms of stability--or lack thereof:

If you look down that list of countries by highest rates of population growth, you can see where the biggest problems have emerged--Gaza, Iraq, Syria, Iran. Jordan is the outlier in this list both because it has had a lot of western support and because it has had good governance. Of course, being so close to so much other population growth has not been easy. Yemen is also right up there in terms of population growth and at the time its total fertility rate of 7.5 children per woman was highest in the region and one of the highest in the world. Iraq was a close second at 7.3 children per woman. Dr. Waterbury added the somber warning about the low level of precipitation in the region--more people, but not more water. Indeed, it is good to remember that when Saudi Arabia found oil in the 1930s they had originally been looking for water...

Patterns of Population Change in Europe

The general view of demographic change in Europe is that populations are either declining or are on the verge of declining. Reality is more complicated--the devil is in the details and a new map out from Germany, and summarized by CityLab, shows those details. The map shows the average annual rate of population growth by subnational district between 2001 and 2011.

The map works as follows. Dark blue patches show an average annual population fall of 2 percent or more, the medium blue patches a fall of between 1 and 2 percent, and the lightest blue patches a fall of up to 1 percent. Areas in beige have experienced no statistically significant change, while the red areas show population growth. Municipalities in deep red have experienced an average annual population rise of 2 percent or more, the medium red of between 1 and 2 percent, and the pale pink areas of up to 1 percent. The different sizes of each colored shape, meanwhile, show the radically different sizes of municipal units across the continent—large in the Baltic States, Turkey, and Northern Scandinavia, but far smaller in Ireland, Greece, and the Czech Republic.

Here you can see clearly that the UK and Ireland, along with much of France have been experiencing population growth, partly as a function of immigration. Eastern Europe and the Baltic states are sending migrants westward, while Poland has been experiencing suburbanization. The Mediterranean areas are generally growing, as is northern Italy--at the expense of southern Italy. Turkey is undergoing all kinds of complex demographic shifts, which is consistent with its current political turmoil.

Obamacare Survives Court Challenge--Will US Life Expectancy Improve?

The big news this morning was that the US Supreme Court rejected the latest challenge to the Affordable Care Act. This means that people living in states that have not set up a health care exchange, and thus use the US Government exchange, will still have their health care subsidized. Does that mean that we will now have better health care than before? Probably not. This does really change the health care system. Obamacare mainly brings more people into the market where they can buy health insurance, but of course it is not free for them, and it is still too early to tell exactly where the federal money will ultimately come from to pay for the subsidies. There is no free lunch and when it comes to health care Americans have the most expensive lunch on the planet. Yet, we have life expectancy that is lower than any northern or western European country and Canada. Why? There are four reasons: (1) the health insurance industry, which profits as a broker of health care services; (2) physicians who are the highest paid in the world; (3) lawyers who depend upon medical malpractice for their livelihood; and (4) drug companies who charge more in the US than elsewhere in the world.

My main objection to Obamacare when it was first proposed was that it did not go nearly far enough. Although health as a social movement has had a long history in the US, the fact that it spun off into a fee-for-service program instead of a universal health care program is, in my estimation, the sole reason for the country lagging behind others in life expectancy. And, of course, the four reasons I listed above are the reasons why we don't have universal health care. There are too many people making lots of money from healthcare and, quite naturally, they don't want that to change. One of the more positive things coming from the Affordable Care Act, however, is the idea that health providers should be reimbursed on the basis of quality of care, not on quantity. In particular, people in the public health field have known forever that prevention is the best medicine--it just doesn't pay as well...

Urban "Renewal" in Accra, Ghana

Thanks to Justin Stoler for pointing to a story about the recent demolition of more than 1,000 squatter homes in the Old Fadama neighborhood of Accra, the capital of Ghana, the city where he and I and other of our colleagues have been working for the past decade or more. The neighborhood is also known as Sodom and Gomorrah and has been the gateway for migrants into the city who lack the resources to live elsewhere in the city.

Thousands of the slum dwellers who are mostly migrants from the northern part of the country were consequently rendered homeless, while scrap metals and make shift shops were also destroyed. The residents who are displeased with the demolition hit the streets on Monday to protest against the exercise.

Numo Blafo [the city's public relations officer] further explained that the removal of those structures was aimed at paving way for a major dredging exercise at the Korle Lagoon. According to him, about 100 structures from the Banks of the Lagoon to the Odaw were demolished to that effect, adding that work on the dredging of the river had already taken off.

It may be only coincidental that this action occurred shortly after UN-Habitat announced a new project to build a planned extension of Accra in an area on the exact opposite side of town.

Right now, the Greater Accra Region is experiencing a rapid and unplanned urbanization process due to pressing influx of population and land speculation. Projections show that Accra will rapidly grow from approximately 2.5 million inhabitants to 4.2 million in the next ten years, and a large share of this growth is expected to be accommodated in the Ningo-Prampram District. 

Ningo-Prampram District, located at a short commuting distance east from Accra, represents an unmatched opportunity to respond to unplanned urban sprawl of the capital and the whole region. Availability of land and international connectivity along the trans-national corridor from Abidjan to Yaoundé , the international airport and the access to the coastline make Ningo-Prampram a superb location for a planned city extension to provide adequate access to land, housing, economic activities and services for the growing population.

And it may be only a coincidence that my analysis of census data for 2010 shows that Old Fadama has the highest proportion of Muslims of any neighborhood in Accra (69%) and the worst housing in the city.

Sadly, all of this turmoil comes at the same time that the Economist reported just this week on the growing fragility of the Ghanaian economy, perhaps caused by government overspending in anticipation of future oil revenues. The concern inside and outside of Ghana is that oil could push Ghana in the political direction of Nigeria and away from its long-time status as the model nation in the region.