GEOG 102 – Population, Resources, and the Environment

Professor: Dr. Jean-Paul Rodrigue

Topic 4 – Population Policy

A – Fertility Policies
B – Mortality Policies
A Fertility Policies

■ 1. Population Policy
■ 2. Fertility Enhancement
■ 3. Fertility Decline
■ 4. Family Planning
■ 5. Missing Female Population
1 Population Policy

■ Context
• Fairly recent phenomenon.
• Few nations had formal population policies prior to the 1950s:
• Developed and developing world alike.
• India was the first country to have a family planning policy in 1951.
• Still today the place where the needs are among the most urgent.
• Became an issue with the population explosion.
• The world undertook a reproductive revolution.
• About 80% of the population of developing countries is subject to
population policies.
• Most of them are words without meaning.
1 Population Policy

■ Definition
Government • Official government strategy.
• Set of guidelines specifically intended to
affect:
• Size of the population.
• Rate of growth of a population: fertility
Policy
(enhance or reduce).
• Distribution.
Intentional • Composition (ethnic).
■ Population program (direct policies)
Program • Means to make to policy operational.
• Public or private initiatives.
Impacts • Services, information, persuasion or
legitimation.
Population
1 Population Policy

■ Indirect policies
• Economic and social programs can have an impact on
population.
• Taxation (credits and deductions for children).
• Health and education.
• Welfare.
■ Migration
• Either promote emigration or immigration.
• Often related to the labor market.
• Becoming a very sensitive issue in several developed countries:
• The United States and Europe facing migration pressures.
1 Population Policy

Conventional Perspective Contemporary Perspective

Population = power. Human capital = power.
The more people the more Quality of the human capital is
powerful the country. more important than quantity.
Most work was physical and Most work is skill-oriented.
required little training.
Empire building, slavery, and wage Globalization and migration
labor. (exploitation of labor differences).
1 Population Policy

■ Labor force
• Population in age of working:
• On average between 15-65.
• Composition and quality are two major concerns.
• Substantial changes forthcoming:
• More workers and they will be better educated.
• More minorities and more women.
• Older retirement age.
■ Size of the labor force
• Size of the working age population:
• Determined by the population’s age structure.
• How many people fall between the ages of 15 and 65.
• Rate of labor force participation:
• Participation rates are affected by many factors.
• The role of women in the society in general.
1 Employment as % of Population Aged 15-
64, 2001
90
80 Males
Females
70

60
50
40
30

20
10
0
Canada France Italy Japan Mexico Sweden United United
Kingdom States
2 Fertility Enhancement

■ Pro-natal policies
• Exist in many European nations currently experiencing
population decline or ZPG.
• Policies:
• Generous welfare benefits.
• Liberal maternity / paternity leave programs.
• Substantial investment in child day care facilities.
• Free education through University level.
• Sweden:
• 12 months maternity leave.
• At least 1 month paternity leave.
• Payments of $160 per month through age 16 (1st and 2nd child).
• $240 per month (3rd and 4th child).
3 Fertility Decline

■ Context
• Lower the number of new children.
• Policies and programs oriented toward fertility decline have been
increasingly common during the past 30 years.
• Controlling population growth is often a politically controversial
issue.
• Third World Nations:
• Attained the 3rd stage of the Demographic Transition.
• The promotion of birth control policies for Third World nations has often
been viewed as racist.
4 Family Planning

Fertility Decline Fertility Enhancement

Decrease TFR Increase TFR

Promotion of family planning Welfare benefits (healthcare,
Some cases of forced sterilization education and financial rewards)
Controversial to enforce because Rarely effective
of cultural values
4 Family Planning

■ Concept
Result of Pregnancies, World 2000 • Designed to help families achieve a
desired size.
• 1/3 of the population growth in the world
22% is the result of incidental or unwanted
pregnancies.
• 210 million pregnancies in the world per
year, of which 100 million are unwanted
pregnancies (47%).
15%
63%
• 46 million abortion per year.
• 500,000 women die each year from
unsafe abortions.
• 49% of pregnancies in the US are
unwanted.
Live births • If women could have only the number of
Miscariages children they wanted, the TFR in many
Abortions countries would fall by nearly to 1.
4 Family Planning

■ Contraceptive use
• Significant increase in the 1960s and 1970s.
• From 10% to 50% in the 1990s.
■ Traditional methods
• Abstinence.
• Withdrawal.
• Douche.
■ Modern methods
• Oral contraceptives.
• Intra Uterine Devices (IUD; e.g. diaphragm)
• Injectables and implants.
• Male and female condoms.
• Spermicides.
• Emergency contraception (day after pill).
• Voluntary sterilization.
• Abortion.
 Percentage of Users Becoming Pregnant
4 During 1st Year of Contraception, United
States
Male Sterilization
High
Implant Low

Injectable

Female Sterilization

UID

Pill

Condom

Diaphragm

Spermicides

Periodic Abstinence

Widthrawal

0 10 20 30 40 50 60
4 Contraception Methods used among
Married Women, 15-49

100%

90%
80%

70%
60% No Method
50% Traditional Methods
Modern Methods
40% Sterilization
30%

20%
10%

0%
World Africa East Asia Western Developed
Europe Countries
4 Abortion Rates in Western Industrialized
Countries

Holland

Germany

England & Wales

Canada

Denmark

Sweden

Australia

United States (2000)

0 5 10 15 20 25
4 Main Events Related to Family Planning

19th century Malthusian idea. Moral restraint.

1873 Comstock Law. Family Planning labeled as indecent. Diffusion of contraception

information made illegal.
1916 Comstock Law judged anti-constitutional. First birth control clinic opened by
Margaret Sanger in Brooklyn.
1951 India adopt an official family planning policy.

1952 International Planned Parenthood Federation (IPPF) founded.

1954 First World Population Conference, Rome.

1960 First oral contraceptive.

1967 Founding of the UNFPA (United Nations Fund for Population Activities).

1979 China’s One Child Policy

1994 International Conference on Population and Development. Importance of

woman in controlling reproduction (rights and reproductive health).
4 Family Planning

■ US view on family planning

• Contributes between 40 and 50% of international FP aid.
• Characterized by paradoxes:
• Between the religious ethics of the leaders and a liberal urban society.
• Strongly supportive of FP in the 1960s and 1970s.
• Change in the 1980s:
• Reagan stopped support to the United Nations Population Fund.
• Revoked by Clinton in 1993.
• Current policies:
• Anti-abortion and increasingly anti-family planning (anti-contraception)
domestic policies.
• Promote a conservative moral and religious agenda.
• First action of President Bush in 2001 was to ban funding to international
agencies promoting abortion (and thus FP).
• Growing violence against family planning and abortion clinics.
4 Family Planning

■ Controlling population growth

• Natural increase:
• Biggest factor in population growth in most countries.
• Reducing this component will require substantial progress in social and
economic development.
• Empowerment of women:
• Guarantee of their human rights:
– No jobs, no education, no money,
– Equal access to nutrition, health care and education
– Unable to own land or inherit property
• Right to reproductive and sexual health.
• Reproductive health services:
• Family planning.
• Contraception.
• Abortion.
4 Family Planning

■ Family Planning programs

• Still considerable unmet demand for reproductive health
services.
• Require financing.
• Must be equitable:
• Disparity between accessibility to the poor and the wealthy.
• Better access in cities.
• Fertility levels among the poor are generally higher:
• In rural areas, unwanted fertility reduces the ability to provide for the
children.
• Put stress on local resources and local environments.
• Help push people into migration.
4 Family Planning

■ Efficient Family planning activities

• Strong government support.
• Must be medically, economically and culturally acceptable.
• Counseling ensures informed consent in contraceptive choice.
• Provision of contraceptives.
• Training of staff and education of public.
• Monitoring the results.
• Research for new or improved methods.
• Privacy and confidentiality are ensured.
■ Impact
• Much evidence to support the idea that family planning programs
have been having a great affect.
• Economic development and socioeconomic transformations are
a necessary precondition for family planning programs to have
an impact?
4 Female Literacy and Fertility in Selected
Countries, 1997

TFR
0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5

Thailand

Colombia

Sri Lanka

Jamaica

El Salvador

Pakistan Female literacy rate

Sudan TFR

Mali

Afghanistan

Burkina Faso

0 10 20 30 40 50 60
Literacy (%)
4 Family Planning

■ Family planning in the United States

• Birth control use:
• 20% of sexually active U.S. teens reported using no birth control
• 4% in Great Britain, 6.5% in Sweden, 12% in France and 13% in Canada.
• Between 50% and 70% of girls in other countries used birth control pills,
only 32% did so in the United States.
• Different attitudes of developed countries:
• Accepting attitude about teen-age sexual relationships.
• Clearer expectations for responsible sexual behavior.
• More accessible reproductive health services.
• The U.S. is the only country with a formal policy promoting abstinence
only.
• One-third of school districts teaching sex ed mandate as an abstinence-
only program.
5 Missing Female Population

■ Missing female population

• About 100-135 million females are missing from the world
population.
• Normal ratio at birth is about 100 girls to 105 boys.
• Boys are weaker and the ratio evens out after 5 years.
• Since 1900 the ratio has been declining, especially after 1990.
• Particularly the case for China and India (0-4 age group):
• China accounts for about 60 million missing females; India for 25 million.
• 1990: 110 boys per 100 girls.
• 1995: 118 boys per 100 girls.
• 2000: 119 boys per 100 girls.
• Ratios even higher for second and third child.
• Problems exacerbated by declining fertility and growing
standards of living.
5 Sex Ratio (males per 100 females), 2000

Less than 90
90 - 95
95 - 100
100 - 105
105 - 110
More than 110
NA
5 Infant Mortality Rate (per 1000 under age
5), by Sex, Selected Countries, 2000

104
Pakistan 108

116
Bengladesh 106

97 Female
India 82
Male

China 54
43

8
United States 10

0 20 40 60 80 100 120 140

5 Missing Female Population

■ Missing female population in India

• Sex determination tests outlawed (1994):
• Nobody ever convicted of infringing the law.
• Ultrasound for “abdominal cyst”: 500 rupees ($11).
• Abortion: 2,000 rupees ($44).
• 25% of all female deaths between the age 16 and 24 are due to
“accidental burns”.
• Between 5,000 and 12,000 “dowry deaths” per year.
• Sex ratio is still declining:
• 962 girls for 1000 boys (1981).
• 945 girls for 1000 boys (1991).
• 927 girls for 1000 boys (2001).
• Can go as low as 770 in some regions.
5 Missing Female Population, 1998

Philippines 1.5

Indonesia 2

Bangladesh 2.9

Pakistan 6.5

India 43.7

China 54.9

0 100 200 300 400 500 600 700

Female Population

Female population (millions) Missing females (millions)

5 Males minus Females, China, 2000

80+
75-79
70-74
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
0-4

-3,000,000 -2,000,000 -1,000,000 0 1,000,000 2,000,000 3,000,000 4,000,000 5,000,000 6,000,000

5 Missing Female Population

■ Gender roles and the missing female population

• Sons are perceived as an asset:
• Farm work.
• Security for old age (no social security in several countries).
• Take over the family name.
• Sons get better health care, food and schooling.
• 100% of them must find a bride and produce an heir.
• In China, the birth of a boy is labeled as “big happiness” while the birth of
a girl is labeled as “small happiness”.
• Daughters are perceived as a liability:
• Marry and leave home to provide labor to another family.
• Dowries are often to be paid.
5 Missing Female Population

■ Causes of the missing female population

• High female mortality in infancy or childhood:
• Preferential treatment for boys; better food and health care.
• Infanticide.
• Excess female mortality in utero:
• Sex-selective abortion.
• 500,000 and 750,000 unborn Chinese girls are aborted every year after
sex screening.
• Net out-migration of female children:
• International adoptions.
• Abandon; Orphanage are strictly populated by girls.
• In some cases 90% of the girls in orphanages will die.
• Sex-selective undercount of children:
• Daughters are not declared.
• No education provided by the state.
• “Sold” / “rented” as a factory worker, wife or prostitute.
5 Missing Female Population

■ Consequences of the missing female population

• Demographic “backlash”:
• May help achieve demographic stability.
• Fast decline in fertility.
• Fast decline of population growth and then of absolute population.
• Social consequences:
• Limit the advancement of women in society.
• The “value” of females will increase considerably in the future:
• Millions of men will not be able to find a wife.
• Changes in the economics of marriage.
• Inverted dowry; “Bride prices” are becoming more common (about $4,000
in China).
• Daughters increasingly an asset for industrial work.
B Mortality Control

■ 1. Context
■ 2. Major Epidemics
■ 3. Human Health
■ 4. Genocide
1 Context

■ Mortality control
• Goal of most governments.
• Seek to improve the health standards and life expectancy of their
populations.
• Expenditures for such health programs are often diminished by
conflicting priorities for limited government funds:
• Health programs lose out to military spending.
• Grandiose infrastructure development programs whose benefits accrue to
a small minority of the overall population.
• Surveys have shown that small investments over the most threatening
causes of death lead to significant increase in health.
• More accepted (culturally and socially) than fertility control.
1 Context

■ Health
• Key component of human development.
• Broad indicators of human health show that significant progress
has been made over the past few decades.
• Globalization has enabled new threats of diffusion.
• Conditions in many Third World countries remain difficult,
especially for the poorest groups.
• Health conditions in Third World countries are not necessarily
related to climate, but mostly to poverty.
■ Density issues
• Human densities favor the diffusion of diseases.
• Strong urbanization can be linked with declining health
conditions.
1 Context

■ Endemic
• Many diseases exists in a state of equilibrium within a population.
• Many develop an immunity.
• Saps energy, lowers resistance, shortens lives.
■ Epidemic
• Sudden outbreak at local, regional scale.
• Generally short lived.
■ Pandemic
• Worldwide spread.
2 Major Epidemics

■ Black Death
• Europe, 14th century (the Plague)
• Bacteria originating in Asia.
• Moved through the trade routes.
• Entered Europe in 1347.
• Transmission by rats and coughing and sneezing.
• 90% death rate of those infected.
• 25 million deaths; 25-33% of the European population.
• 75 million deaths in Eurasia out of a population of 300 million.
2 Estimated Population of Europe, 1000-
1500

90
80
70
60
50
40
30
20
10
0
1000 1100 1200 1300 1400 1500
2 Major Epidemics

■ Smallpox
• New World, 16th Century.
• Virus introduced by Spanish conquistadors and European
colonists.
• Spread through respiratory system and physical contact.
• Between 10 and 20 million killed.
• Decimation of the Inca, Aztec and Native American civilizations.
• Was officially eradicated in 1977.
2 Major Epidemics

■ Influenza
• Global, 1918-1919 (Spanish Flu).
• Virus brought by troops.
• Spread through transport routes all over the world.
• Transmission through respiratory channels.
• Between 25 and 40 million killed (1.2-2.2 % of the global
population).
• WWI (1914-1918) killed 9 million people.
2 Major Epidemics

■ HIV/AIDS
• Global (Pandemic), 1980 to present.
• Originated in Africa.
• Mutation of a primate virus to infect humans.
• Transmission by body fluids.
• 28 million deaths so far.
• 68 million infected (0.5% of the global population).
• 14,000 new infections per day.
• More than 20% of the population infected in several African
countries.
 Global Estimates of Cumulative HIV/AIDS
2 Infections and Deaths Worldwide, 1980-
2002 (in millions)
70
HIV infections
60
AIDS deaths

50

40

30

20

10

0
3 Place of Death, 2001

■ Deaths per year

• 56 million deaths.
• 12 million in developed countries.
23% • 44 million in developing countries.
• In the poorest regions, 1 in 5 children will
die before their 5th birthday.
■ Contribution to mortality (world)
• Tobacco use : 6% (4 million).
• Hypertension: 5.8%.
• Inadequate water and sanitation: 5.3%.
77% • STDs: 2.2%.
• Alcohol use: 1.5%.
■ Contribution to mortality (USA)
• Smoking: 18%
Developed countries • Poor diet and physical activity: 17%
Developing countries • Alcohol-related: 4%
3 Cause of Death, 2001

Infectious and parasitic diseases

9%
19% Respiratory infections
3%
6% Perinatal conditions

Cancer
4%
7% Cardiovascular diseases
6%
Respiratory diseases
4%
Digestive diseases

Unintentional Injuries
13%
Intentional Injuries
29%
Other
3 Causes of death in developed and
developing countries, 1997 (in %)

Other 9
23

Diseases of the 5
respiratory system 8

Diseases of the 24
circulatory system 46

Cancers 9
21
Developing world
Perinatal and 10
1 Developed world
maternal causes

Infectious and 43
parasitic diseases 1

0 5 10 15 20 25 30 35 40 45 50
3 Cigarette Consumption per Person, 1960-
2002

3500

3000

2500

2000

1500

1000
World
United States
500 China
Japan
0
France
60

62

64

66

68

70

72

74

76

78

80

82

84

86

88

90

92

94

96

98

00

02
19

19

19

19

19

19

19

19

19

19

19

19

19

19

19

19

19

19

19

19

20

20
3 Human Health

■ Major infectious diseases (2001)

• Respiratory infections:
• 3.9 million deaths.
• Pneumonia affects mainly children under 5.
• Mainly linked to deteriorating air quality.
• Tuberculosis:
• 1.6 million deaths.
• 30% of humanity carry the TB bacteria.
• Growing resistance to antibiotics.
• Diarrheal diseases:
• 2.0 million deaths.
• Improper sanitation of drinking water.
• Mainly affect young children.
• AIDS:
• 2.8 million deaths (see case study 3).
3 Human Health

• Malaria:
• 1.1 million deaths.
• Growing because of resistance to antimalarial drugs and to insecticides.
• Related to mosquito prevalence.
• Linked to urban areas (stagnant water).
■ Obesity
• 300 millions adults obese in the world (“Globesity”)
• Increase risk of heart attack, stroke, diabetes and cancer:
• Could reduce life expectancy by 2 to 5 years.
• United States:
• About 97 million adults, or 55% of people over 20, are overweight or
obese.
• $33 billion a year on weight-loss products and services.
• $70 billion estimated annual health-related costs of treating obesity.
3 Current and Projected Causes of Deaths
Worldwide, 1990 and 2020 (in millions)

Injuries
2020
Other 1990

Diabetes

Lower Respiratory

Stroke

Heart Disease

Cancers

Noncommunicable Diseases

Communicable Disease

0 5 10 15 20 25 30 35 40 45 50
3 Human Health

■ Environmental factors
• 25% of deaths related to environmental factors.
• 1.4 billion people exposed to polluted air:
• Relationship between air pollution and hearth attacks.
• Urbanization.
• Infectious and parasitic diseases:
• Accounted for 43% of the 40 million deaths in developing countries.
• Almost 40% were due to chronic diseases such as circulatory diseases,
cancers and respiratory diseases.
• Mosquito is public enemy number 1.
4 Genocide

■ Definition
• Killed more people than war.
• Intent to destroy, in whole or in part, a national, ethnical, racial or
religious group as such (UN 1948 Convention).
• Killing members of the group, causing serious bodily or mental
harm to its members.
• Deliberately inflicting on the group conditions of life calculated to
bring about its physical destruction in whole or in part.
• Forcibly transferring children of the group to another group.
4 Major Genocides of the 20th Century

Turkey (1915-1922) 2 million Armenians and other minorities. Get rid of

dissidence.
Soviet Union (1929- 30 to 60 million of various ethnic origins. Stalinian policies
1953) (relocation, starvation and purges).
Nazi Germany (1933- 13 million, mostly Jews. Ethnic / religious extermination.
1945)
China (1949-1976) 30 million. Political purges, starvation.
Guatemala (1960- 100,000 civilians. Civil war. Government repression.
1981)
Uganda (1971-1979) 300,000 civilians. Ethnic purges.

Cambodia (1975- Between 1 and 3 million civilians. Ideological purges.

1979)
Rwanda (1994) 800,000 Tutsis slaughtered by Hutus. Ethnic purges.