Demography Exam #2

What are the Two aspects of Mortality

Lifespan and longevity

Lifespan (biological phenomenon)

usually measured by life expectancy - it is the oldest age to which human beings can survive

longevity (biological and social)

social and economic infrastructure and lifestyle - is the age at which we actually die

health and mortality/epidemiological transition

decrease in death rates and change in cause of death structures from infectious to degenerative diseases.

Morbidity

the prevalence of disease in a population

Mortality

the pattern of death

The health and mortality transition

the shift from prevailing poor health (high morbidity) and high death rates (high mortality) from infectious diseases occurring especially among the young to prevailing good health and low death rates from infectious diseases, with most people dying at older ages from degenerative diseases.

What are some of the reasons for the mortality transition in Europe and European-derived populations? Why the changes in types of diseases?

Economic development, institutionalized sanitary reforms and public health measures, social reforms, and advances in medicine.

Causes of death: Communicable

Bacterial (TB, pneumonia), viral (flu, measles), protozoan (malaria, diarrhea), maternal death (300,000+ a year due to lack of prenatal care, poor delivery, unsafe abortions.)

Causes of death: Non-communicable diseases

heart disease, malignant neoplasms/cancer, chronic obstructive pulmonary disease, diabetes, and alzheimers.

Causes of death: injuries

homicide, suicide

Proximate causes of death

most immediate cause of death (what is in the coroner’s report).

Non- Proximate causes of death

factors that contribute to the death & factors that increase the likelihood of experiencing one of the proximate causes of death (stress, smoking, diet, poverty, pollution, occupation, lifestyle, etc.)

What were the top three causes of death in 1866?

Tuberculosis, Cholera, diarrhea/enteritis

What were the top three causes of death in 1901?

Pneumonia/Influenza/Bronchitis, Tuberculosis, Diarrhea/enteritis

What are the top three causes of death in 1930

Heart disease, Pneumonia/Influenza/bronchitis, cancer

What are the top three causes of death today

Heart disease, cancer, injuries

Economic development and rising income levels (mortality shift)

increase income levels, decreased malnutrition and decreased famines. Better living conditions (improved housing and hygiene). Better food supplies to decreased malnutrition to an increased resistance to disease.

Institutionalized sanitary reforms and public health measures (mortality shift)

Garbage removal, clean water, milk, etc.

Social reforms (mortality shift)

Policies that are not meant to keep people alive but do so as byproduct/indirectly. Worker safety programs, social security, unemployment compensation.

Advances in medicine (Mortality shift)

Medical advances came after economic development, institutionalized sanitary reforms and public health measures, and social reforms. Vaccinations for smallpox and other diseases, chemotherapy, antibiotics then came after mortality had already dropped.

When was the smallpox vaccine created and by who

Edward Jenner - 1796

Milk pasteurization

1854 - Louis Pasteur - killing of bacteria and preventing disease, in 1909 Chicago was the first American city to require pasteurization. In 1920 unpasteurized milk was outlawed.

Water chlorination

Chlorine in the drinking water - kills cholera. By 1914 50% of Chicagos public-water was disinfected.

Penicillin

Medical drugs final began to have a material impact on the life expectancy in the middle of the 20th century - led by penicillin

Oral Rehydration Therapy

a solution of salts and sugars taken orally that treats diarrhea - a major cause of death in young children.

What are the two ways to postpone death to the oldest possible ages

1) prevent diseases from occurring or spreading when they do occur (vaccine, clean water, sanitation.)

2) curing people of disease when they’re sick (technology, drugs, physicians)

Senescence

a decline in physical viability accompanied by a rise in vulnerability to disease.

What are the reasons for Senescence?

1) wear and tear - humans are like machines - eventually we wear out due to stress and strain of constant use. Immune system may lose ability to attack “Invaders”

2) Planned obsolescence - built-in biological clock. We die when “our number is up.”

Infant mortality rate

deaths to infants under age 1, year (x) divided by births in a given year (x)

Neonatal mortality

deaths to infants 0-28 days (typically due to endogenous factors like malformation and frailty).

Post neonatal mortality

deaths to infants 2-12 months (typically due to exogenous factors).

Why is IMR so important?

every infant saved adds a lot of life expectancy to the population. (saving an adult doesn’t add that many years) person years added for infants is greats. additionally, its a stronger indicator of socioeconomic development and it effects fertility.

Years of life lost (YLL)

a measure of premature mortality that takes into account both the frequency of deaths and the age at which it occurs. One YLL represents the loss of one year of life. (if someone dies at 40 and their life expectancy was 80, their YLL is 40.)

Years lived with Disability (YLD)

One YLD represents the equivalent of one full year of healthy life lost due to disability or ill-health

Disability adjusted life-years lost (DALY)

One DALY represents the loss of the equivalent of one year of full health (DALY = YLL +YLD)

Crude death rate

the total number of deaths in a year divided by the average total population. (# of deaths in a year divided by the total population times 1,000)

the age/sex-specific death rate

deaths in a specific age group and sex divided by the population of that same age group and sex times 1,000

_____ have a lower probability of death at every age from the moment of conception

women (unless society intervenes with a lower status for women that gives them less food, less access to health care, etc)

Populations with ___ ______ are those with ___ _____

High Mortality — High morbidity

What is the Fertility Transition?

It is the shift from high fertility, with minimal individual control, to low fertility, which is entirely under a woman’s control - it involves a later start to childbearing and an earlier end to childbearing.

Fertility

number of children born to a women (biological and social components)

High fertility society

a population in which most women have several children

low fertility society

a population in which most women have few children

Fecundity

Whether you can produce children or not

a ____ person can produce children; an ____ person cannot

fecund ; infecund

impaired fecundity

if a woman believes it is impossible for her to have a baby; if a physician told her not to get pregnant because of health risks to her or baby; or if she has been continuously married for at least 36 months, has not used contraception and has not gotten pregnant.

Natural Fertility

level of reproduction that exists in the absence of deliberate fertility control (6 or 7 children)

Social components of fertility

Need to replenish society, children as security and labor, lower status of women in traditional societies.

Social components of fertility: Need to replenish society

Children as an essential for status and prestige

Social components of fertility: Children as security and labor

in premodern settings the quantity may have mattered more than the quality of children. nature of parents may have been more to bear children rather than to rear children.

Social components of fertility: Lower status of women

in traditional societies, women have poor status, leading to a desire for sons.

how is high fertility accomplished?

having children early and often (control over women), and lacking acceptability of contraception and/or abortion

What are the preconditions of a substantial fertility decline

1) acceptance of choice as element in marital fertility (Ready - ideational changes - the enlightenment, secularization), 2) perception of advantages from reduced fertility (willing- motivation for limiting fertility), 3) knowledge and mastery of effective techniques of birth control (Able - controlling reproduction)

Motivation for lower fertility: the supply-demand framework

The need for households to balance the demand for children (what are they good for?) with the supply of them. (Level of fertility in a society is determined by the choices made by individuals within their cultural and household context.) (children seen as consumer costs).

supply-demand framework: when the ____ begins to exceed the _____, then the motivation to limit fertility increases.

supply, demand

why is fertility so sensitive to education?

Because education expands horizons beyond boundaries of traditional society. Education also increases the opportunity for mobility. Benefits of children become less tangible than the costs.

What are the benefits of having children

Psychological satisfaction, proof of adulthood, more integration into the family and community. Rewards are largely centered on person and social satisfaction.

The innovation/diffusion and “cultural” perspective:

1) Fads and fashions - influential change agents (social pressure)

2) Social Stratification:

• Cultural innovation takes place in higher social strata because of privilege, education, and resource (lower social strata adopt new preferences through imitation)

• Rigid social stratification inhibits downward cultural mobility thus inhibits diffusion of low fertility ideas unless there are effective means of communication among and between strata (we follow what those around us do when it comes to marriage and kids.)

How is lower fertility accomplished?

The first sign of decline in population is often an increase in the age at which women have their first birth. When couples have an ideal family size in mind, they still make decisions about children one at a time.

Proximate Determinants of Fertility (intercourse variables): Age of entry into sexual unions

The longer a woman waits to begin engaging in sexual unions, the fewer the kids as there will be less time at risk of pregnancy.

Proximate determinants of Fertility (intercourse variables): Permanent celibacy

Proportion of women never entering sexual unions

Proximate determinants of fertility (intercourse variables): Amount of reproductive period spent after or between unions.

When unions are broken by divorce, separation, desertion, or death

Proximate determinants of fertility (intercourse variables): Voluntary postpartum abstinence

this is not a popular option, but it is not uncommon except for shortly after the birth of a child when abstinence does not have much of an impact of fertility. But, in some societies, there is postpartum taboos on intercourse that lasts months or even a few years.

Proximate determinants of Fertility (intercourse variables):involuntary abstinence

Due to impotence, illness, unavoidable but temporary separations - not easy to tell now important this is, but we do know that temporary separations are common in many occupations, military, and migrant families.

Proximate determinants of fertility (intercourse variables): coital frequency

excluding periods of abstinence - more intercourse increases the chance of pregnancy.

Conception Variables: Fecundity or infecundity as affected by involuntary causes.

1) involuntary factors include age of menarche which depends largely on nutrition.

2) length of fecund period - sub fecundity affected by morbidity - from infectious diseases and malnutrition.

3) Breastfeeding - it prolongs postpartum amenorrhea and suppresses ovulation, 2 months of infecundity if not nursing; 10-18 months if exclusively nursing, and closer spacing of children threatens mother and child health.

Conception variables: contraceptive use

use or non-use of contraception by mechanical and chemical means

conception variables: Voluntary causes

sterilization, medical treatment, etc

Gestation variables: Miscarriages

As many as 40% of conceptions may not survive through birth. This number is similar in all countries and thus does not explain national differences.

Gestation variables: Abortion

Abortion because legal in the US in 1973 until Dobbs decision in 2022.

Abortion rate

number of abortions per 1,000 women ages 15-44

Abortion ratio

number of abortions divided by # of live births.

Crude Birth rate

indicates the number of live births per 1,000 population in a given year (# of births / total mid-year population x 1,000

General Fertility rate

the number of live births per 1,000 women ages 15 - 49 in a given year (# of births / number of women ages 15-49 × 1,000

Age- specific fertility rate

this allows us to see differences in fertility behavior or to compare over time (# of births to women ages 20-24 / # of women ages 20-24 × 1,000

Total fertility rate

the average # of children that would be born to a woman by the time she ended childbearing if she were to pass through all her childbearing years conforming to the age-specific fertility rates of a given year. (the fertility of all women at a given pooint in time.)

Gross reproduction rate

the average number of daughters that would be born to a women during her lifetime if she passed through her childbearing years conforming to the age-specific fertility rates of a given year. This rate is like the TFR except that it counts only daughters and literally measures “reproduction” - a women reproducing herself by having a daughter.

Net reproduction rate

the average number of daughters that would be born to a woman if she passed from birth to the rest of her life conforming to the age-specific fertility and mortality rates of a given year. this is like the GRR, but it is always lower because it takes into account the fact that some women will die before completing their childbearing years.

child-woman ratio

the number of young children (0-4) per 1,000 women of reproductive age (15-49) (# of children 0-4 / # of women 15 -49 × 1,000