Pop. Society 2nd Exam

lifespan

the oldest age humans can survive

longevity

our ability to remain alive from one minute to the next

life expectancy

average number of yers that a baby born today can expect to live

crude death rate

number of deaths divided by mid period of population today; current rate is about 9.2%

how do you calculate infant mortality?

total number of infants deaths in given year divided by total births in same year, x1000

What are the factors that contribute to population aging?

lower fertility (not necessarily/always lower mortality), negative net migration, raising life expectancy

what regions of the world are aging the fastest

southern europe: italy, greece

japan, singapore

LDRs are aging at a faster pace

what are the economic consequences to aging

• increases the dependency burden and old-age dependency ration, also leads to declines in youth bc of lower fertility

• old people consume more than they contribute, general resource strain

• social security and medicaid, very expensive: lots of money spent on elderly

political consequences to aging

• old people are more politically active and people vote on their behalf more

• old people stay in power longer, various consequences

• children are harmed by this: not voted for enough, money is given to and spent on old people more than children

social consequences of aging

• decline in upward career mobility

• new product developments like easy to swallow foods in japan

• desire for independence, new caregiving systems

describe the social security system and why it’s threatened

• pay as you go system, the workers today are taxed - payroll tax - and that money is given to their parents/the previous generation

• threatened bc it works best with a young population so there are more people working, now they aren’t enough young people, there isn’t enough money coming in and there’s too many dependents

• also people are living longer therefore staying on the system longer, the older you get the more treatment and medicine you need so that threatens it too

what are the commonly suggested to fix this

1. increase retirement age - would mean tax increase and benefit reduction

2. privatization - would basically turn it into medicaid

3. changing the benefit formula - reforming entitlements

what is medicaid

federal program established in 1965 that provides free or heavily subsidized healthcare to all over 65 or youths with disabilities: very expensive for the country

how has aging affected children

• disproportionately affected by voting so they aren’t represented therefore aren’t given money, leads to poverty being more prevalent in children than elderly

• people vote on behalf of elderly more than on behalf of children

what piece of info is needed to construct a period life table?

age specific mortality rates in a given year

what is the difference between incidence and prevalance

incidence = new cases of disease in pop. in period of time

prevalance = total number of cases at given time

why is life expectancy a better measure of mortality than crude death rate

life expectancy accounts for different age structures, pyramids, crude rate does not; life expectancy is also more intuitive

why is infant mortality rate an important measure to demographers

has a big effect on life expectancy, picks up everything in a society: health conditions, nutrition, women’s education/treatment of women

also close link between IMR and high fertility

what are 2 measures of mortality

life expectancy and infant mortality rate

what are the theories of why we die, how do they explain variation between and within species

planned obsolscene/gene expression theory of aging (programmed theories)

• lifespan is programmed, we die by design

• aging follows biological timetable, the number of repeats in a telomore determines the max life span of a cell, may explain variation across species

damage/error theories

• life span is determined by the damage our bodies experience

• emphasizes environmental factors that may accelerate aging process

• may explain variation within species

how do olshanky and vaupel differ in their view of future life expectancy

Olshanksy - pessimist, limited, glass ceiling: humans have biological limits, the longer you live the harder it is to live, thinks we may see reductions in life expectancy bc of things like obesity

Vaupel - no limits to human life expectancy, unlimited, no inherent limits, believes that the future will resemble the past so expectancy will continue to increase

what evidence do each use to support their positions

Olshanksy - also history, says that much of previous progress is due to decreases in infant mortality, salmon exploding ex., rising concerns like obesity

Vaupel - relies heavily on historical data, data from Japan and Sweden

where do olshanksy and vaupel agree about life expectancy

• gains need to be made in terms of prolonging the age of elderly

• accurately predicting life expectancy is important for allocation of resources

aubrey de gray, his argument

• Gerontologist (studies aging), believes that science will soon enable us to live longer into hundreds of years, we’ll fight off degeneration

• believes that aging is a curable disease caused by accumulation of metabolic damage, advocates for repairing the body’s flaws in order to live longer

• believes that aging is not inevitable

calorie restriction

severely restricting caloric intake

what does the aids pandemic look like today

• has already reached it’s peak, declining in many countries

• about 41 million people living with it worldwide

• re-emergence of incidence in some countries, resistance to antibiotics

• funding and policy strain, sub-saharan africa hit hardest

• medical interventions offer hope

who is hit hardest by aids

• sub-saharan Africa

• working class

recent trends of hiv incidence worldwide

• global incidence rates have declined by 21% from 1997-2010

• many sub-saharan countries saw incidence decline by over 25%

• incidence increased by more than 25% in some countries

what factors contribute to higher prevalence of disease of the disease in sub-saharan africa

• different patterns of sexual networking: polygamy, premarital and extramarital relations, men having multiple partners linked to high male migration rates, women can be pushed into dangerous positions bc of low status

• historical widespread denial and misinformation: condoms linked to prostitution, former president claiming hiv does not cause aids

what demographic and geographic groups are hit hardest by hiv in U.S.

• men who have sx with other men, black and latino men, black men who have sx with other men, youth and young adults at high risk, working class hit hardest

• D.C. highest in U.S., and Miami

how do we measure obesity and what are issues with this measure

• uses BMI: body mass index, weight/height²

• doesn’t take into account that muscle weighs more than fat, can classify muscular people as obese

• too crude

how is the U.S. environment obesogenic

large portion sizes, increasingly less active, fast food, quality of food

social implications of GLP 1s

• double edged sword with stigma: can reduce obesity stigma but also increase bc people are judged for taking them

• body positivity movement comes into question

• changes food, alcohol, pharma markets

examples of gov. efforts to reduce obesity, reactions to them

Michelle Obama’s ‘Lets Move’ campaign: wanted to make movement less intimidating, focused on children, worked to change menus and created new guidelines for school lunches, planted garden in White House - extreme backlash from conservative

RFK: more focused on adults, re-emergence of presidential fitness test, focus on getting rid of ultra processed foods, MAHA and inverted food pyramid - has no clear definition of ultra processed food

how does aging differ in LDRs and MDRs

• MDRs rely on institutional/structural support: social security, retirement homes

• LDRs rely more on informal family support like multigenerational living

• LDRs have younger populations, MDRs have older pop. generally

• LDR age at a faster pace, and have had sharper declines in mortality bc of medical interventions, more gradual historically in MDRs

what are social determinants of health

• non-medical systemic conditions that shape people’s health, quality of life, etc.

• economic stabiliy/SES, education, living conditions/environment, healthcare

threshold model of poverty vs. social gradient model

• Threshold model: idea that if you’re living in poverty, improving those living conditions will have positive impacts on health but after basic needs are met there is no effect/above a certain income level there is no impact on health (inaccurate)

• Social gradient of health: from Whitehall studies, showed an increase in health unlike a plateau like threshold suggests; the lower you go down in social gradient, lower the SES, the lower the health is, and vice versa, if you continue to improve SES there will be a continued improvement in health, unlike a plateau in threshold model

Whitehall studies, full overview

• Studied public servants in the U.K., they were interviewed to understand their living conditions, health etc., then checked to see if they were alive 10 years later and again 25 years later; males aged 20-64

• Distinguished between ranks of civil servants, top to bottom of hierarchy

• Found that the higher ups died at lower levels than lower ranked employees

• First study (after 10 years) showed a sharp gradient in relationship of SES and mortality, second showed same gradient, those higher up had lower risk of mortality

• Social gradient in mortality across job positions is linked to differences in hierarchy, inequality is more important than poverty: those at the bottom were 3x likelier to die sooner than at the top, showed health-wealth gradient

What is the “SES as a fundamental cause” explanation for social disparities? Know some examples of evidence to support this theory

• Park and Burgess study in 1925, studied families in different Chicago neighborhoods and found that inner zones/transition areas were characterized by poverty, with lots of families relying on relief/monthly support, also high infant mortality rates and insanity: high rates were concentrated in these areas, this pattern held no matter the kinds of people that came in, the continuous bad health outcomes suggested that it was more about the environment causing bad health, not individuals

• 1960s, renewed interest in social disparities in health: chronic diseases are predominant killers with clear link to social, economic, behavioral factors; Johnson’s war on poverty 

• Link and Phelan theory, argues that SES acts as a fundamental cause by embodying flexible resources that people use to avoid risk and treat illness

What are the differences in life expectancy between major educational groups and racial/ethnic groups in the U.S. today and how have these patterns been changing over time

• The more education you have, the longer you life

• Females across racial groups have higher rates, for all groups the more education you have the longer you live

• Life expectancy increased significantly for white women with more education

• As time passes, education becomes more and more important to life expectancy

What are some causal mechanisms through which SES might affect health?, as described by the WHO social determinants of health framework?

• Material circumstances: living and working conditions, food availability

• Behaviors and biological factors, psychosocial factors

• Socioeconomic position: gender, race, class, education

• Context (socioeconomic political): structural factors like governance, social policies, culture and societal value

drift vs. selection in regards to SES-health link

• Drift = loss of job and wealth due to poor health, downward mobility

• Selection = poor health may limit capital accumulation in first place, prevents upward mobility

• Both are Examples of how health can cause SES

What is the Hispanic health paradox in the U.S. and how might we explain it?

• Despite having lower average levels of SES, Latinos in U.S. often have better health outcomes

• Possible explanations: cultural or social buffering effects, migration effects - people who migrate are healthier or stronger than those who don’t, “salmon bias effect” those who become ill return home, data artifacts: mismeasurements of age, ethnicity, which inflates mortality rates for some Latino groups

What are current trends in the infant mortality  rate?

• Remains high in many places of the world

• Rates have been lowered from public health campaigns, expansion of vaccination units

• Persistent racial and socioeconomic disparities

basic patterns of sex differentials in LDRs and MDRs today

• Women live longer than men on average, more so in MDRs

• Males live less due to behavioral choices like smoking

• High rates of maternal mortality in LDRs; severe gender inequality greatly harms women

What are current trends in the infant mortality  rate?

approximate life expectancies in major regions of the world

• 63 in sub saharan africa

• 71.5 in india

• 79 in china

• 75 in asia as whole

• 76 in latin america/carribean

• 79 ish in europe

• 79 in U.S.

Be familiar with the Caldwell “Low Routes to Mortality” piece discussed in lecture.

• Countries like Sri Lanka and Costa Rica were particularly successful in lowering mortality rates: important cultural factors like women having autonomy and education with an emphasis on mass and fair education between sexes, societies had no rigid class structure, health services: relied on immunization campaigns, nutritional floors - subsidized food so the minimum nutrition was met, household visits to inform and educate people about health rather than expensive tech

• These factors created an important symbiosis between health services and culture, led to the importance of women’s schooling

How does the LDR mortality decline differ from the MDR mortality decline in terms of timing, speed and important contributing factors?

• Much of MDR decrease occurred before medical advances so medicine is not seen as the primary explanation for decline

• LDR mortality decline is more owed to programs targeting smallpox, plague, polio

• LDR has double burden of disease: new burden of chronic diseases on top of infectious, typical

• Medical tech and vaccinations play important role for LDRs

• Happened faster in LDRs bc of introduction of medical innovations (late 20th century), more gradual in MDRs

• For MDRs: more about economic growth, industrialization, LDRS: medical tech

What were the primary factors that contributed to the MDR mortality decline after 1850 (know the persons and evidence associated with each explanation as discussed in class)?

• Economic growth led to improved standards of living, mortality decline was a byproduct

• Thomas McKeown said that the bulk of decline of disease came before effective drugs were available, concluded that economic growth must be responsible: no evidence, more so a process of elimination

• Robert Fogel: found a close connection between improved nutritional (height) status and lower mortality; problematic because he didn’t take into account previous factors that stunted growth and affected longevity

• Improvements in public and personal healthcare: water sewage systems, pasteurization of milk, improved personal health behaviors like better mothering campaigns, 1912 formation of children’s bureau

• Germ theory replaces miasma theory, leads to public and private health initiatives: dramatic declines in infant mortality

When did mortality rates start to decline substantially in MDRs?

• With the transition to more sedentary lifestyles which reduced injury related illnesses, transitional segment

• Not all MDRs entered transition at the same time so life expectancy varied from 40-60 across Europe in 20th century

• During rapid MDR mortality transition, life expectancy at birth grew more than 50%

What were the primary causes of death during major historic periods (as discussed in class)?

• Golden age of bacteria 1300-1650, exchange of diseases among populations newly in contact: smallpox, syphilis; the plague and black death

• 1650-1850: disappearance of plague, small pox vaccination

• Classification of death causes by WHO

  • Infectious and parasitic diseases, degenerative/chronic diseases, products of social and economic environment

 What are critiques of the original theory described by Omran?

• He says that as societies modernize, high death rates from infectious diseases are replaced by chronic, degenerative, and man made conditions, driving longer life expectancies

• Critiqued for inaccuracies, too much reliance on western data/nations

What are the three stages of the epidemiological transition, and which age groups are affected during each stage?

• Pre-transitional segment of high mortality before 1850, transitional segment decline in epidemic and infectious diseases 1850-1950, and late transition segment characterized by degenerative and human made diseases 1950-present; currently in progress worldwide

• Hunter gatherer societies: life expectancy of low 20s

• 1650-1850: 

• Historically, mortality improvements occurred among young, today improvements are concentrated among old