Lecture 2 - Population and Health Geography PDF

1/20/21 2 Population and Health Geography Understanding Demography The science that studies: o Population size and composition o Processes influencing population composition o Links between populations and larger human environments Population geography and health geography use demography and examine...

1/20/21 2 Population and Health Geography Understanding Demography The science that studies: o Population size and composition o Processes influencing population composition o Links between populations and larger human environments Population geography and health geography use demography and examine spatial dimensions Population studies emerged in the 19th century with concerns about rapidly changing populations 1 1/20/21 Population Distribution Relevant dimensions of distribution o Concentration, dispersion, density Dependency on census data Factors affecting distribution o Physical: temperature, water, relief, soil quality o Cultural: continuity of ancient civilizations and recent trade and migration shifts Distribution of World Population Three areas of historic concentration 1. South-Central Asia clustered along key rivers and coasts 2. East Asia clustered toward east coast and along rivers, disperses to west 3. Europe (including Russia) clustered toward west and along rivers, relatively more urban 2 1/20/21 Distribution of World Population Distribution of World Population 3 1/20/21 Other Regional Patterns and Trends Relative growth in Africa, South Asia Declining growth in areas Population Density Measures of population over area Not always captured by country size General patterns reflect historic agriculture Other pockets of high density o More variable, recent causes 4 1/20/21 Population Density Population Dynamics Components of fertility, mortality, migration Demographic equation 5 1/20/21 Measuring Fertility Fertility and fecundity Crude birth rate: Total live births in a given period for every 1,000 people already living o Simplest measure Total fertility rate (TFR): Average number of children a woman will have, assuming she has children at the prevailing age-specific rates as she passes through the fecund years o Between 2.1 and 2.5 is considered replacement-level Measuring Fertility-CBR 6 1/20/21 Factors Affecting Fertility Biological o Age, nutritional well-being, diet Economic o Cost–benefit decision o Affected by economic structure and social needs Cultural o Marriage age and rates, changing correlation to birth o Contraceptive use o Views on abortion Variations in Fertility Spatial variations correspond to economic change o Not necessarily the root cause More developed countries o Industrialization correlated to fertility decline Most less industrialized o Fertility decline more correlated to education of women 7 1/20/21 Measuring Mortality Crude death rate (CDR): Total deaths in a given period for every 1,000 people o Less variable worldwide: affected by well-being and age Infant mortality rate (IMR) o Better indicator of social well-being o Deaths of infants < 1 year old per 1,000 live births/year Life expectancy (LE) o Not a mortality measure; good indicator of well-being o Anticipated average number of years lived Measuring Mortality-CDR 8 1/20/21 Factors Affecting Mortality Unlike CBR, a CDR can never be zero LE more sensitive to factors of: o o o o o o Food availability Nutrition quality Sanitation quality Health care availability and quality Disease Conflict Variations in Mortality World patterns of CDR less variable than CBR LE reflects socio-economic status o Varies between countries o Varies within countries Affected by access to resources 9 1/20/21 Variations in Mortality- LE Natural Increase Rate of natural increase (RNI) is CBR – CDR o Often expressed as a percentage: (CBR – CDR)*10 In 2017, the world RNI was 12 per 1,000 (1.2%) RNI is declining but still positive o world population is increasing, but at a decreasing rate Population momentum: a relatively young world population currently maintains growth 10 1/20/21 Natural Increase, cont’d Regional patterns reflect RNI and base population Doubling time o Was often used to compare different RNIs 11 1/20/21 Government Policies Can address mortality and fertility Mortality policy generally aims to lower o Wars and uneven social well-being as exceptions Fertility policy more variable o May lower or raise, depending on perceived need Some governments may not have formal policies o Indifferent o Divided public opinion Pro-Natalist Policies Theological reasons Social or political reasons o Dominant ethnic group fears relative decline o Economic strategy: raise workforce, market size 12 1/20/21 Anti-Natalist Policies Common after 1960 o Many less-developed countries tried reducing fertility Fears that carrying capacity could be exceeded o Carrying capacity is now seen as more changeable Controversial example of India and China Many now argue intervention inherently unjust o Reflect colonial legacy of control and fear Age and Sex Structure of a Population Fertility and mortality vary significantly with age o A population’s growth is affected by age composition Population pyramid o Representation of age and sex composition Information rich indicator o Shows changes in fertility, mortality, sex ratio, and relative age 13 1/20/21 Age and Sex Structure of a Population, cont’d Age and Sex Structure of a Population, cont’d 14 1/20/21 Global Population Aging In 2000, people over 60 first outnumbered people under 14 o Declining fertility plus increasing life expectancy Rising median age of world population Significant regional and national differences History of Population Growth Species are usually constrained by climate and food availability Cultural development changed adaptive abilities o Ancient: speech, monogamy, fire, clothing o Recent: agriculture, industry 15 1/20/21 Reasons for Growth Agriculture: systematic use of natural processes o Rapid growth with occasional crises Industry: systematic mechanization of processes o New phase of exponential growth Population Projections Growth slowing, but from a high base number Population projections show levelling by 2050 o Dependent on consistent TFR and CDR trends Continued debate o Pessimists: natural limits can be reached o Optimists: technology will increase limits 16 1/20/21 Population Projections Explaining Population Growth Malthusian theory The demographic transition model 17 1/20/21 Malthusian Theory Developed hypothesis from observations o Food production increases at an arithmetic rate o Population increases at a geometric rate o Hypothesis: growth reduces the means of subsistence Additional assumptions: checks on growth o Preventative checks fail: delayed marriage, moral restraint o Positive checks more effective: war, famine Theory lost favour with birth rate, migration changes Lasting impact on population studies: o Neo-Malthusians The Demographic Transition Descriptive generalization of fertility and mortality change in more developed countries Based on known facts rather than assumptions Lacks predictive and explanatory capacity Only appears to describe demographic transition in less developed countries o Differing causes and patterns of change 18 1/20/21 1. State Creation The Demographic Transition Four stages of demographic transition o The demographic transition is a process of change in a society’s population from high crude birth and death rates and low rate of natural increase to a condition of low crude birth and death rates, low rate of natural increase, and higher total population. o Every country is in one of these stages The Demographic Transition, cont’d 19 1/20/21 1. State Creation The Demographic Transition Four stages of demographic transition 1. State Creation The Demographic Transition Stage 1 (Low Growth) o Very high CDR and CBR, very low NIR o This is the stage for most of human history, but no country remains in stage 1 today. o During most of this stage, people depended on hunting and gathering for food. When food was easy to obtain, the population increases. 20 1/20/21 1. State Creation The Demographic Transition Stage 2 (High Growth): The Gambia o High CBR, rapidly declining CDR, very high NIR 1. State Creation The Demographic Transition Stage 3 (Moderate Growth): Mexico o Rapidly declining CBR, moderately declining CDR, moderate NIR o After 1974, a National Population Council promoted family planning, 40 percent of Mexico’s married women have sterilizations. 21 1/20/21 1. State Creation The Demographic Transition Stage 4 (Low Growth): Denmark o Very low CBR, low CDR, 0 or negative NIR Migration Long-term relocation of an individual or group o Movement of residence o Subdiscipline excludes temporary movement Humans have always migrated Has expanded resource base, facilitated population increase, stimulated cultural change 22 1/20/21 Why People Migrate Two explanations: 1. Push–Pull Logic: a useful generalization ! favourable and unfavourable conditions ! Natural environment, economy, political/cultural conditions ! Problematic assumption: All people behave according to one common logic 2. Moorings: allow for individual differences ! Considers the perception of location attributes—What gives meaning to people’s lives in place? Why People Migrate 23 1/20/21 The Selectivity of Migration Different factors affect an individual’s choices o o o o o Age Marital status Gender Occupation Education General effect of life cycle Impact of policy, other political and social restrictions 24 1/20/21 Types of Migration Primitive Forced and impelled Free migration Mass migration Illegal migration Health Geographies Distribution of disease and poor health Risks and effects of environmental contaminants Socio-economic determinants of health Availability of and access to care 25 1/20/21 Distribution and Diffusion of Disease Spatial patterns of infectious and degenerative disease o Natural environments o Social conditions E.g., ebola: tropical locations, risk increased by social conditions o Occasional epidemic outbreaks E.g., HIV/AIDS: tropical origins, social behaviours increased spread o now pandemic Distribution and Diffusion of Disease 26 1/20/21 The Epidemiological Transition Shift in prevalence of types of disease o Corresponds to demographic transition Three initial stages extended to a fourth 1. 2. 3. 4. Age of Age of Age of Age of pestilence and famine receding pandemics degenerative diseases delayed degenerative diseases Speculated re-emergence of infectious disease? The Epidemiological Transition, cont’d 27 1/20/21 Health Care Shift from disease focus to health focus Health care provision o Public, private and hybrid systems Variations in distribution by nation-state Variations in distribution within nation-states Health Care 28 1/20/21 Conclusion World population continues to increase markedly but at a decreasing rate Population is distributed unevenly on the earth Women in less developed countries are having fewer children Declining fertility and longer life expectancy are causing populations to age Government attempts to either decrease or increase fertility have had little impact The current distribution of people is an outcome of a long history of migration Health and illness vary spatially, at a variety of scales, and over time 29