Friday, December 19, 2014

One note on the global revolution in longevity


A recent Bloomberg article, Dani Bloomfield's "It’s the Best Time to Be Born as Life Expectancy Tops 70", caught my eye.

These are good times to be a baby. A child born last year will live six years longer on average than one born in 1990, the first time in history that life expectancy worldwide extends past age 70.

Much of the gain has come from poor countries, where better health infrastructure has helped people live dramatically longer lives, according to a paper published today in the journal Lancet. In rich countries, new drugs and other advances are stretching lifetimes, the study’s authors said.

Eastern sub-Saharan Africans saw a 9.2-year gain in life expectancy between 1990 and 2013, the biggest increase of any region. In some countries, such as Rwanda, Nepal, Niger and Iran, the outlook increased by more than 12 years.

“Outside of Southern Africa there’s been quite substantial improvement in life expectancy everywhere,” said Christopher Murray, the study’s lead author and a professor at the University of Washington, in Seattle. Except for 1993, when the worldwide estimate was hurt by genocide in Rwanda, “you can see that global life expectancy, particularly since 2000, has been going up 0.3 of a year, every single year.”

Worldwide, the expected length of life for an infant born last year grew 6.2 years, to 71.5 years old, according to the study, which was sponsored by the Bill & Melinda Gates Foundation.


The paper in question, "Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013", is available in its entirety online.

Global life expectancy for both sexes increased from 65·3 years (UI 65·0–65·6) in 1990, to 71·5 years (UI 71·0–71·9) in 2013, while the number of deaths increased from 47·5 million (UI 46·8–48·2) to 54·9 million (UI 53·6–56·3) over the same interval. Global progress masked variation by age and sex: for children, average absolute differences between countries decreased but relative differences increased. For women aged 25–39 years and older than 75 years and for men aged 20–49 years and 65 years and older, both absolute and relative differences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10·7%, from 4·3 million deaths in 1990 to 4·8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100 000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions.


Causes of mortality, the authors suggest, are shifting globally away from communicable diseases towards non-communicable diseases and injuries.

This news item put me in mind of a 2010 post I made about the grim demographics of the Roman Empire, and by extension almost all other pre-modern societies of note. Mortality was by our contemporary standards terrifyingly high, especially high in the early lives of human beings, to an extent that even the least developed societies in our 21st century world would have difficulty comprehending. That world life expectancy is now comparable to that of Canada in the 1960s is a remarkable transformation without precedent, and something quite worth watching.

Thursday, December 18, 2014

On looking at peripheries


For the next little while here at Demography Matters, I'll be posting examinations of various lengths about the demographic dynamics of peripheries, territories and populations both. Part of my reason for this has to do with my own personal interests in the topic, coming from a relatively marginal area of Canada myself. Relationships between peoples and individuals and regions located in the core and periphery and semi-periphery, to borrow the language of world-systems theory, have always interested me, especially as these relationships change.

More of my interest has to do with the ways in which this division of the world is starting to have real consequences for population change. As the distribution of human and economic capital changes, becoming scarce in some parts of the world and more abundant in others, with some being united by borders and others being cut off, real tensions do develop. This is especially so where things change unevenly. What areas are winners? What areas might catch up? What areas might end up declining?

Stay tuned.

Tuesday, December 16, 2014

On how Afghanistan shows the importance of having a census


A recent article by Joseph Goldstein in The New York Times, "For Afghans, Name and Birthdate Census Questions Are Not So Simple", caught my attention.

After long delays, false starts and squandered millions in foreign aid, the great Afghan census is finally underway. The process is more than an exercise in counting bodies but one that, officials hope, will head off the kind of voter fraud that plagued the presidential election this past year.

The census teams generally include a man and a woman who often spend considerable time waiting in front of doors that never open, often because of purdah, the custom of sequestering women indoors away from men not their husbands or relatives and requiring a burqa when outside.

[. . .]

Since census workers began knocking on doors in Kabul this year, they have registered 70,000 people — just 2 percent of the city. Optimistic Afghan officials say it will take years before the entire country is surveyed.

“We believe we will reach 70 percent of the population in five years,” said Homayoun Mohtaat, the project’s director.

Nobody knows just how many people reside in Afghanistan. The last census, in 1979, found some 14.6 million people. Afghanistan’s Population Registration Department currently has records for about 17 million Afghan citizens, according to officials.
Wikipedia's "Demographics of Afghanistan" article notes that, apart from a survey performed in 2009, Afghanistan really has no firm data on demographic trends at all. This, as Goldstein notes, can harm individual lives.

Each name is listed in a clothbound ledger book stacked on sagging metal racks in four dusty rooms in the offices of the department, a government agency.

For years, this is where citizens have come to seek a passport, join the army or change their marital status. Before that can happen, though, the petitioner’s identity must be verified in one of the books. Clerks say they almost never fail to locate an entry, except for people with the bad luck of being listed on the first or last page. Those names and photos have largely worn away from use over the decades.

The clerks who work here have the carnival-worthy ability to guess a person’s age within a year, a necessity in a place where few actually know how old they are.

Mr. Mohtaat guesses the census will yield a count of 35 million to 40 million Afghans.

As Sune Engel Rasmussen writing in The Guardian noted in the case of Kabul, the lack of firm data makes it difficult for governments and others to get a handle on the country's problems. The case of booming Kabul is the particular focus of Rasmussen's article, but doubtless similar stories could be told about other Afghan cities and regions.
Though exact data is impossible to obtain (the last official census was conducted in 1979), Kabul is estimated to be the fifth fastest growing city in the world, with a population which has ballooned from approximately 1.5 million in 2001 to around 6 million people now. The rapid urbanisation is taking a heavy toll on a city originally designed for around 700,000 people. An estimated 70% of Kabul’s residents live in informal or illegal settlements.

“The situation is putting a strain on the existing infrastructure and resources – and makes it difficult to ensure security across Kabul,” said Prasant Naik, country director of the Norwegian Refugee Council, which provides legal counselling and shelter to displaced Afghans and is one of the largest humanitarian organisations in Afghanistan.

A significant share of Kabul’s economy is driven by illicit businesses, such as the drug trade, facilitated by corruption. (According to a recent survey by the UN Office on Drugs and Crime, Afghanistan’s opium cultivation hit record levels this year.)

With economic growth slowed from 9% in 2003 to 3.2% in 2014, jobs are scarce and the vast majority of Kabul’s workers are either self-employed or casual labourers.
Afghanistan has many problems. One particularly important problem, I'd argue, is the lack of firm data about just who is living in Afghanistan and what they're doing. Without good data, many things become difficult. Here's to hoping that Afghanistan succeeds in this particular project.