Geoffrey McNicoll, Senior Associate, Population Council, New York The usual lessons drawn from East Asia's striking experience of health and fertility transition concern the efficacy of well-designed government programs catering to an existing or ideationally stimulated demand. An alternative interpretation sees the demographic change—and the uptake of services—as a byproduct of social and economic development together with, in some cases, strong government pressures. This article probes more deeply into this experience, seeking to identify common features of development design and administration that underlay it. The broad sequence entailed, initially, establishment of an effective, typically authoritarian, system of local administration, providing (sometimes incidentally) a framework for promotion and service delivery in health, education, and family planning. Subsequent economic liberalization offered new opportunities for upward mobility—and greater risks of backsliding—but along with erosion of social capital and the breakdown or privatization of service programs. The study is mainly focused on seven countries: Taiwan and South Korea ("tiger" economies), Thailand, Malaysia, and Indonesia ("second wave" countries), and China and Vietnam ("market-Leninist" economies). The period is roughly from the 1960s to the 1990s. [32, no. 1 (Mar 06): 1–26]
- Young Adulthood as a Factor in Social Change in the United States
Michael J. Rosenfeld, Assistant Professor, Department of Sociology, Stanford University This essay compares family change during two periods of social and historical upheaval in the United States: the industrial revolution of the late nineteenth century and the more recent family changes of the late twentieth century. Despite the manifest social and demographic changes brought about by the industrial revolution, some aspects of family life remained unchanged. Almost all new families formed in the United States before and during the industrial revolution were same-race heterosexual marriages. In the past half-century, however, family diversity has become the new rule; interracial marriages and extramarital cohabitation have both risen sharply. A key to understanding the lack of family diversity in the past and the recent rise in diversity is the changing nature of young adulthood. [32, no. 1 (Mar 06): 27–52]
- Political History and Disparities in Safe Motherhood Between Guatemala and Honduras
Jeremy Shiffman, Associate Professor of Public Administration, The Maxwell School of Syracuse University
Ana Lucía Garcés del Valle, independent consultant in reproductive and women's health in Guatemala Each year, worldwide, more than 500,000 women die of complications from childbirth, making this a leading cause of death globally for adult women of reproductive age. Nearly all studies that have sought to explain the persistence of high maternal mortality levels have focused on the supply of and demand for particular health services. We argue that inquiry on health services is useful but insufficient. Robust explanations for safe motherhood outcomes require examination of factors lying deeper in the causal chain. We compare the cases of Guatemala and Honduras to examine historical and structural influences on maternal mortality. Despite being a poorer country than Guatemala, Honduras has a superior safe motherhood record. We argue that four historical and structural factors stand behind this difference: Honduras's relatively stable and Guatemala's turbulent modern political history; the presence of a marginalized indigenous population in Guatemala, but not in Honduras, that the state has had difficulty reaching; a conservative Catholic Church that has played a larger role in Guatemala than Honduras in blocking priority for reproductive health; and more effective advocacy for maternal mortality reduction in Honduras than Guatemala in the face of this opposition. [32, no. 1 (Mar 06): 53–80]
- Long-Term Trends in Life Expectancy and Active Life Expectancy in the United States
Kenneth G. Manton, Scientific Director, Center for Demographic Studies, Duke University, Durham, North Carolina
XiLiang Gu, Research Associate, Center for Demographic Studies, Duke University, Durham, North Carolina
Vicki L. Lamb, Research Scientist, Center for Demographic Studies, Duke University, Durham, North Carolina Changes in life expectancy and in active life expectancy may have effects on the fiscal integrity of both the Social Security and Medicare programs. Analysis of the fiscal stability of these programs shows that the most serious problem may be the growth of Medicare expenditures projected to surpass, in about 2024, Social Security costs. This is aggravated by the associated rapid growth of the Medicaid program. To understand how the growth of Medicare, Medicaid, and Social Security might be correlated we present estimates of changes in life expectancy and active life expectancy from 1935 to 1999 and then project those values to 2080. How the correlation of life expectancy and active life expectancy changes over time, and by age, may provide insights into how increased health care expenditures, if effective in changing health in the elderly, could modify the age structure of the labor force and the availability of human capital. [32, no. 1 (Mar 06): 81–106]
Notes and Commentary - The Emotions and Reproductive Health
Alaka Malwade Basu, Associate Professor, Department of Sociology, and Director, South Asia Program, Cornell University, Ithaca, New York It is surprising that social demography has so little to say on the emotional underpinnings of demographic behavior. The central proposition of this essay is that emotions are particularly important for understanding the problems of reproductive health. This understanding allows one to consider the usual determinants of personal autonomy, or access to knowledge or services, but also to take into account the fact that much sexual and reproductive behavior is motivated by emotional states that can suppress prior knowledge, services, or agency. The essay draws upon the emerging theoretical literature on emotions in the disciplines of sociology and anthropology to explore the role of emotions in behavior and outcomes related to reproductive health. It looks especially at the cultural meaning, the ideal, and the experienced reality of the emotion of "love." All these aspects of what is a positive emotion have important positive as well as negative implications for the diagnosis and treatment of reproductive tract problems and for unsafe sexual activity. [32, no. 1 (Mar 06): 107–122]
Data and Perspectives - Diverging Trends in Female Old-Age Mortality: The United States and the Netherlands versus France and Japan
France Meslé, Directrice de recherche, Institut national d'études démographiques, Paris
Jacques Vallin, Directeur de recherche, Institut national d'études démographiques, Paris In the most advanced countries, child mortality and adult mortality under age 65 years have fallen so low that further improvement in life expectancy relies almost completely on the decline of mortality at older ages. This phenomenon is particularly pronounced among women, who are far ahead of men in survival rates. Thus, to project the future of life expectancy, this study focuses on trends in female life expectancy at ages 65 and older. Four countries are selected for this analysis: the United States, Netherlands, France, and Japan. It is particularly interesting to understand why American and Dutch trends in female old-age mortality have been diverging from those in France and Japan for two decades. It is shown here that most of the divergence derives from the fact that decline in cardiovascular mortality is more and more offset by increases in other causes of death in the United States and the Netherlands, while the other two countries are more successful in reducing mortality from all causes at increasingly older ages. This latter phenomenon could represent a new stage of the health transition. [32, no. 1 (Mar 06): 123–146]
- Many Chinas? The Economic Diversity of China's Provinces
Gerhard K. Heilig, formerly of the International Institute for Applied Systems Analysis (IIASA), Laxenburg, Austria, and the Institute for East-Asian Research, Sinology, Vienna University, is an independent consultant This note analyzes China's provincial diversity from two perspectives. First, the regional gross domestic products of China's 31 mainland provinces are compared with the national GDP of other countries. This demonstrates that China's most advanced provinces and urban areas have per capita GDP levels comparable to those of Sweden and Singapore. On the other hand, China's least developed provinces have a standard of living similar to those of Sudan and Honduras. The second part of the analysis demonstrates that China's economic diversity is not unique. In fact, European countries exhibit almost the same degree of income diversity as do Chinese provinces. [32, no. 1 (Mar 06): 147–162]
Archives - John Weyland on Encouragements to Population Increase
Book Reviews Reynolds Farley and John Haaga (eds.), The American People: Census 2000, reviewed by Donald J. Bogue Arland Thornton, Reading History Sideways: The Fallacy and Enduring Impact of the Developmental Paradigm on Family Life, reviewed by Steven Ruggles Susan Greenhalgh and Edwin A. Winckler, Governing China's Population: From Leninist to Neoliberal Biopolitics, reviewed by Siri Tellier - I. Bernard Cohen, The Triumph of Numbers: How Counting Shaped Modern Life, reviewed by William Seltzer
Short Reviews Rashmi Dube Bhatnagar, Renu Dube, and Reena Dube, Female Infanticide in India: A Feminist Cultural History Charles Blackorby, Walter Bossert, and David Donaldson, Population Issues in Social Choice Theory, Welfare Economics, and Ethics Josef Gugler (ed.), World Cities Beyond the West: Globalization, Development and Inequality Panel on Urban Population Dynamics, National Research Council, M.R. Montgomery, R. Stren, B. Cohen, and H.E. Reed (eds.), Cities Transformed: Demographic Change and Its Implications in the Developing World UNAIDS/WHO, AIDS, Epidemic Update: December 2005 - The World Bank, Improving Health, Nutrition, and Population Outcomes in Sub-Saharan Africa: The Role of the World Bank
Documents - Sub-Saharan Africa's Future: A US National Intelligence Council Conference Report
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