Population Dynamics and Health

POPULATION
DYNAMICS
AND HEALTH
Kai-Lit Phua,PHD
DEMOGRAPHY
Scientific study of population
 Births (Fertility)
 Sickness (Morbidity)
 Deaths (Mortality)
 Population movements (Migration)
 Other e.g. abortion rates, divorce rates etc.
 Scholars often focus on subtopics e.g. teenage

fertility, immigrant fertility, infant mortality,
maternal mortality
DEMOGRAPHY
 Composition of population --- ethnic, age, sex

(also, how many are non-citizens)
 Distribution --- % rural, % urban, % suburban.

Also, how many citizens live overseas
 Growth --- rapid growth, slow growth,

population decline
DEMOGRAPHY
Population is affected by fertility, mortality

and migration rates
Final population = Initial population +

(Births – Deaths) + (Immigration –
Emigration)
AGE-SEX COMPOSITION OF A
POPULATION
Depicted by the Population Pyramid
 “Young” population: pyramid is triangular
 “Ageing” population: pyramid becomes

more and more rectangular
“YOUNG” POPULATION
% of total population under age 15 is high
Median age as low as 15 or 16
Due to high fertility

“AGEING” POPULATION
 Elderly rises from 5% to more than 20% of total
population
 Due mainly to low fertility e.g. Japan, Singapore
 “Young-old” versus “old-old”
 More and more elderly women
 More chronic & degenerative diseases
 Multiple health problems are common in elderly people
THE DEMOGRAPHIC TRANSITION
This refers to the change from:
High rates (births and deaths) to

Low rates (births and deaths)
Death rates drop before birth rates: therefore, there is a

period of rapid population growth. This ends when birth
rates finally drop.
DEMOGRAPHIC TRANSITION
Falling death rates are due to better nutrition and higher
standards of living
Falling birth rates are due to social and economic

changes:
1) Women stay in school longer

2) More women work outside the home
3) Women marry later
4) Women postpone childbearing
5) People choose to have fewer kids
(1) FERTILITY
Fertility rates differ by social variables:

Differ by religious group e.g. Catholic Church and
contraception
Differ by social class – lower classes tend to have higher
fertility
Differ by region – people in rural areas tend to have higher
fertility
Differ by country – people in poor countries tend to have
higher fertility
(1) FERTILITY
Fertility rates can be affected by:
 Public policy e.g. some governments pressure couples to have fewer

kids, other governments encourage them to have more!
 Culture e.g. religion and contraception
 Economics e.g. expense of having kids in industrial versus
agricultural societies
 Technology e.g. are effective contraceptive methods available?
FERTILITY AND HEALTH
 High fertility can increase maternal and child
mortality
 Continuous child-bearing can have a negative
impact on maternal health
 Closely-spaced births (<18 months apart) & low
birth weight babies (<2,500g) at higher risk
 Illegal abortions and maternal mortality
 “Female genital mutilation” & maternal mortality
 Sex-selective abortion in China and India
FERTILITY AND HEALTH
 Problem of teenage pregnancies in USA
 STDs such as gonorrhea can lead to infertility in
women
 Use of condoms reduce transmission of STDS
e.g. HIV/AIDS
 Monogamous women at risk of being infected
with HIV by husbands and boyfriends
INFERTILITY AND “ASSISTED
REPRODUCTION”
Infertility = inability to conceive children
Options for infertile couples:

Adoption
In some societies: second spouse, or even divorce or
even abandonment of “infertile” spouse
Treatment for infertility
 Ethical issues e.g. surrogate motherhood,

Baby M case in USA, sperm donors and sperm banks
(2) MORBIDITY AND
MORTALITY
The Epidemiological Transition
 This refers to the change in disease

patterns from mostly infectious diseases to
mostly chronic and degenerative diseases
 Cancer, heart disease, stroke, injuries,

diabetes, arthritis etc versus HIV/AIDS,
SARS etc
MEASURES OF MORTALITY
 Infant mortality rate (deaths of babies under 1 year old)
 Neonatal mortality rate (<28 days after birth)
 Postneonatal mortality rate (between 28 days and 1 year
old)
IMR = Deaths of babies under 1 year X 1,000

Total live births
MEASURES OF MORTALITY
 IMR = Neonatal Mortality Rate +
Postneonatal Mortality Rate
 Low Birth Weight (<2.5 kg at birth)

greatly increases the risk of infant
mortality
OTHER MEASURES OF
MORTALITY
 Under 5 mortality rate
 Life expectancy at birth
 Age-specific mortality rates
 Cause-specific mortality rates
 Maternal mortality rate

MEASURES OF MORBIDITY
Very important:
 Incidence rate
 Prevalence rate
INCIDENCE RATE
No. of NEW cases in fixed time period X 1,000
Population at risk
PREVALENCE RATE
No. of people with a disease X 1,000
Population at risk
(3) MIGRATION
 Involuntary: slavery, ethnic persecution, wars,
natural disasters, famines
 Voluntary: to seek jobs (skilled or unskilled),

to get an education, because of marriage, upon
retirement
------------------------------
 Internal migration: within a country e.g. rural to urban
 International migration: skilled professionals to other
countries
MIGRATION AND HEALTH
 Migrants (workers, prostitutes, truck drivers) may spread
infectious diseases e.g. HIV/AIDS, TB, diphtheria
 Jet travel speeds up disease transmission
 Migrants often live in urban slums and experience adjustment

problems (these can affect their physical or mental health)
THE END
THANK YOU
Further reading
Adjustment of Hmong (Laotian hill tribe)
refugees in America:
www.pbs.org/newshour/bb/asia/vietnam/h
mong_5-4.html
Biographical details
Kai-Lit Phua received his BA (cum laude) in Public Health &

Population Studies from the University of Rochester and his PhD in
Sociology (Medical Sociology) from Johns Hopkins University. He
also holds professional qualifications from the insurance industry.
Prior to joining academia, he worked as a research statistician for
the Maryland Department of Health and Mental Hygiene and for the
Managed Care Department of a leading insurance company in
Singapore.
He was awarded an Asian Public Intellectual Senior Fellowship by
the Nippon Foundation in 2003.

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POPULATION

 Scholars often focus on subtopics e.g. teenage

 Composition of population --- ethnic, age, sex

 Distribution --- % rural, % urban, % suburban.

 Growth --- rapid growth, slow growth,

Population is affected by fertility, mortality

Final population = Initial population +

 “Young” population: pyramid is triangular

 “Ageing” population: pyramid becomes

% of total population under age 15 is high

Median age as low as 15 or 16

Due to high fertility

This refers to the change from:

High rates (births and deaths) to

Death rates drop before birth rates: therefore, there is a

Falling birth rates are due to social and economic

1) Women stay in school longer

Fertility rates differ by social variables:

 Public policy e.g. some governments pressure couples to have fewer

Options for infertile couples:

 Ethical issues e.g. surrogate motherhood,

 This refers to the change in disease

 Cancer, heart disease, stroke, injuries,

IMR = Deaths of babies under 1 year X 1,000

 Low Birth Weight (<2.5 kg at birth)

 Life expectancy at birth

 Age-specific mortality rates

 Cause-specific mortality rates

 Maternal mortality rate

 Voluntary: to seek jobs (skilled or unskilled),

 Jet travel speeds up disease transmission

 Migrants often live in urban slums and experience adjustment

Kai-Lit Phua received his BA (cum laude) in Public Health &

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