Fertility and Mortality Ct2 Notes

7/21/2019 Fertility and Mortality Ct2 Notes

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Fertility

Factors afecting Fertility

Factor Example Description

Biological Years in

marriage

Low fertility of many DCs is attributed to later

marriages. Couples nowadays may want to focus on

their career, or further their education rst before

starting a family. !herefore this reduce the number of

childbearing years of a woman. "eople may also be in

sexual unions without the desire to ha#e children.

$tability of marriage is declining especially in DCs.

% DCs generally experiencing increasing pre#alence of

di#orce.

% $ome LDCs ha#e low le#el of di#orce. &Eg. 'uslim

countries allow multiple marriages(

"atterns of

sexual acti#ity

$tudies ha#e shown that sexual beha#iour a)ects

female reproducti#e endocrinology

*omen with increasingly greater degrees of infertility

showed increasingly later rst coital ages.

Length of

breastfeeding

Breastfeeding is a natural contracepti#e as the release

of reproducti#e hormones is suppressed.

Breastfeeding by females a few years after birth is

normal in many societies.

'ost prominent in $ub $aharan +frica and also in

ndonesia where breast feeding is prolonged up to age

- or . !his reduces family si/e &0( and delays childbearing of females

1F !echnology has aided women who ha#e problems

concei#ing.

% 2nly women who can a)ord it will be able to get

treatment.% +ssisted conception can gi#e rise to multiple

births% Largely limited to DCs


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3se of

contraception

!echnology of contracepti#es has impro#ed so that

women ha#e more choices.

% 4as changed sexual patterns of DCs drastically

so that people are sexually acti#e at a younger

age than before.% n DCs as contracepti#es are easily a#ailable and

a)ordable, this contributes to low birth rate% +ccessibility to contraception in LDCs has

increased therefore lowering the !F5.

Europe has the lowest !F5 of 6.0 per women and 78

of the women in child bearing years uses contraception

whilst in +frica the !F5 is the highest with only -98 of

women using contracepti#e. 4ence there is indeed a

strong lin: between the !F5 and the 8 of women usingcontraception.

nduced

abortion

LDCs generally ha#e more restricti#e abortion policies

than DCs.

4owe#er, abortion rates #ary more widely than do

policies

European abortion rates from under 0 per 6;;; women

in reland and $pain to 7< in 5omania.

+frican countries and other countries of high fertility

generally ha#e low incidence of abortion

% Bangladesh= .ermany experienced a rapid increase in birth

rates from the end of the ** until the economic boom of the 690;s.

n the 690;s the contracepti#e pill became a#ailable and e?uality laws

changed society so that women could more easily follow career paths in fulltime wor:. !his reduced fertility rates. Current !F56.6


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Life expectancy has also increased as li#ing and wor:ing conditions ha#e

impro#ed and medical ad#ances ha#e been made. n Europe the baby boom

generation is large in number and li#ing longer, there are fewer people in

younger generation to support them.

Highest old age dependency ratio of over 28% as of 2009.

Second oldest population with 20.7% of the nation population being over 6

years old.

Shrin!ing population. "ace #atural decrease in population growth

Pro-natal policy in Germany

Childcare costs can be o)set against tax

4igh maternityApaternity payments are made to encourage higher birth rates

6 wee:s maternity lea#e and parental lea#e up to 0 months along with

child benet payment of o#er ; euros per month.

"ension credits are increased where there is a loss of income while parents

raise their children.

Family friendly policy = allow parents to ha#e a more exible wor:ing

arrangement.

Efectiveness:

Despite lots of go#ernment in#estment in maternity and paternity pay and

promotion of family friendly policy the birth rate continues to decline.

Conse?uently >ermany has increased charges for health insurance each

wor:er pays 6.8 of their wages and retirement ages ha#e been increased.

!his is done so as to reduce the tax burden on wor:ing class.

*hether problems or opportunities dominate depends on the policies &socio%

economic, birth rate, immigration( adopted and implemented by Europeancountries. +geing populations will continue in Europe for most of this

century. 4owe#er, after the baby boom generation passes, population

structures are li:ely to stabili/e.

DC Case Study: Sweden

Pro-natal policies

Gon%taxable family allowance paid to parents for each child, payment

continuing till 60 or -; &if child is educated full%time(, with rate of paymentincreasing with more children s $g only a sum of money(


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months fully paid lea#e before childbirth, 6- months lea#e after child%birth

&


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'ortalityGlo#al &ariations in 'ortality (ates

!he age%structure characteristics of the population is indicati#e of the

mortality rates

'ost of the mortality rates in DCs are concentrated in the older age group of

the population due to ailing health and illness associated with old age. &eg.

heart attac:s and cancers(

n LDCs, mortality rates concentrated in the young and infant, account for up

to 0;8 of all death rates in many sub%$ahara countries

nfant mortality rates generally lower in DCs compared to LDCs

De#eloped Countries Less De#eloped Countries

4eart Disease and $tro:es &diseases

associated with auence(

5espiratory diseases= inuen/a,

pneumonia, tuberculosis &collecti#ely

-8 of all deaths(Cancer "arasitic Diseases= 'alaria, $leeping

sic:ness &68(

nternational *ars &eg. - *orld *ars( Ci#il *ars &eg. Ethiopia, 5wanda(

- decades of war in +fghanistan,

million ha#e died since the last

oMcial census in 69


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+D$ &greater impact compared to

DCs( N Ienya and

Factors 5easons

Demograp

hy

LDCs ha#e higher infant mortality rate and hence the younger age

group are more li:ely to ha#e a higher mortality rate. n big families,

few children may sur#i#e due to malnutrition or diseases.

nfant and young in many sub%saharan countries account for up to

0;8 of all death rates.

n DC$, as life expectancies are higher, the older age group is

expected to ha#e a higher mortality rate

'en ha#e a lower life expectancy than women.

'ales ha#e a higher death rates than females at all ages, e#en

before they are born. &miscarriages disproportionately occur with

male fetuses(

!hese biological di)erences are li:ely to be exacerbated by social

factors.

% 'en are more li:ely to engage in ris: ta:ing beha#iours such as

dri#ing faster, which lead to higher death rates from accidents.

% 'en are also more li:e to smo:e and drin: alcohol increasing their

ris: of lung cancer and li#er disease.

% 'en tend to neglect their health more than women as witnessed by

fewer #isits to the doctor.

+d#ances

in

healthcare

andsanitation

n DCs= Death rate decreased since pre%industralisation

6( 4ygiene and $anitation= "ro#ision of safe drin:ing water

reduces the threat of water borne disease of cholera andtyphoid

-( Compulsory #accination from childhood diseases such as

tuberculosis and small pox.

( 'edical technology= de#elopment in antibiotics, cancer ghting

druges and less in#asi#e surgical procedures. &technology

imported to LDCs(

( Diet= De#elopment brings about auence and impro#ements in

diet O decrease in malnutrition and under nourishment.


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n LDCs= Decline in death rate may ha#e been slower as

6( citi/ens are unable to e#en a)ord basic healthcare ser#ices,

go#ernment may not e#en ha#e schemes for basic healthcare

pro#ision for the de#eloping regions

-( E#en though ad#anced medical technology may be a#ailable in

LDCs, there is a problem of accessibility for the poor and needy

li#ing in rural areas.

( LDCs themsel#es are under debt and cannot a)ord to pro#ide a

benecial basic healthcare scheme.

!he ratio of doctors to patients ha#e increased greatly o#er the

years, esp. in DCs

mpro#ed sanitation in most cities has also led to decline in mortalityrates &cleaning up of slums and ghettos(

"olitical Civil warswill increase mortality rates due to battle wounds and

deaths.

)rea*down o t+e +ealt+ systemof the country, the collapse of

utilities and the outbrea: of epidemics and pandemics brought about

by unsanitary conditions in the warring country.

Genocidessuch as the attempted extermination of the Hews inEurope or the murder of -;8 of Cambodia@s population from 697%7irls, esp. those with little or no education are drawn into the

sex industry with its associated sexually transmitted diseases

o *omen tend to su)er more ill health, especially from

pre#entable illnesses.

Dangers of pregnancy and childbirth

"osition within their societyhealth is often not a

priority (=

Low le#els of #accinationpoor people in many de#eloping areas

commonly su)er from potentially fatal childhood illnesses such as

measles and diphtheria.

"oorer diet, one that lac:s the protein for healthy growth

o mpact on the ability to carry out physical wor:, such as farming,

and may result in lower le#els of food production for the family.

o Diseases of malnutrition

:washior:or and marasmus.


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*ithout some in#estment in pre#entati#e medicine, such diseases can

create a negati#e cycle of po#erty.

E#en in wealthier nations, there is still a lin: between po#erty and health.

!he health problems caused by unclean water and poor sanitation ha#e

largely been sol#ed, but other diseases such as heart disease and cancerspersist, and incidences of these are higher in areas of depri#ations. n poor

areas in de#eloped nations, problems lin:ed to li#ing in poorly built, damp

and under%heated housing also cause respiratory diseases.

LDC Case Study: Pa*istan and maternal +ealt+

+ lac: of care in pregnancy &lin:ed to lac: of medical facilities and low

educational le#els of young mothers( and during birth can lead to obstructed

labour, when the baby cannot be deli#ered.

+ caesarean operation is then needed, but many #illages are miles away

from any hospital and transport infrastructure is too poor and families

cannot a)ord such care

Delay in accessing medical help means the baby usually dies and because of

the prolonged labour, stulas occur between the birth canal and the bladder

andAor rectum of the motherpermanently incontinent and then often

abandoned by family &can no longer perform their main role of child%bearing(

10*000 woen suer fro 3stulas in /a!istan* caused by an obstructed

birth. 4nnually 6*000 new cases occur* but only 800 woen receive

corrective surgery.

*omen in DCs rarely su)er from stulas, but worldwide o#er . million

women experience the condition, which is 6;;8 pre#entable.

"a:istan has a high occurrence because of

6. + lac: of trained medical personnel

-. Low le#els of education amongst rural women

. >i#ing birth when too young

. "oor general health

. *omen@s health not considered a high priority in some sections of society


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LDC Case Study: enya , +e need to tac*le t+e causes o poor

+ealt+

Ienya has a high le#el of foreign debt and therefore cannot in#est in

healthcare as much as it needs to. Due to nancial limitations, it relies on

curati#e medicine, rather than getting to grips with underlying problems andfocusing on pre#enti#e measures.

n the long term, pre#entati#e measures such as education about disease

transmission, wor: out cheaper, as there is less need for drugs and

hospitali/ation in the future.

H(54(S is a aor proble in enya* esp. aong the poor. 'here are .1

illion H(54(S suerers in the country : 7.% of the adult population

.2 illion 4(S orphans being brought up by grandparents or have beenabandoned

*ithout inter#ention, the cycle of po#erty and 41A+D$ infection will

continue. "oor people cannot a)ord the retro#iral drugs that can extend life,

and many do not ha#e access to medical facilities in rural areas, so the

death rates for the poor are high.

LDC Case Study: C+ina , (egional Disparities ./r#an0(ural

Disparity1

(ural vs /r#an

*ealth is not e#enly distributed, most being found in the eastern regions

'any of the western, rural and mountainous regions continue to su)er from

po#erty and associated poor health le#els

;aternal ortality rates 600*000 in rural areas vs 2000*000 in urban

and eastern regions

4ealth being roughly times worse in rural areas

nfant 'ortality 5ates

Life expectancy lower

Lower health le#els=

"oor transport infrastructure, isolated

Fewer hospitals and trained sta) &low accessibility too due to Q(

"oor educational attainment

Li#ing conditions more primiti#e=


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"oor sanitation

Contaminated water supplies

o#ernment use health insurance system, most hospitals and clinics arepri#ately run

"oorest wor:ers do not ha#e Robs where their employer pays for the health

insurance, nor do they ha#e spare money to pay for medical treatment

directly.

DiMcult for a poor person who is seriously ill to access the necessary drugs

or modern medical care.

DC Case Study: Glasgow

DC (ic+ vs DC Poor

ensington and =helsea vs >lasglow* nearly 9 years dierence in life

e,pectancy

Li#ing on benets and ha#ing less moneyless li:ely to be able to a)ord

good ?uality fresh fruit and #egetables and to ha#e a balanced, healthy diet

&poor nutrition("oor healthFuel po#erty, not possible to :eep the home warm enough to

pre#ent moulds and damp, cause respiratory problems

>lasgow has areas of multiple depri#ation, impact on health le#els.

4owe#er, e#eryone in the 3I has access to medical care #ia the G4$ to deal

with illnesses as they occur.

$pringburn Len/ie= expect 67 more years of life

;8 adults smo:ing, more li:ely tosu)er from asthma and other

7 times less li:ely to su)er fromcoronary heart disease before 7=


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respiratory problems non%smo:ing en#ironment

4igher '5= Little breastfeeding, do

not benet from natural immunity to

disease ac?uired #ia mother@s mil:

Breastfed more, healthier diet

"o#erty= 4igh le#els of Roblessness,

o#ercrowding, low le#els of access to

a car and low educational attainment

child ha#e fewer chances in life

Less crowded household, Roblessness

rare

>ood health is needed for economic and social producti#ity, leads to higherproducti#ity.n industralised nations, although there has been high in#estment in health

systems, there is still ine?uality in health le#els, lin:ed to income. 3ne#enaccess to health care and the growing income ine?uality need to be

addressed if impro#ements in health le#els are to continue

De#eloping nations= greater in#estment in healthcare in order that all

sectors of the population can benet from, and further contribute to

de#elopment

"andemics often begin in poor o#ercrowded areas with limited sanitation,

and it is to e#eryone@s ad#antage if all sectors of humanity ha#e the access

to and :nowledge of healthcare in order to li#e as healthy li#es as possible.

Documents

Fertility and Mortality Ct2 Notes