Category: Population

Related directly to population issues.

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Population Public Health

Age Gracefully—1-2014

Last July, when I turned 70, I wrote about my own aging. What happens as a large group of people age?

Let’s look at the start of the process of demographic change, when birthrates fall. This causes a decrease in the number of young people so there are fewer dependents. With more people in the working age range and not many old people yet, the group can prosper; this is the “demographic dividend”. Many regions have experienced this, notably in Africa and Asia. A European example will serve us better, however, since the information is more complete.

The Republic of Ireland is strongly Roman Catholic. In 1935 the government made contraception illegal, except for fertility awareness methods.  Their Total Fertility Rate (TFR—the average number of children a woman will bear during her lifetime) climbed to 4.  Despite its strong religious heritage, the country legalized contraception in 1979. Then TFR gradually dropped to about 2—below replacement and in the current range of other European countries. During the 1990s Ireland enjoyed a period of economic growth.

What is going to happen to countries as their populations age? Will it be as much of an detriment to economies as the demographic dividend was a benefit?

Never before have whole countries had their populations shrink voluntarily so markedly as is happening now. Perhaps the closest western civilization encountered was in Europe during the mid-14th century—the Black Death. This pandemic is estimated to have killed half of all Europeans. Indeed, the popular press has drawn the analogy of population shrinkage to a plague.

Half of the world’s countries have a TFR less than replacement—less than 2.1—which means they will decrease in population. This shrinkage has been slow at first, but birthrates seem to continue dropping. What some people fear is the change in the age structure. There will be an advantage because there will be fewer dependent young people. At the same time, people are living significantly longer than previously, so the number of older people will increase, increasing the number of dependents for each working person.

How can countries deal with this change in demographics? Will this transformation in age structure spell economic disaster? Some writers think so.

Perhaps the best glimpse into the future is the example of Japan, where one quarter of its population is 65 years old or older. It has the very low TFR of 1.4, little immigration and its population is shrinking at about 0.2 % annually. Furthermore, because of good diet and fine medical care, the life expectancy for a child born now is 83 years—about the best in the world.

How has the graying of its population affected the Japanese people? One trivia is the sale of diapers. They are unique in the world because sales of baby diapers will soon be by equaled by sales of adult diapers.

Birth control pills were not available in Japan until 1999. For many years people relied on just condoms and abortion to plan their families. Nevertheless, the TFR dropped below 2.0 in 1975. The sociological changes that have catalyzed this low reproductive rate include the changing role of women. Instead of staying home, now many women are well educated, work outside the home and postpone marriage until they are older.

Japan has avoided economic disaster despite the aging of its people, although they did suffer from the 2008 recession. The average retirement age is close to 70—since people are healthier, they can work longer. Because of the smaller number of children, there are still plenty of workers to support each dependent person.

Many European countries also have aging populations, but they use a different method to deal with the decreasing number of native young, low-skilled workers. They have “guest worker” programs, which allow people to immigrate from poorer countries to do work that the locals don’t want to perform.

Demographics are changing in many countries. In cultures that are aging, some occupations and businesses will have decreased demand, including obstetricians, childcare and teachers. Other occupations and businesses will increase—geriatricians, retirement communities and physical therapists.

The “population explosion” is not over. We are still growing by almost 80 million people yearly—mainly in poor, southern countries. Many people have enjoyed the demographic dividend, but the time has come to adjust to a new reality. Since growth cannot go on forever, it is absolutely necessary to reach a stable population, which means a period of population aging.

© Richard Grossman MD, 2014

Categories
Population

Honor Your Father–12-2013

Honor Your Father

We were listening to NPR when the news came on. “The dentist with the greatest name recognition worldwide died yesterday. Dr. Louis Grossman developed modern endodontia (root canal therapy), a technique to save teeth”.
My father, Louis Grossman, was born 112 years ago this month in the little farm village of Teplik, in Czarist Russia. He was the first son of conservative Jewish parents, Harry and Roche (Rose). 1901 was not a peaceful time in Russia, especially for Jews who were often the focus of persecution. They had to live in separate communities where pogroms were frequent. These organized massacres killed and wounded thousands.
In 1905, when my father was just 3 years old, Harry left Russia to seek his fortune in the USA. A year later Harry had saved enough money to pay steamboat fare for my grandmother and father. They came steerage class on the S.S. Potsdam, arriving at Ellis Island after an 18-day crossing. The “Manifest of Alien Passengers” states that my 22-year-old grandmother was able to read and write. It declares that neither she nor Louis was an anarchist or a polygamist, and that they were in good mental and physical health. There is also a column on this document “Whether in possession of $50, and if less, how much?” The sum of $22.50 was crossed out and replaced by $20.
My father grew up in South Philadelphia in a Jewish/Italian neighborhood. Many of his childhood friendships became lifelong. He met for lunch with some of those men on a regular basis, and I got to know them as a kid.
When my father graduated from high school he wanted to be a physician, but his family couldn’t afford the 2 years of college needed at that time for admission to medical school. Dental school only required a high school diploma.
After graduation Louis started his own dental practice and also taught at the University of Pennsylvania School of Dental Medicine. One day he was very taken by a young undergraduate student with a toothache. Emma May MacIntyre would become my mother, but the marriage would have to wait.
Interested in furthering his education, my father had already made arrangements to study in Rostock, Germany in 1928. The course there usually took a year, but he was motivated to return to his fiancée and finished in 6 months. The wedding was a simple civil ceremony, but the marriage lasted 60 years. He didn’t receive his diploma until much later because the rising Nazi power suspected that he was Jewish.
My father never spoke about what happened, but gradually I learned that his family disowned him. Indeed, when my parents married they sat shiva for him. This is a seven-day long Jewish ceremony to mourn someone who has died. He never spoke to his mother after this, and I grew up without much contact with my father’s family. By Hebraic law, a child is the religion of his mother. Since my mother was Christian, my father’s children (my sister and me) would be considered gentiles and lost to the Jewish faith.
Many years later I was invited to a bris (ritual circumcision) in Durango of a baby boy I had delivered. The boy’s dad is Jewish and mom, Christian—the same as my parents. It was with trepidation that I attended: would there be friction between the two sets of grandparents? Indeed, would the paternal grandparents even attend?
My fears were unfounded. Everyone, Christian and Jew, had a great time with smiles and congratulations all around. Only the little boy didn’t seem to enjoy the party when the mohel performed his surgery!
Religions are changing. It is no longer a sin for Roman Catholics to eat meat on Fridays. Not all Muslim women wear headscarves. The Religious Society of Friends (Quakers) used to shun music, art, dance and reading other than the Bible, but now we enjoy all these.
The Bible supports owning slaves (Leviticus 25:44), executing people who work on the Sabbath (Exodus 35:2) and forbids sowing seeds of more than one plant in the same field (Leviticus 19:19) even though we now know that planting beans and corn together is beneficial.
I honor my father who thrived despite his family disowning him. I also honor that the world is changing. So much depends on whether we can change our way of life quickly enough to minimize damage to our planet. Religions must adapt to the vast changes humanity has gone through since many religious rules were decreed.
© Richard Grossman MD, 2013