Thursday, April 3, 2014

Week 3: Population Dynamics

I have to admit that when our professor Dr. Jo Dunham asked us to write down what we knew about population dynamics at the start of our third class, I was really at a loss for words.  From the many quizzical looks that I saw around the room, I was not the only one.  Eventually the wheels began to turn and terms began coming to mind such as population growth, birth and mortality rates, fertility and migration.  I also started to think of gender and age demographics (i.e. is a population younger or aging) and how they influence the economic and social systems of a country, but more on that in the next post.  

Perhaps the best way to identify what those figures mean and how they impact societies is to compare them both between and within countries, especially as their populations transition.  But the numbers are not always what we expect.  We did a short quiz comparing the infant mortality rates of nine pairs of countries and many of the answers proved to be quite surprising.

The Quiz:

In each pairing, one of the countries has an infant mortality rate that is twice as high as the other.  The answer from each pair is in bold.

                                    Sri Lanka vs  Turkey                          
                                    Poland vs South Korea                      
                                    Cuba vs Russia                                    
                                    Pakistan vs Vietnam                          
                                    Thailand vs South Africa                  
                                    Germany vs Singapore                      
                                    Romania vs Chile                              
                                    United States vs Slovenia                 
                                    Seychelles vs Mexico          

I only managed to correctly select six of the nine right answers and in truth, they were all guesses with the exception of Cuba vs Russia (simply because I am familiar with the Cuban health system).  I have to say that I was blown away by the size of the differences between the countries, many of which I previously thought would have been quite comparable.  I suppose it shows that preconceived notions cannot and should not be trusted in public health.

The answers could be indicative of several things, including the value placed on providing good healthcare (especially antenatal, maternal and postnatal services) and maternal education in one society compared to another.  They could also point to harmful (or, for the countries who have done better, beneficial) cultural/social practices, gender inequality, malnutrition, unstable governments (and therefore unreliable services), extreme poverty or socioeconomic disparities, long distances to health services, hygiene and sanitation concerns as well as poorly managed levels of communicable disease.  

Overall, I would say education and the implementation of and access to services generally make the biggest differences, especially after watching the following IdeasLab with Julio Frenk: 

While discussing the triple health burden facing many countries, Frenk points out the significant impact knowledge and modern medical discoveries have had on improving health, even in impoverished settings.  I have to say that I was incredibly impressed when he highlighted Chile's success at raising its national life expectancy to 79 in 1990, despite having a very low income per capita (equivalent to that of the U.S.A in 1900).  It's proof that even people living in developing countries can live significantly longer lives (probably provided that the country is not caught in civil war or ravaged by natural disaster).  

In the end, sharing and utilizing information can and has (in some cases) dramatically reduced the disparities in survival between the rich and the poor of the world so long as health and education can be made a priority.  If we know better, we do better.


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