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PubMedDate not supplied

[The demographic impact of famines].

"Demographic research into famine has long been dominated by studies of its impact on mortality. Only recently some attempts have been made to relate famine to the other demographic processes of fertility, marriage and migration. Based on five case-studies, this article tries to identify the often complex interrelationships between famine and the major demographic processes. At the same time, attention is paid to the interactions between the demographic processes themselves. Furthermore, two conceptual frameworks examining these relationships are discussed. Finally, the importance of this subject both for the study of demographic behaviour and for famine relief programmes is stressed." (SUMMARY IN ENG)

Conservation of Natural Resources↗

PubMed1998

The demographic impact on ambulatory pharmaceutical expenditure in Belgium.

It has become customary in our society to attribute the rise in health care expenditure to a large extent to the aging of the population. The Belgian Institute of Health Economics (BIGE-IBES) finalised a study to measure the impact of the demographic trend on public spending for ambulatory pharmaceuticals. The results show that the changes in age structure as such have a relatively small impact on health care expenditure. Over the period 1986-1996 an annual growth of +0.73% was observed, while total public spending showed an annual average increase of +6.2% (in constant francs 1996). This first static demographic impact will become +0.75% per year for the next decade 1996-2006. It is, however, possible to calculate the extent to which per capita expenditure envolved differently according to age group: over 1986-1996 expenditure for the elderly was rising more sharply than for the younger age groups. This leads to a second dynamic demographic impact which will cause an annual growth rate of +1.91% for the next decade, according to the working hypothesis put forward. This growth rate is to be compared with the authorized budgetary increase of +1.5% per year (inflation excluded), according to the EU-Maastricht quotes..., and it does even not take into account the other increasing factors as technological innovation and epidemiological needs.

Age Distribution↗

PubMed1993

No reason for complacency about the potential demographic impact of AIDS in Africa.

Much uncertainty surrounds the likely demographic impact of AIDS in the worst afflicted regions of the developing world such as sub-Saharan Africa. Various research groups have published projections of future trends but these differ widely with respect to potential impact on net population growth rates. Pessimistic forecasts suggest that AIDS may reverse the sign of a 3% to 4% population growth rate before the establishment of HIV, over time periods of a few to many decades. Optimistic forecasts suggest a decline in population growth rates, but predict that a 3% growth rate before AIDS may be reduced by only about 50% over a period of a few decades. This paper reports new analyses of the demographic impact of AIDS, based on observed age-stratified prevalences of HIV-1 infection amongst women of child bearing age. It is assumed that the observed patterns reflect the final endemic state and the implications of this assumption for adult and infant mortality and female reproductive life expectancy are assessed. It is concluded that a variety of scenarios is possible, depending on the detail of assumptions concerning life expectancy before the arrival of AIDS, the incubation period of the disease, and the rate of vertical transmission. Realistic assumptions do suggest, however, that the observed prevalences of infection in the worst afflicted regions of sub-Saharan Africa are sufficient to reduce current population growth rates to close to, or below, zero in the coming decades.

Adolescent↗

PubMed2002

Demographic impact of AIDS in a low-fertility urban African setting: projection for Addis Ababa, Ethiopia.

The study estimated the potential demographic impact of acquired immunodeficiency syndrome (AIDS) in a low-fertility urban setting in sub-Saharan Africa. The prevalence of human immunodeficiency virus (HIV) projected using a deterministic mathematical model was put into the AIDS Impact Model (AIM) of the SPECTRUM Policy Modelling System to estimate the potential demographic impact ofAIDS in Addis Ababa, Ethiopia. Demographic indicators from 1984 (the start of the HIV epidemic in Ethiopia) to 2024, including and excluding the HIV epidemic, were compared. Addis Ababa is experiencing a demographic transition in which the total fertility rate has declined from 3.8 to below replacement level over the last 20 years. The prevalence of HIV is predicted to stabilize at 10% in adults, resulting in a total number of people living with HIV at 200,000 and a cumulative number of deaths due to AIDS at 50,000. About 60% of adult deaths can be attributable to AIDS by 2000. The epidemic is predicted to reduce life expectancy by 10 and 17 years in 2000 and 2024 respectively, and to turn to negative, the rate of natural increase after 2009. Accordingly, the rate of natural increase will be -0.18%, -0.35%, and -0.71% per annum by 2009, 2014, and 2024 respectively. Population growth is expected to continue with or without HIV, as a result of high net in-migration, although data for migration are scanty. In a low-fertility urban society of Africa, this study shows the potential for the HIV/AIDS epidemic to turn the rate of natural increase to negative.

Acquired Immunodeficiency Syndrome↗

PubMed2000

Uncertainties in predicting the demographic impact of AIDS.

A model giving the demographic impact of AIDS is analysed to examine the sensitivity of the projections when various complicating features are included. The model deals with age and sexual partner change rate as continuous variables and uses a device to specify arbitrary correlations between the ages of the people who form sexual partnerships. The device ensures consistency, in that the amount of partner formation is the same regardless of whether the partnerships are counted from the point of view of males or females. Arbitrary correlation between partner change rate and fertility is also permitted. The results show the uncertainty in model predictions that population growth will reduce over the next 20 years to approximately zero in parts of East Africa severely affected by the AIDS epidemic. The main sources of uncertainty in the model predictions are assumptions concerning the correlation between ages in a partnership, the correlation between partner change rate and fertility, the incubation period of AIDS, and the variability of the female partner change rate.

Acquired Immunodeficiency Syndrome↗

PubMed1989

The influence of different sexual-contact patterns between age classes on the predicted demographic impact of AIDS in developing countries.

A model is developed to describe the spread of HIV within heterosexual communities and the demographic impact of AIDS. The model combines epidemiologic and demographic processes and is designed to mirror the impact of AIDS in sub-Saharan Africa. Refinements on past work in this area include unequal probabilities for transmission from females to males and from males to females, the inclusion of an age- and sex-dependent sexual-partner choice function and distributed incubation plus infectious periods. Numerical studies suggest that unequal transmission probabilities (weighted to a greater probability from males to females than vice versa), and the tendency of males to choose sexual partners of the opposite sex younger than themselves, both act to increase the demographic impact of AIDS over that predicted with equal transmission between the sexes and partner choice restricted within given age classes. Analyses support the conclusions of past work that the epidemic will only have a small detrimental impact on the dependency ratio of a population (the ratio of dependents to working adults) even when a weighting is added to take account of the extra burden imposed by the care of adult AIDS patients. However, a small increase in the ratio can imply a significant rise in the number of dependents within the population. Stimulation studies of the impact of changes in behavior to reduce transmission highlight to the need to induce such changes as early as possible in the course of the epidemic in order to minimize its impact. Directions for future research are discussed emphasizing the need to acquire quantitative data on sexual habits and to construct models to represent heterogeneity in sexual behavior.

Acquired Immunodeficiency Syndrome↗

PubMed1992

The global epidemiology of the HIV/AIDS pandemic and its projected demographic impact in Africa.

The global epidemiology of HIV/AIDS has evolved to the point that the pandemic now predominantly affects heterosexuals, especially in developing countries. This article summarizes the status of the HIV/AIDS pandemic as of the early 1990s; provides estimates and short-term projections of AIDS mortality in a hypothetical country of sub-Saharan Africa; projects the potential demographic impact of AIDS in a hypothetical sub-Saharan country; and describes the major problems associated with modelling the long-term demographic impact of this pandemic. Estimated AIDS cases and deaths up to 1992 were extrapolated from public health surveillance data and through use of the WHO model. Estimates of HIV seroprevalence were based on available HIV serological data. For developed countries, HIV estimates developed by national experts and/or national AIDS programmes were used, and for developing countries estimates by regional experts were used or were prepared by WHO. For the first half of the 1990s, projections of AIDS cases and deaths were derived from the WHO model; beyond the mid-1990s, the potential effects of AIDS on selected demographic indicators were derived from a demographic projection model developed by the World Bank. Although estimates and long-term projections cannot be made with great precision, the general dimensions of the HIV/AIDS pandemic have been more clearly delineated now at the start of its second decade. Epidemiological data indicate that in industrialized countries, where extensive spread of HIV began in the late 1970s or early 1980s, the majority of HIV infections occurred during the first half of the 1980s.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗

PubMed1982

The demographic impact of the family planning--health services project in Matlab, Bangladesh.

This paper evaluates the demographic impact of the Family Planning-Health Services Project in Matlab Thana of rural Bangladesh. The project was begun by the International Centre for Diarrhoeal Disease Research, Bangladesh in October 1977. Contraceptive services--including pills, condoms, IUDs, sterilization, and injectables--are supplemented by oral rehydration, tetanus toxoid, and other services. About 33 percent of eligible couples are using contraception. Impact is evaluated by direct measurement of birth rates in the treatment and comparison areas. An overall fertility decline of about 25 percent is observed, concentrated among older women. The impact is two-to-three times that of an earlier project that included fewer methods and used lesser trained workers. The study shows that intensive family planning efforts can affect fertility in the absence of socioeconomic changes.

Adolescent↗

PubMed1998

Demographic impact of the HIV epidemic in Thailand.

OBJECTIVE: To assess the impact of the HIV epidemic on the demographic development of the Thai population. METHODS: A deterministic mathematical model was used to predict simultaneously epidemiological and demographic processes. Partial differential equations express the relationships between biological, behavioural and demographic variables. The model allows the evaluation of different sexual mixing patterns, variable transmission probabilities and incubation times. Validity analysis was performed by generating antecedent HIV prevalence patterns among military recruits and pregnant women. RESULTS: On the national level in Thailand we predict that the cumulative number of people in Thailand with HIV infection will exceed 1 million by 1999; the number of deaths from AIDS will be 555000 by the year 2000 but will not reach 1 million until after the year 2014. Without the HIV epidemic the population growth rate was estimated at 1.3% per annum until 1995, after which a decline to 0.9% by 2005 is predicted. The HIV epidemic started to affect the population growth rate by 0.026% per year in 1991, and the difference is predicted to rise to about 0.12% per year during the period 1995-2000, to decline to 0.06% in 2005 and then to disappear. In the mid-1990s HIV affected mainly the 15-35-year-old age group, but over time younger and older age groups have been affected as a result of perinatal transmission, and a decline in fertility as well as ageing of the 15-35-year-old birth cohort. Because of HIV, in 2000 there will be 612000 (1%) fewer people than expected and by 2010, 1140000 fewer (1.6%). We predict that the demographic impact of the HIV epidemic in the northern region will follow the same pattern, but with greater severity. Here, the effect on the population growth rate and the population age distribution is likely to be twice as high as at the national level. CONCLUSIONS: It is estimated that 1 million Thais will be infected with HIV by the year 2000 and an almost equal number will have died of AIDS by the year 2014. Although these numbers seem high, their direct and indirect effects on the demographic structure of the Thai population are small. However, at a regional level, for example in the northern region, the effect of the HIV epidemic may be more severe.

Acquired Immunodeficiency Syndrome↗

PubMed1982

West Indian migration to the United States Virgin Islands: demographic impacts and socioeconomic consequences.

"This article examines the movements of British West Indians to the United States Virgin Islands. It emphasizes the demographic impact on the host society and the underlying socioeconomic forces and legal framework."

Americas↗

PubMed1994

Demographic impact of HIV infection in rural Rakai district, Uganda: results of a population-based cohort study.

OBJECTIVES: To examine HIV-1-related mortality and demographic impact in a high HIV prevalence rural district of Uganda. DESIGN: One-year follow-up (1990-1991) in a population-based rural cohort. SETTING AND PARTICIPANTS: Annual enumeration of all consenting residents of 1945 households in 31 randomly selected community clusters in Rakai District. Subjects provided yearly HIV serological samples, behavioral and health information. MAIN OUTCOME MEASURE: Mortality in HIV-infected and uninfected persons. RESULTS: Mortality among HIV-seropositive adults aged > or = 15 years of 118.4 per 1000 person-years (PY) was substantially higher than in HIV-seronegative adults [12.4 per 1000 PY; relative risk (RR), 9.5; 95% confidence interval (CI), 6.0-14.9]. Infant mortality among offspring of HIV-infected mothers was almost double that for uninfected women (210 compared with 111 per 1000 live births; RR, 1.9; 95% CI, 1.0-3.5). Adult HIV-related mortality was associated with HIV prevalence and, in this cohort, with higher education, non-agricultural occupation and residence in roadside trading centers. We estimate that adult HIV prevalence in the district is 13% and adult HIV attributable mortality 52%. For all ages combined, district HIV attributable mortality is 28%. CONCLUSION: HIV is the leading cause of adult death in Rakai. Its effects on mortality are particularly marked in the most economically active sectors. However, the overall crude birth rate in the district (45.7 per 1000 population) remains higher than the crude death rate (28.1 per 1000 population), resulting in continued rapid population growth.

Adolescent↗

PubMedDate not supplied

Population policy in industrialized countries: evaluating policy theories to assess the demographic impact of population policy.

"In this contribution the concept of population policy theory is defined. Also, the relevance of studying these theories in order to assess the demographic impact of population policy is discussed. The policy theory underlying the pronatalist marriage and family founding loans is evaluated as is the policy theory underlying antinatalist family planning communication programs. It is concluded that the behavioral mechanisms behind the two policy measures appear not to work in a way the policy theory assumes they work, i.e. appear not to be able to change fertility behavior substantially." The geographic focus is worldwide. (summary in FRE, ITA)

Demography↗

PubMed1988

[Demographic impact of AIDS mortality in France in 1990: AIDS before suicide and next to traffic accidents].

This paper presents an evaluation of the demographic impact of mortality by AIDS in the next future years, in France. Future cases are predicted by using a regression technique based on an exponential model. Three demographic indicators are computed: Years of Potential Life Lost (YPLL), Expectancy of Life (EL) and Expectancy of Active Life (EAL) for males. For example, in 1990 AIDS would be responsible of a loss of 0.67 and 0.38 years for EL and EAL respectively. These results would raise AIDS almost to the Accidents level and ahead of Suicide. Moreover, we consider that the estimations presented in this article are rather optimistic, taking into account the fact that there is an increasing proportion of IV drug abusers cases, younger than the other cases.

Accidents, Traffic↗

PubMed2003

Demographic impact of epilepsy in Africa: results of a 10-year cohort study in a rural area of Cameroon.

PURPOSE: To evaluate the demographic impact of epilepsy a rural area of Africa. METHODS: A cohort study was conducted between 1991 and 2001 in the Mbam Valley (Cameroon) on two groups of subjects (one of persons with epilepsy, and the other of control individuals matched for sex, age, and village of residence). At the end of the follow-up, information on mortality, marital status, and numbers of offspring was obtained from 128 pairs of subjects. RESULTS: Thirty-seven (28.9%) persons with epilepsy and six (4.7%) controls died between 1991 and 2001. The relative risk of dying during the follow-up among the group of people with epilepsy, compared with the controls, was 6.2 (95% CI, 2.7-14.1). The most frequent causes of death in the persons with epilepsy were status epilepticus, sudden unexpected death in epilepsy (SUDEP), and drowning. Of the 90 pairs, of which both members were still alive in 2001, 15 (16.7%) persons with epilepsy were married as compared with 53 (58.9%) controls. The mean number of children was 0.9 in the subjects with epilepsy, and 1.7 in the controls (p < 0.0001). CONCLUSIONS: Health personnel should be trained and sensitized about the devastating effect of this neglected disease in developing countries. In those areas where onchocerciasis control programs are organized by using the community-directed-treatment approach, the possibility that the ivermectin distributors could also be responsible for distributing antiepileptic drugs should be considered.

Adolescent↗

PubMed2001

Demographic impact of HIV/AIDS in Addis Ababa.

Using secondary data from various sources, a model was adopted as installed in Demproj. software program to determine the demographic impact of HIV/AIDS epidemic in Addis Ababa. It was found that the adult HIV prevalence will reach a plateau level of about 10.8% in the year 2001 and 10.3% in the year 2004 respectively. AIDS will slow the decline in infant mortality rate and under 5 mortality rates and will increase crude death rate and lower the life expectancy at birth by about 15 years by 2004 compared to the "no AIDS" scenario. AIDS will reduce the size of the Addis Ababa population by about 160,000 people by the year 2004, but will not stop or make its growth negative. Based on the above findings preventive measures such as STD control, condom promotion, IEC and blood screening, and approaching the problem multisectorally, incorporating the HIV/AIDS epidemic in the demographic projection and establishing HIV/AIDS data base were recommended.

Adolescent↗

PubMed1993

The demographic impact of the First World War: an anthropometric perspective.

During the 1970s and 1980s Jay Winter published a series of highly influential articles on the demographic impact of the First World War, culminating in his study of The Great War and the British People in 1986. Winter argued that the war led to a dramatic improvement in average living standards, and that the survival chances of most sections of the civilian population improved more rapidly than they might have done if peace had been maintained. This paper seeks to test the strength of Winter's hypothesis in three main ways. Section I examines the arguments which Winter himself put forward to support his view that the war led to a systematic erosion of pre-war differentials in infant mortality. Section III utilizes evidence relating to children's heights to examine the extent to which the war led to improvements in children's 'nutritional status'. The paper's overall conclusion is that the war did not lead to any dramatic improvements in civilian health; the overall impression to be gained from an analysis of wartime health statistics is one of continuity rather than change.

Demography↗

PubMed1991

The spread of HIV-1 in Africa: sexual contact patterns and the predicted demographic impact of AIDS.

The spread of HIV-1 in Africa is examined here in the light of recent information on the main epidemiological and behavioural determinants of transmission. Mathematical models incorporating demographic, epidemiological and behavioural processes are used to assess the potential demographic impact of the disease AIDS. These analyses highlight the significance of patterns of sexual behaviour, and in particular networks of sexual contact, on the predicted spread of infection. Current data reveal substantial variations in the degree of spread between and in countries, but new analyses support earlier predictions that in the worst-afflicted areas AIDS is likely to change population growth rates from positive to negative values in a few decades.

Acquired Immunodeficiency Syndrome↗

PubMed1992

Some aspects of sexual behaviour and the potential demographic impact of AIDS in developing countries.

This review examines recent research on the influence of heterogeneity in sexual behaviour on the transmission dynamics of the human immunodeficiency virus (HIV), the aetiological agent of AIDS. Attention is focused on the potential demographic impact of AIDS in developing countries and how this is influenced by the structure of networks of sexual contacts (who mixes with whom), age-dependency in rates of sexual partner change and differences in the ages of female and male sexual partners. Analyses based on the construction of simple and complex mathematical models of the spread of HIV via heterosexual contact serve as a template for the interpretation of observed pattern and as a guide to the major aspects of sexual behaviour that govern the transmission dynamics of the virus. It is argued that much greater attention must be addressed to the quantification of patterns of sexual behaviour in defined communities, despite the many practical problems that surround data collection and interpretation.

Acquired Immunodeficiency Syndrome↗