Population change

Demographic Transition Model

 What is the demographic transition
theory
• The DT theory which seeks to explain changes in a
country’s population growth as it moves from a stage of
high fertility and mortality to low fertility and mortality
rates.
• It is one of the most widely accepted theories of
demographic change, as it seeks to identify the factors
responsible for fertility and mortality decline and the
mechanisms which serve to link these two vital population
processes.
• In spite of its many limitations, the demographic
transition theory provides us with a useful conceptual
model for discussing demographic changes within and
between countries
 Warren Thompson, 1929
• Collected data from countries in Europe
and the United States between 1908-1927
• Distinguished 3 groups of countries
according to differences in birth and death
rates and population growth
•
 Countries in group A
• Rapidly declining birth and death rates, with the
birth rates declining faster than the death rates
• The result was a decline in the rate of natural
increase
• From the latter part of the 19th century to 1927
they had moved from having high rates of
natural increase
• These countries will shortly become stationary
and will start to decline in numbers
 Countries in group B
• Birth rates and death rates were declining
• Death rates were declining as rapid or
even more rapid than the birth rates
• Effect was a large and rising rate of
natural increase
• This same pattern were seen in countries
in group A 30 – 50 years
 Countries in group C
• Both death rates and birth rates were high
and fluctuating
• Natural increase was low
• Population increase was largely
determined by the opportunities they had
to increase their means of subsistence
 The theory of DT
• Refined by Frank Notestein, 1945,
• Stage 1. high growth potential
• Stage 2. transitional growth
• Stage 3. incipient decline
Warren Thompson (1925)
 Stage One
• In, pre-industrial society
• Death rates and birth rates are high and
roughly in balance
• Hunter gathering societies
• Poor health care
• Housing
• food
 Stage Two
• In developing country, the death rates drop rapidly due to:
• Improvements in food supply and sanitation which increase
life spans and reduce disease.
• These changes usually come about due to improvements in
farming techniques
• Access to technology
• Basic healthcare
• Education
• Without a corresponding fall in birth rates this produces an
imbalance, and the countries in this stage experience a large
increase in population.
 Stage Three
• Birth rates fall due to:
• access to contraception
• increases in wages
• urbanization
• a reduction in subsistence agriculture
• an increase in the status and education of women
• a reduction in the value of children's work
• an increase in parental investment in the education of
children and other social changes
• Population growth begins to level off.
 Stage Four
• Both low birth rates and low death rates

• Birth rates may drop to well below replacement level

.e.g as has happened in countries like Germany, Italy, and Japan,

leading to a shrinking population

• Creating a threat to many industries that rely on population growth.

• The ageing of the large group born during stage two ages creates
an economic burden on the shrinking working population

• Death rates may remain consistently low or increase slightly due to

increases in lifestyle/chronic diseases due to low exercise levels
and high obesity and an aging population
 Effects of the demographic transition on population age
structures

• During the first, there is a rejuvenation of the age distribution

as the proportion of children increases(ST2)
• During the second, triggered by fertility reductions, the
proportion of children begins to decline while the proportion
of adults and older persons rise(ST3)
• During the third stage reached usually after lengthy periods of
fertility and mortality decline, the proportions of both children
and adults of working age decline and only the proportion of
older persons rises.(ST4)
 Stage 3
• Adults of working age constitute a significantly larger
proportion of the total population than during the 2nd stage of
the transition
• so that the number of adults of working age per dependent
(that is, children and older persons) increases for a certain
period until it reaches a maximum.
• During that period, a population is optimally placed to benefit
from economically productive investment because its levels of
economic dependency are low and there are relatively more
• potential workers to support persons in the non-productive
ages (children and the older population).
• The terms “demographic dividend”, “demographic bonus” or
“demographic window of opportunity” have been coined to
describe this stage of the transition
 limitations
• Eurocentric
• Extremely deterministic
• Does not specify the timing in which
demographic change would occur
• Unable to predict future demographic
events
• Does not explicitly account for the
mechanisms of chance
• Does not highlight the role of migration
 The age of delayed degenerative
disease
• Beyond the 3 stages, Oshansky and Ault
(1986)argued for a fourth stage:
• The age of delayed degenerative disease.
• This is related less to cause and more to the age
pattern of degenerative-disease mortality, where
there are declines in old age mortality observed in
the USA as early as 1970s.
• After transition – many people kept alive through
intervention do not necessarily have optimal
physical and mental well being. New interventions
such as medication for diabetes, hypertension,
kidney dialysis, organ transplants, open-heart
surgery, and in the case of cancers, chemotherapy
and radiation.
 Variants
• Western model- Europe
• Accelerated model- Japan
• Contemporary - Latin America and the
Caribbean
 The Dem ographic Transition in Jamaica

50

45

40

35
Rates per 000 persons in mid-year

30
population

CBR
25
CDR
20

15

10

0
1943 1950 1955 1957 1960 1965 1970 1975 1980 1985 1990 1995 2000
Year
 Epidemiological transition
Long-term shift in mortality and
disease patterns
• Typically mortality patterns distinguish 3
stages
– Age of pestilence and famine
– Age of receding pandemics
– Age of degenerative & man- made
diseases
 Age of pestilence and famine
• High mortality rates
• Wide fluctuations in mortality rates
• Little population growth
• Very low life expectancy (20-40 years)
• Before transition – infectious and parasitic
diseases, wars, natural disasters and
famines. Colonisers exposed natives to
new diseases
 Age of receding pandemics
• Epidemic peaks less frequent
• Lower incidences of infectious diseases
• Slow rise in degenerative diseases
• Average life expectancy increases from 30 to 50 years
• Sustained population growth
• Early stages of transition – evening out of the fluctuations of
mortality through improved food supply, better living standards,
medical progress, (such as immunization against specific
diseases, antiseptics and antibiotics) sanitation measures, public
health activities such as purification of water, better sewerage
disposal, proper food hygiene. In the US improvements in living
standards, personal hygiene such as hand washing, laundering
and maintaining clean housing and recession from certain
diseases. Better transportation improves health by improving the
delivery of food and medical supplies.
 Age of degenerative & man-
made diseases

• Mortality continues to decline

• Emergence of chronic degenerative
diseases esp. cancer and cardiovascular
diseases and accidents
• Life expectancy exceeds 50 years
 Stage 3 continues
• Later stages – heart diseases, cancers and stroke,
accidents.
• Different populations completed the later stages at
different paces.
• The male-female gap has widened, with socio-cultural
and behavioural factors at work.
• Higher life expectancy due to life style practices such
as reducing the intake of dietary fats and salts,
avoiding obesity, exercising, sleeping enough, eating
regularly, low consumption of alcohol and smoking
tobacco, and a programme of regular moderate
exercise.
 Counter Transitions
• experience of Mexico, have pointed to the occurrence of
a rise in age-specific mortality rates rather than a fall
over time.
• One of the most notable examples of a counter transition
is the HIV/AIDS pandemic in sub-Saharan Africa (Gaylin
and Kates 1997).
• but other historical examples include a period of rising
mortality rates for males over age 35 in France between
1850 and 1900 (Anderson 1955)
• in­creases in adult male death rates in Eastern Europe
between 1952 and 1985 (Uemura and Pisa 1988;
Eberstadt 1989)
• and rising adult male mortality in Nauru, attributable
largely to accidents, cardiovascular diseases, and
diabetes mellitus (Taylor and Thoma 1985; Schooneveldt
et al. 1988).
 Continued Relevance
• Amid questions as to whether the theory of the epidemiological
transi­tion represents a universalizing concept, one of the most
enduring lessons from the model of the transition is the notion of a
systematic relationship between the level of mortality from all
causes and the relative composition of causes that contribute to this
overall level.
• , Frederiksen (1969) delineated specific patterns of disease
characterizing various levels of mortality.
• He postulated endemic infections, parasitisms, infestations, and
nutritional deficiencies in high-mortality populations being replaced
by bronchopulmonary and cardiovascular diseases, malignant
neoplasms, mental illness, accidents, and obesity in low-mortality
populations.
 Global Burden of Disease Study 1990

• Classification into three groups

• Group1-communicable- include maternal, perinatal, and
nutritional diseases,
maternal causes, diseases of early infancy, and acute
respiratory infections along with traditional infectious and
parasitic diseases such as diarrhea, helminthes diseases
(any of various parasitic worms, for example, a fluke,
nematode, or tapeworm), malaria, and tuberculosis
All of the causes in Group 1 decline at much faster rates
than overall mortality and account for a small proportion
of deaths in industrialized coun­tries