Case uitwerking
All cases: Demography and Epidemiology of Ageing, and Migration in the EU
- Instelling
- Maastricht University (UM)
All cases: Demography and Epidemiology of Ageing, and Migration in the EU (2223-EPH2021).
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Cases: Demography and Epidemiology of Ageing andmigration in the European Union
Case 1, What is demography?
Demography
Demography is the scientific study of human population, including its size, distribution,
composition, and the factors that determine changes in its size, distribution, and com-
position.
Demography focuses on five aspects of human population:
(1) size number of people in an area at a certain time
(2) distribution how population is distributed or scattered in a geographic space
(3) composition numbers of person in age, sex, race, year or birth etc.
(4) population dynamics
(5) socioeconomic determinants and consequences of population change
Key factors that affect demography:
Fertility (babies per women)
Mortality connected to epidemiology
Migration
Studying demography
To describe changes in population, counts of persons, births, deaths, immigration, and
emigration need to be obtained from censuses, population registers, administrative records,
and sample surveys.
Other sources of data are:
- Genealogies
- Cemetery data
- Church records
- Military records
- Satellite imaging
Various demographic measures such as ratios, percentages, rates, and averages may be
derived from them.
Demography is largely concerned with answering questions about how populations change
and their measurement.
The broader field of population studies embraces questions of why these changes occur, and
with what consequences.
Demography in relation to epidemiology
,Epidemiology is the method used to find the causes of health outcomes and diseases in
populations. It’s interested in disease states (mortality and morbidity).
Demographers are interested in the size and structure of populations; this is affected by
mortality (thus, epidemiology).
Epidemiologists are less interested in population and more in the diseases that affect
individuals. It is more focused on the ‘micro-level’ (the level of individuals), whereas
demographers are more interested in the ‘macro-level’ (the aggregate level).
Importance of demography for public health
We need demographic knowledge to understand public health patterns and population
trends.
Demography is important to describe changes in population size, distribution, and
composition as a guide for decision making.
Demography measures the health and health care needs of a population by understanding
population dynamics.
This understanding is necessary for making forecasts about future population size and
structure which should underpin health care planning.
The momentum of population processes links the present with the past and the future in
clear and measurable ways.
And in many parts of the world, these processes have been recorded with reasonable
accuracy for many generations, even for centuries in some cases.
Examples.
In the Netherland there are more old people than in Yemen.
Thus, more there are more chronic diseases like Alzheimer’s in the Netherlands than in
Yemen.
Poland has more women in its population than Yemen.
Thus, more there is a higher breast cancer incidence in Poland.
Demographic change
Demographic change refers to changes in the ‘composition’ of a population.
This includes not just changes in population size, and in age and sex structures, but also
changes in ethnic composition, regional distribution, and lifestyle.
Key factors that influence demographic change: fertility, mortality rates, and urbanization.
,In Stage 1, which applied to most of the world before the Industrial Revolution, both birth
rates and death rates are high. As a result, population size remains constant but can have
major swings with events such as wars or pandemics.
In Stage 2, the introduction of modern medicine lowers death rates, especially among
children, while birth rates remain high; the result is rapid population growth.
Many of the least developed countries today are in Stage 2.
In Stage 3, birth rates gradually decrease, usually because of improved economic conditions,
an increase in women’s status, and access to contraception. Population growth continues,
but at a lower rate.
Most developing countries are in Stage 3.
In Stage 4, birth and death rates are both low, stabilizing the population. These countries
tend to have stronger economies, higher levels of education, better healthcare, a higher
proportion of working women, and a fertility rate hovering around two children per woman.
Most developed countries are in Stage 4.
A possible Stage 5 would include countries in which fertility rates have fallen significantly
below replacement level (2 children) and the elderly population is greater than the youthful
population.
There will be a question on this model in the exam!
,Narrowly defined, the components of change are births, deaths, and migration.
In a more inclusive definition, we add marriage and divorce as processes affecting births,
household formation, and household dissolution; and the role of sickness, or morbidity, as a
process affecting mortality.
- Birth and death
- Migration and immigration
- Declining fertility and child mortality
- Rapid urbanization
- Internal and external migration
Germany and three demographic measures in the graphs (see text case 1)
In the first graph we can see that the births were high from 1800-1900, they then decreased
heavily because there was a lesser need for so many kids.
In 1820, there was industrialization and life was more expensive thus less babies.
The decrease in births between 1915-1920 and 1940-1945 are because of WWI and WWII.
The decrease in births around 1930 are because of the economic crisis at that time.
After WWII in 1950 there was a baby boom, this explains the increase in births.
After the baby boom in 1970 the births just decline because of birth control and women
decide to get less and less children.
In the second graph we can see that the life expectancy in 1800 was way lower than in 2019.
Better living conditions, hygiene, medicine, and life in general.
The life expectancy gradually increases, but we can see two downwards peaks between
1915-1920 (WWI) and between 1940-1945 (WWII).
In the third graph we see that the international migrant stock had been increasing from
1990-2010. Lots of migrants from Eastern Europe (former soviet republic).
From 2010-1015, the increase had been less intense (stricter migrant policy’s).
The importance of tracking migration for public health
The demographic profile of immigrants is an important element in future population
developments in Europe.
Migrants are usually young and healthy; thus, they can help us take care of the older
generation.
They enter the market here and they reduce the burden on the younger generation.
Migrants can change the size, distribution, and composition of a country.
Migrants can also take diseases with them, thus tracking them is important.
,Case 2, Making sense of labels: migrants, refugees, and expats
‘Asylum seekers’, ‘refugees’, ‘expats’, ‘internally displaced people’, ‘migrants’,
and ‘legal’ and ‘illegal’ migrants
Asylum seeker
An asylum-seeker is a person who has left their home country as a political refugee and is
seeking asylum in another.
Someone whose request for sanctuary has yet to be processed. If their case is accepted, they
become considered a refugee.
Refugee
A person who has been forced to leave their country to escape war, persecution, or natural
disaster.
This person will be called an asylum seeker if they formally make a claim for asylum until
granted refugee status by the contracting state.
Expat
A person who willingly lives outside their native country.
In common usage, the term often refers to professionals, skilled workers, or artists taking
positions outside their home country or retirees and others who have chosen to live outside
their native country.
Internally displaced people (IDP)
People who are forced to leave their home country but who have not crossed a border to
find safety.
IDPs stay within their own country and remain under the protection of its government, even
if that government is the reason for their displacement.
They do not fall within the legal definitions of a refugee.
Migrant
A person who moves from one place to another, especially to find work or better living
conditions. This is an umbrella term for all other terms mentioned above.
- Legal: a foreign person who is living in a country with official permission to live there
- Illegal: a foreign person who is living in a country without having official permission
to live there (in violation of the immigration laws of that country), this creates the
risk of detention, deportation, and/or other sanctions.
The biggest source of illegal stay is migrants who entered legally but who have
overstayed the duration of their visa or residence permit.
The category of illegality can be broad, and often used for those who intend to make
an asylum claim but have not yet done so.
, Push and pull factors and how they influence each other
The reasons people migrate are usually economic, political, cultural, or environmental.
o Social: education, family
o Economic: employment opportunities, accessibility of products/housing
o Political: discrimination, freedom, conflicts
o Demographic: population size and structure/disease prevalence
o Environmental: exposure to hazards and access to resources (land fertility and
habitability, floods, and natural disasters)
Push Factors are negative things that make people want to move to a new area (e.g war).
Pull Factors are positive aspects that attract people to move to a place (e.g good
employment opportunities).
Migration usually happens as a result of a combination of these push and pull factors.
Examples:
Push = fall of the iron curtain
In Burkina Faso, drought didn’t cause people to migrate, thus climate change is not always
the main reason to migrate.
How migration influences the
demography of the EU
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