Lots of Surprising Results

By Marian Starkey

The XXVI International Population Conference (IUSSP) ended last Friday in Marrakech and I am finally settling back into my normal office routine. I didn't have the greatest Internet connection while I was overseas so I neglected to post a final blog entry about the conference sessions. Here it is, a week late.

Climate change was a bigger topic of discussion at this conference than at other demography conferences I've attended in recent years. Brian O'Neil, who does population/climate research at the International Institute for Applied Systems Analysis (IIASA) in Laxenburg, Austria was supposed to present his research but was not able to make it to Marrakech at the last minute. His colleague, Leiwen Jiang, presented in his place. Basically what they've found is that aging has a negative effect on carbon emissions while urbanization and smaller households have a positive effect (in this instance, negative means "good" i.e. fewer emissions, and positive means "bad" i.e. more emisisons). They stress that although the number of people on earth does have an effect on emissions, more potent factors are the age structure and lifestyle choices of those people.

The Guttmacher Institute led a training session early on Thursday morning for demographers who wanted to learn to translate their research results into policy recommendations. Session panelists encouraged researchers to communicate their results by starting with the study conclusions and not getting bogged down in methodology, which lawmakers and program managers trust them to execute responsibly. I have to admit that sometimes at these conferences I wish demographers would spend more time presenting their results than their methods for the same reason. Their papers are usually available for download for those who wish to delve deeper into the study methods they used.

A few sessions focused on the demographic consequences of HIV/AIDS. Lori Hunter, who edits the journal Population and Environment, found that families in South Africa who have experienced the death of a family member due to AIDS were negatively affected in terms of food security. One person she talked to actually said, "Locusts are our new beef." Losing an adult in a family of dependents has severe destabilizing effects, both socially and economically.

Another researcher found that female infidelity in Africa might be more widespread than previously believed, based on the high number of couples in which only the woman was infected with HIV. The somewhat counterintuitive results also suggest that girls who attend school are at higher risk of contracting HIV because they are away from their families and experience more independence than girls who stay home.

Joseph Potter from the University of Texas-Austin presented a very interesting study of women in El Paso, TX who use the contraceptive pill. Those who traveled across the border to Mexico to buy pills over the counter for about $5 per pack had much lower discontinuation rates than women who got one pack at a time at the El Paso clinic for free. Only when women were given six packs or more at the clinic did their discontinuation rates drop to the level of the women who bought them at Mexican pharmacies. These results imply that increasing ease of accessibility (no clinic appointment) and providing multiple months of protection at a time increase the continuation rates of pill users.

A researcher from the American University in Cairo studied the fertility differences between Morocco and Egypt. She asked the question "Why is fertility decline faster in Morocco when Egypt has a higher Human Development Index?" She found that although desired fertility is higher in Morocco, later marriage and longer birth intervals make actual fertility lower. The fertility rate of educated women in Morocco is lower than equally educated women in Egypt.

As usual, the most valuable parts of being at this huge conference were the side conversations I had with people at lunch and during coffee breaks. I made a lot of new professional alliances and reinforced existing ones for Population Connection. I know that our info table also helped spread the word about our unique and important work. By the end of the week, only a few copies of The Reporter remained in my booth--everything else had been taken.

The next IUSSP conference will be in four years, location as yet undecided. I am already looking forward to it and will make sure to stock my table more heavily with the fun supplies that conference-goers like to take home: pens, tote bags, stickers, etc. For a serious bunch of researchers, they sure do like their freebies.

Eager to show off

By Marian Starkey

Marrakech presents itself as laid back and fast-paced all at once. Men lounge at cafes drinking sugary mint tea while motor scooters whiz by, nearly crashing into pedestrians and each other at every turn. Horns honk and donkeys bray, trying to be heard over the calls to prayer which blare throughout the city over loudspeakers five times a day. Still, everyone has a smile and is eager to help the tourists from France? England? No, USA! Ah, USA! New York? No, Washington, DC. Ah, Washington, welcome my friends!

I spent the last two days playing hooky to conference sessions and instead visiting various agencies and organizations around Marrakech and the surrounding towns. Yesterday, my bus got a police escort and a royal welcome at the reproductive health clinic about an hour southeast of the city. Town residents lined up along the streets for miles, waving us in. Doctors and staff at the clinic were eager to show us their beautiful facility at the foot of the Atlas mountains. Women who had just given birth proudly showed us their newborn babies. We were all impressed to hear that all services at the clinic, from family planning to safe delivery, are free. Perhaps clinics like this are the reason why Morocco has been so successful at reducing its fertility rate from over 7 to 2.4 in just four decades. The urban fertility rate in Morocco is just an even 2, lower than the U.S. rate.

Today I visited an intake center at the hospital for women and children victims of violence. Doctors were sensitive to the victims' privacy and did not allow us to tour the center, but were happy to answer many of our most pressing questions in the courtyard outside.

This afternoon, I went to a local orphanage for kids 5-18 years old. Many of the 80 residents were plucked from the streets where they had been abandoned by their parents and were begging for a living. They now attend school full time and share a loving home with dedicated staff.

I always expect program directors to exaggerate the success of the work they're accomplishing, but all three of these operations truly did seem to be improving the lives of the most vulnerable women and children who live in and around Marrakech.

Tomorrow it's back to the grind with back-to-back research sessions all day. Publications are flying off my info table too, which is a very good thing, not least because it means I won't have to lug them back to good old Washington, DC.

International Population Conference Day 1

By Marian Starkey

Greetings from Marrakech! I am here for the International Union for the Scientific Study of Population (IUSSP) conference, which happens in a different location every four years. This is the first time that the conference has been held in an African and/or Arab nation, and King Mohammed VI has been a very gracious host so far. He even invited the participants to a special dinner on Tuesday evening. Of course, there are 2,300 of us, so I'm guessing it won't be an intimate affair with lots of photo ops one-on-one.

The conference started today with side meetings, rather than typical research presentations. My first session was a follow-up to the research conference I attended in Ghana last September. It was fun seeing friends that I made a year ago and hearing about the success many of them have had in getting their papers published. There was also a request for more research in the future that could be translated into policy, which I was happy to hear.

The next session I attended featured our expert Board member, Duff Gillespie, as a panelist. The topic was training a new generation of reproductive health specialists and how to do that most effectively. Duff told the story of his own career (I learned that he actually trained in criminology before becoming a USAID career professional!). He criticized donors for neglecting population studies and identified this as the core reason why the field of demography is not sustainable. He called for a renewed interest in population studies by private donors and governments in order to keep the field alive.

The day ended with the official opening ceremony. We heard from IUSSP president, John Cleland; UNFPA director Thoraya Obaid; and several other panelists (who spoke in Arabic so I could not understand their addresses, unfortunately). Berber percussionists rounded out the evening with their energizing chanting, dancing, and drumming.

I got my information table set up this morning and by the end of the day all of the tote bags and pens that I brought were gone! Hopefully now that the "fun" freebies are gone, people will feel compelled to pick up a copy of The Reporter or some of our educational materials.

More tomorrow, after I visit a local reproductive health clinic...

Is family planning a carbon mitigation panacea?

By Marian Starkey

Several newspaper articles have covered the release of a report about family planning and climate change from Optimum Population Trust (OPT), an organization in the UK. I have been posting those articles on our website's "News" page. The attention has reached a critical mass and now it's time to comment.

The study claims to prove that meeting all unmet need for family planning is a more cost effective way of reducing carbon emissions than are other "green" technologies. To do this, the researchers calculated how many tons of carbon will be emitted between now and 2050 without meeting unmet need. They also determined how many tons of carbon would be emitted if unmet need were met (i.e. if there were fewer people emitting carbon). Then they subtract the latter from the former to calculate the difference in tons of carbon emitted between the two scenarios. Finally, they divided the total cost of providing family planning to the women with unmet need for the next 40 years by the number of tons of carbon that would be avoided by meeting unmet need. This is the cost per ton of carbon mitigated, which they estimate is $6.46.

The press releases have all stated that OPT commissioned the London School of Economics (LSE) to do the research, which leads one to believe that world-class faculty researchers are behind the paper. This is not the case. The research paper was actually written by a student at the LSE with the help of a non-faculty supervisor.

While population stabilization is obviously crucial to solving the climate crisis, there are a few methodology issues in this study that must be addressed. Here are the biggest ones, in descending order of importance:

• The figure used for current unmet need--201 million women--refers only to women in the developing world. The authors calculate the proportion of people in the world with unmet need by dividing 201 million by the current world population--6.8 billion (the result is 3%). They assume that this proportion of "unmet need" equals "demand for family planning," which they hold constant for each year between now and 2050 for their cost-benefit analysis. Of course, demand for family planning is not actually the same as unmet need, and is much greater than 201 million women worldwide.
• Then they take a figure from Guttmacher Institute, again for developing countries only, that unintended births could be reduced by 72% if all unmet need in the developing world were met. They apply this figure to every country in the world, including developed countries. Meaning, for example, that they assume that women in the United States who have unintended births would have 72% less if only they had access to contraception. The problem with this methodology is that in most developed countries, most women do have access to family planning if they want it. So spending an additional $22 per woman (the estimated cost of providing contraception to a woman in the developing world each year) on contraceptive supplies will probably not actually reduce the percentage of unintended births by very much. In the United States especially, more money must be spent on teen pregnancy prevention and reproductive health education. Indeed, the most prevalent answers women give in the U.S. for becoming pregnant accidentally are that they didn't expect to have sex and they didn't think they could become pregnant. Spending more money on birth control pills would not help these women. Education and better preparation would.
• It is not clear which population projection was used for the scenario in which unmet need is not met. The authors simply state that the projection came from the UN. The UN produces several projections based on different fertility and mortality assumptions and it would be helpful to know which one was used for this study. * Correction: the author directed me to a footnote that I overlooked, which stated that the medium UN population projection was used.
  

Having said all this, the discussion of the role of family planning in climate change mitigation is long overdue. Indeed, any serious effort to combat global climate change simply must include a commitment to universal access to family planning and contraceptives.

Is it even possible to have a more equitable distribution of emissions with a decent standard of living in a world of 12 billion people or more? It will already be hard enough in a world of 8 or 9 billion. Right now, in our world of 6.8 billion people, too many are not using enough carbon to sustain healthy, productive lifestyles. Yet, we are still raising the concentration of carbon in the atmosphere to dangerous levels.

The per capita emissions in wealthy countries have to be dramatically reduced. But, at the same time, in some developing countries, per capita emissions will have to increase if people are to meet their most basic needs. Reaching that balance that allows everyone a healthy quality of life while protecting the environment will be a challenge made even more difficult by a growing population.

Meeting the existing unmet need for family planning is an important and cost-effective way to help meet the climate crisis. But, it alone will not solve the problem. In fact, the author found that only 9.3 gigatons of carbon emissions would be averted over the next 40 years, which is just a little more than what we currently emit globally in one year. But it must be part of any thorough discussion on mitigation strategies and any rational discussion on climate justice.

Texas Again Leads the Way?

By Brian Dixon

Texas once again shows the folly of allowing right wing ideology to substitute for good health policy. It has one of the highest rates of teen pregnancy in the country and the highest rate of repeat births to teenagers. It is also a state where it is very difficult for teenagers to get birth control.

According to a report in the Dallas Morning News, many doctors in the Dallas region refuse to prescribe contraceptives to teenagers without parental consent. Experts believe that Dallas policy requiring parental consent for birth control at ten school based health centers also applies to them – even though it doesn’t.

Not even young parents can get birth control confidentially – leading to the fact that Dallas leads the nation in repeat teenage pregnancy. Here is real evidence that parental consent rules are utterly counterproductive.

Sadly, a number of conservative organizations and lawmakers are pushing for federal legislation imposing this failed approach on the entire nation. When, and if, health reform comes to the full House and Senate, you can expect many amendments to limit access to reproductive health services for young people – and indeed for all Americans.

Those lawmakers need to hear from you that ideology can’t substitute for evidence when it comes to health policy and that young people need access to confidential family planning services.

Demographic Bomb is a Dud

By Marian Starkey, Communications Manager

This week, Amsterdam is playing host to the ultra-conservative World Congress of Families. An international gathering of family traditionalists, the WCF offers seminars that range from homeschooling to faith to MTV. Sessions like "The Social and Economic Effects of Declining Birth Rates" and "The Philosophical Roots of Demographic Winter" are also part of the program. There's even a seminar called "Threats to the Family from Addiction to Pornography."

Tonight, participants will attend the first international screening of Demographic Bomb: Worldwide Decline of Human Fertility Rates. The incendiary film is the sequel to Demographic Winter, a documentary released in 2008 that was alarmist enough as a stand-alone, in my opinion.

Here's the trailer for Demographic Bomb:

Here's the trailer for Demographic Winter:

Some of the footage overlaps with the trailer above, but there are a few unique opinions that make watching it worthwhile. I especially like the part where a 1970s "preoccupation" with the population bomb is blamed for informing women's rights, gay rights, and environmentalist movements. Yes, what a tragedy that women, homosexuals, and the other species that share our planet finally got a voice.

Demographic Bomb is supposed to scare viewers into believing that an impending economic collapse will be the result of our refusal to continue a century of rapid population growth. One talking head points out that never has a country with a shrinking population experienced economic growth. That can be explained by the fact that until this decade, the only time regional populations shrank was during an epidemic. The Black Plague in Europe had people a bit too preoccupied with burying relatives and trying to stay alive to be able to think about increasing their capital. Population decline due to increased affluence and lifestyle choices is brand new and we cannot predict how it will affect national economies in the near or long-term future.

The end of the trailer is the part that disturbed me the most, when a man mused that really, only "certain kinds of people are on their way to extinction." The ensuing spooky white text on black background laments that it's not politically correct to say so, despite the fact that academics are well-informed about this "problem." I guess the guy at the beginning who described a France with no "original" French people went out on an un-PC limb in making his comments. After all, a future France filled with North Africans is something that makes xenophobes shake in their boots.

Basically, what the World Congress of Families wants you to know is that it supports you and your family. That is, if you are heterosexual, have at least two children, are [preferably] white, Christian, and do not look at pornography.

Tiny People, Big Footprints

By Brian Dixon

A new study by statisticians at Oregon State University points out that reducing family size may be as much as 20 times more important than anything else people might do to reduce their carbon footprint.

This is just the latest evidence of the clear connection between population growth and climate change. We can only hope that sometime soon policymakers will make the same connection as the scientists.

It’s an especially critical connection to make as the world stumbles toward a global plan to bring emissions to a level that allows for climate stability. Really, is it even possible to achieve that if the global population grows to 12 billion by 2050? That’s not outside the realm of the possible.

It seems obvious that if we’re ever to get to a fair, just and humane level of global per capita emissions – one which isn’t dependent on keeping billions and billions of people in abject poverty and despair – stabilizing population is necessary.