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Abstract/Syllabus:
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Population Change and Public Health
Spring 1999
Description
This course introduces the basic elements of population studies, including: population size, composition, and distribution, and the causes and consequences of changes in these characteristics. An overview of demographic processes and measures used to assess them is presented. The course also focuses on reproductive health issues important in the context of Sub-Saharan Africa. The impact of population policies and programs on population change will be analyzed for different countries. Current issues and problems in program design, implementation, and evaluation will be outlined with the help of several case studies.
This course was developed by JHSPH faculty with the generous support of the Andrew W. Mellon Foundation and the Bill and Melinda Gates Foundation. Qualified educators may order this course and others on CD-ROM from the Bill and Melinda Gates Instiute for Population and Reproductive Health.
OCW offers a snapshot of the educational content offered by JHSPH. OCW materials are not for credit towards any degrees or certificates offered by the Johns Hopkins Bloomberg School of Public Health.
Syllabus
Course Description
This course introduces the basic elements of population studies including: population size, composition, and distribution, and the causes and consequences of changes in these characteristics. An overview of demographic processes and measures used to assess them is presented. The course also focuses on reproductive health issues important in the context of Sub-Saharan Africa. The impact of population policies and programs on population change will be analyzed for different countries. Current issues and problems in program design, implementation and evaluation will be outlined with the help of several case studies.
Course Objectives
After completion of this course the student will be able to:
- Describe the current status and trends in population size, composition and distribution, and analyze the causes and consequences of changes in these characteristics.
- Calculate and interpret basic measures used to assess demographic processes: fertility, mortality, migration and urbanization.
- Describe and analyze the theories and empirical evidence to explain the observed trends in fertility, mortality, migration, and urbanization in the developing and developed world .
- Describe trends in household/family structure, number, composition and types, and their demographic and social implications.
- Describe and interpret basic biological reproductive processes and major contraceptive technologies.
- Identify the important reproductive health issues in the Sub-Saharan region of Africa and their socioeconomic, health and demographic impact; and devise programmatic strategies to tackle them.
- Analyze population policy, its formulation and role in the future of sub-Saharan Africa's demographic and reproductive health trends.
- Outline the steps and issues involved in designing a reproductive health/family planning program.
- Analyze organizational, administrative, financial and technical issues involved in program design, implementation and evaluation.
Readings
Recommendations for each lecture are listed on the Readings page.
Key terms are defined in the Glossary.
Schedule
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Key topics covered:
- Sources of population data
- Demographic transition
- World population growth: 1750-2050
- World population growth: future prospects
- Demographic processes affecting population growth
- Measuring Population growth
Upon completion of this module, the student should be able to:
- List the historical and current sources of population data
- Describe population/demographic balancing equation
- Compare and analyze the importance of different processes affecting population change
- Define, calculate and differentiate between crude rate of natural increase and population growth rate
- Define and distinguish features of population growth (demographic trends) in different time periods and different regions (in time and space)
- Define 'demographic transition'
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Key topics covered:
- Population distribution and implications
- Demographic determinants of age-sex structure
- Measures and graphical tools to describe the age-sex structure of the population
- Three general profiles of age-sex composition
- Replacement reproduction and Population momentum
- Implications of age structure
- Dependency ratios
Upon completion of this module, the student should be able to:
- Define population density
- Contrast and describe population distribution in developed and developing countries, rural vs urban and examine its implications
- Identify (describe) the determinants of age-sex structure
- List the measures used to describe the age-sex structure of the population
- Interpret the population pyramids
- Describe and interpret replacement reproduction
- Define and explain the demographic changes associated with population momentum and explain how the initial age structure affects it
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Key topics covered:
- Theories on population and development interrelations
- Economic, social and environmental consequences- relationship between demographic variables, poverty and affluence
- Population, agriculture and environment nexus (environmental consequences)
Upon completion of this module, the student should be able to:
- Describe and critique the existing theories on population and development interrelations
- Evaluate the existing evidence for economic, social and environmental consequences of population growth
- Identify and analyze other exogenous factors perpetuating/mitigating the effects of population growth
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Key topics covered:
- Definitions
- Measures of fertility: from crude to specific measures
- Measures of reproductivity : Gross and net reproduction rate
Upon completion of this module, the student will be able to:
- Interpret and calculate indicators of fertility
- Interpret and calculate indicators of reproductivity
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Key topics covered:
- Fertility trends and differentials in developed and developing countries
Proximate and distal determinants of fertility
- Classical Demographic Transition theory
- Sociological theories for fertility decline
- Economic theories for fertility decline
- Critique of classical and sociological theories
Upon completion of this module, the student will be able to:
- Compare and contrast fertility trends and differentials in developed and developing countries
- Describe the classical demographic theory and evaluate the existing empirical evidence in favor or against it
- Describe and critique Sociological and economic theories to explain the observed fertility trends
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Key topics covered:
- Measurement of mortality: sources of data
- Crude mortality indicators
- Specific mortality indicators: age specific mortality rate, cause specific mortality rate
- Special mortality indicators: Infant mortality rate, maternal mortality rate
- Sources of data and measurement of morbidity
Upon completion of this module, the student will be able to:
- Describe the strengths and weaknesses of the existing sources of data for measuring mortality and morbidity
- Interpret and calculate basic and specific mortality indicators
- Interpret and calculate morbidity indicators
- Critically examine the trends and differential in mortality over time and space and their implications
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Key topics covered:
- Trends in mortality decline in developed and developing countries
- Determinants of mortality decline: proximate and distal
- Income and health: relationships and structural shift
- Maternal education and health
- Population theories of mortality decline: Epidemiological transition and epidemiological polarization
- Compression of mortality and morbidity
Upon completion of this module, the student will be able to:
- List proximate and distal determinants of mortality
- Analyze the relationship between income and health
- Describe, interpret and critique the existing theories of mortality decline
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Key topics covered:
- Migration: definition
- Migration: basic indicators and their calculation
- Migration and population growth rate
- International migration: overview
- International migration in Africa
- Migration theories: Early theories, Neo-classical economic theories, and Socio-political theories
- International migration: prospects and challenges
Upon completion of this module, the student will be able to:
- Identify different sources of data for measuring migration
- Define and calculate basic measures of migration
- Describe and interpret the impact of net migration on population growth rate in different setting
- Describe, interpret and critique the existing theories of migration
- Describe recent trends in international migration all over the world, with particular reference to SSA
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Key topics covered:
- Urbanization: definitions
- Urbanization: basic indicators and their calculation
- World urbanization trends
- Urbanization in SSA
- Demographic impact of urbanization
- Impact of urbanization on health, environment, economy
- Options for dealing with urbanization
Upon completion of this module, the student will be able to:
- Define and calculate basic measures of urbanization
- Describe trends and issues in urbanization in SSA context and at the global level
- Describe and analyze the demographic, social, health, enviornmental and economic impact of urbanization
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Key topics covered:
- Male reproductive tract: anatomy
- Hormonal basis of male reproduction
- Female reproductive tract: anatomy
- Hormonal basis of female reproduction
- Safe period and fertile period
- Methods of contraception: Classification, mechanism of action, effectiveness, side effects, and advantages
Upon completion of this module, the student will be able to:
- Describe anatomy of male and female reproductive organs
- Describe the hormonal events underlying male and female reproductive life cycle
- Define 'safe period'
- Describe the mechanism of action, advantages and disadvantages of different contraceptive methods
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Key topics covered:
- Definitions
- Family planning and reproductive health
- Safe motherhood and reproductive health
- Reproductive tract infections: prevalence, etiology, programmatic options
- HIV/AIDS: prevalence, demographic, social and economic impact
- Adolescent reproductive health
- Unsafe abortion in SSA
- Harmful traditional reproductive health practices
- Gender and reproductive health
Upon completion of this module, the student will be able to:
- Define reproductive health
- Describe different components of reproductive health
- Identify different reproductive health problems in SSA context
- Describe different programmatic strategies for dealing with different reproductive health problems
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Key topics covered:
- Definitions
- Sources of data
- Prevalence of infertility in SSA
- Infertility: preventable and non-preventable causes
- Infertility: treatment, management and programmatic strategies
Upon completion of this module, the student will be able to:
- Describe different types of infertility
- List sources of data to measure infertility
- Describe different causes of infertility
- Describe different programmatic strategies to deal with infertility
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Key topics covered:
- Key components of population policies
- Evolution of population policies in SSA
- Population policies: Post ICPD shifts
- Population policies on mortality and morbidity
- Policies on population redistribution
- Population related policies
- Policy process
- Population policies: ethical issues
Upon completion of this module, the student should be able to:
- Define and distinguish between different types of population policies
- Describe the key components of a population policy
- Critically evaluate the evolution of population policies in Sub-Saharan Africa
- Describe the post ICPD shifts in population policies
- Identify complementarities and contradictions between population policy and other policies of Government having demographic implications
- Outline the policy process for the development of population policy and its importance
- Describe different aspects of population policies
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Further Reading:
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Readings
Key population terms are defined in the Glossary.
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| 1 |
Population Size, Growth, and Demographic Transition |
Haupt, Arthur and Thomas T. Kane. "Population handbook", 4 th international edition, 1998, (Washington DC: Population Reference Bureau, September 1998).
Joseph A. Mcfalls, Jr., "Population: A Lively Introduction," vol. 53, no.3 (Washington DC: Population Reference Bureau, September 1998).
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Population Structure, Composition and Distribution |
Yaukey, David and Douglas L. Anderton. Demography: The Study of Human Population. 2001. Chapter 4. 2 nd Edition Illinois: Waveland
Shryock, H.S. and Jacob S. Siegal. "The methods and materials of Demography." Chapter 7 and 8. 1978. Academic Press, New York
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Social and Economic Consequences of Population Growth |
Finkle Jason L., and Barbara B. Crane. March 1985. "Ideology and politics at Mexico city: The United States at the 1984 International Conference on Population.Population and Development Review 11(1): 1-28
Hodgson, Dennis. December 1988. "Orthodoxy and Revisionism in American Demography." Population and Development Review 14(4): 541-569
McIntosh C. Alison, and Jason L. Finkle. June 1995. "The Cairo Conference on Population and Development: A new paradigm?" Population and Development Review 21(2): 223-260
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Fertility and Reproduction: Data Sources and Measurement |
Haupt, Arthur and Thomas T. Kane. "Population handbook", 4 th international edition, 1998, (Washington DC: Population Reference Bureau, September 1998).
Yaukey, David and Douglas L. Anderton. Demography: The Study of Human Population. 2001. Chapter 7, 2 nd Edition Illinois: Waveland
Shryock, H.S. and Jacob S. Siegal. "The methods and materials of Demography." Chapter 16,17and 18. 1978. Academic Press, New York
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Fertility Change: Trends, Differentials, Determinants and Theories |
Hirschman ,Charles. 1994 "Why Fertility Changes" Annual Review of Sociology, 20: 203-233.
Bongaarts, John, Susan Cotts Watkins. Dec., 1996. "Social Interactions and Contemporary Fertility Transitions". Population and Development Review, 22( 4):639-682.
Caldwell, John C., I. O. Orubuloye, Pat Caldwell. June 1992. "Fertility Decline in Africa: A New Type of Transition?" Population and Development Review , 18 (2): 211-242.
Martin, Teresa Castro. Jul. - Aug., 1995. "Women's Education and Fertility: Results from 26 Demographic and Health Surveys". Studies in Family Planning , 26(4) pp. 187-202.
Ahn, Namkee., Abusaleh Shariff. Mar., 1994. "A Comparative Study of Socioeconomic and Demographic Determinants of Fertility in Togo and Uganda". International Family Planning Perspectives ,20(1): 14-17+22.
Caldwell, John C., Pat Caldwell. Jun., 1993. "The South African Fertility Decline" Population and Development Review, 19(2): 225-262.
Chimere-Dan, Orieji . (Mar., 1996) "Contraceptive Prevalence in Rural South Africa". International Family Planning Perspectives 22(1): 4-9.
Mason ,Karen Oppenheim. November 1997. "Explaining Fertility Transitions (in Presidential Address)." Demography 34(4): 443-454.
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Mortality and morbidity: Data Sources and Measurement |
Yaukey, David and Douglas L. Anderton. "Demography: The Study of Human Population." 2001. Chapter 5, 2 nd Edition Illinois: Waveland
Haupt, Arthur and Thomas T. Kane. "Population handbook", 4 th international edition, 1998, (Washington DC: Population Reference Bureau, September 1998).
Shryock, H.S. and Jacob S. Siegal. "The methods and materials of Demography." Chapter 14 and 15. 1978. Academic Press, New York
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Mortality Decline: Trends, Differentials, Theories and Prospects |
Income and mortality: relationships
DaVanzo J. Infant mortality and socio-economic development: Evidence from Malaysian household data. Demography 25:581-595, 1988
Hobcraft JN, Mcdonald JW, and Rutstein SO. Socio-economic factors in infant and child mortality: a cross-national comparision. Population studies 38:193-223,1984
McCormic MC, Shapiro S, and Horn SD. The relationship between infant mortality rates, medical care and socio-economic variables, Chile 1960-1970. International Journal of Epidemiology 8: 145-154,1979
Epidemiological transition and Epidemiological polarization
Bobadilla JL, Frenk J, Frejka T, Lozano R, and Stern C. The epidemiological transition and health priorities. Chapter 3 in DT Jamison, WH Mosley, AR Measham, J-L Bobadilla (eds) Disease control priorities in Developing countries. New York: Oxford University Press of World Bank, 1993
Horiuchi, Shiro. Epidemiological transitions in developed countries: Past, present and future. Pages 237-254 in population division, UN, Symposium on health and mortality, brussels, Belgium, 19-22 November,1997
Olshansky SJ and Ault AB. The fourth stage of the epidemiologic transition: the age of delayed degenerative diseases. Milbank Quarterly 64:355-391, 1986
Olshansky SJ, and Carnes BA. Demographic perspectives on human senescence. Population and Development Review 20(1):57-80, March 1994
Omran AR. The epidemiologic transition: a theory of the epidemiology of population change. Milbank Memorial Fund Quarterly 49:501-538,1971
Pappas G. Queen S, Hadden W, Fisher G. The increasing disparity in mortality between socio-economic groups in United States, 1960 and 1986. Socioecomonic disparity in mortality in US. 329(2):103-109
Compression of mortality and morbidity
Fries JF. The compression of mortality: near or far? The Milbank Quarterly 67(2):208-231, 1989
Fries JF, Green LW, and Levine S. Health promotion and the compression of morbidity. Lancet i:481-483, March 4,1989
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Migration: Sources of Data, Measurement, Trends in Time and Space, Theories and Implications |
No Reading |
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Urbanization: Measurement, Theories, Trends, and Prospects |
Brockerhoff M. P. September 2000. "An urbanizing World�"Population Bulletin, Vol. 55(3 ). Washington D.C: Population Reference Bureau. Can be accessed online at www.prb.org
Brockerhoff, M. and E. Brennan. 1998. "The poverty of cities in developing regions." Population and Development Review, 24(1): 75-114
John D. Kasarda, Edward M. Crenshaw.1991."Third World Urbanization: Dimensions, Theories, and Determinants." Annual Review of Sociology , 17: 467-501.
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Reproductive Health: Biological Processes and Contraceptive Technology |
Jones R.E. 1996. "Human Reproductive Biology" Chapters 1-4. Academic Press, New York
"How Contraceptives work."Outlook 11(3): 6-8, 1993 [www.path.org]
Hatcher R.A., W. Rinehart, R. Blackburn, Geller G.S., and J.D. Shelton. 1997 . "The essentials of contraceptive technology." Baltimore. Johns Hopkins School of Public Health, Population Information Program, 1997. [www.jhuccp.org]
Baird D. T. and Glasier, Anna F. 1993 "Hormonal contraception." New England Journal of Medicine 328(21): 1543-1549
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Components of Reproductive Health |
STD Control and Primary Health Care for women: Experience and Challenges. 1997. Features article. Outlook 15(2): 1-10
Ropey, B., Ross, J., and Bhushan, I. Meeting unmet need: New strategies. Population Reports, Series J, No. 43. Baltimore, Johns Hopkins School of Public Health, Population Information Program, September 1996.
McCauley, A. P. and Salter, C. Meeting the Needs Of Young Adults. Population Reports, Series J, No. 41. Baltimore, Johns Hopkins School of Public Health, Population Information Program, October 1995.
Lande, R. Controlling Sexually Transmitted Diseases Population Reports, Series L, No. 9. Baltimore, Johns Hopkins School of Public Health, Population Information Program, June 1993
Heise, L., Ellsberg, M. and Gottemoeller, M. Ending Violence Against Women. Population Reports, Series L, No. 11. Baltimore, Johns Hopkins University School of Public Health, Population Information Program, December 1999.
Garenne M., S. Tollman, and K. Kahn. March 2000. "Premarital fertility in rural South Africa." Studies in Family Planning 31(1): 47-54
Hulton L.A., R. Cullen, and S.W. Khalokho. March 2000. "Perceptions of the risks of sexual activity and their consequences among Ugandan adolescents." Studies in Family Planning 31(1): 35-46
Meyhew S.H., L. Lush, J. Cleland, and G. Walt. 2000. "Integrating components of reproductive health." Studies in family planning 31(2): 151-162
Caldwell, John C., Pat Caldwell .Dec., 1993. "The Nature and Limits of the sub-Saharan African AIDS Epidemic: Evidence from Geographic and Other Patterns" Population and Development Review ,19( 4): 817-848.
Safe motherhood: Successes and Challenges. 1998. Features article. Outlook volume 16 (sp. Issue):1-11 [www.path.org]
Adolescent Reproductive Health: Making a Difference . 1998. Features article. Outlook Volume 16, Number 3 (December 1998) [www.path.org]
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Fertility and Infertility: Processes and Management |
Infertility in Developing countries. 1997. Features article. Outlook 15(3): 1-9
Frank O. 1983 "Infertility in Sub-Saharan Africa: estimates and implications." Population and Development Review 9(1): 137-144
Ericksen K, and Brunette T. 1996. "Patterns and predictors of infertility among African women: a cross-sectional survey of twenty-seven nations ." Social Science and Medicine 42(2): 209-220
Larsen, Ulla. 1994. "Sterility in sub-Saharan Africa." Population Studies 48(3): 459-474
Cates, W., T.M. M. Farley, and P.J. Rowe. 1985. "Worldwide Patterns of Infertility: Is Africa Different?" Lancet , p 596-598
Okonofua F. E., Dianna Harris, Adetanwa Odebiyi et al. 1997. "The social meaning of infertility in Southwest Nigeria." Health Transition Review, 7: 205-220
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Population Policies and Programs |
Heckel, Nancy I. 1986 "Population Laws and Policies in Sub-Saharan Africa: 1975-1985." International Family Planning Perspectives. Volume 12(4): 122-124
Chamie, J. 1994. "Trends, Variations, and Contradictions In National Policies To Influence Fertility" Population and Development Review . Volume 20 (supp): 37-50
Abumere, S. I. 1981 "Population distribution policies and measures in Africa south Of the Sahara: A review". Population and Development Review . Volume 7(3): 421-433
Ashford, Lori S. March 2001."New Population Policies: Advancing women's health and rights."Population Bulletin , Vol. 56(1). Washington DC: Population Reference Bureau, Inc.
Hodgson D. 1988. "Orthodoxy and Revisionism in American demography ." Population and Development Review , 14(4): 541-570
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