Chapter 2 – Population and Health

Key Issues

Core Ideas

•Where is the world population distributed?

•Why is global population increasing?
•Why does population growth vary among
regions?
•Why do some regions face health threats?

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 Where Is the World’s Population Distributed?

• Population Concentrations
– 2/3 of the world’s inhabitants are clustered in
four regions.
• East Asia
• South Asia
• Southeast Asia
• Europe
– Site and Situation of Population Clusters
• Low-lying areas with fertile soil and temperate
climate
• Near an ocean or near a river with easy access to
an ocean.
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 countries are displayed on this
map by size of population rather
than land area.

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 People are not distributed uniformly across
Earth’s surface.

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 Where Is the World’s Population Distributed?

• Sparsely Populated Regions

– Humans avoid clustering in certain physical
environments.
• Dry Lands
• Wet Lands
• Cold Lands
• High Lands
– Places considered too harsh for occupancy
have diminished over time.
• Places of permanent human settlement are termed
the ecumene.

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 Seven thousand years ago humans
occupied only a small percentage of
Earth’s land area, primarily in Southwest
Asia, Eastern Europe, and East Asia.
Even 500 years ago much of North
America and Asia lay outside the
ecumene. Still, approximately three-
fourths of the world’s population live on
only 5 percent of Earth’s surface.
The balance of Earth’s surface consists of
oceans (about 71 percent) and less
intensively inhabited land.

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 Where Is the World’s Population Distributed?

• Population Density
– Density can be computed in up to three ways for
a place.
1. Arithmetic Density
– Total number of objects in an area
– Computation: Divide the population by the land area
2. Physiological Density
– Number of people supported by a unit area of arable land
– Computation: Divide the population by the arable land area
3. Agricultural Density
– Ratio of the number of farmers to amount of arable land
– Computation: Divide the population of farmers by the arable
land area
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 Geographers rely on the arithmetic density to compare conditions in different
countries because the two pieces of information–total population and total land
area–are easy to obtain. The highest arithmetic densities are found in Asia,
Europe, and Central America. The lowest are in North and South America and
South Pacific.

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 Physiological density provides insights into the relationship between the size of a population and the
availability of resources in a region. The relatively large physiological densities of Egypt and the
Netherlands demonstrates that crops grown on a hectare of land in these two countries must feed far more
people than in the United States or Canada, which have much lower physiological densities. The highest
physiological densities are found in Asia, sub-Saharan Africa, and South America. The lowest are in North
America, Europe, and South Pacific.

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 The highest agricultural densities are found in Asia and sub-Saharan
Africa. The lowest are in North America, Europe, and South Pacific.

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 Why Is Global Population Increasing?

• Components of Population Growth

– Geographers measure population change in a
country or the world as a whole by using three
measures:
• Crude Birth Rate (CBR) – total number of live birth
in a year for every 1,000 people alive in society.
• Crude Death Rate (CDR) – total number of deaths in
a year for every 1,000 people alive in society.
• Natural Increase Rate (NIR) – percentage by which
a population grows in a year.
– Computation: CBR – CDR = NIR
» Remember NIR is a percentage ( n per 100, while CBR
and CDR are expressed as n per 1,000)
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 Through most of human
history population growth
was virtually nil.
Population increased
rapidly beginning in the
eighteenth century.

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 Why Is Global Population Increasing?
• Components of Population Growth
– Natural Increase
• About 82 million people are added to the population
of the world annually.
• Rate of natural increase affects the doubling time–
number of years needed to double the population,
assuming a constant rate of natural increase.
– Twenty-First Century Rate (1.2 percent): 54 years
» Global population in 2100 would reach 24 billion.
– 1963 (2.2): 35 years
» Global population in 2010 would have been 10
billion instead of nearly 7 billion.
• More than 95 percent of the natural increase is
clustered in developing countries.
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 The world average is currently about 1.2 percent. The
countries with the highest NIRs are concentrated in Africa
and Southwest Asia.

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 Why Is Global Population Increasing?

• Components of Population Growth

– Fertility
• Total Fertility Rate (TFR)
– Measure also used by geographers to measure number of
births in a society.
– Defined as the average number of children a woman will
have throughout her childbearing years (15–49)
– TFR for world is 2.5.
– TFR exceeds 5 in sub-Saharan Africa, while 2 or less in
nearly all European countries.

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 Why Is Global Population Increasing?

• Components of Population Growth

– Mortality
• Infant Mortality Rate (IMR)
– Measure used by geographers to better understand death
rates in a society
– Defined as the annual number of deaths of infants under
one year of age, compared with total live births
– Usually expressed per 1,000 births rather than a
percentage
– IMR is 5 in developed countries and 80 in sub-Saharan
Africa.

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 The global distribution of CBRs parallels that of NIRs.
The countries with the highest CBRs are concentrated in
Africa and Southwest Asia.

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 As with NIRs and CBRs, the countries with the highest
TFRs are concentrated in Africa and Southwest Asia.

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 Why Is Global Population Increasing?

• Summary of Spatial Patterns

– Developed Countries
• Lower rates of…
– Natural increase
– Crude birth
– Total fertility
– Infant mortality
– Developing Countries
• Higher rates of…
– Natural increase
– Crude birth
– Total fertility
– Infant mortality
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 The global pattern of CDRs varies from those for the other
demographic variables already mapped in this chapter. The
demographic transition helps to explain the distinctive
distribution of CDRs.

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 Why Is Global Population Increasing?

• Population Structure
– Fertility and mortality vary not only spatially
but also temporally within a country.
– A special bar graph known as a population
pyramid can visually display a country’s
distinctive population structure.
• X-axis
– Percent male displayed to the left of zero
– Percent female displayed to the right of zero
• Y-axis
– Age cohorts typically grouped in 5-year intervals
– Youngest displayed at bottom and oldest at top

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 Why Is Global Population Increasing?

• Population Structure
– Dependency Ratio
• Defined as the number of people who are too
young or too old to work, compared to the number
of people in their productive years.
– People aged 0 to 14 and over 65 years old are
considered dependents.
– Larger dependency ratios imply greater financial burden
on the working class.
» 85 percent in sub-Saharan Africa, while 47 percent in
Europe.

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 Why Is Global Population Increasing?

• Population Structure
– Sex Ratio
• Defined as the number of males per 100 females
in the population
– Developed countries have more females than males,
because they tend to live 7 years longer.

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 A map of the percentage of people over age 65
would show a reverse pattern, with the highest
percentages in Europe and the lowest in Africa and
Southwest Asia.

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 Why Does Population Growth Vary among
Regions?
• The Demographic Transition
– It is a model consisting of four stages that
helps to explain the rising and falling of
natural increase over time in a country.
– Historically, no country has ever reverted back
to a previous stage.
• Thus, the model can be thought to have a
beginning, middle, and an end.

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 Why Does Population Growth Vary among
Regions?
• The Demographic Transition
– Stage 1: Low Growth
• Marked by very high birth and death rates.
– No long-term natural increase
– No country presently is in Stage 1
– Stage 2: High Growth
• Marked by rapidly declining death rates and very
high birth rates
– High natural increase
– Europe and North America entered stage 2, as a result of the
industrial revolution (~1750).
– Africa, Asia, and Latin America entered stage 2 around 1950,
as a result of medical revolution-improved medical care.

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 Why Does Population Growth Vary among
Regions?
• The Demographic Transition
– Stage 3: Moderate Growth
• Marked by rapid decline in birth rates and steady
decline in death rates
– Natural increase is moderate.
» Gap between CBR and CDR is narrower in stage 3
countries than stage 2 countries.
• Population grows, because CBR is still greater
than CDR.
• Most European countries and North America
transitioned to stage 3, during first half of twentieth
century.

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 Why Does Population Growth Vary among
Regions?
• The Demographic Transition
– Stage 4: Low Growth
• Marked by very low birth and death rates
– No long-term natural increase and possibly a decrease
• Country reaches stage 4 when population gains by
CBR are diminished by losses because of CDR.
– Condition known as zero population growth (ZPG)
» Demographers more precisely define ZPG as the
TFR that produces no population change.
• Population change results from immigration.

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 Why Does Population Growth Vary among
Regions?
• Declining Birth Rates
– Two Successful Strategies for Lowering Birth
Rates
1. Improving Education and Health Care
– Emphasizes improving local economic conditions so that
increased wealth is allocated to education and health
programs seeking to lower birth rates.
2. Contraception
– More immediate results reaped than previous approach
– Met with greater resistance, because it goes against
cultural or religious beliefs of some.
» Roman Catholics, fundamentalist Protestants,
Muslims, and Hindus.

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 More than two-thirds of couples in developed countries use a family-planning
method. Family-planning varies widely in developing countries. China reports
the world’s highest rate of family planning; the lowest rates are in sub-
Saharan Africa.

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 Why Does Population Growth Vary among
Regions?
• Malthus on Overpopulation
– He claimed the population was growing faster
than the increase in food supply.
– Malthus’s Critics
• Many geographers consider his beliefs too
pessimistic.
– Malthus’s theory based on idea that world’s supply of
resources is fixed rather than expanding.
• Many disagree that population increase is not a
problem.
– Larger populations could stimulate economic growth, and
therefore, production of more food.

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 Why Does Population Growth Vary among
Regions?
• Malthus on Overpopulation
– Theory and Reality
• Food production has increased over last 50 years
faster than Malthus predicted.
• His model predicted world population to quadruple
over the course of 50 years.
– Not even in India has population growth outpaced food
production.

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 Production of wheat and rice has
increased more rapidly than has
population.

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 Why Does Population Growth Vary among
Regions?
• Population Futures
– Demographic Transition Possible Stage 5:
Decline
• Characterized by…
– Very low CBR
– Increasing CDR
» More elderly people than young persons
– Negative NIR
– Over time, few young women in child-bearing years
» Contributing to ever falling CBR
• Several European countries already have negative
NIR.
– Russia is most notable hosting a negative NIR for 50 years.
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 Why Do Some Regions Face Health
Threats?
• Epidemiologic Transition
– Medical researches have identified an
epidemiologic transition that focuses on
distinct health threats in each stage of the
demographic transition.
– Stage 1: Pestilence and Famine (High CDR)
• Principal cause of death: infectious and parasitic
diseases
– Ex. black plague (bubonic plague)

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 Why Do Some Regions Face Health
Threats?
• Epidemiologic Transition
– Stage 2: Receding Pandemic (Rapidly
Declining CDR)
• Pandemic is a disease that occurs over a wide
geographic area and affects a very high proportion
of the population.
• Factors that reduced spread of disease, during the
industrial revolution
– Improved sanitation
– Improved nutrition
– Improved medicine
• Famous cholera pandemic in London in mid
nineteenth century.
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 Why Do Some Regions Face Health
Threats?
• Epidemiologic Transition
– Stage 3: Degenerative Diseases (Moderately
Declining CDR)
• Characterized by…
– Decrease in deaths from infectious diseases.
– Increase in chronic disorders associated with aging.
» Cardiovascular diseases
» Cancer
– Stage 4: Delayed Degenerative Diseases
(Low but Increasing CDR)
• Characterized by…
– Deaths caused by cardiovascular diseases and cancer delayed
because of modern medicine treatments.
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 Why Do Some Regions Face Health
Threats?
• Infectious Diseases
– Reasons for Possible Stage 5
• Evolution
– Infectious disease microbes evolve and establish a resistance to
drugs and insecticides.
– Antibiotics and genetic engineering contributes to the emergence of
new strains of viruses and bacteria.
• Poverty
– Infectious diseases are more prevalent in poor areas because of
presence of unsanitary conditions and inability to afford drugs
needed for treatment.
• Increased Connections
– Advancements in modes of transportation, especially air travel,
makes it easier for an individual infected in one country to be in
another country before exhibiting symptoms.
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 Why Do Some Regions Face Health
Threats?
• Health Care
– Health conditions vary around the world,
primarily, because countries possess different
resources to care for people who are sick.
• Expenditures on Health Care
– More than 15 percent of total government expenditures in
Europe and North America.
– Less than 5 percent in sub-Saharan Africa and South Asia.

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 Why Do Some Regions Face Health
Threats?
• Health Care
– Health Care Systems
• Developed Countries
– Public service available at little or no cost.
– Government pays more than 70 percent of health-care
costs in most European countries, and private
individuals pay about 30 percent of the expense .
• Developing Countries
– Private individuals must pay more than half of the cost
of health care.
» U.S. is an exception to these generalizations, because
private individuals are required to pay about 55 percent of
health care costs making it more closely resemble a
developing country, in regards to health care.
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 The lowest levels of per capita health care
expenditure are in sub-Saharan Africa and South
Asia.

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 The lowest levels of government
expenditures are in Africa and Asia.

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 HOSPITAL BEDS PER 10,000 PEOPLE
The lowest rates are in sub-Saharan
Africa and South Asia.

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 PHYSICIANS PER 10,000 PEOPLE The
lowest rates are in sub-Saharan Africa.

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 PUBLIC EXPENDITURES ON HEALTH CARE AS A
SHARE OF TOTAL HEALTH CARE EXPENDITURES
The highest percentages are in Europe.

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 Summary

• Global population is concentrated in a few

places that are not too wet, too dry, too
cold, or too mountainous.
• Nearly all NIR is concentrated in
developing countries.
• Developed countries have a stable
population, if not slightly declining.
• Population growth varies among regions,
because not all countries are in the same
stage of the demographic transition model.
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 Summary

• Intimately connected to the demographic

transition model is the epidemiologic
transition model that helps to explain why
different regions face varying health
threats.

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