Dimensions: 9.25'' x 6.25'' 256 pages Transaction Publishers Publication Date: January 2000 Hardcover ISBN: 1560004231

Much of our current public and intellectual discourse takes as self-evident the proposition that the entire modern world--from the affluent United States to the poorest of the low-income regions--is beset today by a broad and alarming array of "population problems." Around the globe, leading scientists, academics, and political figures now attribute all manner of miseries--poverty, hunger, social tension, even political conflict--to contemporary demographic trends. According to these authorities, the size, composition, and rate of growth of population routinely pose direct and major threats to human well-being. That same argument further posits that a society's "population problems" should be addressed by interventions aimed specifically at altering its demographic rhythms.

The essays collected in this volume represent a dissent from this modern-day canon. As the book demonstrates, the very conception of "population problems" is inherently ambiguous and arbitrary, lending itself to faulty analysis and inappropriate diagnoses. Much of the prevailing thinking about population problems is also plainly careless: rooted in faulty analysis, sometimes even based on the most evident of misconceptions. Such careless thinking about population problems is a result of inattention to, or indifference toward, the fundamental unit in all populations: the individual human being.

Nicholas Eberstadt holds AEI's Henry Wendt Chair in Political Economy. His recent works include The End of North Korea (1999) and The Tyranny of Numbers: Mismeasurement and Misrule (1995).

This volume's recurrent finding is that phenomena identified as "population problems" reveal themselves again and again to be at heart ethical problems--or ethical problems transmuted into political problems through the power of the state. This is the case in the United States, in the territories of the Soviet bloc, in low-income regions of the globe, and for the world as a whole.

Chapter 1 examines the nature of poverty in modern America. Ours is a new and very modern sort of poverty: progressive American minds from earlier generations did not anticipate it. Indeed, they would hardly have imagined our current circumstance; in the most affluent society the world has ever known, immiseration blights millions of lives. In 1993, the officially measured poverty rate in the United States was slightly higher than it had been in 1966; from 1935 (the depths of the Great Depression) to 1992, the percentage of African American households receiving means-tested assistance doubled, and the percentage of whites receiving such assistance increased by one-fourth.

This modern variant of immiseration, however, is rooted in individual behavior rather than in strict financial need. It is characterized by the spread of criminality, illegitimacy, and dependence, and by the embrace of such practices by persons who would not, in the historic meaning of the word, be regarded as "poor." The troubling social syndromes that travel under this rubric in our country today have less to do with a lack of financial resources than a lack of moral resources.

As the poverty problem has evolved in unfamiliar new directions in modern America, so too has the health problem. The acute infant mortality problem in our nation's capital is the subject of chapter 2. The infant mortality rate in Washington is higher than in any of the fifty states--and in the late 1980s and early 1990s, D.C.'s infant mortality rate was actually higher than it had been years earlier.

The prevailing public health paradigms would attribute Washington's infant mortality problem to a lack of material and medical resources, that is, to poverty and inadequate access to health care. This explanation, however, is wholly inadequate. Washington's infant health problem stems from its incidence of low-birth-weight babies and its poor rate of prenatal care utilization; these factors, in turn, appear to be very closely associated with three distinct, but in practice overlapping, phenomena: fatherlessness, welfare dependence, and violent crime. Income and educational levels, by contrast, appeared to be rather weak predictors of infant health risk in the nation's capital. The traditional "structural" factors for explaining infant mortality, it seems, have given way to new factors--factors relating more directly to particular modalities of parental behavior and lifestyle.

Chapter 3 addresses the contributions of Daniel Patrick Moynihan, America's leading intellectual-in-politics, to our understanding of three contemporary public health hazards: traffic injuries, violent crime, and drug abuse. Perhaps surprisingly, death from violent causes has been assuming a steadily increasing prominence in the mortality structure of postwar America. Understanding the dynamics of these three behaviorally rooted dangers may bring us closer to mitigating them, and Moynihan has brought his polymath insight to each of these areas.

No less important than those specific insights has been Moynihan's subtle, but more general, appreciation of the inherent tension at the very heart of the quest to reduce behavioral harm through social and medical interventions. Moynihan warns that "epidemiologists have powerful insights that can contribute to lessening the medical trauma, but they must be wary of normalizing the social pathology that leads to such trauma." In the final analysis, as the eminent epidemiologist Dr. H. O. Lancaster has written, a rise in deaths from violent causes reflects a "lessened appreciation of the sanctity of human life"; consequently, "the prevention of a proportion" of such deaths is not so much a medical problem as "a moral problem."

Overwhelmingly, current commentary about population problems focuses on birth rates rather than death rates. This emphasis is curious; after all, it is much easier to identify genuine and severe population problems that devolve from mortality trends than ones caused by fertility trends. It is by no means self-evident that every country with a rising fertility level is automatically beset by a population problem. There is no obvious, a priori answer to the question of whether it should be preferable for a birth rate to rise, decline, or hold steady. It is incontestable, on the other hand, that a rising mortality level would be taken as a problem by any modern society so unfortunate as to suffer it.

Central Europe and what is now sometimes termed "Eurasia" have been subject to demographic problems for several decades. For much of the cold war era, mortality rates throughout the Soviet bloc were on the rise, with the most dramatic increases occurring within the Soviet Union itself. Chapter 4 shows that if we had devoted more attention during the cold war to Soviet and Eastern European mortality trends, the collapse of the Soviet empire and the Soviet system itself might have come as rather less of a surprise. All of the communist countries that recorded long-term rises in mortality are no longer communist, whereas for China, Cuba, and Vietnam, secular mortality declines still prevail. In our era, long-term increases in mortality are fraught with an unavoidable political significance: they may indicate a government's uncorrectable policy, its administrative incapacity, or even the erosion of its ability to maintain control.

Soviet bloc demographic and health trends are examined in greater detail in chapters 5 and 6. The systemic nature of the democratic malaise in the Soviet bloc is underscored by the fact that every one of the peoples under the sway of the Warsaw Pact--despite their multiplicity of languages, cultures, and levels of economic attainment--came to report a cessation of health progress, and then a sustained retrogression in health conditions, among broad segments of the general population. The proximate causes of these mortality reversals were all the same: an alarming upsurge in deaths attributed to cardiovascular disease and to injuries (including suicide).

Although Soviet-style systems might plausibly have qualified as public health hazards by the end of the cold war, the termination of Soviet-style rule did not result in an immediate turnaround in health trends for all the populaces of the former Soviet bloc. Quite the contrary: the collapse of communism was associated with immediate and sometimes acute increases in death rates for broad segments of the general population.

Chapter 7 examines the reverberations of German unification in the population trends of the former German Democratic Republic. Perverse and distorted as the Soviet-style system may have been, the process of adjusting to a radically different system posed grave challenges to much of the general population. The attainment of Western European health levels in what was the East may have to unfold over lengthy time horizons.

In the estimate of many of today's respected public voices, the premier population problem of our time is rapid population growth--and more particularly, rapid population growth on the part of the world's poorer peoples. The appropriate--indeed urgent--intervention required by rapid population growth, these voices advise, is effective antinatal policy: measures capable of successfully depressing levels of childbearing.

Proponents of these antinatal policies are championing an intervention that is in continuous search of a justification. Chapter 8 outlines and analyzes the shifting arguments employed to advocate what was once forthrightly called "population control" policy. A generation ago, the rationale for antinatal population policies was held to be primarily economic: lower fertility and slower rates of population growth were said to directly accelerate the tempo of material advance and ease the burden of poverty. Years of subsequent economic research, however, have failed to generate the empirical support necessary to substantiate that proposition. Sophisticated proponents of antinatalism have thus shifted to other arguments such as the need to mitigate "demographic momentum" and the obligation to meet "unmet need" for contraceptive services. These new briefs for the old policy are no more convincing than the ones they were intended to replace.

To many observers, global hunger is taken as clear proof that there is a world population problem, and that excessive birth rates and rates of natural increase are at the root of this problem. Serious malnutrition and famine, these observers note, are the lot of societies with high birth rates--not low ones. Chapter 9 demonstrates that such reasoning stumbles through an elementary fallacy of composition. Although undernutrition is indeed generally more prevalent in higher-fertility settings, it does not necessarily follow that the incidence of hunger in these locales would be appreciably altered by changes in childbearing patterns--even sudden and dramatic ones. The phenomenon of modern-day famine is quite unmistakably driven by the hand of state: more specifically, by killer regimes that have embraced and driven forward cruelly and predictably destructive policies with indifference to the suffering engendered. Like a number of today's other purported population problems, mass starvation is actually a moral problem: a problem grounded not on human numbers or patterns of childbearing, but in the political treatment of human beings.

The prevailing view of population problems and the now-fashionable predisposition toward antinatalism may perhaps be explained as a reaction to the overarching demographic phenomenon of our era: the "population explosion." While long-term demographic predictions are problematic in the extreme, accumulating evidence suggests that global demographic trends in the coming century will be very different from those that are familiar from living memory. If so, the prevailing conception of population problems seems certain to change--perhaps even to change drastically.

At the moment, the world's most populous region is Eastern Asia. A third of the world's people now reside in the expanse that extends from Indonesia to China. Chapter 10 considers the political, economic, and social implications for this area of the demographic developments it is likely to experience over the next couple of decades.

Over the past generation, Eastern Asia was swept by a great wave of population growth. Nothing like that is likely to happen again in the coming several decades. Although fertility levels are hardly uniform in this vast region, the overall average is actually now slightly below replacement: continued into the future, that would presage an eventual population decline.

Some places in Eastern Asia--most importantly, Japan--may actually experience the onset of population decline in the years immediately ahead. But even in countries where population totals are still growing, demographic profiles will be changing portentously. For most of Eastern Asia, a rapid aging of populations looks to be immediately in store; for much of the region, a peaking of population of working ages would also appear to be just around the corner.

Whether these trends prove to be population problems, of course, will depend upon many factors—the most important among these being how societies and governments respond to them. Population aging, of course, is the natural corollary of improved life expectancies; its implications are hardly unambiguously adverse. But another demographic trend on Eastern Asia's horizon may be rather more ominous, precisely because it is so unnatural. This is the gender imbalance now emerging in areas of Confucian heritage.

In China, Hong Kong, Taiwan, and South Korea, the conjuncture of sub-replacement fertility, strong son preference, and availability of sex-selective abortion has resulted in an arresting imbalance between baby boys and baby girls. Thus an impending "bride shortage" has already been set into motion in East Asia. This prospective "population problem" can be attributed to a lack of respect for the life of human beings: in this case, female human beings.

The final chapter contemplates a contingency far removed from the preoccupations of current population policy: the prospect that global numbers might peak, and thereafter decline indefinitely. Conventional expectations--and concerns--presume the continuation of human population growth. But it is no longer fantastical to describe the demographic paths that would lead, by the middle of the coming century, to a peaking of world population--and thereafter, a steady drop. Such a prospect does not presuppose catastrophic upheavals: to the contrary, long-term global population decline could be entirely consonant with continuing, uninterrupted improvements in health conditions around the world.

In contemplating a world given over to orderly, progressive population decline, one is of course obliged to picture societies quite different from the ones with which we have to date been familiar. These societies would, for one thing, be more elderly than any we have yet known. But perhaps the most mysterious of the implications of a world population decline would surround the structure, and operation, of actual families. For such a world it is entirely possible that in some countries, a majority of children would have no biological relatives except their ancestors--full siblings, cousins, uncles, and aunts would have become a sort of social anomaly.

With declining population, the pressures upon economies and governments would clearly change--but those demographic trends would by themselves neither forestall the spread of prosperity nor greatly complicate the task of protecting a citizenry's rights. The family patterns that could attend an orderly population decline might well look strange to a contemporary eye (to many contemporary eyes, perhaps troubling or unattractive as well). But even such seemingly radical transformations of demographic rhythms need not result in "population problems": with humane adjustments, new arrangements may help individuals and societies cope with a new and unfamiliar terrain. Humane adjustments, indeed, are key, because in such a possible future it is our very humanity that will serve as the first line of defense against potential population problems--just as it does today.