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Population Issues- 1999

The New Generations, the Family and Society
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Reproductive Rights, Reproductive Health and Family Planning

Empowering Women

Population and Sustainable Development

Population Trends:
The Numbers and Beyond


Demographic Trends by Region

Migration and Urbanization

Knowledge that Empowers

Breaking the Data Barrier:
A Priority for Research


Challenges for the 21st Century

The New Generations, the Family and Society

 
Over the last 30 years, changing patterns of fertility, mortality, education, and migration have profoundly affected people’s lives. The family, the basic unit of all societies, is adapting itself to new challenges and opportunities and changing its structure and activities to cope with new realities and enhance the quality of life of its members.

Greater numbers of people are living to older ages and higher proportions of most countries’ populations have lived at least 60 years. At the same time, countries with historically high levels of fertility are dealing with unprecedented numbers of children moving into adolescence. Accelerating social and economic change is posing new challenges to societies and families in preparing youth for productive social roles.

The emergence of "new generations" on a new scale -- large numbers of young being prepared to enter into a rapidly changing social world and growing numbers of women and men reaching older ages -- is a special distinguishing feature of this time. These new generations are linked by more than a coincidence of time. To a large extent the prospects of both groups depend on the strength, adaptability and foresight of families.

Around the world, family support networks are in decline and the proportion of single-parent-headed households is growing. In rural areas of sub-Saharan Africa, urbanization often leads to young people being separated from their grandparents, who previously played a special role in the traditional education and socialization of the young. In the Middle East, traditional extended families are gradually disappearing as is the case in Egypt, where 84 per cent of all households are now nuclear families. In the United States, the growing number of female-headed house-holds is one factor contributing to the feminization of poverty in that country. In many countries, the HIV/AIDS epidemic is affecting the health and lives of young adults as they reach their most productive years. In the absence of social services to bridge the gap previously filled by other family members, the consequences of these changes are often negative, especially for the poor. In the absence of a social "safety net," the elderly and children have no choice but to work, parents are forced to leave their children unsupervised and the birth of a child may result in a loss of pay or even in unemployment. In addition, existing gender-based division of household labour places a disproportionate burden on those women who either have to, or choose to, work outside the home.

In addressing these issues, the Programme of Action adopted at the ICPD in 1994 recognized that despite recent declines in birth rates in many countries, further large increases in population size are inevitable. Owing to the youthful age structure, for numerous countries the coming decades will bring substantial population increases in absolute numbers. Population movements within and between countries, including very rapid growth of cities and the unbalanced regional distribution of population, will continue and increase in the future. The Programme of Action also recognized the need for policies that support the family, whatever its form, as it seeks to do what families have always done: provide mutual support and protection for its members, whether children, young adults, mature adults or the elderly.

A comparison of the working-age population to the combined young and old populations in the more developed regions shows the impact of the baby boom. In 1950, there were 1.85 working-age people for every old or young dependant, decreasing to 1.72 in 1960-1965. This was followed by a period of sustained increase which is expected to last until around 2005-2010. From that point on, however, as older populations grow, the ratio will fall to 1.42 in 2050.

The Youth Factor

At the approach of 6 billion, world population continues to grow at 77 million a year and will exceed 70 million more per year for the next two decades. What happens after depends largely on decisions made now and over the next 10 years by the 1.04 billion young people who today are between 15 and 24 years of age.

What these young people, the largest generation ever to enter adulthood, decide about the size and spacing of their families will determine how many people will be on the planet by 2050.

Educating young people about the immediate and longer-term effects of their behavioural choices enables them to make responsible decisions. Their ability to make informed choices, to fulfil their individual potential and contribute to economic development, will be shaped by the way families, communities, nations and the world respond to their health, schooling and job needs.

Between now and 2010, 700 million young people will enter the labour force in developing countries, an unprecedented "demographic bonus" of human resources. The ILO projects that more than 1 billion jobs will be needed to accommodate these new workers and reduce unemployment, a challenge that cannot be met without continued progress in lowering birthrates and expanding education programmes.

Earlier sexual maturity, later marriage and changes in the form of the family have contributed to the acceptance of adolescence as a distinct phase of life. With puberty occurring earlier and average marriage age rising, young people today face a longer period of time during which they are sexually mature and, perhaps, sexually active.

Young people’s right to exercise their basic human rights must be recognized and respected in helping them realize their full potential. In the case of young women, this entails the right to exercise greater control over their sexual and reproductive lives, free of coercion, discrimination and violence. The development of more positive attitudes towards girls and women will remove many of the barriers to better reproductive health.

Traditional practices such as expectation of early marriage and pregnancy, the 2 million young girls who face female genital mutilation each year, the fact that only 76 per cent of girls compared to 96 per cent of boys receive some level of primary schooling and that among children who receive no schooling at all, girls outnumber boys, are all symptoms of a wider prejudice against empowering girls to make their own decisions.

Young people have their own special needs for health care and education, particularly in matters of sexual and reproductive health, an area where adolescents can be especially at risk. But better communication about sexuality, about gender relations, and about the avoidance of unwanted pregnancy and STDs is essential to improving young people’s life options when:

  • One in every 10 births worldwide is to teenage mothers -- 1 in every 6 to young women aged 15-19 in the least developed countries.
  • Pregnancy before age 18 carries many health risks -- girls aged 10-14 are five times more likely to die in pregnancy or childbirth than women aged 20-24.
  • Adolescent mothers will have more children than those who start childbearing later.
  • At least 1 in 10 abortions worldwide occurs among women aged 15-19 -- over 4.4 million young women in this age group have abortions every year (40 per cent of which are performed under unsafe conditions).
  • Ultimate population size depends not only on the size of completed families but on decisions about when to start them -- raising mothers’ age at first birth from 18 to 23 could reduce population momentum by over 40 per cent.
  • Each day, 500,000 young people are infected with an STD -- most in the 20-24 age group, followed by the 15-19 age group.
  • Those under age 25 account for half of all HIV infections -- 8,000 a day.

Unintended pregnancy early in life is usually the consequence of lack of access to information and services, unwanted sexual relations, unprotected sex or ineffective use of contraception. Unmarried pregnancy is often unintended. As reproductive health and family planning programmes become well established, adolescents’ and young people’s unmet need for contraception remains greater than that of any other age group.

More countries are recognizing the need to address the unique needs of adolescents in the area of reproductive and sexual health concerns. Many have made significant advances in meeting young people’s need for information and services. But attitudes need to be changed and programmes better supported to sustain this progress.

Integrated primary health services are the most effective and cost-efficient way of meeting the multiple health needs of adolescents, including their sexual and reproductive health concerns. Services and information should be accessible as well as available, offering sensitive counselling in a youth friendly environment.

Community leaders, parents and teachers should have input in the design of programmes for adolescents, as should young people themselves. While families are still the strongest influence on adolescent behaviour and choices, parents are often uneasy about teenage sexuality, uncertain about what sort of information to provide, and may need training to help adolescents deal with health and sexuality issues.

Education programmes are essential to address issues of adolescent sexual and reproductive behaviour. Contrary to popular believe, sex education does not lead to promiscuity.
A WHO survey of sex education studies found none that indicated increases in sexual activity among participants and clear evidence in 21 studies of higher levels of abstinence, a later start to sexual activity, higher use of contraceptives, fewer sexual partners and/or reduced rates of unplanned pregnancy and STDs among participants.

A similar survey by UNAIDS of over 50 studies has shown that sexual health programmes do not encourage sexual experimentation, that they can help delay the age of first intercourse and, among adolescents who are sexually active, reduce the instance of sexually transmitted diseases.

 

Investing in young people

The large size and rapid growth of the adolescent and young age group demands a considerable investment if their potential is to be fully realized. The practical benefits are wide-reaching and include:

  • Avoiding unwanted pregnancies and their consequences, especially for women’s health and opportunities.
  • Reducing recourse to abortion and the consequences of unsafe abortion.
  • Fewer unwanted children.
  • Prevention of teenage pregnancy, protecting girls from the health risks of too-early childbearing and allowing them to complete their education and to marry later.
  • Stronger primary and preventive health care systems and improvements in public health.
  • Slowing the spread of sexually transmitted diseases, including HIV/AIDS.
  • Longer generations, reduced population momentum, quicker transition to sustainable low levels of population growth.
  • Progress towards gender equity, social participation and grass-roots partnerships for development.
  • Better integration of young people into responsible adult roles.
  • Better preparation of the young for creating and responding to social change and opportunity.
  • Better communications and active partnerships between men and women and between the generations.

Ageing

Today there are more than 580 million people over 60 years of age and their numbers are growing at over 11 million a year. More people are living to older ages, with higher proportions of most countries’ populations aged 60 years and above than at any time in history.

Better medical care is preserving life at both ends of the age spectrum: infant mortality has fallen rapidly and more people are living longer. Combined with lower fertility, the effect is to increase the proportion of older people. This is what is meant by an "ageing" population.

All countries will experience some change in their age structures in the next several decades. Adaptation to the new realities will change relationships between generations, as well as approaches to work, health care and education.

Increasing numbers of elderly people and the erosion of family support systems will call for new arrangements for elder care. A majority of the elderly are female, underscoring the need to address women’s health needs throughout the life cycle. Most of the burden of caring for older family members has fallen on women -- as the burden grows heavier, national policies must respond.

The proportion of people’s lives in which they can expect to have either elderly relatives or a child in the household is growing, though at different rates in different regions. Countries at different stages of the demographic transition and under different social and economic conditions face different scenarios.

Improving health, financial security and comfort in later life will become a higher priority as populations grow older, issues that should be assessed as an integral part of the formulation of social development policy, programmes and strategies.

The health of older people depends on the quality of available health care, on income and living conditions and on health status in earlier years, itself the result of a wide range of economic, social, political and cultural conditions. These include:

  • Ensuring the right to health, particularly basic primary health care, including sexual and reproductive health;
  • Emphasizing public health measures and preventive health care to reduce the cost of curative medicine;
  • Giving special attention to the health needs of older women, which have so far been neglected by policy makers (older populations and particularly the oldest old in most parts of the world are predominantly female, because of women’s longer life expectancy).

Public systems for old-age, disability or survivor support are now a feature of some 155 countries and territories, though their coverage varies greatly. It is estimated that formal public programmes cover only 30 per cent of the world’s population over the age of 60. Some 40 per cent of the world’s working-age population are making contributions to that support. Higher levels of coverage obtain in more developed settings.

Projections of the increases in population at older ages and of their needs for services challenge the ability of public, private and community institutions to respond with a commitment to equity among social groups over time. Decisions about the allocation of public services and the burden of financing them are fundamentally political and moral decisions.

Support for the ageing

Better health, social and financial support services for ageing populations, and policy choices that support intergenerational equity will:

  • Promote the role of families and other informal support providers;
  • Enable older people to remain healthy, independent and productive for longer;
  • Promote the participation of elders in local institutions for self-help, mutual assistance and outreach to others in their communities and thereby strengthen civil society;
  • Encourage the re-evaluation of cultural traditions, to preserve beneficial practices and eliminate harmful ones;
  • Facilitate the reorientation of health services to concentrate on prevention rather than medication and surgery to address conditions related to ageing, and focus attention on the impacts of other social programmes on different age groups;
  • Take the place of large families in providing for old age, and encourage smaller, healthier, better-educated families;
  • Lead to balanced investment in the full range of basic social services (in health, education, sanitation and nutrition) in order to improve the quality of life and future potentials for all segments of the population.

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