First Things
Population Policy:
Ideology as Science
Nicholas Eberstadt
Copyright (c) 1994
First Things 40 (January 1994): 30-38.
I
In recent years the poorer regions of the earth have been swept by a
"population revolution" which, though it has attracted comparatively
little attention, is nevertheless both unprecedented and pregnant with
consequences for the peoples of the countries affected. This
"revolution" has been taking place neither in the bedroom nor in the
health clinic, but rather in the corridors of government. Among
otherwise diverse countries in Africa, Asia, and Latin America, a single
idea has rapidly gained currency: that a modern government should have a
population "policy"-an array of laws and measures specifically aimed at
shaping the composition, size, and rates of change of the national
population.
India's was the first Third World government to endorse the principle of
an active population policy. It took that step in December 1952, with
the adoption of its first Five Year Plan, a document establishing as a
long-run governmental objective the direction of the country's
population toward "a level consistent with the requirements of the
national economy." By the mid-1980s, over thirty governments in the
less-developed regions of the world were following suit. This group
included the governments of six of the world's ten most populous
countries. By the late 1980s, more than seventy of the world's
governments reported that they viewed their national fertility or
population growth rates as "unsatisfactory," and that they considered
policy interventions to alter these rates to be "appropriate." As of
1990, more than three billion people were living under such governments:
over four-fifths of the population of the less-developed regions of the
earth at the time, and nearly two-thirds of the population of the entire
globe.
The adoption of comprehensive population policy marks an eventful change
in the conception of the role of government in civic life. In the past,
governments were often called upon to perform duties with demonstrable
demographic consequences-the regulation of immigration, for example, or
the eradication of communicable disease. The demographic impact of such
programs, however, was typically subsidiary to their intended purpose
(the preservation of national sovereignty, the promotion of public
health, etc.). The idea of harnessing state power to the goal of
altering the demographic rhythms of society per se suggests-and indeed
almost seems to require-a new sort of relationship between the state and
the citizen.
The nature of this new relationship is indicated by some of the targets
that have been set by contemporary population policies. The government
of Bangladesh, for example, has committed itself to the goal of a total
fertility rate of 2.34 births per family by the year 2000; women in
Bangladesh today, however, are thought to have an average of just under
five children. The government of Ghana, for its part, has determined
that its national fertility rate at the start of the twenty-first
century should be 3.3 births per family; yet Ghana's parents are
currently guessed to be having an average of about six children per
family. If Bangladesh and Ghana are to meet their established targets,
both governments must apparently oversee a reduction in their people's
fertility by roughly 50 percent in the next six years-and in Ghana there
are as yet no indications of sustained fertility decline. Just how such
a radical alteration of personal behavior in so intimate a sphere of
life is to be achieved is not clear to outside observers; it may not
even be apparent to the planners who envision these targets. But if such
reshaping of national fertility patterns is to be set in motion by
government action, there would obviously have to be direct, far-
reaching, and even forcible state interventions into the daily lives of
the overwhelming majority of the citizens of these two countries-as well
as others with similar "targets."
What accounts for the rise of population policy? "Population planning"
as currently practiced in China-with its "birth quotas" and its manifold
pressures and penalties to "convince" parents to have but a single
child-may seem particularly consonant with the philosophical
underpinnings of a Communist dictatorship. Yet a stringent and
encompassing population policy, only somewhat less ambitious than
Beijing's, has also been executed in Singapore-a society with a
nominally democratic government. Indeed, the list of Third World
governments committed to the goal of shaping the demographic pattern of
their societies seems to cover the political spectrum, including not
only dictatorships and one-party states (Haiti, Indonesia), but also
monarchies (Morocco, Nepal) and a number of genuine constitutional
democracies (such as Barbados and Botswana).
The revolution in government presaged by an activist population policy
would thus seem to be based less in politics per se than in "science,"
for in the final analysis it is the field of learning known as
"population studies" that provides population policy with its raison
d'etre. This field, it is widely believed, has advanced sufficiently to
permit meaningful predictions of the impact of population changes on the
social and economic development of both rich and poor societies. Insofar
as modern governance is predicated on the idea that national
directorates can and should act to improve the material well-being of
their subjects, and insofar as a useful understanding of the specific
economic and social consequences of population change appears to have
been developed, it should not be surprising that a growing number of
governments have seen merit in the prospect of shaping the demographic
contours of their country so that national welfare and social prosperity
might be "scientifically" advanced.
Unfortunately for all involved, contemporary population policies have in
large part been promoted and adopted on the basis of a serious
misconception. The relationship between population change and economic
development is as yet rather poorly understood, the assertions of
certain bold professionals to the contrary notwithstanding. For many of
the relationships between the two that have been suggested are at best
highly tentative, and in any event cannot be construed to imply
causation. Still others are characterized by false precision or
misplaced specificity. And despite the authority that population
"scientists" today lend to the worldwide effort to promote birth
control, convincing evidence that voluntary family planning
programs have resulted in sustained changes in fertility norms is still
lacking. None of this augurs well for the populations upon which far-
reaching and purportedly scientific population policies are to be
applied.
II
The relationship between population change and social or economic change
is a topic awesome in its complexity. Many of the issues raised by the
"population question," moreover, involve matters of the deepest personal
conviction or preference. Any discourse on population quickly comes to
touch, if only implicitly, on such questions as the nature of free will;
the equality of man; the rights of the living and the unborn; the
obligation of the individual to his group, his society, or his God; the
sanctity of the family; society's duties to the poor; the destiny of
one's nation or one's race; the prospects for mankind; and the value of
life. Such questions are best, or at least most comfortably, addressed
in consultation with one's conscience, creed, or ideology. Thus, in any
analysis of so-called population problems, the element of faith, whether
directly expressed or inadvertently demonstrated, is unavoidable.
Although ostensibly secular in nature, population studies often exhibit
many of the trappings most commonly associated with religious movements.
In recent decades much of the most influential thinking on the
"population question" has acquired a certain messianic tone. It has not
been uncommon for respected authorities to evoke the image of an
apocalypse brought on by adverse population trends-and to justify
programs requiring great sacrifice or exertion by the salvation from
hideous alteratives that they alone would offer. In 1992, for example,
the UN Population Fund announced that "a sustained and concerted program
starting immediately" to curb worldwide population growth was essential,
since current trends, in the words of Nafis Sadik, UNFPD's director
general, create a "crisis [that] heightens the risk of future economic
and ecological catastrophes."
Such warnings have been issued before. Stanford University's Paul
Ehrlich began his 1968 bestseller, The Population Bomb, with a
prophecy: "The battle to feed all of humanity is over. In the 1970s the
world will undergo famines-hundreds of millions of people will starve to
death in spite of any crash programs embarked upon now." The most
optimistic of Professor Ehrlich's "scenarios," involving a radical
worldwide program of population control and resource conservation to
reduce the world's total population to 1.5 billion (less than a third of
its present level) in some future century, envisioned the death by
starvation of about a fifth of the people alive in the world in 1968. By
the same token, The Limits to Growth, the 1972 million-selling
computer modelling study sponsored by the Club of Rome, produced
simulation of future trends that suggested an impending "collapse" of
global population-proportionately and absolutely more devastating than
was the Black Death in medieval Europe-in the absence of a balancing of
world birth and death rates by 1975, cutbacks in pollution, and
substantial increases in industrial and agricultural efficiency.
Belief in such visions was not always diminished when predictions
predicated upon them were decisively disproven by events. Instead, the
demographic "true believers," in the fashion of millenarians, often
simply reformulated their prophesies so that they could not be
empirically disproven.
Rapid population growth is not the only demographic phenomenon that has
prompted observers to invoke specters of catastrophe. Dire consequences
have with equal assurance been ascribed to population slowdown or
decline. During the 1930s, noted economists such as John Maynard Keynes
and Gunnar Myrdal warned that the failure of Western populations to
reproduce themselves would contribute to unemployment, insufficiency of
investment, agricultural crisis, and low living standards-precisely the
problems that a more recent generation of population experts has
described as consequences of rapid population growth!
The tendency to invest in population theories with an almost religious
zeal-as well as to harness them to the service of political movements
buoyed by public hysteria-might be considerably reduced if there
actually were a body of knowledge demonstrably capable of explaining
population change, or of connecting this change predictively with
various determinants or consequences. Unfortunately, such an
understanding of the process of population change does not exist.
Although the postwar field of "population studies" has occasioned wide-
ranging, detailed, and often ingenious academic investigations of the
interplay between population, economy, and society, nothing like a
generalized understanding of the socioeconomic causes or effects of
population change can be found today-or even looks to be in the offing.
One is, of course, asking too much of demographers to expect them to
provide any overarching "laws of population." No one would demand of an
historian that he provide a unified "theory of history." For all the
mathematical rigor required in some of its investigations, the study of
human population is a field of social inquiry, not a natural science.
Such relationships as it may uncover at given times in diverse places
are, like all social phenomena, shaped by the factors of human values
and volition, quantities that may seldom be reduced to fixed parameters.
It is instructive to consider some of the limits of today's "population
science." Despite the sophistication of population mathematics, the rate
of growth of human populations cannot be predicted with accuracy over
any extended period of time. Population projections from the fairly
recent past highlight the problem. In the 1920s Raymond Pearl, then one
of America's leading population biologists, predicted that the United
States would reach a population of 200 million around the start of the
twenty-second century; in actuality, America passed the 200 million mark
in the 1960s. In the 1930s, France's foremost demographers agreed that
French population was certain to fall; various projections indicated a
drop of between two and twelve million people-that is, from 5 to 30
percent-between 1930 and 1980. In actuality, despite the losses it
sustained in the Second World War, France's population rose by about 30
percent over that period. More recent refinements of techniques have
added little to the precision of demographic forecasts. In 1959, for
example, the United Nations' medium variant projection put India's 1981
population at 603 million-an estimate which, twenty-two years later,
turned out to be off by about 100 million people. Long-term population
projects are not always wrong, of course, but they can be right only by
chance, for there is no scientific method for predicting either death
rates or birthrates.
There is reason, moreover, to expect population projections to become
even less accurate in the future. Advances in the fields of public
health and public administration now make it possible for governments in
low-income countries to reduce national mortality at an increasingly
rapid pace-if these governments are resolved to pursue the necessary
policies for doing so-even in the absence of more general social
improvement. At the same time, the speed with which fertility change may
occur has been increasing. In England and Wales, it took almost eighty
years in the nineteenth and early twentieth century for the birth rate
to fall by 15 points. In the People's Republic of China in the 1970s, a
reduction in the national birthrate of about 20 points was accomplished-
by whatever means-in a single decade. Even without aggressively anti-
natalist measures, a drop in birth rates of over 15 points occurred in
postwar Japan in barely ten years (1948-1958). With a growing
possibility of the rapid alteration of demographic trends, the horizon
of accuracy on population projections, far from extending, may be
drawing ever closer to the present.
One of the reasons that long and even medium-range population
projections are of such limited accuracy is that there exists no method
for predicting fertility change in contemporary societies. There is, in
fact, no method for predicting even the onset of fertility decline in
those societies where birth rates are high, and seemingly stable. The
search for social or economic determinants or preconditions for changes
in fertility has in large measure proved frustrating, for societies of
the modern world and the recorded past exhibit a breathtaking diversity
of relationships between demographic, economic, and social conditions.
Low fertility, for example, is commonly thought to be associated with
high levels of health; yet life expectancy in contemporary Kenya, where
the total number of births per woman is currently believed to hover
around 6.5, appears to be similar to that of Germany in the mid-1920s,
where the total fertility rate was only 2.3. Fertility decline in
nineteenth-century France proceeded even when levels of national
mortality were considerably higher than those prevailing in Bangladesh
today; by contrast, there is as yet no indication of secular fertility
decline in Oman, even though its birthrate is thought to be 30 percent
higher, and its life expectancy nearly thirty years greater, than that
of France in 1830. It is commonly said that fertility and income are
negatively correlated, but the limits of such generalizations are
suggested by the World Bank's latest World Development Report,
in which Tajikistan's level of per capita output and its birthrate are
both depicted as being about twice as high as the corresponding
figures for Sri Lanka. The great diversity of relationships that may be
seen between demographic and social or economic conditions makes
virtually any simple generalization about populations and development
hazardous, for there is almost always at least one example that can be
found to call the generalized relationship into question.
If there are broad difficulties with theories of population, there are
also a number of serious problems in the study of population and
development that are entirely practical. Foremost among these is the
problem of false precision. In the statistical accounts used most
frequently for the analysis of world demographic and economic
conditions, numbers and trends are often presented with a degree of
implied specificity that is entirely unwarranted by the actual margins
of error surrounding them. Not surprisingly, this has often led scholars
to erroneous or untenable conclusions.
The nature of the problem is suggested by the 1985 edition of the World
Bank's World Development Report, the most widely circulated
annual publication on development issues. In its statistical appendix,
it presents an estimate for the population of Somalia as 5.1 million-
implying a margin of error of 100,000, or about 2 percent. The same
appendix gives Somalia a birthrate of fifty per thousand for both 1965
and 1983-again implying a 2 percent margin of error. It might therefore
come as a surprise to learn that Somalia has no system whatsoever for
registering births, and as of 1985 had never conducted a national
census. Those figures for Somalia were essentially invented: guesses
dignified with decimal points.
Somalia, to be sure, is an extreme example. Still, it would be unwise to
assume the accuracy of most current demographic estimates. Near-complete
vital registration systems cover only about a tenth of the population of
the Third World-and in general tend to be least comprehensive in
precisely those nations where the connection between population and
development is of the greatest humanitarian concern. Indicative of the
uncertainties attendant on measuring world population is the lag time
between the estimated peaking of world population growth and the
announcement of that event by demographers. It is now widely believed
that the world rate of natural increase reached its maximum between 1960
and 1965, and has declined since then. Demographers, however, did not
begin to suggest with any confidence that the world rate of population
growth might have peaked until 1977-more than ten years after the
presumed date of that event.
If demographic trends are beset with uncertainties, estimating economic
output must be an even more tentative undertaking, involving as it does
not only the measurement of populations, but also of their per capita
production and consumption of goods and services-not to mention the
valuation of these latter. For less-developed countries the problems of
estimating levels of economic output and their rates of change can be
arresting. To cite but one of many possible examples, a team lead by
Irving Kravis of the University of Pennsylvania concluded that India's
nominal gross domestic product per capita for 1970 would have been
tripled if it had been measured not in terms of dollars at the
prevailing rupee-dollar exchange rate, but rather in terms of the
standard international costs of the goods and services that the
"average" Indian produced. Kravis' estimates of purchasing power,
however, did not apply to all poor countries equally. Measured by the
regular exchange-rate method, 1970 per capita GDP in Kenya appeared to
be 44 percent higher than in India, but after adjusting for differences
in actual purchasing power, the Kravis team concluded that the Kenyan
per capita GDP was almost 9 percent lower than India's. The
effect of such adjustments on any presumed correlation between
demographic and economic levels in the two countries, clearly, would be
profound.
Population change itself further compounds the difficulty of measuring a
society's economic welfare. Because children tend to consume less-often
substantially less-than adults, standards of living at any given level
of national income can be significantly affected by the age composition
of a population. A rapidly growing population in which average age is
comparatively low will appear to have a lower per capita level of
consumption than a stationary population with a higher average age, even
if at every single age people in both populations consume exactly the
same amount. And changes in mortality can introduce even greater biases.
Innovations in public health during the course of this century have
typically had a disproportionate impact on the mortality of children and
on diseases associated with poverty. If poorer parents tend to have more
children than richer parents, as is the case in many (but not all) low-
income societies today, improvements in health could appear to be
lowering per capita income and contributing to greater income
inequalities in society as a whole, even though the families affected by
these life-saving changes could regard themselves as indisputably better
off.
Dan Usher, an economist at Queen's University in Canada, has attempted
to impute an economic value to improvements in life expectancy in
several developed and less-developed countries. Though his results are
sensitive to his assumptions about interest rates and the self-perceived
value of additional consumption, they are nonetheless interesting. By
Usher's computations, adjustments to account for the value of lengthened
lifespans to those whose lives were extended would have raised the
nominal annual economic growth rate for Chile for the years 1931-1971 by
over half, and would have more than doubled Sri Lanka's for 1946-1968.
These may be extreme cases: health improvements in both societies were
rapid during those years, and measured rates of economic growth were
comparatively slow. Nevertheless, Usher's computations may suggest the
sorts of factors that are ignored in conventional discussions of the
impact of population growth on society and economy-and of the effect
that ignoring such factors may have on the evaluation of the
consequences of population change.
III
In the less-developed countries of Asia, Africa, and Latin America,
governmental concern with population trends today focuses chiefly on the
issue of rapid population growth. The problem is that "overpopulation,"
a term so familiar and used so frequently as to suggest that it has a
fixed and understood meaning, cannot in fact be defined unambiguously.
Which is to say, there is no workable demographic definition of the idea
of overpopulation.
Consider some of the possible demographic criteria by which to judge
that a society is "overpopulated." Is it that the rate of natural
increase-the birthrate minus the death rate-is "unusually" high? If so,
the United States in the first decade of its independence was almost
certainly overpopulated: between 1790 and 1800 its rate of natural
increase was 3 percent per year-a rate significantly higher than that
ascribed to Bangladesh today, and roughly half again as high as the
rates currently estimated for Haiti or India. What about birthrate
itself? Again: the U.S. birthrate in the 1790s was about 55 per
thousand-a rate higher than any of the 127 national birthrate
"estimates" the World Bank gives in its World Development Report
1993, and at least 25 points higher than the latest World Bank
estimates for India, Indonesia, or the Philippines. Perhaps, then,
overpopulation should be judged by a country's population density, i.e.,
its ratio of people to land area. In that case, taking United Nations'
figures for 1991, France would have been more overpopulated than the
Indonesian archipelago, Japan would have been far more overpopulated
than India, and Singapore (where government policy is now striving to
raise the birthrate) would have been vastly more overpopulated than
Bangladesh. But by far the most overpopulated state on earth would have
been the Kingdom of Monaco! On the other hand, if the criterion were
what is called the "dependence ratio"-the proportion of children under
fifteen and adults over sixty-five in relation to the population of
"working age" (conventionally designated as fifteen to sixty-five)-then,
according to UN figures, as of 1960 Ireland and Nepal were approximately
equally overpopulated, in 1980 Israel was more overpopulated than Sri
Lanka, and the least overpopulated societies in the world as of 1990
were Singapore and Hong Kong! If emigration were to be taken as the
measure of overpopulation, then Mozambique, Angola, and the other
"front-line" states adjacent to the Republic of South Africa would be
overpopulated, while South Africa, which is said to employ more than one
million migrants from neighboring nations, would presumably be
underpopulated. By the same token, the former East Germany, whose loss
of citizens to West Germany proceeded with alacrity until the
construction of the Berlin Wall, would have been an overpopulated
country, its government's constant complaints about labor shortages
notwithstanding. Finally, if overpopulation is indicated by unemployment
(not strictly speaking a demographic measure, but one that is sometimes
used as such), it would seem that the United States experienced serious
overpopulation during the Depression (when fertility fell below
replacement levels), and was least overpopulated in the mid-1960s (the
years directly following the postwar baby boom).
"Overpopulation" does indeed point to a problem, but it is a problem
mislabelled and misidentified. In a more careful discussion, the
phenomena most frequently cited as proof of overpopulation would be
deemed characteristics of poverty. Inadequate incomes, poor
health, malnutrition, overcrowding, unemployment-it is images such as
these that are conjured up by the notion of "overpopulation," but they
are unambiguously images of poverty and material deprivation.
Poverty and material deprivation, in all their various manifestations,
cause great suffering, and in some cases government can do much to
alleviate them-and even more, to provide an atmosphere conducive to
broad social and material advance. But to mistake the great range of
social and economic problems experienced by human populations for
problems driven or created by demographic forces is a profound error.
Rapid population growth is a pervasive fact of life in less-developed
countries today-a form of social change so typical, and at the same time
so profound, that it may spuriously be associated with almost any other
social phenomenon of the present generation. Many of the problems
typically ascribed to "population pressures," however, turn out on
closer examination to be caused by factors quite independent of
demographic trends. And in the case of other such problems, the impact
of demographic change is, at best, secondary. Attempting to redress such
problems all too often simply compounds the difficulties of certain
groups, and even of entire populations, in their efforts to maintain or
improve their standards of living in the face of a hostile political or
economic environment.
IV
Yet, as noted, activist population programs have been embraced by
governments presiding over something like four-fifths of the people of
the Third World. Western governments and Western-funded multilateral
organizations are currently spending over $1 billion a year on
population programs in Third World countries. In some of these
countries, such as Bangladesh, the budget for family planning by the
1980s was larger than the budget for all other health-related services
combined. Thus it seems appropriate to ask, what do family planning
programs, and national population policies, actually do? What is their
demographic impact, and how do they affect living standards and future
development prospects?
Voluntary family planning programs typically subsidize, advertize, or
otherwise promote the use of modern contraceptive technologies by
sexually active couples (usually but not always partners in marriage).
Modern contraceptives are not necessarily more effective than
traditional means of birth control; on grounds of effectiveness alone,
nothing can improve upon total abstinence or infanticide. Modern
contraception is, however, a much more pleasant alternative, and, used
properly, can be more effective than the traditional methods of birth
control (such as coitus interruptus, the rhythm method, or the local
contraceptive potion). A cheap and readily available supply of simple
modern contraceptives can allow parents who wish to make use of them to
improve their own level of comfort, and may also (by facilitating the
spacing of births) improve family health chances-even if their adoption
has no ultimate effect on the size of the family. Such services would be
seen as raising living standards today (albeit in ways whose benefits
are not easily computed), and might even improve prospects for material
progress by augmenting society's stock of "human capital."
Government-sponsored voluntary family planning programs could under
these circumstances best be justified as a public health service-one of
the many activities a government may promote to reduce mortality,
augment human capital, and improve the well-being of individuals and
families. Unfortunately, many contemporary advocates of family planning
programs for the Third World-be they decision-makers in local capitals
or enthusiasts from Western countries-have been looking for much more
than this. Typically, they see voluntary family planning as a technique
for accelerating enforced reductions in fertility for societies where
family size is large.
Their hopes are misplaced. As long as family planning is voluntary, it
will remain a tool with which parents can attain the family size, or
spacing, they desire. No research has so far suggested that the advent
of modern contraceptives intrinsically alters parents' view of children,
or ideals about the family. For this reason, similar patterns of
contraceptive use may be associated with very different levels of
parental fertility.
By World Bank estimates, 56 percent of the married women of reproductive
age in Japan in 1989 used modern methods of contraception (pill, IUD,
diaphragm, sterilization, etc.). Japan's total fertility rate for 1991
is put at 1.5 births per woman. In Turkey, where the rate of use is put
at 63 percent, the total fertility rate is said to be 3.4 births per
woman-over twice the level in Japan. That gap speaks not to the
ineffectiveness of Turkish contraceptives, but to the decisive
importance of the attitudes and intentions of the people who use them.
New inexpensive contraceptive technologies will, in many places, result
in a decline in "unwanted" fertility by making birth control less
prohibitively difficult. But it is unclear how large such a decline
would be, and there is no reason to expect that it must always be
substantial. The impact of reducing unwanted pregnancies, moreover,
would not be as great on population increase as on fertility, since the
mortality rate for "unwanted" births would be higher than average. And
unless the very availability of modern contraceptives by itself
stimulates a revolution in attitudes toward family size-as over a
quarter of a century of family planning efforts have failed to do in
Nepal, and three decades of programs have not done in rural Pakistan-the
demographic impact of family planning would be a discrete and self-
extinguishing adjustment, as the previously "unmet demand" of motivated
users is progressively satisfied.
In many parts of the globe, an effective family planning program might
actually increase the birthrate and the rate of population
growth. In much of sub-Saharan Africa, for example, there is little
demonstrated interest in modern contraception, but considerable concern
about infertility. In those societies, the fate of a barren
woman is unenviable. Helping parents attain their desired numbers of
children might in such circumstances result in heightened fertility. The
example of postwar Kenya, where the total fertility rate apparently rose
from about six to nearly eight during a generation of substantial
improvements in health, and despite nearly twenty years of family
planning efforts, should make it clear that increasing parents' freedom
to choose will serve the purposes of parents, whether or not these are
in accordance with the preference or ideology of the government and its
advisers.
The underlying thrust of most family planning efforts in less-developed
countries over the past generation has been unmistakably anti-natalist.
The anti-natalist sentiment behind support for family planning
initiatives is explicitly expressed by the principal international
institutions funding these initiatives, including the World Bank and the
U.S. Agency for International Development. This sentiment has affected
not only the allocation of public funds, but also the evaluations of
performance.
In a number of less-developed countries, the commitment of public funds
to family planning efforts is striking. In 1980, the World Bank
estimates, government expenditure per current contraceptive user was $68
in Ghana and $69 in Nepal. These figures compare with World Bank numbers
suggesting that the total governmental expenditure on all
health programs worked out to be about $20 per family in Ghana, and $8
in Nepal, in the same year. In such societies, where general levels of
mortality are high and health problems are pressing, it would appear
that family planning programs are not subject to the same strict
criteria in competing for scarce funds that other health programs must
meet. The exemption of family planning from the ordinary constraints of
budgetary finance may be due to belief that family planning provides
additional "services"-such as lowering the birthrate.
The unscientific faith that proponents of family planning have placed in
the ability of their programs to "work" is suggested by the lack of
careful investigation into the actual effects of family planning
projects in trial areas. Although billions of dollars are being expended
annually on family planning services in less-developed countries, and
such programs have been promoted by various governments at the national
level for four decades, there are only a few studies that have attempted
to measure the demographic and health impact of family planning against
a "control group"-a similar area which lacks the service. This lacuna is
all the more striking in that "control studies" are standard practice in
the health sciences.
Some proponents of family planning programs have argued that there is an
enormous "unmet need" (as distinct from "unmet demand") for family
planning services in less-developed countries. By their estimates,
meeting this need would require substantially greater funding for these
services in the less-developed countries than they currently receive.
The advocates may be right, but no thanks to the strength of their
analysis. Their method of computing "unmet need" is, typically, to
measure by sample questionnaire the fraction of married women in various
societies who say they are not using modern means of contraception and
also say that they want no more children, or that they wish to delay the
birth of their next child. It is by no means clear that this method
measures either the unmet demand for modern contraceptives, or the
fraction of the female population exposed to unwanted pregnancy. Women
not using modern contraceptives may be practicing traditional (albeit
less pleasant or less effective) means of birth control.
Western fertility questionnaires, moreover, have a mixed record in
eliciting accurate responses from poor people in less-developed
societies. It is sometimes the case that illiterate villagers, whether
in deference or out of politeness, attempt to please the interrogator
with their answers. At other times questions are pursued in a way that
can be of only limited relevance in the society in question. Most
fertility questionnaires, for example, are devoted entirely and
exclusively to the responses of women, even in areas where the tradition
of male dominance invests much of the power of decision with husbands,
or even fathers-in-law. Still other parts of such questionnaires may
probe into areas of interest and salience to the interviewer but be of
limited intuitive meaning to the respondent. In the World Fertility
Survey, for example, over a third of the fecund women who indicated that
they wanted no more children also said that they would like to have a
larger number than they presently had. Given such problems, the results
produced by fixed-form, rapidly conducted questionnaires are notoriously
unstable. A major survey in Indonesia, to cite another example, found
that fewer than half the women interviewed gave the same figure for
"ideal family size" when they were re-questioned four months later.
In places like Taiwan, Korea, and Hong Kong, family planning programs
have been widely credited with bringing birthrates down. But fertility
decline was underway in these areas before their family planning
programs had been established. In India, by contrast, national fertility
declines did not become unmistakable until decades after the adoption of
the national planning program-giving the advocates of the program the
opportunity to ascribe all change in fertility to governmental
birth control efforts. In still other countries, like Mexico and
Thailand, the establishment of family planning programs coincided with
the onset of rapid fertility decline. It is not clear whether the
alleged success of these programs was due to government commitment to
push for contraception, or from a change in national attitudes toward
family size and spacing (which may have prompted the establishment of
the programs in the first place).
In any case, in a growing number of countries, the governments do not
seem satisfied with the family choices parents have been making. The
chosen governmental instruments for altering fertility have ranged from
campaigns of information, propaganda, and exhortation, to the exercise
of incentives and penalties to promote desired patterns of fertility, to
the use of legal sanctions against parenting, to the refinement and
application of techniques of force against would-be mothers and fathers.
Such inducements may or may not, under the given circumstances, be
successful in changing national fertility patterns, or in bringing birth
trends more nearly into consonance with the numerical goals targeted by
government planners. But to the extent that they are effective in
enforcing involuntary adjustments in the behavior of parents, they may
be seen to reduce-not raise-current standards of living, and to
compromise, rather than advance, future prospects for development.
V
What, in the final analysis, can be said with confidence about the
consequences of demographic change on the prospects for social and
economic development in the less-developed regions? Among policy makers,
ideology has often been substituted for judgment, and emotion has
overpowered caution, in the assessment of changes in population, with
all that these changes seem to imply about the fate of national, ethnic,
or local populations. It may therefore be appropriate to conclude with a
few cautious observations.
First, the obvious: population change is a form of social change. Though
the implications of population change are profound-no less so because it
involves the generation and termination of human life-it is a form of
change that seems slow by comparison with many others. A rate of
population increase of 4 percent is considered extremely rapid; a rate
of price inflation of 4 percent a year is, in most developing countries
today, considered to be fortuitously slow. Moreover, for all the
uncertainties of long-term population forecasting, the likely change in
size and composition of a national population can be predicted over the
course of the coming calendar year with far greater certainty than can
changes in the harvest, the gross national product, the unemployment
rate, the foreign exchange rate, or the demand for any particular
product. Population change, like other forms of social change,
emphasizes the ability of individuals, communities, and governments to
manage and to cope. For populations that cope poorly with change, any
quickening in the pace of change-including the pace of demographic
change-is likely to prove difficult and perhaps even costly to society
as a whole. Yet coping with change-or as Nobel Laureate in Economics
Theodore W. Schultz put it, "dealing with disequilibria"-is in itself an
integral part of the process of modern economic development. It is a
learning process that generates real economic returns. To the extent
that population change may prompt this learning process, it can even
contribute to the acceleration of material development in a given
society.
Second, insofar as demographic change may assume a variety of
manifestations, its form in the modern era has typically been both
comparatively benign and relatively advantageous for the purposes of
economic growth. Worldwide population growth has been propelled
principally by falling death rates, which is to say, by rising
expectation of life at birth. Rising life expectancy is itself an
indication of improved general levels of health, and is suggestive of
other changes in living conditions supportive of general improvements in
health. Improvements in health, moreover, may figure importantly in
augmenting the human capital upon which the potential productivity of
different populations ultimately rests. Augmenting human capital does
not assure the acceleration of material advance-that will depend on many
other things, including the environment of governmental policies in
which human talents are set to work. But improved health, and its
handmaidens, may well make it possible for the pace of material advance,
under auspicious circumstances, to be quickened.
Third, much of the current discourse on the population "problem" seems
implicitly to assume that the elimination of poverty may be served by
preventing the birth of poor people. This appears to be a fundamental
error-an elementary fallacy of composition. Mass affluence is typically
associated with great transformations of society, economy, and
individual outlook. The role of the family, the status of women, and the
patterns of fertility typically change in the course of this
transformation. But the extent to which reductions in fertility
themselves stimulate improvements in human productivity is far
less clear, either for given families or whole societies.
Fourth, while the economic consequences of overall rates of population
growth are often ambiguous or obscure, the impact of smaller groups
within larger populations on the economic well-being of the whole
society, or the impact of differential rates of growth within a national
population on prospects for material advance, may be direct and
important. The contribution of religious or ethnic minorities to
innovation or economic advance, as Lord Peter Bauer of the London School
of Economics has emphasized, has often been vastly greater than would be
expected by their numbers on society. By the same token, conflict
between rival groups within a society may be intensified by differences
in their net reproduction rates; such differences may have implications
for the tenor of civil life or the composition and character of the
national directorate, factors that may play a decisive role in
determining the climate for development.
Finally, the likelihood of accruing unambiguously positive benefits from
an active population policy devoted to shaping the demographic
composition of society seems extremely low. This is not only because it
has as yet proved impossible to define consistently the notion of the
"optimum" population upon which activist efforts to shape the
demographic composition of society seem in theory to rest. In its
applications to date, population policy in the less-developed countries
has often attempted to alter through demography social problems whose
causes can be traced to ill-advised or injurious governmental policies.
It is a peculiar theory of the "second best" that would suggest that the
fertility decisions of a nation's parents must be altered because the
distorting and inefficient policies promoted by its government are
immutable. Yet thinking very similar to this seems to have governed the
formulation of some of the population policies put into effect in the
years since World War II.
In principle, this problem could easily be corrected. But even if it
were, difficulties would remain with the notion of an active "population
policy." Interventions in education, health, housing, regional planning,
and other areas may have demographic consequences, but they are
justified on other grounds. On what grounds would a policy whose primary
aim is to induce demographic change be justified? The acceleration of
economic growth is one possibility (although, if current patterns of
fertility reveal the preferences of households within the society about
current and deferred consumption, it is not immediately apparent why
such preferences should be ignored or overridden).
Consider what an active policy to shape population in the service of
accelerated economic growth would require. One possible justification
would be "market failure": the possibility that, through distortions and
externalities in the price structure of the economy, parents are
encouraged to rear the "wrong" number of children. There are good
reasons for overcoming market failures-entirely apart from whatever
effect such reforms may have on childbearing. Attacking distortions and
externalities directly, furthermore, would seem preferable to
compounding these distortions through "compensating" economic penalties
or rewards for additional births. And it would be necessary to ask, in a
systematic fashion, whether there would be any reason to assume that in
the absence of distortions and market imperfections, parents would not
be able to "price" the birth of their child correctly.
To make the economic case for an active population policy, population
planners would ultimately need to center their arguments on estimates of
the economic value of human life. They would have to show, in effect,
what would be the "present value" of a child born today, and also to
show how that present value would be changed by altering the size of the
baby's cohort of peers, or the cohorts following. If attempted
seriously, this would prove to be an extraordinarily difficult task.
Assessing the present value of any given, innate, physical investment
over the course of its projected "life" is at best a tentative and
highly uncertain undertaking. Albert Hirschmann, the eminent economist
at the Institute of Advanced Studies, has noted that many of the factors
that affect the actual productivity of an investment project once it is
in operation are not foreseen in even the most detailed exercises in
planning. If estimating the present value of innate objects is
difficult, how much more uncertain it must be to ascribe such a value to
an entity imbued with life!
Long-term economic forecasts are notoriously inaccurate. Japan, Taiwan,
and Korea are among the nations that defied all expectations of informed
foreign observers in the postwar period; by the same token, Burma and
Ghana, two of the countries most frequently cited as likely economic
successes after independence, did an equally creditable job of
disappointing the experts. It is hard to imagine how a population
planner would have arrived at an accurate assessment of the present
value of a birth in Korea in 1955, much less make confident assertions
about the ways in which the present value of that birth would be changed
through alterations in the contemporary Korean birthrate. Population
planning for "development," it seems, is easiest to envision under the
assumptions of total technological stasis, absence of social change, and
rigid restriction of social choices and alternatives. Yet such
assumptions, in themselves, contradict the method of economic
development and defeat its purpose, which is, in essence, the extension
of human choice.
Nicholas Eberstadt is a Visiting Scholar at the American Enterprise
Institute in Washington, D.C. and Visiting Fellow at the Harvard Center
for Population and Development Studies. An earlier version of this essay
was presented last October at a conference on World Population Issues
sponsored by the Ethics and Public Policy Center in Washington, D.C.
This article provided by First Things Journal.
Be a TLC Lifeguard
Before You Leave...
We hope you enjoy our web site and find it useful as a resource center.
Please take a moment to rate our site.
Will you help?
Will you help us continue to make this resource
available to thousands of monthly visitors from around the world?
Yes
Texans for Life Coalition
P.O. Box 177727
Irving, TX 75017-7727
(972) 790-9044
webservant@texlife.org
|