Fertility rates have dropped steadily and life expectancy increased over the past 20 years, with few exceptions, according to Lancet Medical Journal.
In their new study, Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, they said that much of this change followed historical patterns linking social and economic determinants. The study was done for from 1950 to 2019.
The GBD study said that several countries experienced a combination of low fertility and stagnating improvement in mortality rates that pushed more population into the late stages of the demographic transition.
South Asia has seen the most annual live births since 1969. The region accounted for around a quarter of global live births (24.7 per cent in 2019). The share of live births from sub-Saharan Africa increased from 23.7% in 1990 to 27.1 per cent in 2019, the Lancet said in the study.
East Asia has seen a sharp decline since 1950 when it accounted for 24.6 million live births or more than a quarter of all live births globally. Since then East Asia saw 22.1 per cent of global live births in 1970, 16.2 per cent in 1990 and 11.4 per cent in 2019.
Total Fertility Rate
The study said that 179 of 204 countries and territories saw a decrease in Total fertility Rate between 2010 and 2019. Saudi Arabia, Yemen, Puerto Rico, Kuwait and Palestine showed the fastest annualised decline at a rate of at least 3.6 per cent per year. India, Pakistan, and Zambia, Bangladesh is among the 57 countries that recorded more than two per cent annual decline in TFR.
The GBD study said that half of all countries (102 of 204) had reached below replacement-level TFR by 2019. It said that 43 countries reached an ultra-low TFR of 1.5 or lower.
With respect to China, the study said that the country experienced sustained decline in TFR since 1950. But after 2010, the TFR started to increase, especially for females in the older maternal ages, who already had one child. The TFR in 2016 was 1.65 and since then there was decrease of 13 per cent over a period of just three years, the study noted.
The Lancet said that number of deaths globally steadily increased in the past seven decades. It reported that Global deaths increased from 43.6 million in 1950 to 50.7 million in 2000 and to 56.5 million in 2019.
With respect to under five deaths, the study said it saw a decrease from 19.9 million in 1950 to 16.3 million in 1970, 9.6 million in 2000, and five million in 2019. North Africa Middle East, Latin America, Caribbean; Central and Eastern Europe and Central Asia contributed relatively little to the global decline in child deaths. The decline was driven by Southeast Asia, South Asia, East Asia, and Oceania.
The report pointed out that sub-Saharan Africa saw much more the decline in deaths to a level similar to south Asia since 2001.
The report said that life expectancy at birth increased from 51.1 years in 1950 to 65.4 years in 1990, 67.2 years in 2000 and 73.5 years. It said that difference in life expectancy at birth between females and males increased from 4.5 years in 1950 to 5.4 years in 2012 and then decreased to 5.1 years in 2019.
It said that Southeast Asia, South Asia, East Asia, North Africa, Middle East, Oceania, Latin America and Caribbean exhibited some convergence toward life expectancy. However, it added that inequalities still persist. Meanwhile, Life expectancy in Sub-Saharan Africa declines in 1980s, 1990s, and early 2000s. Central and Eastern Europe and Central Asia experienced much lower life expectancy in the 1950s and 1960s. All these regions showed improvement after 2000.
The study also notes that increase in mortality, especially among adult age groups, was observed in countries severely affected by HIV/AIDS epidemic in the 1990s and early 2000s. In recent years, the study noted that similar mortality increases among young adult age groups was witnessed in USA, UK, Sweden, Iceland, Norway, Malta, New Zealand, Israel, Greece, and Argentina, Brunei and Belgium,
Healthy Life Expectancy (HALE)
Global Health Life Expectancy increased from 56.9 years in 1990 to 58.6 years in 2000, 61.3 years in 2010 and 63.5 years in 2019. The report points that HALE increased in 202 of 204 countries between 2000 and 2019. It also said that Health Life Expectancy in every region increased between 1990 and 2019. The largest increase was seen in eastern sub-Saharan Africa.
The GBD study said that there was strong correlation between Socio Demographic Index (SDI) and HALE at birth and at age 65 years. The correlation coefficient between HALE at birth and SDI is 0.85 based on data for years 1990, 2010, and 2019, the report said. The correlation coefficient is 0.70 for age 65 years. Lesotho, Zimbabwe, Uzbekistan and eSwatini are the countries that experienced declines in HALE at birth. Ethiopia, Rwanda, Eritrea, and Uganda are among the 21 countries were HALE at birth increased by more than 10 years between 1990 and 2019.
The GBD study said that population increased from 2.5 billion in 1950 to 5.3 billion in 1990, 6.2 billion 2000 and 7.7 billion in 2019. The report notes that sub-Saharan Africa accounted for 8.8 per cent of the total increase in population in 1951. It increased to 10 per cent in 1970 and rose to 16 per cent in 1990 and to 35.9 per cent in 2019.
The study finds that Southeast Asia, East Asia and Oceania region showed a decline from 37.3 per cent in 1951 to just less than 11.7 per cent in 2019. In South Asia, the population saw a growth between 1953 and 1980 and then stabilised in the 1980s before continuing to increase in the 1990s. It started to decline since 2005.
The Lancet study maintains that 174 of the 204 countries had a decline in the under-15 age group population declined between 1950 and 2019. United Arab Emirates, South Korea, Qatar, Taiwan, Puerto Rico, Bahrain, Andorra, Thailand, Singapore, Northern Mariana Islands, North Korea Saudi Arabia and Bosnia and Herzegovina showed declines of more than 25 percentage points. The report stated that several countries in the high income super-region as well as countries in Europe showed substantial increase in population aged 65 Many countries in the high-income super-region as well as countries in other regions in Europe have had substantial increases in the proportion of population aged 65 years and older over the past seven decades, often by more than ten percentage points. It gives the example of Japan where proportion of people aged 65 years and older increased by more than 480 per cent from 4.9 per cent in 1950 to 28.4 per cent in 2019.
Sub-Saharan Africa with Afghanistan being the only exception had an increase in proportion of the population younger than 15 years between 1950 and 2019.