Do Falling Birthrates Pose a Threat to Welfare?

World population will reach ten billion by the year 2050. India will have emerged as the most populous nation on earth. Population growth is the most important development issue of this decade and high population growth is considered one of the major obstacles to economic growth in developing countries. Debate about population growth and development over the past thirty years has led to increasingly sophisticated research. Population growth has been the topic of address and papers by many distinguished demographers, among them Demeny’s presidential address to the Population Association of America in 1986. Research on the relationship between population change and economic development provides very divergent viewpoints, which may be classified into two categories. The first category suggests that population growth impedes economic development. Population growth causes hunger in the short run and poses a threat to the survival of the human race in the long run. The other category suggests that population growth contributes to economic development in the long run. People are seen as innovators. A large number of people are more likely to generate contributions toward the production of social and physical technologies that are likely to improve human welfare.

There are also few countries in Africa such as Gabon that experiences low fertility rates indicative of a quite different population problem. In Gabon and in parts of Cameroon, Zaire, and Zambia, very low fertility rates have wiped out several ethnic groups. The reasons for low fertility are not well known but i0t is speculated that sterility caused by venereal and other diseases is one of the main factors. Gabon’s health and fertility problems are compounded by a pronatalist policy that prohibits the importation of contraceptives.  A change in this policy would also assist in the control of disease. Population growth increases income inequality and the likelihood of starvation for some. A second concern, related to population growth, is the depletion of natural resources and the effect this has on economic development.  Although there is disagreement about which are the mo0st important causes of natural resource depletion and scarcity, there is general agreement that population growth is a major cause. Finally, it is argued that the population growth has a weak negative effect on savings, therefore constraining capital-intensive investment in development projects.

The paper moves on from theoretical constructions, using examples from current debates about disability and social inequalities to show how competing discourses and ideologies are played out in practice. The discussion draws on two substantive areas of concern, identified as priorities within the international governance of birth choices, and the combination of increased technological knowledge and declining birth rates in modern societies has been taken by many to suggest that reflexive choices are now a more significant factor in deciding to have a child than, say, economic necessity, social pressure, or chance. From a sociological perspective, it is tempting to view these developments as a function of reflexive modernization. However, the distinction between personal and public remains contested since economic imperatives, cultural values, and the power of the medical profession continue to be significant factors in shaping individual reproductive decision making. Determining which human characteristics are socially desirable or undesirable, and where we “draw the line” between them, is central to decision making about who should or should not be born. In this context, impairment characteristics are generally seen as undesirable and practices such as genetic counseling, prenatal screening, and selective abortion are widely offered as a means to reduce the number of disabled children born.

This in turn reinforces the low social and economic value attributed to the lives of those who do survive. Birth choices are embedded within cultural discourses of personhood and citizenship that devalue disabled lives, and there is increasing pressure on mothers to produce “normal babies.” Consequently, there has been considerable concern about the bioethical implications of birth choices arising from genetic research and the Human Genome Project. Access to new genetic information raises particular concerns for minority genetic groups, including groups of disabled people, about confidentiality and the potential for new forms of “genetic discrimination.” “More broadly, there is concern that new genetic knowledge will impact not simply on individuals but on identifiable social and ethnic groups, whose genetic capital is viewed as undesirable or at the very least devalued” (Abdulla, 2007). If the new genetics does pose a threat to global human diversity then it is important to ask which characteristics are most likely to be targeted in eugenic birth decisions. Medical ethicists have consistently sought to justify selection based on other characteristics such as sex.

At the heart of these debates is an argument about whether it is right, or even acceptable, for a person to begin life with impairment when such a life could be prevented. Thus, to confront birth choices at the beginning of the life course is also to confront birth choices is also to confront the criteria we use to value different lives in society. Disabled people’s lives have been widely devalued on many levels – as biologically inferior, as psychologically damaged, as culturally “other,” and as presenting an economic “burden” to welfare capitalism. Consequently, it is perhaps unsurprising that contemporary birth choices continue to be framed within a pervasive view of disabled lives as “wonderful lives.” Yet those who argue that we should prevent the birth of children with impairments wherever possible – and many do – are making a significant assumption about the relationship between impairment and disability (Abdulla, 2007). The assumption is that people born with certain biological characteristics, defined by medicine as impairments, will inevitably lead disadvantaged social lives. Social models of disability challenge this reasoning, suggesting that social inequalities result primarily from social rather than biological causes. To recap on earlier arguments, it is not biological difference that causes “disability” but our inability to accommodate human difference in society. Consequently, it is not biological differences that should be removed from the world but disabling barriers; it is not disabled lives that are “wrongful” but disabling societies. Similar tensions are apparent in debates over end-of-life decisions for disabled people. There is a clear disparity between disabled people’s life chances and those of nondisabled people, and eugenic arguments about the relative value of disabled and nondisabled lives also frame social interventions to prevent or hasten death.

The construction of death and dying in contemporary societies reveals a cultural attachment to longevity and notions of the “good” or “timely” death. Yet, in this context, the deaths of disabled people are often viewed as less tragic or more “merciful” than those of nondisabled people – reflecting the low social and economic value attributed to disabled lives as human capital. It is true that life expectancy for different population groups may be biologically determined, but it is also culturally constructed and socially produced. There is considerable evidence that people with certain impairments are more likely to die at a younger age than the average within populations, and this may sometimes be attributed to the biological impact of impairment on the body’s capacity for survival chances of disabled people throughout the world. Clearly, these are issues of social inequality rather than biological differences. Turning to, more active interventions, the most graphic example of the wholesale killing of disabled people occurred in Nazi-occupied territories before and during World War II. Although the remembrance of those who died during this period has emphasized the particular catastrophic experience of Europeans Jews, it is less often acknowledged that the genocide programs began with the killing of disabled people. This apparent oversight reflects both an absence of reliable data and a failure to recognize people with different impairments as part of a common disability group. However, there is also a danger of collusion with the underlying eugenic assumption that the killing of disabled people might be regarded as somehow less outrageous, in its historical and medical context. As with the state-sponsored murder of Jews and others, the legitimacy of killing disabled people relied upon their dehumanization and on propaganda that characterized them as lacking the potential to live a worthwhile life.  On the other side, it is easily possible to illustrate the fact that both pro- and antinatalist population policies can violate human rights. European history is replete with examples of moral and ideological justifications which have been advanced to subordinate individual control over fertility, by available means, to the population aims and needs of the state.

The manner of implementation of policies is the critical factor; in this respect, family planning can be viewed both as an aim and as a tool. It is important to note that whereas the term ‘planned parenthood’ is preferred to ‘family planning’ for the title of this research, it was nevertheless felt that the former was still unsatisfactory, for it failed to convey the notion of responsible parenthood extending over a period of time. It was agreed that ‘conscious parenthood’ comes closer to what the working group understands by Planned Parenthood. The original feminist movement for birth control was founded upon the quest for better maternal and child health, and basic sexual freedom, through access to and unfettered use of existing methods of fertility regulation. The preceding discussion of eugenics, bioethics, and diversity illustrated how social inequalities for disabled people have become life-and-death issues for modern societies. It is not possible, or necessary, in this paper to provide a comprehensive review of the full range of contemporary issues in disability and social inequalities. However, it is useful to broaden the illustration of themes by considering some further substantive areas of inequality.  With reference to the opening discussion on models and theories, it is important to understand that the devaluing of disabled lives may be explained both in cultural and structural terms. The following section uses the examples of education and employment to examine social inequalities in terms of investments in disabled and nondisabled lives. Education has been a prominent area of concern in disability equality debates at the international level.

This is perhaps unsurprising. As global markets and technologies develop in new ways, access to education and lifelong learning become ever more important to social inclusion and economic survival. Yet, many disabled people have been denied opportunities to acquire the knowledge and skills required in a changing world. Many millions have been excluded from formal education altogether, and where access has been granted, the legacy of “special” education steers them to institutions and educational programs that separate those with accredited impairments from their nondisabled peers. The share of deaths induced by infectious diseases, which are traditionally related to living standards, is also high for a country at Russia’s level of development, and the incidence of tuberculosis and other “poverty-related illnesses” remains high, although viral hepatitis infection rates have fallen. This is not to suggest that there has been no improvement in recent years: while life expectancy overall has not yet risen much from the lows of the 1990s, there has been a significant rise in the average life expectancy of persons diagnosed with chronic illness over the last five years. This suggests that the economic provision. Nevertheless, the overall picture remains extremely grim. Poor health and high levels of preventable, premature death inflict enormous human and economic costs on Russia. They also pose a threat to economic development, particularly when viewed alongside very low birth rates.  Russia’s population has been declining for some years, and the working-age population will begin to decline from about 2007. The more immediate economic costs of ill health arise as a result of productivity losses, reductions in household income and early exit from the labor force. Moreover, the impact of the health crisis is socially regressive: both the likelihood of chronic illness and the probability that illness leads to early retirement are negatively correlated with income.

The most serious problems that cause falling birthrates is the infant mortality in the world are poverty and teen pregnancies, accounting for half of all births. ‘“People can’t believe those stats when I tell them,’ Northwest Louisiana Coalition for the Health of Women and Children director and registered nurse Linda Brooks told the Shreveport Times.” One factor that contributes to the high IMR is race in Mississippi. “Among the highest socioeconomic groups, the infant mortality rate for African-Americans was more than twice that of the white population, but this gap narrows significantly when comparing the poorest white and African-American mothers”. Black women who are well-educated and rich are more likely to have problem pregnancies than white women. Another reason that causes the high IMR is the issue of low birth-weight. Low birth-weight could be showed the status of health of the community.

The causes of low birth-weight are various, but it is obvious that low birth-weight babies are not from healthy community. Moreover, many teens that are pregnant are not enrolled in high school and even are unemployed in Louisiana. In addition, “approximately 350,000 or 32 percent of Louisiana’s children under the age of 18 lived with parents who lacked full-time work”. So, they can’t afford their babies. Additionally, other factor which could be responsible for the high IMR in Louisiana is maternal smoking. “Poor women are more likely to smoke while pregnant and this helps explain some, but not all, of their greater risk of having a stillborn infant, new research shows.” Smoking during pregnancy restricts growing infant’s access to oxygen, which can lead adverse pregnancy. It could be one of the causes that increase the risk of respiratory infection and inhibit allergic immune responses in infants and birth outcomes such as low birth weight, preterm delivery, intrauterine growth retardation, and infant mortality.

In conclusion, few would argue that the roots of this crisis are entirely, or even primarily, to be found in the state of the healthcare system. Indeed, some studies find little evidence of a link between health and morality outcomes and access to healthcare in Russia. High levels of mortality and morbidity reflect many other factors, including environmental degradation, unhealthy diets and high levels of tobacco and alcohol consumption, high levels of traffic-related fatalities and a sharp rise in murders and suicides. Nevertheless, the evidence suggests that access to quality medical care has declined for much of the population since 1990 and that this aggravates Russia’s health problems.

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