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  1. 1
    Peer Reviewed

    The inter-relationship among economic activities, environmental degradation, material consumption and population health in low-income countries: a longitudinal ecological study.

    Chuang YC; Huang YL; Hu CY; Chen SC; Tseng KC

    BMJ Open. 2015; 5(7):e006183.

    OBJECTIVES: The theory of ecological unequal exchange explains how trade and various forms of economic activity create the problem of environmental degradation, and lead to the deterioration of population health. Based on this theory, our study examined the inter-relationship among economic characteristics, ecological footprints, CO2 emissions, infant mortality rates and under-5 mortality rates in low-income countries. DESIGN: A longitudinal ecological study design. SETTING: Sixty-six low-income countries from 1980 to 2010 were included in the analyses. Data for each country represented an average of 23 years (N=1497). DATA SOURCES: Data were from the World Development Indicators, UN Commodity Trade Statistics Database, Global Footprint Network and Polity IV Project. ANALYSES: Linear mixed models with a spatial power covariance structure and a correlation that decreased over time were constructed to accommodate the repeated measures. Statistical analyses were conducted separately by sub-Saharan Africa, Latin America and other regions. RESULTS: After controlling for country-level sociodemographic characteristics, debt and manufacturing, economic activities were positively associated with infant mortality rates and under-5 mortality rates in sub-Saharan Africa. By contrast, export intensity and foreign investment were beneficial for reducing infant and under-5 mortality rates in Latin America and other regions. Although the ecological footprints and CO2 emissions did not mediate the relationship between economic characteristics and health outcomes, export intensity increased CO2 emissions, but reduced the ecological footprints in sub-Saharan Africa. By contrast, in Asia, the Middle East and North Africa, although export intensity was positively associated with the ecological footprints and also CO2 emissions, the percentage of exports to high-income countries was negatively associated with the ecological footprints. CONCLUSIONS: This study suggested that environmental protection and economic development are important for reducing infant and under-5 mortality rates in low-income countries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
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  2. 2

    The Indaba Declaration on Food, Nutrition, Health and Sustainable Development.

    SAJCN. South African Journal of Clinical Nutrition. 2003 Feb; 16(1):9-11.

    Good health is a vital input to, and outcome of, sustainable development. Good health can be achieved only by addressing the underlying and basic causes of disease. The modifiable causes of health and disease are environmental. The nature and quality of food systems, and therefore of diet and nutrition, are fundamental determinants of human health and welfare, and that of the whole living and natural world. Levels of environmentally determined diseases now amount to a global emergency, projected to become an irretrievable catastrophe. The triple burden now borne by almost all middle- and low-income countries of nutritional deficiencies, infectious diseases including HIV-AIDS, malaria and tuberculosis, and chronic diseases including cancer, heart disease and stroke, and often also the burden of violence, is too heavy for any country to bear. (excerpt)
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  3. 3
    Peer Reviewed

    Food items consumed by students attending schools in different socioeconomic areas in Cape Town, South Africa.

    Temple NJ; Steyn NP; Myburgh NG; Nel JH

    Nutrition. 2006 Mar; 22(3):252-258.

    We investigated the food consumption patterns of adolescent students at schools. Our findings are intended to reveal the overall nutritional quality of foods eaten by students at school, including foods brought to school and foods purchased at school. A questionnaire was completed by 476 students, mostly from grades 7 and 10, from 14 schools in Cape Town, South Africa. The schools were representative of the various ethnic groups and socioeconomic strata of the population. The questionnaire requested information on eating habits at school, foods brought to school and food purchases, and breakfast consumption before school. We also tested whether students knew which foods are healthy and which are less healthy choices. The students were mostly 12 to 16 y of age (mean age 14.5 y). The large majority had breakfast before school (77.8%) and ate at school (79.7%). Food was brought to school by 41% to 56%, whereas 69.3% purchased food at school, mainly at the school store (tuck shop). Predefined “unhealthy” foods brought to school outnumbered “healthy” ones by 2 to 1. Among students who purchased food at school, 70.0% purchased no healthy items, whereas 73.2% purchased two or more unhealthy items. With six foods 84% of students correctly stated whether they were healthy or unhealthy; however, with cola drinks, samoosas (deep-fried pastry with spicy filling), and pies, only 47% to 61% knew that these were less healthy choices. Students’ scores on this question were unrelated to whether they purchased healthy or unhealthy foods. Students who attended schools of high socioeconomic status were twice as likely to bring food to school (64.7% versus 31.0%, P < 0.001), scored higher marks on the quiz of healthy versus unhealthy foods (P < 0.01), but were no more likely to purchase healthy food. The large majority of food eaten by adolescent students in Cape Town is classified as being unhealthy choices. This applies to foods brought to school and food purchases. Consideration needs to be given to policy measures to improve this situation and to improve education of students and their parents. (author's)
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  4. 4

    Making the link: population, health, environment.

    Nash JG; De Souza RM

    Washington, D.C., Population Reference Bureau [PRB], MEASURE Communication, 2002 Aug. [8] p.

    The number of people on Earth, where they live, and how they live all affect the condition of the environment. People can alter the environment through their use of natural resources and the production of wastes. Changes in environmental conditions, in turn, can affect human health and well-being. Human demographic dynamics, such as the size, growth, distribution, age composition, and migration of populations, are among the many factors that can lead to environmental change. Consumption patterns, development choices, wealth and land distribution, government policies, and technology can mediate or exacerbate the effects of demographics on the environment. The precise impact of a given change depends on the interplay among all these factors, but it is clear that demographic change can affect the environment. (excerpt)
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  5. 5
    Peer Reviewed

    [Health and environment: a global challenge] Sante et environnement: un defi mondial.

    World Health Organization [WHO]. Commission on Health and Environment


    WHO's Commission on Health and Environment states that a healthy environment is not only a necessity: the right to live and to work in an environment favorable to physical and mental health is recognized by the Universal Declaration of Human Rights. It is for everyone to see to it that this right be respected. It is the duty of individuals and businesses to act and of public powers to supply a strategic and institutional framework necessary for action. Three major objectives can be defined at the global level: establish a sustainable base for health for all, assure a favorable environment for health (i.e., reduce physical, chemical, and biological risks and furnish all the means to acquire the necessary resources for health), and make all individuals and organizations aware of their responsibilities in regard to health and environmental conditions which are necessary to all. To achieve a sustainable base for all, it will be necessary to slow down and finally stop population growth as fast as possible and to promote ways of life and plans of consumption conforming to requirements of ecological sustainability in developed countries. Two principles are at the center of all actions aiming to guarantee a healthier and more stable environment: more equitable access to resources between individuals on the national level and between countries, and full participation of citizens in planning. Participation contributes to the promotion of health and the quality of the environment because it serves as a means to organize action and to motivate individuals and communities while allowing them to work out policies and projects based on their own priorities. It also allows individuals to influence the choices of the means to reap the best part of limited resources. Participation policy structures offer the means to fight against environmental degradation.
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  6. 6

    Caracas statement on environment and development.

    Inter-Parliamentary Meeting on Socio-Economic Development and Environmental Protection (1991: Caracas)


    By the close of an international meeting on socioeconomic development and environmental protection, a statement was prepared by the participants, and is presented as the body of this paper. Parliamentarians and environmental experts were in attendance from Barbados, Bolivia, Brazil, Canada, Colombia, Ecuador, Mexico, Peru, the United States, Venezuela, and other governmental and private agencies. Participants acknowledged global threats to the environment and overall quality of life caused by some forms of agrarian development, population growth, poor land use, excessive consumption, energy waste, and inequitably distributed resources. Responding to these threats, strategies and policies for sustainable development while meeting the needs of future generations were developed. Heightened awareness of the importance of environmental protection and resource management among parliamentarians, business leaders, communications professionals, and the general community is a priority. Effective international cooperation is also stressed in facing these global-scale challenges. Moreover, developing countries should be accorded favored treatment by developed countries due to incurred ecological debt, while local populations should be actively involved as participants in any development process. Sustainable economic growth of poverty-stricken nations is deeply interrelated with equitable wealth distribution, adequate land use, education, conservation, health, employment opportunities, the advancement of women, and population policy. Successful strategies must consider such interrelationships, and include policy elements accordingly.
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  7. 7

    [The Permanent Household Survey: provisional results, 1985] Enquete Permanente Aupres des Menages: resultats provisoires 1985

    Ivory Coast. Ministere de l'Economie et des Finances. Direction de la Statistique

    Abidjan, Ivory Coast, Ivory Coast. Ministere de l'Economie et des Finances. Direction de la Statistique, 1985. 76 p.

    This preliminary statistical report provides an overview of selected key economic and social indicators drawn from a data collection system recently implemented in the Ivory Coast. The Ivory Coast's Direction de la Statistique and the World Bank's Development Research Department are collaborating, under the auspices of the Bank's Living Standards Measurement Study, to interview 160 households per month on a continuous basis for 10 months out of the year. Data are collected concerning population size, age structure, sex distribution, family size, nationality, proportion of female heads of household, fertility, migration, health, education, type of residence, occupations, employment status, financial assistance among family members, and consumption. Annual statistical reports based on each round of the survey are to be published, along with brief semiannual updates.
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  8. 8

    Environment and health: 1. Population, consumption and human health.

    Speidel JJ

    CMAJ: Canadian Medical Association Journal. 2000 Sep 5; 163(5):551-6.

    This paper focuses on the impact of population growth on human health, socioeconomic development, and the environment. The impact of humans on their environment is related to population size, per capita consumption and the environmental damage caused by the technology used to produce what is consumed. Human activity has already transformed an estimated 10% of Earth's surface from forest or range land into desert. Unproductive land and food scarcity contribute to malnutrition among 1 billion people, with infants and children suffering the most serious health consequences. Water scarcity also impairs health as fresh water supplies for human use become polluted. These are considered to be among the many important interactions between population growth, consumption, environmental degradation and health. Meeting the family planning needs of the 100-120 million women in developing countries would lower the total fertility rate (TFR) from 3.2 to 2.1, the TFR needed for population stabilization. With the political will to make available good reproductive health care, population growth is likely to decline to manageable levels.
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  9. 9

    Intergenerational resource flows in Cote d'Ivoire: empirical analysis of aggregate flows.

    Stecklov G

    POPULATION AND DEVELOPMENT REVIEW. 1997 Sep; 23(3):525-53.

    Application of new intergenerational resource flow models to data from the Ivory Coast 1) reveals that wealth flows from older to younger generations in this high-fertility setting, 2) indicates how wealth is accumulated by individuals, and 3) exposes the complementary role of private and public transfers in the redistribution of resources between different age groups. The article begins with a review of the theory and evidence covering intergenerational transfers. The next section notes that data for the present study were gathered from the World Bank's 1986 Living Standards Measurement Study of the Ivory Coast and discusses 1) reasons for the fact that per capita consumption is about 20% greater than per capita labor income, 2) the assumptions used to allow individual-level consumption and labor earning measures to be derived from the household-level data, and 3) how individual labor earning estimates were derived. The third section provides the analysis of the consumption and labor income profiles, and section 4 explains the derivation of per capita wealth and per capita transfers. Section 5 deals with the role of population growth, and the sixth section covers the intergenerational flows of public-sector resources through a look at the composition of the public sector in the Ivory Coast, government expenditures, government revenues, and the combination of family and public-sector flows. It is concluded that application of this new framework has yielded important findings including the fact that wealth flows downward in this high-fertility setting. Public-sector flows were also strongly downward and were dominated by education expenses. The average citizen in the Ivory Coast experiences negative life-cycle wealth until nearly age 50. High fertility may continue despite the high cost of children as long as children remain the best source of old-age support for parents.
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  10. 10

    The mother of battles: confronting the implications of automobile dependence in the United States.

    Bronner ME

    POPULATION AND ENVIRONMENT. 1997 May; 18(5):489-507.

    In refusing to recognize the malignant effects of our automobile dependence, which requires a straightforward acceptance and direct treatment, we allow its ill-effects to grow beyond control. Each day that our automobile dependence grows, our capacity to affect the character of this change slips a notch. The objective of this paper is to characterize the true cost of automobile dependence on our society, not in a dollar estimate, but in human terms. The author discusses the impact on human health. (EXCERPT)
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  11. 11

    Healthy world, healthy people.

    McMichael T

    PEOPLE AND THE PLANET. 1997; 6(3):6-9.

    This article discusses the challenges to human health from environmental degradation. The environment includes the social environment as well as the physical and chemical environment. Housing quality, recreation, population growth, density and mobility, social networks, and political and distributive equity also impact on health. There are well known examples of man-made disasters, such as in Bhopal, Chernobyl, and the Love Canal. What are less understood are the general conditions of poor health, low life expectancy, and early death due to polluted air, contaminated drinking water, and pesticide and other chemical contamination. An estimated 66% of diarrhea episodes are attributed to contaminated food or water. Health and vital statistics do not measure public health problems, such as declines in intelligence from lead ingestion from auto emissions. Epidemiological tracking of cause and effect of environmental contaminants is elusive. Some key features of environmental impact are the threshold effect, indirect pathways, and long-term and systems effects. Environmental hazards may deplete or disrupt natural biophysical processes that are the basic source of sustained good health. These basic systems include the food production system, the vector borne disease routes, global hydrological cycles, and the stratosphere. Gains in life expectancy have been due to declines in infectious disease mortality in early life, food security, improved hygiene and water sanitation, vaccination, and antibiotics and other medical treatments. Rapid technological change, acquisitive consumerism, ignorance of distant and deferred environmental impacts, and a free market ethic limit social advancement and ignore public health and environmental stresses. The scale of today's environmental problems requires priority setting and socially and ecologically sustainable ways of living.
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  12. 12

    Survey of economic and social conditions in Africa, 1991-1992.

    United Nations. Economic Commission for Africa

    Addis Ababa, Ethiopia, United Nations, 1994. xvi, 139, 63 p. (E/ECA/SERP/94/1)

    This 1991-92 survey report summarizes economic conditions in Africa. This report differs from the 1990-91 survey report in that it uses 1990 as the base year for constant prices. The topical structure of the survey has remained the same, with the exception of a new chapter on the construction industry. Chapter topics include an overview of the global economy in 1992, the economy of Africa in 1992, fiscal and price developments, external debt and new structural adjustment programs (SAPs), foreign trade, agriculture and forestry and fisheries, petroleum and natural gas, mining, manufacturing, construction, transportation and telecommunications and tourism, and a review of selected social issues. The economy of Africa is stagnating and in crisis. During the 1980s there was not a single African country that successfully industrialized or started to industrialize. The gross domestic product per capita in the region was lower than other regions, and the African share of the global economy and world trade declined. Even African commodities that were almost monopolies declined. The African economy grew by an average of 2% annually during 1980-90 and an estimated 1.3% in 1992. The African region has suffered from the effects of the Gulf War, drought in Southern Africa, and civil wars and conflicts in many countries. The growth rate of the world economy was 1.4% in 1992 and 2.0% in 1994. The growth rate of developing economies was 6.1% in 1992 and 5.7% in 1993. The growth rate in Africa was 2.0% in 1992 and 2.3% in 1993. The extent of outstanding debt in developing countries continued to rise. The African share of developing country debt was $292 billion out of $1478 billion in 1991. Economic conditions in Africa deteriorated sharply in 1992. The prospects for 1993 were not even for modest growth. The crisis in the social sector continued without stop into the 1990s. Women and children are the most seriously affected.
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  13. 13

    Gender and nutrition.

    Patterson AW

    In: Gender, health, and sustainable development: perspectives from Asia and the Caribbean. Proceedings of workshops held in Singapore, 23-26 January 1995 and in Bridgetown, Barbados, 6-9 December 1994, edited by Janet Hatcher Roberts, Jennifer Kitts, and Lori Jones Arsenault. Ottawa, Canada, International Development Research Centre [IDRC], 1995 Aug. 285-90.

    This paper presents an overview of some of the issues pertaining to nutrition in the Caribbean region: food production, food availability, food consumption, poverty, culture, and nutrition-related health problems. It is concluded that sustainable development should assure survival and the ability to be healthy. Research and programs are lacking in the attention given to the management and control of obesity and chronic diseases. Prevention of chronic diseases requires the adoption of healthy life styles and life skills in all population groups regardless of age, sex, or social status. Policy directions and the national allocation of resources are necessary for developing and implementing health education programs. Program strategies must involve multidisciplinary disciplines and personnel. The International Conference on Nutrition recommends further activity on improving household food security, preventing and managing infectious diseases, caring for the deprived and nutritionally vulnerable, promoting healthy diets and life styles, protecting consumers through improved food quality, preventing micronutrient deficiencies, researching nutrition situations, and including nutrition objectives within development plans. Little research, other than a small study in Jamaica, is available on the health impact of women's agricultural work in the Caribbean, particularly on pesticide and agricultural chemical exposure. Caribbean countries rely heavily on food imports to meet basic food needs. Currently there is adequate food availability at the national level. Poverty is a major cause of undernutrition and women in female-headed households are a particularly vulnerable group. Food consumption data in the Caribbean are inadequate for a variety of reasons. Indigenous food that is nutritionally of high quality is rejected as "poor people's food." The leading causes of death in the Caribbean include anemia, obesity, hypertension, cardiovascular and cerebrovascular disease, cancers, and diabetes.
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  14. 14

    Population and energy.

    Weber M; Seery T; Russell A

    Boulder, Colorado, National Audubon Society, Human Population and Resource Use Dept., [1994]. 39 p.

    Human population growth and energy consumption will radically alter the quality of life for Americans, even though most Americans do not experience the poverty and crude life conditions suffered by most inhabitants of the world. Americans can limit family size to two children in the present generation. If world fertility declines from 4.3 in 1990 to 2.3 by 2025, and energy consumption in developing countries does not increase, world energy consumption will increase by 33% by 2025, or 22.5 billion barrels of oil annually. 55% more energy will be consumed if developed countries halve their energy consumption and developing countries double theirs. The recommendations are made to increase energy efficiency and conservation, promote the transition to alternative energy sources, exercise international leadership in energy, and stabilize population growth. The US should promote energy efficiency in buildings. For instance, 80% of every energy dollar is spent on lighting. Heating units can be replaced with more efficient models. Fluorescent light bulbs should replace incandescent bulbs. 65% of US oil consumption is due to automobiles. A change to more efficient models with fuel rates of 50 miles per gallon is feasible. The federal government should set an example by buying right. Photovoltaic and other alternative energy sources should be encouraged. The price of energy should reflect its true cost. Incentives can work. Foreign assistance and multilateral banks should promote energy efficiency, particularly in rural areas of developing countries. The UN Framework Convention on Climate Change should be implemented fully by the US government. The social status of women should be improved, and funding for family planning and contraceptive research should be increased. Programs should be developed to suit the needs, values, and cultures of populations. Foreign policies must recognize population as a major factor in sustainable development and not solely as a developing country problem. For example, the impact on the environment is the same for 100 births in Bangladesh as it is for only one birth in the US. US teenage pregnancies result in many unwed mothers and unwanted births. The 1992 Earth Summit established that sustainable development and new models of energy use must be implemented.
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  15. 15

    Environmental issues of special concern to women and children. Discussion note.

    United Nations Environment Programme [UNEP]

    [Unpublished] 1992. Presented at the International Conference on Population and Development [ICPD], 1994, Expert Group Meeting on Population and Women, Gaborone, Botswana, June 22-26, 1992. 5, [1] p. (ESD/P/ICPD.1994/EG.III/DN.17)

    Environmental degradation is a universal concern, affecting such basic human needs as food and water. Consumption and population need to be managed in order to assure natural resource sustainability, worldwide survival, environmental protection, and global well-being. Women and children are affected differently in developed compared to developing countries. In developing countries survival is a struggle, and environmental damage affects women first through, for instance, increased workload or poor quality water. Children are affected, for instance, through increased mortality and disease. The most critical environmental problems affecting women and children are conditions that threaten provision of food, safe water, and fuel for cooking or warmth. Contaminated water supplies, lack of adequate sanitation, and overcrowded conditions increase the human, animal, and crop hazard. Water is contaminated by agricultural run-off, industrial waste deposits, and sewage. Protection of watersheds and water quality have implications for the many rural women dependent on farming for their livelihood. Chemical contaminants from pesticides and fertilizers are particularly harmful to pregnant or breast feeding women, if ingested. Hazardous wastes from urban and industrial areas provide other hazards to women and children. High energy consuming countries contribute to natural resource depletion and pollution from industrial releases into the air, water, and soil. Women in developing countries use fuelwood, which contributes to deforestation. The time and energy used to collect fuelwood diminishes human resources. Deforestation reduces supply and contributes to greenhouse gas build-up. Other fuel available, such as agricultural waste and dung, are used instead as important fertilizers, without which soil becomes degraded. Land degradation limits food production, contributes to malnutrition and desertification, and limits women's means of livelihood. Women have an important role in managing natural resources, which entitles them to participate in community decision making.
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  16. 16

    The effects of income on food and nutritional status in the Middle Eastern area (1960-1985).

    Younis SJ

    Ann Arbor, Michigan, University Microfilms International, 1993. 132 p. (Order No. 9410654)

    Dramatically increased oil prices significantly and rapidly increased the income of most middle eastern countries after 1973. The author reports on the effect of the income growth on food and nutrition status. He looks at per capita income, food consumption, population per physician, crude birth and death rates, infant mortality rate, child death rate, and life expectancy over 1960-85 for the oil exporting countries Algeria, Libya, and Saudi Arabia, the labor exporting countries Egypt, Morocco, Tunisia, and Yemen, and the agriculture producing countries Jordan, Sudan, Syria, and Turkey. The analysis found the income elasticities of wheat, rice, and corn consumption to be less than one for all countries. The income elasticities for egg, beef, and poultry were more than one for most of the countries. Crude birth and death rates, and child and infant mortality rates decreased with increasing income, while population per physician and life expectancy increased. Only Morocco showed insignificant results for most of the analysis.
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  17. 17

    World development report 1993. Investing in health.

    World Bank

    New York, New York, Oxford University Press, 1993. xii, 329 p.

    The World Bank's 16th annual World Development Report focuses on the interrelationship between human health, health policy, and economic development. WHO provided much of the data on health and helped the World Bank on the assessment of the global burden of disease found in appendix B. Following an overview, the report has 7 chapters covering health in developing countries: successes and challenges; households and health; the roles of the government and the market in health; public health; clinical services; health inputs; and an agenda for action. Appendix a lists and discusses population and health data. The report concludes with the World Development Indicators for 127 low, lower middle, upper middle, and high income countries in tabular form. All developed and developing countries have experienced considerable improvements in health. But developing countries, particularly their poor, still experience many diseases, many of which can be prevented or cured. They are starting to encounter the problems of increasing health system costs already experienced by developed countries. The World Bank proposes a 3-part approach to government policies for improving health in developing countries. Governments must promote an economic growth that empowers households to improve their own health. Growth policies must secure increased income for the poor and expand investment in education, particularly for girls. Government spending on health must address cost effective programs that help the poor, such as control and treatment of infectious diseases and of malnutrition. Governments must encourage greater diversity and competition in the financing and delivery of health services. Donors can finance transitional costs of change in low income countries.
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  18. 18

    Scientific, technical, resource, environmental and health constraints on sustainable growth in agricultural production: into the 21st century.

    Ruttan VW

    [Unpublished] 1990. Presented at the Population-Environment Dynamics Symposium, University of Michigan, Ann Arbor, Michigan, October 1-3, 1990. [2], 24, [5] p.

    This draft paper is a summary on constraints on sustainable growth in agricultural production. The ideal circumstance for lifting these constraints is a country with slow population growth and rapid growth of income and employment in nonagricultural sectors. Productivity growth in major food grains pace with demand, but there is uncertainty in the future because of population growth and growth in income/capita which will increase consumption. The constraints are biological and technical on crop and animal production, resource and environmental on sustainable growth, and health on agricultural development. The issues and priorities for the 21st century are related to the question of how health treats might become a serious constraint on food production capacity. Four issues were identified: 1) that the problems are transitional, 2) that social scientists have a limited capacity to design the institutional infrastructure needed to sustain growth in agricultural production, 3) that more attention needs to be paid to providing more options in the design of technologies and institutions, and 4) that there are inadequate mean of monitoring changes in the sources of productivity and environmental change and the impacts on health. Thinking globally and acting locally is not possible any longer. Structures need to be designed to facilitate communication between different disciplines and to apply research findings. The highest incidence of AIDS occurs in countries with the weakest capacity to sustain food production. Soil erosion can be identified but there is no measure of its impact on food production. The author is cautiously optimistic about the future of agricultural production. The author is cautiously optimistic about the future of agricultural production. The research, supply, and production systems are much better equipped today to deal with food crises, but the challenges are institutional and technical. Institutions must be designed to protect the soil, water, and atmosphere from the impacts of agricultural and industrial intensification. The rate of economic change in developing countries also affects the capacity to achieve sustainable development. The landless or near landless are particularly vulnerable. If demand rises due to higher incomes, diversification of crops of higher value is possible.
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  19. 19

    The consequences of adult ill-health.

    Over M; Ellis RP; Huber JH; Solon O

    In: The health of adults in the developing world, edited by Richard G.A. Feachem, Tord Kjellstrom, Christopher J.L. Murray, Mead Over, Margaret A. Phillips. New York, New York, Oxford University Press, 1992. 161-207.

    The consequences of adult ill-health are greater than previously believed. These consequences go beyond suffering and grief and consist of indirect adverse effects on society which increase the cost of adult ill-health in developing countries. At the household level, family and friends try to reduce the effects of an illness or injury afflicting an adult household member. Work colleagues increase their workload to pick up the slack of the ill or injured colleague. An unhealthy labor force results in slow work schedules and less specialization of employee job descriptions. These coping processes reduce the effects of illness, but are costly. Yet traditional empirical studies do not examine them. Anticipatory coping mechanisms to mitigate adverse consequences of adult ill-health include formal and nonformal insurance mechanisms, both of which bear high costs. Informal insurance mechanisms include high fertility and extended families and social networks. Formal mechanisms are investment and savings and formal health insurance. Further, adult ill-health harms children more than child ill-health harms adults. thus, the total ill-health burden of children is greater than originally surmised. Household costs of adult ill-health are effect on production and earnings, on investment and consumption, and on household health and consumption and psychic costs. At least 70% of hospital resources in developing countries goes to adult and elderly patients. A considerable proportion of primary care costs is also dedicated to adults. Even though researchers agree that disease affects income, this effect is preceded and overshadowed by the effect of disease on health status, of health status on functional capacity, and of functional capacity on productivity. In conclusion, adult ill-health restricts development in societies burdened by adult ill-health.
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  20. 20

    Fresh water.

    Rogers PP

    In: The global possible: resources, development, and the new century, edited by Robert Repetto. New Haven, Connecticut, Yale University Press, 1985. 255-98. (World Resources Institute Book)

    Everyone uses fresh water. Water is the most used substance by industry. Even though industry only makes up 5-10% of current worldwide water use, it contributes a disproportionate amount of toxic contaminants to the water supply. The most important socioeconomic factors of municipal water demand are household income and size. Agricultural demand is the single largest demand for water. In the US, it makes up 83% of annual total water consumption. Water demand has resulted in some of the world's biggest construction and weather modification projects which greatly alter basic ecosystems. Multinational institutions such as the World Bank and the International Development Association support most of these projects in developing countries. We have abused water perhaps more than any other resource. These abuses have caused considerable adverse effects. For example, after farmers in Africa and Asia began irrigating fields, many people fell ill with schistomosiasis. Other waterborne diseases include typhoid fever and diarrheal diseases. Investments in water supplies as well as in wastewater treatment are needed to improve public health. The largest consumers of fresh water in the world are those countries with the largest populations (49% of the world's population) and largest total land area (32% of the this area): China, India, the US, and the USSR. These 4 countries have 61-70% of the world's total irrigated land, but China and India have most of it (54%). Most US water expenditures are for water pollution control. The US has a very efficient agricultural system but the efficiency is technical rather than economic. Most water expenditures in the USSR and India are for irrigation. China spends most of its water resource funds on irrigation and drainage systems. All countries in the world should conduct a rational analysis of fresh water uses, implement rational water pricing policies to conserve water use, and stabilize water supplies such as capturing surface runoff.
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  21. 21
    Peer Reviewed

    Health is a sustainable state.

    King M

    Lancet. 1990 Sep 15; 336(8716):664-7.

    This commentary by Maurice King questions the viability of current public health strategies. He advocates for an ecological approach that seeks to improve the health of the entire planet. He discusses the concept of the demographic trap. Being demographically trapped refers to a population being stuck in an "unsustainable state with a high birth rate and death rate, with an ever increasing pressure on its resources, and with a rapidly deteriorating environment". King points out that the possible outcomes are limited for a population that becomes trapped. Some of the possible outcomes include dying from starvation and disease; fleeing as ecological refugees; being destroyed by war or genocide; or being supported by food and other resources from elsewhere, first as emergency relief and then perhaps indefinitely. King believes that ecological collapse has already taken place in parts of Ethiopia and the process may have begun on a wider scale elsewhere. According to King, this ecological predicament can be found in both rural and urban areas in the developing world. This article also discusses the problem of high fertility. King believes that the widely held belief that the necessary and sufficient condition for reducing the birth rate is to reduce the child death rate is erroneous. He states that a causal relationship between the 2 rates is untenable, instead, it is more reasonable to say that both rates respond to other common factors. The author suggests that a fall in the birth rate requires the harnessing of social and economic gains to reduce poverty and promote socio-economic development. He also believes that the continued growth in the size of the world's population is due to declining efforts in family planning and declining child mortality not having its alleged effects on fertility. King also brings forth an ethical dilemma. He asks, "are there some programs which, although they are technically feasible, should not be initiated because of there long-term population-increasing consequences?" He suggests that other factors such as ecological deterioration, integrity of the ecosystem, and the welfare of future communities need to be taken into consideration. King presents a new global strategy based on the concept of "sustainability". He says that "sustainability should be the maintenance of the capacity of the ecosystem to support life in quantity and variety". Specifically, he advocates for consumption control in the industrial North with intensive energy conservation and recycling. In the South, he calls for renewed vigor in family planning efforts. Public health measures need to be understood in terms of their demographic and ecological implications. If measures are found to be desustaining, King says that complementary ecologically sustaining measures should be introduced with them. He also believes that desustaining measures, such as oral rehydration, should not be introduced on a public health scale if no adequately sustaining complementary measures are possible. He asserts that desustaining measures, without complementary interventions, can ultimately increase the man-years of human misery.
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  22. 22

    [Luxembourg statistical yearbook 1987/88] Annuaire statistique de Luxembourg 1987/88.

    Luxembourg. Service Central de la Statistique et des Etudes Economiques [STATEC]

    Luxembourg, STATEC, 1987 Dec. xx, 529 p.

    The 1987/88 Statistical Yearbook of Luxembourg contains data on a wide variety of topics organized into 23 chapters with data on economic and noneconomic topics specific to Luxembourg and a final chapter with a series of international comparisons. Each of the chapters and many of the tables and graphs contain introductory notes and explanations. The work opens with a listing of basic statistics followed by chapters on territory and climate and on population. The chapter on population includes subsections on evolution of the total population, the active population, natural movement of the population, migratory movement, and housing and households. The major section on economic statistics includes chapters on national accounts, agriculture and forestry, industry, artisanry, services, banks and credit, public finances, income and social security, consumption and prices, research and external economic relations. The section on noneconomic statistics includes chapters on accidents, anthropometry, culture and education, environment, justice, names and surnames of the national population, politics, religion, health, and sports.
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  23. 23

    Trends and opportunities abroad, 1988.

    Rusoff D

    Ithaca, New York, American Demographics, Inc., 1988. xvi, 217 p.

    To better understand consumer markets in today's world, this annual volume clusters the world's 150 largest countries according to their demographic and socioeconomic characteristics. The 5 clusters--the Dependents, the Seekers, the Climbers, the Ultimate Consumers, and the Rocking Chairs--help identify the kind of consumer markets the countries represent. The clusters give market researchers a quick way of targeting potential world markets for further research effort. Population trends are powerful movers and shakers. For Seeker and Climber countries, current and anticipated growth in populations and income mean expanding markets far into the future. For Ultimate Consumer and Rocking Chair countries, increasingly sophisticated tastes and the needs of the aging will fuel the market. For Dependent countries--the poorest part of the world economy--only intensified efforts by the countries themselves and greater assistance from the international development community can pull these countries up in the face of relentless demographic pressure. The sheer size of the market in Seeker and Climber countries is enough to indicate increasing consumer demand. 4 demographic factors help identify market potential: 1) the average annual population growth rate, 2) the average number of lifetime births per woman, 3) the status of women, and 4) urbanization. Dependent countries rely primarily on others for food supplies, for professional assistance in building infrastructure, and for educating their youth. Concerted efforts are being made in Seeker countries to improve health and education, slow population growth, upgrade the status of women by encouraging them to participate in higher education and the labor force, and increase access to family planning. Climber countries are demographically the most important expanding markets in the world today. Change lies ahead in the purchasing behavior of mature households in Ultimate Consumer countries as the more educated, more moneyed middle-aged people enter the ranks of the elderly.
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  24. 24
    Peer Reviewed

    International cross-section analysis of the determination of mortality.

    Gravelle HS; Backhouse ME

    Social Science and Medicine. 1987; 25(5):427-41.

    An essential ingredient in the evaluation of policies concerning health services is knowledge of the impact of health services and other factors on the health of the population. One method for obtaining this information is from the regression analysis of international cross-section data on mortality rates, health service provision, income levels, consumption patterns, and other variables hypothesised to affect population health. The investigation of the determinants of population health is in many ways akin to the estimation of production functions which describe the relationship between the output of goods or services and the mix of inputs used in their production. The purpose of this paper is to use this analogy to discuss, and provide examples of, the problems which arise with the statistical investigation of mortality rates. Issues raised include simultaneous equation bias, multicollinearity, selection of explanatory variables, omitted variable bias, definition and measurement of variables, functional forms, lagged relationships and temporal stability. These problems are illustrated by replication and re-analysis, using new data, of the well known study by Cochrane, St. Leger and Moore. (EXCERPT)
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  25. 25

    Trends and opportunities abroad, 1987.

    Rusoff D; Walsh D

    Ithaca, New York, International Demographics, 1986. x, 217 p.

    This volume contains descriptions of demographic and socioeconomic characteristics and basic statistics on social indicators, the status of women, urbanization, and economic indicators for 50 countries grouped into 5 clusters--the Dependents, the Seekers, the Climbers, the Ultimate Consumers, and the Rocking Chairs--to help identify the kind of consumer markets the countries represent. The clusters give market researchers a quick way of targeting potential world markets for further research effort. Population trends are powerful movers and shakers. For Seeker and Climber countries, current and anticipated growth in populations and income mean expanding markets far into the future. For Ultimate Consumer and Rocking Chair countries, increasingly sophisticated tastes and the needs of the aging will fuel the market. For Dependent countries--the poorest part of the world economy--only intensified efforts by the countries themselves and greater assistance from the international development community can pull these countries up in the face of relentless demographic pressure. The sheer size of the market in Seeker and Climber countries is enough to indicate increasing consumer demand. 4 demographic factors help identify market potential; 1) the average annual population growth rate, 2) the average number of lifetime births per woman, 3) the status of women, and 4) urbanization. Dependent countries rely primarily on others for food supplies, for professional assistance in building infrastructure, and for educating their youth. Concerted efforts are being made in Seeker countries to improve health and education, slow population growth, upgrade the status of women by encouraging them to participate in higher education and the labor force, and increase access to family planning. Climber countries are demographically the most important expanding markets in the world today. Change lies ahead in the purchasing behavior of mature households in Ultimate Consumer countries as the more educated, more moneyed middle-aged people enter the ranks of the elderly.
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