The documentary is hosted by the ever-reliable Richard Bilton, who seems to be the BBC’s go-to guy for these social injustice documentaries.
Teeside has the largest life expectancy gap in the country. Those in poorest boroughs of the region have a life expectancy of just 67, the same as Ethiopia. Those living just a couple of miles away in the wealthiest boroughs live until 85, 4 years above the national average.
This means that the life expectancy gap between the poorest and richest boroughs in Teeside is 18 years.
The inequalities are literally written on the gravestones, where in some graveyards, 60 years seems like a ‘good innings’
Richard Bilton points out early on that most babies in the U.K are born healthy, but a baby’s health is shaped by what comes next, and a crucial variable which influences health and life expectancy is wealth, or lack of it.
He also suggests more than once that leading an unhealthy life is not simply a matter of individuals making poor choices. Rather, being socialised into poverty restricts the kinds of choices people can make, and in extreme cases results in stress which seems to literally take 10 years off an individual’s life.
The first of the three emotionally charged case studies focuses on a 46-year-old male whose life is nearly over. He has fluid on the lungs, sciatica, and type 2 Diabetes, among other things, and is dependent on breathing apparatus.
There’s quite a lot of footage of his 4/5 kids musing about how he hasn’t got much time left…. And I guess that’s the ultimate negative consequence of his dying in his late 40s: a partner left to bring up 4 distraught kids on her own
His Illnesses are down to smoking and poor diet: people are four times more likely to smoke than those from wealthy areas.
The second case study focuses on a gran mother who is bringing up her daughters two children because she seems to be a hopeless crack addict. We see an interview with the drug-addict daughter who just appears to have given up the will to look after her kids. (Possibly because she knows her mother will do it?).
Drug deaths in Stockton have doubled in a decade and nationally they are substantially higher in the more deprived areas.
The grandmother attends a support group for grandparents who look after their grandkids because their children are drug addicts…. And we can see clearly how the stress she’s under is reducing her own life expectancy.
Finally, the documentary visits a middle-aged woman suffering from depression and anxiety who has made multiple (unsuccessful) suicide attempts. Suicides are twice as common in the poorest areas.
One of the problems here is that mental health services have been cut. There’s nowhere for her to go. If it were not for a voluntary support group, she’d probably be another early death statistic.
So how do we tackle low life expectancy?
This is a very short section towards the end of the documentary which visits a school in a deprived area. The headmistress of the Carmel Education Trust thinks she can turn things around. She doesn’t believe the poor-health life path of those in poverty is fixed.
She believes that therapies help kids to better at school, and if they do better at school, they get better jobs, and that seems to be the key to a healthier life…
NB the documentary doesn’t actually go into any depth about what these ‘therapies’ are. This section is very much tagged on the end of the gawp-fest.
Final critical appraisal of the documentary
What I like about the documentary is that it’s rooted in what you might call micro-statistics. It ‘digs down’ into the sub-regional variations in life expectancy in Teeside. It even distinguishes between life expectancy and health life expectancy.
However, the documentary spends too much time ‘gawping’ at the poor sick poor people rather than analysing the deeper structural causes of poverty related health problems.
There’s no real mention of the longer term historical downturn in the North East of the U.K. which highlights the high levels of unemployment, for example.
I’m also not entirely convinced by the (too brief) look at the solutions on offer. Therapeutic interventions in schools was offered up as the solution. Relying on the education sector yet again to sort out this social mess of extreme in equality in life expectancy just isn’t practical.
Having said that, if the mission of the documentary was to alter us to the extent of the problem and shock us, I think it did a reasonable job overall.
Possibly most shocking of all is that men in the poorest boroughs have a life expectancy of just 64: the average man doesn’t even make it to retirement age. And this isn’t the only region in the UK where this happens. In the very poorest regions, men work hard, pay their National Insurance, and get nothing back for it. There’s something not quite right about that!
Ultimately, I agree with the message the documentary puts out, even if it gets somewhat lost in the emotionalism of the three case studies: the reasons people die young are complex, but the most common reason is poverty – low income limits your choices. There is also no reason why anyone should be getting a chronic illness and dying in their 40s. All of the likely soon-to-be deaths in the documentary are entirely preventable!
Relevance to A-level sociology
This documentary offers some us some qualitative insights into the causes, but mainly the consequences of low life expectancy in the poorest regions of the United Kingdom and so should be relevant to the ‘ life expectancy and death rates‘ aspect of the families and households module.
It’s also quite a useful reminder of how we need qualitative data to give us the human story behind the statistics.
If you want to find out more about variations in life expectancy in the UK, you might like this interactive map as a starting point.
Consequence 1 – The ageing population may put a strain on public services
Increasing numbers of pensioners puts a strain on the NHS because pensioners use health services more than younger people
Furthermore, with increasing numbers of pensioners ‘sucking money’ out of the welfare state’ there is less left for everything else – services for the young are being cut to compensate
This is because healthy life expectancy is not keeping pace with life-expectancy, and there are increasing numbers of people in their 80s who spend several years with chronic physical conditions such as arthritis, and also dementia both of which require intensive social care.
While the ageing population presents problems, there are solutions – such as improving education about how to stay healthy in later life, changing ideas about working so that people are able to work for longer could be part of the solution.
Consequence 2 – The ageing population puts more of a burden on the younger generation
An ageing population means the dependency ratio has increased – there are fewer working aged people around to support pensioners. The next two generations are bearing a disproportionate cost of the current ageing population.
People in their 50s have become a ‘sandwich generation’ – they are now caught between having to provide care for their elderly parents, while still having their 20 something children living at home.
However, things are even worse for today’s teenagers – the retirement aged has now been pushed back to 68 – young people today are going to have to retire much later than their current grandparents.
While the ageing population presents problems, there are solutions – such as improving education about how to stay healthy in later life, changing ideas about working so that people are able to work for longer could be part of the solution.
A couple of not very pleasant news-items which relate to the problems of the ‘ageing population’:
The U.K. is on the brink of a social care crisis according to The Independent (November 2016) – with local authorities saying they could face a £2.6 billion funding gap by 2020.
According to The Guardian (December 2016), this is because funding has been slashed by 10%; there has been a 25% reduction in the number of people receiving help, and a third of all care homes face bankruptcy after cuts in the fees paid by local authorities.
All of this of course means that elderly people receive a lower quality of care, either in care-homes, or through reduced numbers of home-visits, but Age UK (Sept 2015) further calculates that up to a million people who have difficulties with basic activities such as getting dressed get no help at all.
All of this suggests that the problems of the ageing population are very much real, and given the present government’s neoliberal ideology, seem likely to get worse.
Demography refers to the study of the causes and consequences of changes to the size and structure of a society’s population. There are generally three things which can change the size and structure of a population – birth rates, death rates and migration, and these three things make up the three major sub-topics.
As with marriage and divorce, we break this down into discussing the reasons for the changes and then consider the consequences. A final additional topic here is migration patterns, which we deal with separately.
7.1: Reasons for changes to the Birth Rate
7.2: Reasons for changes to the Death Rate
7.3: The consequences of an Ageing Population
7.4: The reasons for and consequences of changes to patterns of Migration
Key concepts, research studies and case studies you should be able to apply
Total fertility rate
Infant Mortality Rate
Child Mortality Rate
Healthy Life Expectancy
Possible exam style short answer questions
Suggest two reasons for the long term decline in birth rate (4)
Suggest changes in the role of women that may explain why they have fewer children (4)
Suggest three consequences of the decline in the birth rate (6)
Suggest three reasons for the long term decrease in the death rate (6)
Suggest three problems society may face as a result of an ageing population (6)
Suggest three ways in which the elderly might be represented in stereotypical ways (6)
Suggest three ways in which society might respond to the challenges of an ageing population (6)
Suggest three pull factors which might attract people to immigrate into a particular country (6)
Suggest two push factors which might explain patterns of migration (4)
Identify two changes in the patterns of child-bearing over the last thirty years (4)
Possible Essay Questions – You should plan these
Examine the reasons for, and the effects of, changes in family size over the past 100 years or so (24) (January 2012)
Using material from item B and elsewhere assess the view that an ageing Population creates problems for society (24) (June 2014)
What are the consequences of an ageing population? This is a summary of a recent Radio 4 Analysis podcast – Three Score Years and Twenty on Ageing Britain. It’s of clear relevance to the demography topic within the 7191 families and households module….
Here are some of the main points.
In 1850,half the population in England were dead before they reached 46. Now half the population in England are alive at 85; and 8 million people currently alive in the UK will make it to 100 years or more. And if we extrapolate that to Europe, we can say 127 million Europeans are going to live to 100.
Hans Rosling points out that: We reached the turning point five years ago when the number of children stopped growing in the world. We have 2 billion children. They will not increase. The increase of the world population from now on will be a fill up of adults.
Health Secretary Jeremy Hunt: The two biggest issues that we face as an ageing society are the sustainability of the NHS and the sustainability of the pension system; and within the NHS, I include the social care system as part of that.
The basic problem we have in Northern European countries is the generational tension between individualism and communal responsibility – Across the generations within a typical family we have become more individualistic and less collective/ communal:
People in their 80s (who grew up in the 1960s) are generally very individualistic – they have retired into property wealth and are unwilling to relinquish the independence this gives them. They have also socialised their children into being more independent: most people today in their 50s (the children of those who are in their 80s) have bought into this – The family norm is one of the typical 50 year old living an independent life with their family, miles away from their own parents. Grandparents today of course help out with childcare occassionaly and pay regular visits, but they are generally not taking a day to day role in childcare, and finances are kept seperate. This arrangement is mutual – People in their 80s don’t want to be burdens on their children, they want them to have the freedom to live their own lives – to be able to work and raise their children without having to care for them in their old age. (So I suppose you might call the 2000s the era of the individualised family).
(This is very different to what it used to be like in the UK, and what it is still like in many other parts of the world where grandparents live close by and are an integral part of family life, taking an active role in raising their grandchildren on a day to day basis. Various interviewees from less developed countries testify to this, and to the advantages of it.)
Within this context of increasing ‘familial-individualism‘ a number of problems of the ageing population are discussed:
Firstly, one of the main problems which this increasing ‘familial-individualism’ creates for people in their 80s is one of increasing isolation and loneliness as their friends and neighbours move away or die.
One proposed solution is for older people to be prepared to move into communal supported housing where there are shared leisure facilities, like many people do in Florida. However, people are quite set in their ways in the UK and so this is unlikely. A second solution, which some immigrants are choosing is to return to thier country of origin where there are more collectivist values, trading in a relatively wealthy life in the UK for less money and more community abroad.
A second problem is that healthy life expectancy is not keeping pace with life-expectancy, and there are increasing numbers of people in their 80s who spend several years with chronic physical conditions such as arthritis, and also dementia – which require intensive social care.
As with the first point above, this is more of a social problem when children do not see it as their duty to care for their elderly parents – It is extremely expensive to provide round the clock care for chronic conditions for several years, and this puts a strain on the NHS. Basically, the welfare state cannot cope with both pensions and chronic care.
On potential solution to the above is mentioned by Sally GREENGROSS: The Germans in some cases now export older people to Eastern European countries because they can’t afford – or they say they can’t – to provide all the services they need in Germany itself. Could this be the future of chronic elderly care in the UK – Exporting demntia patients to poorer countries?
However, the idea of care-homes themselves are not dismissed when it comes to end of life care – the consensus seems to be that the quality of care in UK elderly care homes is generally very good, and better than your typicaly family could provide (depsite all the not so useful scare programmes in the media).
A third problem is for those in their 50s – with their parents still alive and ‘sucking money out of the welfare state’ there is less left for everything else – and this has been passed down to the youngest generation – As a result people in their 50s now face the prospect of their own children living at home for much longer and having to help them with tuition fees and mortgage financing, meaning that their own plans for retirement in their late-50s/ early 60s are looking less likely – In other words, the next two generations are bearing a disproportionate cost of the current ageing population.
Worringly, there is relatively little being done about this in government circles – Yes, the state pension age has been raised, and measures have been taken to get people to bolster their own private pensions, but this might be too little to late, and it looks like little else is likely to be done – The issue of the ageing population and the cost of welfare for the elderly is not a vote-winner after all.
The programme concludes by pointing out that pensions and care homes are only part of the debate. What will also be needed to tackle the problems of the ageing population is a more age-integrated society, a possible renogiation at the level of the family so that granparents are more integrated on a day to day basis in family life (trading of child care for a level of elderly care) and also social level changes – to make work places and public places more accessible for the elderly who might be less physically able than those younger than them.
A related topic in the Global Development module is the question of whether ‘overpopulation’ is a problem – an informed view on this topic is that of Hans Rosling’s who argues that ‘overpopulation’ isn’t really a problem at all because of the rapid global decline in birth rates.
This post looks at the recent increase in net migration to the UK, and at some of the reasons for increasing immigration in particular, including push and pull factors. It also looks at some of the consequences of increasing migration and the relationship between globalisation and migration.
Recent Patterns of Migration to the UK
The Office for National Statistics Net migration was actually negative during the 1970s and early 1980s, turning positive but at a relatively low level during the 1980s and early 1990s. Since 1994, it has been positive every year and rose sharply after 1997.
During the 2000s, net migration increased further, partly as a result of immigration of citizens from the countries that have joined the EU since 2004. Since the mid 2000s, annual net migration has fluctuated between approximately 150,000 and 300,000.
The latest figures from the Office for National Statistics show that net migration stood at 336,000 in the year ending June 2015. This is up from 254,000 in the year ending June 2014. This is a statistically significant increase.
Why are people immigrating to the UK?
The most common reason for migrating to the UK is work. This has been the case historically, with the exception of 2009 to 2012, when formal study was the most common main reason for migration.
In the year ending June 2015, a total of 294,000 immigrated for work-related reasons. This is a statistically significant increase from the previous year when 241,000 people immigrated for work-related reasons. Of those immigrating for work-related reasons in the year ending June 2015, 64% (187,000) came with a definite job to go to and 36% (107,000) came to look for work.
There were increases in immigration for work among EU citizens and non-EU citizens. Provisional estimates from the International Passenger Survey (IPS) show that 58% (162,000) were EU citizens (excluding British citizens), which was not a statistically significant increase and 24% (67,000) were non-EU citizens, also not a statistically significant increase from the previous year. The majority of other sources also show that immigration for work has increased over the last year for both EU and non-EU citizens.
The second most common reason for immigrating to the UK was formal study. In the year ending June 2015, a total of 192,000 people immigrated to the UK for formal study. Provisional estimates from the IPS show that the majority (131,000 or 71%) were non-EU citizens while 47,000 (24%) were EU citizens (excluding British citizens).
In the year ending June 2015, a total of 80,000 people arrived in the UK to accompany or join others,this remains relatively unchanged from 82,000 the previous year. Provisional estimates from the IPS show that the majority (45,000 or 58%) were non-EU citizens while 23,000 (30%) were EU citizens (excluding British citizens).
Where are people Emigrating from?
Refugees and Asylum Seekers Coming to the UK
Migrants to Britain hoping to gain citizenship must get 75 per cent or more on the Life in the UK test, which was recently revamped to incorporate “British values” (whatever they are).
The British Red Crossnotes that far fewer people come to the UK to apply for asylum than you might think.
More than 50 million people throughout the world were forced to flee their homes last year. There are more than 13 million refugees worldwide – but developing countries host over 80% of people.
There are an estimated 126,000 refugees living in the UK. That’s just 0.19% of the total population (64.1 million people).
How many asylum seekers came to the UK in 2014?
The UK received 31,400 asylum applications. This was less than Germany (166,800), France (63,100), Italy (56,300) and Sweden (81,300). Just 41%of people applying for an initial decision were granted asylum and allowed to stay. Many are initially refused because it is difficult to provide the evidence needed to meet the strict criteria of a refugee.
Which countries do asylum seekers come from?
More than half of the world’s refugees (52%) came from just five countries in 2014:
Syria: 3 million
Afghanistan: 2.7 million
Somalia: 1.1 million
South Sudan: 508,000
What do the terms mean?
flees their homeland
arrives in another country , whichever way they can
makes themselves known to the authorities
submits an asylum application
has a legal right to stay in the country while awaiting a decision.
has proven to the authorities that they would be at risk if returned to their home country
has had their claim for asylum accepted by the government
can now stay here either long-term or indefinitely.
Refused asylum seeker
has been unable to prove that they would face persecution back home
has been denied protection by the authorities
must now leave the country, unless they wish to appeal the decision or there are legitimate reasons why they cannot yet return home.
has moved to another country to work
could be legally or illegally resident, depending on how they entered the country
may or may not have a legal work permit.
Sources: Home Office, Immigration Statistics, Oct to Dec 2014; UNHCR mid-year report 2014; Office for National Statistics (mid 2013).
The simplest level of analysis lies in explaining increasing migration to the UK in terms of push and pull factors:
Push Factors refer to problems which encourage a person to leave or emigrate from their country
Pull Factors refer to the real or perceived benefits of another country which attract people to it, or migrate towards it
You should be able to identify a number of push and pull factors from the material above note down at least two push and pull factors which repel people from other countries and attract them towards the UK.
Increasing globalisation is also fundamentally linked to globalisation, which is covered below.
The Consequences ofIncreasing Migration forFamily Life
The impact of migration on UK population structure
There are three main effects:
Population size is increasing because net migration is increasing. If it were not for high net migration the UK population would be shrinking due to low birth rates, which on their own are below the fertility rate required to replace the population, which is 2.1. babies per woman.
The age structure changes. Immigration lowers that average age of the population both directly and indirectly. Directly because immigrants tend to be younger by 10 years than the British born population. Indirectly because Immigrant women have a higher fertility ratio – they have more babies than British born women.
The dependency ratio. Here immigration has three effects:
Immigrants are more likely to be of working age and this thus helps lower the dependency ratio.
However because they are younger, immigrants have more children and so the immigrants’ children add to the dependent population.
Finally, the longer a group is settled in the country, the closer their fertility rate comes to the national average, reducing their distinct impact on the dependency ratio.
Impacts on Public Services..
It is not possible to say with certainty what the implications of migration are for public services, and these impacts are likely to vary by area and depending on the type of public service. Migrants contribute to demand for public services. If foreign-born people in the UK used public services in the same way as demographically similar UK-born people, they would be expected to make less use of health and social care, but greater use of education. Migrants also contribute to financing and providing public services, and are over represented in the health care and social care work forces.
The Political Impact of Globalisation
States now have policies that seek to control immigration, absorb migrants into society and deal with increased ethnic and cultural diversity. More recently policies have also become linked to national security and anti-terrorism policies.
Assimilationism was the first state policy approach to immigration. It aimed to encourage immigrants to adopt the language, values and customs of the host culture, to become ‘like us’. However assimilationist policies have mainly failed because of the desire of many migrants to retain aspects of their ‘culture of origin’.
Multiculturalism accepts that migrants may wish to retain a separate cultural identity. One consequence of multicultural policy is the emergence of multicultural education in schools. However,Eriksen criticises such education as encouraging ‘shallow diversity’ – so we accept the surface elements of other cultures such as Samosas and Saris, but it fails to address issues surrounding ‘deep diversity’ such as arranged marriages.
Since September 11th many politicians have demanded a return to assimilationsim
Two further consequences include –
A More Multicultural Society
A divided working class and the white working class backlash.
Globalisation and migration
A final aspect of this topic you need to know about is Globalisation and Migration…
Globalisationis the idea that barriers between societies are disappearing and people are becoming increasingly interconnected across national boundaries.
Globalisation is the result of many processes including the growth of communication systems and global media, the creation of global markets, the fall of communism in Eastern Europe and the expansion of the European Union.
Many see globalisation as producing rapid social changes. One such change is increased international migration – the movement of people across borders. We can identify several trends in global migration.
There has been a speeding up of the rate of migration. For example according to the United Nations between 2000 and 2013 international migration increase by 33%, to reach 232 million, or 3.2% of the world’s population. In the same year, almost a million people either entered or left the UK.
There are many types of migrant. These include permanent settlers, temporary workers, spouses or forced migrants such as refugees. Before the 1990s immigration to the UK came from a narrow range of former British colonies and these migrants tended to form a small number of stable, geographically concentrated and homogeneous ethnic communities.
However, since the 1990s globalisation has led to what Steven Vertovec (2007) has called super-diversity: even within a single ethnic group individuals may differ in terms of their legal status, culture or religion and be widely dispersed throughout the UK.
There are also class differences among migrants. Robin Cohen (2006) distinguishes three types of migrant:
Citizens-with full citizenship rights such as voting rights
Denizens– who are privileged people welcomed by the state – such as billionaire ‘oligarchs’ or highly paid employees of Transnational companies
Helots– the most exploited group – states and employers regard them as disposable units of labour power, a reserve army of labour. They are found in unskilled, poorly paid work and include illegally trafficked workers and legal workers such as domestic servants.
The Feminisation of migration
Almost half of all global migrants are female and the types of job they do tend to fit patriarchal stereotypes such that there is a global gendered division of labour.
Barbara Ehrenreich and Arlie Hochschild (2003) observe that care work, domestic work and sex work in the UK is increasingly done by women from poor countries. This is a result of western women increasingly joining the labour force and the failure of the state to provide adequate child care.
The resulting gap has been filled by women from poor countries. For example, 40% of adult care nurses in the UK are migrants and most of these are female.
There is also a global transfer of women’s emotional labour. For example, migrant nannies provide care and affection for their employers’ children at the expense of their own children left behind in their home country.
Migrant women also enter western countries as ‘mail order brides’ and some as the victims of sex-trafficking.
According to Thomas Hylland Eriksen(2007), globalisation has created more diverse migration patters, with back and forth movements of people through networks rather than permanent settlement in another country.
This results in such migrants being less likely to see themselves as belonging to one culture or another and instead they may develop transnational neither/ nor identities and loyalties. The globalised economy means that economic migrants may have more links to other migrants than to their country of origin or the country they are currently settled in. Such migrants are less likely to want to assimilate into the ‘host country’.
Sources used to write the above include information from the ONS, British Red Cross and Rob Webb et al’s AS level Sociology book for the AQA.
From 1900 to the Second World War the largest immigrant group to the UK were Irish, mainly for economic reasons, followed by Eastern and Central Europian Jews, who were often fleeing from persecution.
Before the 1950s very few immigrants were non-white.
By contrast, during the 1950s, black immigrants from the Caribbean begain to arrice in the UK, followed during the 1960s and 70s by South-Asian immigratnts from India, Pakistan and Bangladesh and Sri Lanka.
Since 2001 the main sources of immigration to the UK have been as follows:
15% UK citizens returning home-ownership
30% from the European Uniion (mainly Polish)
30% from New Commonwealth countries such as india
To what extent is migration responsible for UK population growth?
In short, it’s not all about increased immigration, it’s more complex!
For most of the 20th century, the growth of the UK population was the result of natural increase (more births than deaths). Until the 1980s the numbers of people emigrating was greater than the number of people immigrating
More recently, however, and especially since the turn of the Millennium (around the year 2000), there has been an increase in net migration, reaching a peak in 2011 of just over 250, 000. However, this recent increase in net migration is mainly due to the decrease in emmigration, rather than an increase in immigration.
Finally, there has been a mini baby boom in the UK since the year 2000 which is responsible for about a third of the increase in recent population growth. However,
Explaining the reasons for immigration to the UK
In order to explain immigration, you have to look at both push and pull factors.
Push factors are things llike escaping poverty, unemployment or persecution.
Pull factors include things like better opportunities for jobs, study, a higher shtandard of living, more political and religious freedom and joining relatives.
The main pull factors to the UK in recent years have been:
To study at university (and also resulting in short term immigration only)
For employment – NB historically this is the major reason, and yes this does explain Polish immigration to a large extent but it’s also worth noting that many early migrants from the Caribbean and South-Asia were recruited by the British government to fill labour shortages in the UK – so quite literally pulled to the UK.
To be with family members.
The most significant push factor has been to seek asylum from Persecution. The most significant recent wave of this type was when 30 000 East African Asians escaped racist persecution by Iid Amin in Uganda in the 1970s. More recently Britain has accepted thousands of refugees fleeing persecution from several countries.
Another significant push factor is the high levels of unemployment in some southern and eastern European countries – Spain for example has youth unemployment of around 50%.
Explaining the reasons for emmigration from the UK
Historically the UK has been a net exporter of people. Two of the main reasons for emmigration include:
To take advantage of better employment opportunities
To have a higher standard of living – To benefit from the lower cost of living abroad in retirement.
If we go back into long term history, we could even add ‘colonial conquest’ to list – much early emigration was linked to the British Empire’s desire to control resources in other parts of the world.
The consequences of immigration for the United Kingdom
Explaining the long term decrease in the death rate
What are the Trends?
The death rate has halved in the last century, declining from 19/1000 to 10/1000 today.
In the first part of the century,most of this decrease was due to fewer children dying of infectious diseases, later on in the century, the continued decline is due to people living longer into old age.
The major causes of death have changed – from mainly being due to preventable, infectious diseases in the early part of the century to ‘diseases of affluence’ such as heart disease and cancers today.
There are considerable variations in life expectancy by gender and social class – people in the poorest parts of Glasgow die before 60, in the wealthiest parts of the UK (e.g. Kensington) life expectancy is nearer 90.
Explaining the decrease in the death rate
1. Economic growth and improving living standards
There are number of ways in which this had led to a decline in the death rate:
better food and nutrition (which in turn is related to better transport networks and refrigeration) which has meant that children are better able to resist infectious diseases, reducing the infant and child mortality rates. This is estimated to account for 50% of the decline in the death rate.
Better quality housing – Better heating and less damp, means less illness.
Smaller family sizes – as people get richer they have fewer children, which reduces the chances of disease transmission.
More income = more taxation which = more money for public health services.
Evaluation – It’s worth noting that not all people have benefited equally from the above advances. The wealthy today have longer life expectancy than the poor, who still suffer health problems related to poverty.
Evaluation – In terms of food and nutrition, obesity is now becoming a serious problem – more food doesn’t necessarily mean better nutrition.
Mass immunisation programmes limited the spread of infectious diseases such as measles.
Important in improving survival rates from ‘diseases of affluence’ such as heart disease and cancers.
Only really significant since the 1950s.
Evaluation – It’s easy to fall into the trap into thinking that modern medicine is the most important factor in improving life expectancy, it isn’t – economic growth, rising living standards and improvements in public health are more important.
The setting up of the NHS
Health and safety laws – which legislate so that we have clean drinking water, food hygiene standards and safe sewage and waste disposal
The clean air act and other policies designed to reduce pollution
Health and Safety laws at work.
Evaluation – These are largely taken for granted, but they are important!
There is greater knowledge and concern about health today
The decline of manual work means work is less physical and exhausting and less dangerous.
Overall conclusion/ analysis points
3/4s of the decline between the 1850s and 1970 was due to the reduction of infectious (fairly easily preventable) diseases such as Cholera, and improved nutrition accounts for half of this reduction. In these early years
More recently, the decrease in the death rate has been due to improving survival rates from heart disease and cancers.
The declining death rate is not necessarily all good – in the last decades we have witnessed a declining death rate and a declining birth rate – and so we now have an ageing population, which requires society to adapt in order to meet the different demands of differently structured population.
Between 1901 to 2010 the birth rate declined from 29 per thousand to 13 per thousand
The Total Fertility Rate has also seen a general decline in the last century, from a peak of almost 3 babies per woman in the 1960s to a low point of about 1.6 babies per woman in 2001.
However, the last 15 years have witnessed an increase back up to 2 babies per woman.
Explaining the long term decline in the birth rate
Globally, the general trend is that the wealthier country, the lower the birth rate. It would seem that economic growth and rising living standards mean adults have fewer children. Part of the reason for this is that higher living standards mean better quality housing, better nutrition, better education and better medical care – all of which reduce the infant mortality rate, meaning that parents have fewer ‘replacement babies’ to make up for those who die before their first birthday.
A second factor here is related to Functionalism – as Functionalists see it, as societys evolve and become more complex, other institutions take over key functions of the family – men go into wage labour, which gets taxed, which then translates into schools and hospitals and pensions – the last century in the UK has seen the emergence of all of these institutions – people no longer need children to look after them in their old age, or to work the fields, other institutions do this, so people have fewer children.
A final way economic factors can reduce the birth rate are that people are so busy working they don’t have time to start families – which is the case in contemporary Japan.
A criticism of economic arguments is that they are deterministic, people don’t just react to economic changes like robots, and they also appear a little ‘cold’ – It implies that people only have children for selfish, economic reasons.
The development of contraceptive technologies in the 1960s – Namely the contraceptive pill – gave rise to what Athony Giddens calls ‘plastic sexuality’ = Sex becomes detached from reproduction. Also, importantly, The Pill gave women control of their reproduction and they could choose when to have children. There is no direct correlation between the invention of The Pill and the decline in the fertility rate – in fact the Baby Boom of the 1960s came immediately after The Pill’s invention, and most women clearly still choose to have babies, but this technological change does explain why women have babies later in life and have fewer children.
Other technological innovations which have led to people having babies later in life are IVF and the freezing of eggs – together these technologie mean women can delay having children into their 40s, extending the ‘natural’ period of fertility much later than is traditionally the case.
An attendant analysis point here is that for IVF to be available for all women, it requires the state to fund it, otherwise this would be prohibitively expensive for couples with low incomes, so for this technological factor to have an impact, it needs to combine with political rights and a wealthy state.
Changes in the Role of Women
Anthony Giddens and Ulrich Beck both regard this as the most important factor explaining the decline in the birth rate. Because women how have formal legal equality with men, and increased educational opportunities (girls are now outperforming boys at school), women now make up half the work force, and this has led to changes in attitudes to family life – Career now comes first for many women, and childbearing is delayed by an average of ten years compared to in the 1950s. Women now typically have their first babies in their 30s, not their 20s and up 1/4 women are expected to remain childless.
As an evaluation point here – it’s important not to exaggerate the advances women have made, when the children come along, it is still predominantly women who do the majority of childcare and housework and suffer the consequences in terms of their career.
All of the above changes are part of the broader process of posmodernisation – The decline of traditional norms and values such as those associated with religions mean that contraception is no longer viewed in a stigmatised way and declining birth rates also reflect individualisation – the fact that we put our own needs first and it is acceptable to choose not to have children.
A criticism of Postmodernism is that many people simply don’t choose to have children. Many people are forced into living an uncertain, unpredictable life where having children may not be a possibility or simply not be rational or affordable.
Changes in the position of children
Until the late 19th century children were an asset to their parents because they could be sent out to work. Today, laws protect children from working and dictate that they should spend 18 years in education, and thus children have become an economic liability – they are a net drain on parents’ income. This puts people off having children.
People also have fewer children because we now live in a ‘child centred society’ – It is expected that children be the centre of family life, and parents are expected to spend more money (£250K is the average cost) and more time than ever engaged with their children – it is easier to do this with fewer children.
Explaining the recent increase in the birth rates.
Three factors which could explain this include…
Increasing immigration – immigrant mothers have more children (accounts for approx. 20% of the increase)
Reduction in child poverty – New Labour increased welfare payments to poorer families – easier to have children
Advances in birth technologies – increase in IVF – more women in their 40s having babies