From Death to Birth Mortality Decline and Reproductive Change (1998) / Chapter Skim
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1 Introduction
1 Introduction
Pages 1-38
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Even when first articulated, the mechanisms by which mortality reduction might bring about fertility decline were understood to be complex, involving both individual- and societal-level responses. Subsequent demographic research has done much to clarify the individual-level relationships, and in so doing has added new considerations.
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In the event of an infant or child death, two additional mechanisms could come into play: lactation interruption effects and behavioral replacement strategies. Fourth, the Preston volume made a place for societal-level effects, those having to do with institutional forces that had long served to maintain high fertility in the face of high mortality, and which would therefore continue to shape the fertility response to mortality decline.
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In addition, the potential feedback benefits of fertility decline were cited, these having to do with the role of lower and better-spaced fertility in reducing the risks of maternal, infant, and child mortality. In the view of King's critics, health and family planning programs have the potential to set off a series of responses that could culminate in a more-than-compensating fertility decline over the long term.
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When the full empirical record is assembled, it is seen to encompass a remarkable diversity of experience. Many countries have adhered to the simple scheme of demographic transition in which mortality declines first and fertility decline then follows with a lag.
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First, some researchers have continued to search for statistically significant thresholds of life expectancy or socioeconomic development that, when attained, provide motivation for couples to limit their fertility (see, for example, Cutright, 1983; Cutright and Hargens, 1984; Bulatao, 1985~.2 Such studies have generally failed to identify meaningful thresholds for fertility decline, although measures of social development often appear to be more closely associated to declines in fertility than are measures of economic development (Cleland, 1993~. Second, the emergence of detailed m~cro-level data from developing countries has supported a new generation of studies of both the lactation interruption and replacement effects (A.I.
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and Sah (1991) further refined the dynamic theory that underlies modern economic models of insurance and replacement effects.
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Heavy infant but light child mortality makes child survival more secure and predictable following infancy. When new health behaviors are adopted, and these innovative health decisions are shown to exert a perceptible influence on mortality risks, parents may be led to consider new, more self-conscious strategies of family building in general.
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Although debate continues about the measurement, meaning, and depth of fertility preferences, one aspect is clear: Child replacement effects are likely to be stronger among families that have not yet exceeded their ideal family size and weaker among families that have already experienced
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. The emergence of replacement effects is thus linked, directly or indirectly, to the factors that shape fertility preferences, govern the costs of fertility regulation, and thereby affect the proportion of families that have yet to reach, or have already exceeded, their desired family sizes.
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Such morbidities would undermine children's energies and abilities to learn, thereby reducing the payoffs that parents could expect to receive from their schooling investments. Another possibility is that when higher parental fertility is occasioned by higher child mortality, school-aged children are more often called upon to serve as caretakers for their younger siblings or to assist their mothers in household tasks.
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When micro-level data are used, the discreteness of fertility measures and the nonlinearity of the replacement effect induce an artificial correlation between fertility and child mortality that can also affect estimates of behavioral relationships (Williams, 1977~. When macro-level time series data are used, the time dimension of the analysis raises questions of autocorrelation (Brass and Barrett, 1978)
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ethnic composition. Mortality decline preceded fertility decline across Latin America.
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By analyzing the specific experiences of individual Latin American countries, Guzman (1994) identified no fewer than four distinct patterns of fertility decline.
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Pakistan 0 India + Sri Lanka E1 ~ Am_ a Mexico Columbia - I 6 4 Total Fertility Rate 0 Brazil + costa Rica d;~ OF i 6 Total Fertility Rate 2 FIGURE 1-1 Alternative mortality-fertility pathways, 1950-1990. NOTE: Each line depicts one country's experience over the period from 1950 to 1990.
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Total Fertility Rate 0 Cameroon + Senegal .
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50 1g60 11970 1980 ~ to Mexico Columbia 0 Brazil ~ Costa Rica ~~:X,: lg ;0 1960 1970 1980 Time FIGURE l -2 Rates of population growth, l 950- l 990.
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BARNEY COHEN AND MARK R MONTGOMERY Indonesia ~ Philippines o 3 o ~2 } o _ o em O 4= ~3 o o w _~ CL o ILL i o 03 TIC 0- .
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Here, child mortality has been falling rapidly, but it is not yet low; female education remains low; and the national family planning program is as yet quite weak (Pison et al., 1995~. The apparent relationship between mortality and fertility decline in Senegal can be questioned, not least because Senegal's fertility decline appears to be atypical.
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In China, an aggressive government policy was among the major factors inducing fertility decline (Tien, 1984; Wolf, 1986; Rele and Alam, 1993~. In South Korea and Taiwan, fertility transitions were more spontaneous, as rapid economic modernization and social transformation gave couples the motivation to restrict fertility and governments played significant supporting roles by providing family planning information and subsidized services (Gunnarsson, 1992; Coale and Freedman, 1993~.
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In Sri Lanka, for example, where late age at first marriage for women has traditionally kept fertility rates relatively low, fertility declined rapidly in the late 1960s and early 1970s. By 1974, the total fertility rate stood at some 3.4 children per woman (slam and Leete, 1993a)
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Theory and Evidence on the Strength of Various Mechanisms Lactation Interruption Effects Until now, demographers have not systematically exploited the largest demographic database from developing countries the Demographic and Health Surveys to examine the strength of the lactation interruption and replacement effects. The chapter by Laurence Grummer-Strawn, Paul Stupp, and Zuguo Mei effectively fills this gap.
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Wolpin's chapter underscores a point that has been insufficiently appreciated that insurance and replacement effects have common roots in individual preferences, perceptions, and constraints and guides the reader through an illuminating dynamic formulation. In addition to summarizing the potential contributions of such models to demographic research, Wolpin carefully analyzes the statistical problems that researchers face when trying to estimate replacement and insurance effects.
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Using data from one high-prevalence region and two national surveys of Tanzania, the authors find that higher community levels of child mortality are associated with higher fertility, whereas higher community levels of adult mortality are associated with lower fertility aspirations and lower recent fertility. Reassessment of Historical Events Casual observation of the demographic transition in nineteenth century Europe suggests that the mortality decline preceded the fertility decline, leading researchers to theorize a causal link between the two.
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Studies of changes are less vulnerable to contamination by persistent unobserved heterogeneity. To date, very little work on this topic has been focused on the United States, perhaps because macro-level time series data indicate that fertility decline preceded mortality decline by at least 70 years.
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As we have seen, heterogeneity between and within the various regions of the world has been conspicuous in several dimensions: the initial levels of fertility; the socioeconomic and demographic conditions prevailing at the onset of fertility declines; the date of the onset and the speed of the declines once under way; the extent of the declines (i.e., the ultimate levels of fertility achieved) ; the role of government policy toward population and family planning; and, most important in the context of this volume, the role of prior mortality declines.
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Significantly, however, the government of Indonesia switched from firm opposition to fertility control to a recognition of the disadvantages of continued rapid population growth and made a strong commitment to reducing fertility (slam and Leete,1993b) .l2 Observers of this period of Indonesian history express little doubt that the government family planning program was a central ingredient in the country' s fertility transition and that it speeded the process of decline, especially among the rural poor (Freedman et al., 1981; McNicoll and Singarimbun, 1983; Sanderson and Tan, 1995~.
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Consequently, Rosero-Bixby concludes that although improved child survival may facilitate fertility declines, and low survival chances may delay the transition, there is no critical mortality threshold to be overcome. During focus group interviews, women in Costa Rica who had lived through the fertility transition indicated that the prevailing level of child mortality was not at the forefront of their thinking.
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The precise nature and specific contribution of each of these factors varies from one society to another. Thus, at the macro level, a search for a simple and universal rule linking the timing of mortality and fertility declines would seem to be futile.
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Rather, the research discussed here suggests that child survival and family planning programs play important complementary roles. ACKNOWLEDGMENTS This chapter has benefited from the discussion of participants at a seminar entitled "Reevaluating the Link between Infant and Child Mortality and Fertility," which was organized by the Committee on Population in November 1995.
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1978 Effects of child mortality on subsequent fertility of women in some rural and semi-urban areas of certain Latin American countries. Population Studies 32(1)
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Khan, and L.C. Chen 1976 The effect of child mortality experience on subsequent fertility: In Pakistan and Bangladesh.
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Kelly 1981 The role of family planning programs in fertility declines in less developed countries, 1958-1977. International Family Planning Perspectives 7(4)
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1982 Child mortality and reproductive behavior in German village populations in the past: A micro-level analysis of the replacement effect. Population Studies 36(2)
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1985 The effect of child mortality on contraceptive use and fertility in Colombia, Costa Rica, and Korea. Population Studies 39(2)
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Wolpin 1983 The impact of exogenous child mortality on fertility: A waiting time regression with dynamic regressors. Econometrica 51(3)
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:255-260. 1994b Sources of Fertility Decline in Modern Economic Growth: Is Aggregate Evidence on the Demographic Transition Credible?
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Olsen 1983 Evaluation of the Olsen technique for estimating the fertility response to child mortality. Demography 20(3)
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Population and Development Review 19(2)
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