Demography is the science of population. It studies the total number of people in a given area, growth, decline, age composition, sex ratio, and demographic processes, such as fertility, mortality, and migration. The population of India is increasing rapidly. In spite of economic development, the standard of living is low. The increase in population has created a number of problems, such as poverty; unemployment, lack of food and shelter, poor education, and miserable health. The growth of population has affected the economy of the country. Every year, 17 million people get added to the existing population. The rapidly growing population retards all our development efforts.
Fuller and Myers have defined social problem as ‘a condition, which is defined by a considerable number of persons as a deviation from social norms which they cherish’.
Merton and Nisbet hold that a social problem is a way of behaviour that is regarded by a substantial part of a social order as being in violation of one or more generally accepted or approved norms.
Demography represents a fundamental approach to the understanding of human society. In a general sense, the task of a demographer is to ascertain the number of people in a given area, and the changes that have taken place over the years, and to estimate the future trend on this basis. He or she takes into consideration the births, the deaths, and migration. Fertility, mortality, and migration are of concern not only to a demographer, but also to a sociologist. All these are to a great extent socially determined and determining.
The study of human population begins with how many people are born. Fertility is the incidence of child-bearing in a country’s population. During her child-bearing years, from the onset of menstruation to menopause, a woman is capable of bearing more than 20 children. Demographers gauge fertility using the crude birth rate, which is the number of live births in a given year for every thousand people in population. To calculate the crude birth rate, divide the number of live births in the year by the society’s total population and multiply the quotient by 1,000. A country’s birth rate is described as crude because it is based on the entire population, not just on women in their child-bearing years.
Population size also reflects mortality, which refers to the incidence of deaths in a country’s population. In order to measure mortality, the demographer uses a crude death rate, which is the number of deaths in a given year for every 1,000 people in a population. This time we take the number of deaths in a year and divide it by the total population and then multiply the quotient by 1,000.
The third useful demographic measure is the infant mortality rate (IMR), which refers to the number of deaths among infants below one year of age for each 1,000 live births in a given year. To compute infant mortality, divide the number of deaths of children under one year of age by the number of live births during the same year and multiply the quotient by 1,000.
Population size is also affected by migration, which refers to the movement of people into and out of a specified territory. Movement into a territory or immigration is measured by an in-migration rate, which is calculated as the number of people entering an area for every 1,000 people in the population. Movement out of a territory or emigration is measured in terms of an out-migration rate, which is the number of people leaving an area for every 1,000 people. Both types of migration usually occur during the same period and the difference is the net migration rate.
Fertility, mortality, and migration all affect the size of a society’s population. In general, rich nations grow as much from immigration as from natural increase; poor nations grow almost entirely from natural increase. In order to calculate a population’s natural growth rate, demographers subtract the crude death rate from the crude birth rate. A handy rule of thumb for estimating population growth is to divide the number 72 by a society’s population growth rate and this gives us the doubling time in years.
The demographer also studies the make-up of a society’s population at a given point in time. One variable is the sex ratio, which refers to the number of males for every 100 females in a nation’s population. A more complex measure is the age—sex pyramid, a graphic representation of the age and sex of a population.
We may indicate in summary form some of the general relationships between population and society. Some of these factors have been considered earlier. Others have not been discussed. It is important to understand the complex relationship between the raw material of society and the form and structure of society itself.
The technological advances that have occurred in recent generations throughout the world have meant that a smaller number of persons can now produce all the food and raw materials necessary to support the rest of the population. Especially in the more advanced technological countries, the distribution of income among the various segments of the population is increasing in disparity as a result of the changes in these productive relationships.
Figure 7.1 Factors That Affect the Population and Structure
Large families are characteristic of populations living on farms and under rural conditions generally. When modern sanitation and medicine are introduced to colonial and predominantly rural people, the immediate result in a rapid increase in population, as the high birth rates continue and the death rates are drastically reduced.
In societies where social control is still largely vested in the mores, the birth rate is traditionally high and the ideal family is usually a large one. Efforts on the part of governmental or other agencies to encourage the limitation of family size under such conditions are met with indifference or even open hostility.
Some societies encourage the artificial limitation of families and are moving toward a stabilization of population growth. Such societies are characterized by education, city life, industrial employment, employment of women outside the home in non-agricultural occupations, revolutionary social movements, popular participation in democratic processes, the spread of inventions, and the advance of science.
The social control of population growth presents one of the most obvious, and at the same time most difficult, forms of social planning. The growth of population is more than a simple response of the individual to the reproductive urge. Social and cultural factors combine with other considerations to render any change in reproductive behaviour extremely difficult to accomplish even by organized efforts. This behaviour is extremely difficult to accomplish even by organized efforts. This behaviour is deeply imbedded in the culture pattern, and it cannot be changed without extensive changes in other elements of the pattern.
In the past, people favoured large families because human labour was the key to productivity. Moreover, until rubber condoms appeared 150 years ago, the prevention of pregnancy was an uncertain proposition at best. But high death rates from widespread infectious diseases put a constant brake on population growth. Global population reached 3 billion by 1962 and 4 billion by 1974. The rate of world population increase has slowed in recent years, but our planet crossed the 5-billion mark in 1987, and the 6-billion mark in 1999. In no previous century did the world’s population even double, but in the 20th century it quadrupled. Currently, about 73 million people are being added in the world every year; and 96 per cent of this increase is in poor countries. Experts predict that the Earth’s population will reach 8 billion by 2050.
India is the world’s second most populous country. According to the 1991 census, India’s population was 84.39 crores, which by the end of 1996 increased to 93.4 crores. According to projections made in a World Bank report, India’s estimated population by 2150 will be over 1,756 million against China’s 1, 680 million. India will thereby overtake China and become the most populous country of the world. The World Population Report published by the United Nations Population Division revealed that the world population would reach 6 billion in 1998, and the annual addition to the world population in the subsequent decade would average 97 million, the highest in history. Nearly all of this population growth would be in Africa, Asia, and Latin America. The population of the world was projected to be 11.6 billion in 2150.
It was the sudden population growth two centuries ago that sparked the development of demography. Thomas Robert Malthus (1766–1834), an English economist and clergyman, warned that population increase would soon lead to social chaos. Malthus calculated that the population would increase by what mathematicians call a geometric progression. At this rate, he concluded, world population would soon soar out of control. Food production would also increase, he explained, but only in arithmetic progression because, even with new agricultural technology, farml and is limited. Thus, he presented a distressing vision of the future: people reproducing beyond what the planet could feed, leading ultimately to widespread starvation. He recognized, however, that artificial birth control or abstinence might change the equation.
Figure 7.2 Malthusian Cycle
Fortunately, Malthus’ prediction was flawed. First, by 1850, the European birth rate began to drop, partly because children were becoming an economic liability rather than an asset, and partly because people began using artificial birth control. Second, Malthus underestimated human ingenuity—modern irrigation techniques, fertilizers, and pesticides have increased farm production far more than he could imagine. Some criticized Malthus for ignoring the role of social inequality in world abundance and famine. Karl Marx objected to viewing suffering as a law of nature rather than as the curse of capitalism.
A more complex analysis of population change is the demographic transition theory—the thesis that population patterns reflect a society’s level of technological development. It is explained as demographic consequences at four levels of technological development.
Figure 7.3 Stages in Demographic Transition Theory
A critical evaluation of the demographic transition theory suggests that the key to population control lies in technology Instead of the runaway population increase feared by Malthus, this theory sees technology reining in growth and spreading material plenty.
Demography is derived from two Greek words ‘demos’ meaning the people and ‘graphein’ meaning the record. Demography deals with the study of the size, the composition, and the distribution of human population at a point of time. Community health nursing and population plays a significant relationship. People are the basic unity of community health care.
Demography is as branch of science which studies the human population and their elements. The elements are change in the size of population, structure of population, and geographical distribution of population.
Demography is the scientific study of human population such as changes in population size, the composition of the population and distribution of population in space. It also deals with five ‘demographic process’ namely fertility, mortality, marriage, migration, and social mobility.
The historical roots of demography are spread over centuries. The earliest records of census operations have been traced as far back as 4000 BC in Babylonia, 3000 BC in China, and 2500 BC in Egypt.
Canada was the first country to operate census on modern lines in 1666, followed by United States of America in 1790 and England in 1801. Countrywide census operation was introduced in India in 1881.
The enforcement of vital registration and laws enforcing compulsory registration were initiated during 17th century, thereby stressing the importance of registration of vital events. The process slowly spread to other regions of the world. The first act of this spread was introduced in India in 1886. The voluntary registration of births, deaths, and civil marriages act for compulsory vital registration was passed in 1969.
Figure 7.4 Sources of Demography
Figure 7.5 Demographic Cycle
The population of the world is not uniformly distributed over the globe. It is mainly concentrated in the developing countries. Demographic profile of these countries and their health status is greatly influenced by their levels of socio-economic development. UNICEF has grouped the countries of the world into three categories—industrialized, developing, and least developed.
The world population stood at 6 billion by year 2000. The statistical indices used to assess the health profile of the countries of the world are both crude and specific. The difference between crude birth rate and crude death rate for comparing the health status of countries are IMR, under-five mortality rate (UFMR), and maternal mortality rate (MMR).
India is the second populous country in the world. The population size is about 1027 million in 2001. The population size was about 1000 million between 1991 and 2001. According to 2001 census, the child population, that is, the total number of children of 0–6 years was 15.78 crores, out of which male children were 8.19 crores and female children were 7.59 crores. The sex ratio in India has been generally adverse to women, that is, number of women per 1,000 men has generally been less than 1,000. Kerala had a sex ratio of 1,058 females per 1,000 males in 2001.
In the Indian census, density is defined as the number of persons, living per square kilometre. The family size refers to the total number of persons in the family. The family size depends upon numerous factors, namely, duration of marriage, education of the couple, the number of live births and living children, preference of male children, and desired family size.
Urbanization is a recent phenomenon in the developing countries. The proportion of the urban population in India has increased from 10.84 per cent in 1901 to 25.72 per cent in 1991 and was 27.8 per cent in the year 2001. The expectancy of birth is that the rising birth rate has continued to increase globally, and all people have the expectancy to live longer and they have a right to a long life in good health rather than one of pain and disability.
There are several reasons and methods for population control. Table 7.1 explains them.
TABLE 7.1 Population Control Methods
India requires a very effective population control policy that would launch a well-planned attack on our population. During a population-explosive period, when unemployment is looming large, the population control programme should get the highest priority in our development plans. A national population policy should be immediately framed and effectively implemented. The important points to be noted while drafting a national population policy are as follows:
The population of the world has been growing rapidly in the last hundred years. Industrialization increased the output and in a short span of time more food, more goods, and more wealth could be provided to men. As more and more countries got industrialized, death rate fell. Birth rate, on the other hand, remained constant. So there has been a rapid growth of population. The change in population is caused mainly either by an increase in birth rate or by a decrease in death rate. Table 7.2 enumerates the causes.
TABLE 7.2 Causes of Population Growth
The high growth of population or population explosion affects the people not only economically but also their social, religious, living, and health conditions. Table 7.3 lists these problems.
TABLE 7.3 Effects of Population Explosion
When a nation cannot provide facilities to its growing population, the result is that in order to get whatever facilities are available, corrupt means are used. Thus, corruption becomes widespread in the society. When there is strain on every resource, it becomes difficult to develop talent. Thus, the nation very much loses good talent, putting the entire generation in the reverse gear. It becomes difficult to maintain an even sex ratio. It gets disturbed quite frequently, resulting in many social problems. When a vast majority lives in shanties, the problem of maintaining moral character arises. Degradation of morals results in many social problems.
According to the Census of 1991, the population of the Indian Union has been estimated to have increased 23.50 per cent over the 1981 census (Table 7.4).
TABLE 7.4 State-wise Population According to 1991 Census
State | Population |
---|---|
Andhra Pradesh | 66,304,854 |
Assam | 22,294,562 |
Bihar | 86,338,853 |
Gujarat | 41,174,060 |
Jammu and Kashmir | 7,718,700 |
Kerala | 29,011,237 |
Madhya Pradesh | 66,135,862 |
Tamil Nadu | 55,638,318 |
Maharashtra | 78,706,719 |
Karnataka | 44,817,398 |
Nagaland | 1,215,573 |
Orissa | 31,512,070 |
Punjab | 20,190,795 |
Haryana | 16,317,715 |
Rajasthan | 43,880,640 |
Uttar Pradesh | 138,760,417 |
West Bengal | 67,982,732 |
Chandigarh | 640,725 |
Andaman and Nicobar | 277,989 |
Delhi | 9,370,475 |
Himachal Pradesh | 5,111,079 |
Lakshadweep | 51,681 |
Pondicherry | 789,416 |
According to the census of 1991, 25.2 per cent of the population lived in towns and cities, and the remaining 74.8 per cent in villages. Table 7.5 provides the rural–urban ratio of population over the censuses.
TABLE 7.5 Population Distribution in Rural and Urban Areas
Census | Rural | Urban |
---|---|---|
1872 | 91.3 | 8.7 |
1881 | 90.6 | 9.4 |
1891 | 90.5 | 9.5 |
1901 | 90.2 | 9.8 |
1911 | 90.6 | 9.4 |
1921 | 89.7 | 10.3 |
1931 | 89.0 | 11.0 |
1941 | 87.0 | 13.0 |
1951 | 82.7 | 17.3 |
1961 | 82.0 | 18.0 |
1971 | 80.09 | 19.91 |
1981 | 76.27 | 23.73 |
1991 | 74.8 | 25.2 |
Population in India is very large and it is also growing rapidly. India stands second in the world, next only to China. The pressure of population on land is very heavy. The per capita availability of land is very less. Although India has made considerable development in the field of agriculture and industry; yet we are not able to improve the economic condition of the people because of a continuous increase in population.
The density of population is also very high in India. Manpower is under-fed, diseased, illiterate, and unskilled. Table 7.6 shows how the population of India is increasing rapidly.
TABLE 7.6 Growth of Population in India
The population groups that form the focus for community health nursing can be many and varied. Populations are groups of people who may or may not interact with each other. Population may refer to the residents of a specific geographic area, but can also include specific groups of people with some traits or attributes in common. Three other commonly used, similar but different terms for these smaller sub-groups are—aggregates, neighbourhood, and community (Table 7.7).
TABLE 7.7 Aggregates, Neighbourhood and Community
Population | Type Characteristics |
---|---|
Aggregates | Aggregates are sub-populations within the larger population who possess some common characteristics, often related to high risk for specific health problems |
Neighbourhood | A neighbourhood is a smaller, more homogeneous group than a community and involves an interface with others living nearby and a level of identification with those others. Neighbourhood is self-defined and although it may be constrained by natural or man-made factors, it often does not have specifically demarcated boundaries |
Community | A community may be composed of several neighbourhoods. Some authors define communities within geographic locations or settings. In addition to location, other potential defining aspects of communities include a social system or social institutions designed to carry out specific functions, identity, commitment, or emotional connections, common norms and values, common history or interest, common symbols, social interaction and intentional action to meet common needs |
According to Wilcox and Knapp, population health can be defined as the attainment of the greatest possible biological, psychological, and social well-being of the population, as an entity and of its individual members. Health is derived from opportunities and choices provided to the public as well as the population’s response to those.
Figure 7.6 Characteristics of Healthy Communities
Health care for population takes place at three levels, often referred to as the three levels of prevention. These three levels of health care are primary prevention, secondary prevention, and tertiary prevention (Table 7.8).
TABLE 7.8 Three Levels of Health Care
Figure 7.7 Objectives for Population Health
According to WHO, family welfare means married couple follows one of the family planning methods on their own by following the family planning method. They improve their own health and their family health, thereby improving national health.
For quite some time, in the recent past, the women were treated as inferior to men. But as a welfare state, India has decided that men and women shall be at par with each other. No position or post in social, economic, or political field will be denied on the basis of sex. Both the sexes will be treated on equal footings. There will be equal wage for equal work. The system of child marriage has been legally discontinued and minimum age for the marriage of girls has been fixed. Condensed courses of education for adult women have been started. Mahila Mandals look after the welfare of women in the villages. Working women hostels have been started. Adult women are given vocational training. Women are given every opportunity to occupy highest job at par with men.
The children are today considered as possession of the nation. Today, it is realized that the children of today will become good citizens of tomorrow, and as such, it is essential that they should be given maximum care. Nutrition programmes have been started, and children, particularly those belonging to weaker society, are given free food in the schools. Alter care homes, sections of Balwadis, Crèches, and similar other programmes for the welfare of the children have been introduced. Child marriage has been banned.
In so far as health is concerned special attention has been paid in this regard as well. Medical facilities are being provided to the sick in all parts of the country. Free medical aid is provided. Through hospitals to the poor workers, ESI dispensaries have been opened where medical aid is provided at normal costs. Mobile dispensaries visit far-off villages. Maternity and child care centres operate round the clock.
Although the vast majority of Indian women are uneducated, unemployed, and are kept suppressed by male domination, they are more alive to the importance of family planning. They desperately need help and seek help. For various reasons a women may not want children. Poor health, economic reasons, domestic work pressure, psychological unpreparedness, cruelty of indifference of the spouse, harassment from in-laws are some of the common reasons that compel a women to want family planning. A working woman, unable to combine household responsibilities with the outside job, often goes for birth control. We also come across women wanting contraceptives to enjoy greater sexual freedom. And in sensitive situations where a woman becomes pregnant out of wedlock or in an adulterous relationship, she looks for help desperately.
To make the masses responsible about family planning in a country with over 50 per cent illiterate is not an easy matter. Education is the first step because rightly informed men and women will go out of the way to take necessary birth control measures to achieve what they want— though literacy by itself does not change the attitude or persons. We have numerous instances where an educated man justifies his young wife’s fifth pregnancy, or insists on his wife trying once more because he wants a son. Like in religion, where we see some highly educated persons most fanatical in their religious convictions, so is the thought with family planning.
We need a total social awakening to see the necessity of family planning among the educated and less educated. Every male and female must have the inner conviction that in modern living, smaller family units contribute to greater prosperity and good health and family planning is a pressing necessity for every household in India. Like convenient road rules, good hygienic practices, compulsory basic education, and abolition of dowry, the necessity of family planning must be seen by each adult as a personal responsibility for the good of the individual and the larger group.
The National Family Welfare Programme is at cross-roads. The demographic goal set as early as 1962 has evaded us so far. However, there is no significant improvement due to the outcome of this programme nor there is no significant contribution made by India to the world in terms of innovations, which means the creative ideas and concepts to be inculcated in this programme for the maximum utilization and for the benefit of the people in the society. If the programme is really implemented with proper innovative ideas, then it will be utilized effectively, as innovative ideas can help to move the family welfare programme forward with accelerated speed. The extensive infrastructure, if reoriented and motivated, can be used as a base for building up a much more dynamic, effective, and efficient programme. It is important to get a grip on the correct answer and to be keenly aware of the new demands and adjust our methods so as to achieve success.
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