World Development Report 1984

economic development has been rapid enough to tries, has already fallen considerably. But there are
offset the declining contribution of public health other reasons. Mortality declines affect population
improvements, so life expectancy has gone on ris- growth less when fertility is falling, as is and will
ing steadily. In India in the past decade, however, be the case in most countries. Long-range populapoverty
and illiteracy in rural areas of the north tion growth is less dependent on the addition of
seem to have kept infant mortality high, slowing people whose lives are saved than on the number
any further rise in rural life expectancy despite eco- of children they subsequently bear. When fertility
nomic growth. In Africa slower economic progress is high, saving a baby's life adds a great deal of
(in some countries, even regression) has slowed reproductive potential. To save the lives of an
the rise in life expectancy. Rural mortality tends to infant girl and boy who will go on to have 6 chilexceed
urban mortality, so a slightly slower pace of dren is to add those people plus (perhaps) their 36
urbanization in the late 1970s may also have grandchildren, 216 great grandchildren, and so on.
slowed progress against mortality. By contrast, the But as fertility declines, so does the amount of
remarkable gain in life expectancy in China-from extra reproductive capacity. The infant girl who
forty-one in 1960 to an estimated sixty-seven in survives, grows up, and gives birth to 3 instead of
1982-shows what can be achieved, even by a 6 children has 27 rather than 216 great grandlargely
rural society, through a combination of children (assuming that each of her children will
education, income gains, and a strong health care follow her pattern). Furthermore, as mortality
program. declines, more and more deaths are shifted from
For the future, increasing life expectancy seems younger to older ages. To extend the life of somelikely
to depend more than ever on improved liv- one sixty years old is to keep the population just
ing conditions, education for women, and better one person larger than it would otherwise be, not
health care for the poor. Three indicators lend sup- to boost it by that person plus descendants.
port to this view. In addition, as Chapter 6 will indicate, lower
* Mortality from diarrhea in the developing mortality contributes directly to lower fertility. For
world is two to three times higher than it was in the individual family, fewer deaths usually mean
today's developed countries when overall mortal- fewer births (though the net effect is a somewhat
ity levels were similar. Diarrhea is a disease of the larger family on average). Finally, because further
poor, primarily of poor children. It accompanies mortality declines depend more than before on
malnutrition and is exacerbated by poor sanitation, progress in women's education and on improved
lack of elementary health services, and lack of the living conditions and health care, programs that
basic education that might allow parents to take reduce mortality are likely to reduce fertility as
the necessary precautions to prevent it. well.
* Infant and child mortality, the major contributors
to low life expectancy in developing countries, Demographic prospects and goals
are closely linked to economic and social welfare.
In Latin America infant and child mortality rates Demographic projections should not be treated as
are five times greater among children whose moth- forecasts. The purpose in making projections is to
ers have no schooling than among those with illustrate what the future could be, given certain
mothers having ten or more years of schooling. assumptions. It is the assumptions that determine
* In countries with life expectancy higher than whether the projections will match reality. Some
might be expected from their average incomes- projections have been wide of the mark; for exam-
Costa Rica, Cuba, Korea, and Sri Lanka-income ple, the size and duration of the baby boom after
tends to be more equally distributed than in other 1945 in the United States was unexpected. But
developing countries. Illiteracy is also lower and since the 1950s, when the United Nations began
health services more widespread. producing systematic projections of world population,
demographers have done well in predicting
7. Further declines in mortality rates will boost popu- future trends. In 1963 the United Nations prolation
growth much less from now on than they did in jected a 1980 population of 4.3 billion, only a shade
the 1950s and 1960s. off the 4.4 billion suggested by the latest estimates,
For most of the developing world, the time when and projections of world population in the year
declining mortality produced surges in population 2000 have hardly changed since 1963.
is passing rapidly. In part this is because mortality, But projections for particular regions and counthough
still high compared with developed coun- tries have varied. The 1980 UN projection for
73