"Whenever I go into a restaurant, I order both a chicken and an egg to see which comes first"

Tuesday, March 13, 2012

It Never Was About the Condoms

In an excellent article in today’s (3.13.12) New York Times by David Brooks, he writes about The Fertility Implosion, reflecting on the dramatic reductions in fertility in most countries. http://www.nytimes.com/2012/03/13/opinion/brooks-the-fertility-implosion.html?_r=1&ref=opinion

Despite decades of US intervention, tens of millions of dollars, and hundreds of millions of condoms, advertising campaigns promoting small families, improvements in education and especially income are what most directly affect birth rate and family size.  There are numerous examples to show how sensitive fertility is to income.  Italy and Quebec (Canada) had some of the highest fertility rates in the post-WWII era, but as both gained in income, fertility rates dropped to among the lowest in the world.  Passionately Catholic countries like Ireland followed suit – large families became the exception as young couples saw the economic advantages of fewer children.

Countries of the former Soviet bloc whose birth rates had been kept artificially high because of stringent anti-abortion measures, plummeted after 1989 as real income dropped precipitously.  India’s fertility rate in the economically developed South is approaching replacement levels where in the less-developed and poorer North, these rates are much higher.

As economist Amartya Sen pointed out years ago during the intensive and largely unsuccessful US efforts to influence fertility through mass media campaigns and free condom distribution, Indian villagers, because of their marginal economic existence and reliance on family labor, were unwilling to reduce fertility.  More strong arms meant assuring subsistence and perhaps some measure of economic progress.  Not only that, he argued, these uneducated farmers did not have the information that indicated that mortality rates were falling, and that the chances of children surviving were far greater than ever before.  Had they understood this, Sen argued, they might have taken steps to reduce fertility.  Once again, income and education were predictors of fertility.  No amount of well-crafted, ‘persuasive’ advertisements would change the minds of the many subsistence farmers in India.

Ignorance of these economic and educational realities promoted the fallacy that there was something ‘wrong’ with these peasants – how could they not see the logic in the argument that fewer children meant happier families, the wisdom long since adopted in the West?  Or, as development planners concluded, something must be wrong with the advertising.

Kerala (India) has always been used as an example of the importance of education – especially girls’ education as factors in lower fertility.  Kerala’s per capita income is lower than most low-fertility countries or regions but quality primary and secondary education is universal. 

As Brooks notes:

Usually, high religious observance and low income go along with high birthrates. But, according to the United States Census Bureau, Iran now has a similar birth rate to New England — which is the least fertile region in the U.S.

This can at least partly be explained by education.  In Iran 96 percent of primary school-age children are enrolled, and nearly 90 percent complete primary education.  For secondary school enrollment, Iran ranks 9th out of the 171 countries ranked by UNESCO.  Girls secondary education lags behind boys but is not insignificant at close to 60 percent.

The speed of the change is breathtaking. A woman in Oman today has 5.6 fewer babies than a woman in Oman 30 years ago. Morocco, Syria and Saudi Arabia have seen fertility-rate declines of nearly 60 percent, and in Iran it’s more than 70 percent. These are among the fastest declines in recorded history.

While income and education are the most important factors affecting fertility, the impact of Western media cannot be discounted.  Despite the attempts of many countries to restrict Internet access, films, and television from the West, information about small, upwardly mobile, successful small families are the norm; and attractive, Hollywood norms have always had an influence on behavior.

The era in which I worked in Family Planning, or ‘Population’ as the United Nations liked to call it, was one that was dominated by the theory that if you marketed family planning and its products like any other commercial product, company, or program, you would change behavior.  I must take responsibility for this theory, because I was one of the first exponents of what is now called Social Marketing.  In 1970 I developed a mass media-marketing campaign in India which was based on the advertising model: if you develop a persuasive selling campaign, you can influence choice.  Family planning should, in principle, be no different than shampoo or coffee. 

I was wrong on many fronts – the most important of which was that I and legions after me failed to appreciate the importance of income and education as determinants of fertility.  Secondly, I vastly overestimated the power of advertising.  It is successful in the United States because it has tens of millions of dollars to spend to influence market share by a fraction of one percent; and because it influences this market share on products that are inexpensive and affordable.  Changing sexual and reproductive behavior was another thing altogether.  It was another case of American exceptionalism gone wrong.  Somehow we Americans always feel that we have the right answers and refuse to take off our ideological lenses.

In any case, fertility has continued to drop, which leads Brooks to say, quoting Eberstadt (AEI)  that “the 21st century is looking like the century of the fertility implosion”.

Such an implosion has consequences unforeseen a few decades ago.  China implemented its coercive One-Child policy and was very successful – so successful, in fact, that it will have a shortage of young people not only to support its aged but to compete with India, Europe, and America.

India, which had only one bad patch of attempted coercion under Indira Gandhi, muddled along with low productivity, low GDP, only very slowly rising incomes, and high fertility.  Only after 1999 when the Indian government threw off its Socialist chains and liberalized its economy, did everything take off.  Incomes rose, fertility declined; but because this decline started recently and gradually, India has the unplanned but fortuitous benefit of a large, well-educated young population.  India, many economists believe, will soon overtake China in GDP and will maintain its superiority for decades to come.

Low fertility in Europe (significantly below that of the US) contributes indirectly to social tensions. More and more immigrants are required to labor in the collieries and factories, and many of them come from the Muslim quarters of Africa and the Middle East.  The French government was notorious for offering large subsidies to native French families to increase their fertility.  The amount offered was so far below the actual cost of raising and educating a child, even under the welfare state, that the program not surprisingly was unsuccessful.

So the days of naïve interventionist programs in fertility control such as those by USAID are numbered; and those macro-level policies such as those of China will probably never be repeated.  The Law of Unintended Consequences may finally be respected after all. 

Governments will always tinker with population policy.  Today they are addressing immigration rather than fertility; but ultimately population size and its increase or decrease will finally depend on supply and demand.

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