Americans as a whole may be living longer, but two recent studies reveal growing and disturbing disparities in longevity.  In fact, not all Americans are living longer; life expectancy in some areas of the country is actually declining.

Two weeks ago, the Congressional Budget Office released a report (“Growing Disparities in Life Expectancy”) that found:

Though the gaps in life expectancy between men and women and between whites and blacks have narrowed somewhat, differences by income and educational attainment have been growing. The close relationship between socioeconomic status and mortality—the flip side of longevity—has been long observed and is well documented.5 Individuals with higher lifetime earnings or more education experience lower mortality rates than those with lower lifetime earnings or less education. But in recent decades, socioeconomic status has become an even more important indicator of life expectancy, whether measured at birth or at age 65. 

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  • In 1980, life expectancy at birth was 2.8 years more for the highest socioeconomic group than for the lowest. By 2000, that gap had risen to 4.5 years. The 1.7-year increase in the gap amounts to more than half of the increase in overall average life
    Expectancy at birth between 1980 and 2000.
  • In 1980, the difference in life expectancy at age 65 between the highest and lowest socioeconomic groups was 0.3 years. By 2000, the difference had grown to 1.6 years. That increase in the gap equals more than 80 percent of the increase in overall average
    Life expectancy at age 65 over that period.

Changes in life expectancy between 1990 and 2000 show a similar pattern among people with different levels of educational attainment. The gap in life expectancy at age 25 between individuals with a high school education or less and individuals with any college education increased by about 30 percent over that period. The gap widened because of increases in life expectancy for the better-educated group; life expectancy for those with less education did not increase over that period. The growing differentials by level of educational attainment have occurred for both men and women and for both blacks and whites.

A second study (“The Reversal of Fortunes: Trends in County Mortality and Cross-County Mortality Disparities in the United States”) published in the Journal PLoS Medicine, found that rising mortality from lung cancer, diabetes, and chronic pulmonary disease is beginning to offset some of the progress made in reducing mortality from cardiovascular disease. The study found “overall life expectancy in the U.S. increased more than seven years for men and more than six years for women between 1960 and 2000,” but that, “These gains are not reaching many parts of the country; rather, the life expectancy of a significant segment of the population is actually declining or at best stagnating.”

The report by researchers at the Harvard School of Public Health ( HSPH ) and the University of Washington found that, “4% of the male population and 19% of the female population experienced either decline or stagnation in mortality beginning in the 1980s.”

The study looked at geographical disparities in longevity at the county level and found a significant number of counties where longevity had declined.  The report found that “The majority of the counties that had the worst downward swings in life expectancy were in the Deep South, along the Mississippi River, and in Appalachia, extending into the southern portion of the Midwest and into Texas.”

A number of factors may account for these differences in life expectancy, including smoking, obesity, and disparities in health care treatment, but whatever the causes, the reports suggest that we have long a way to go in reducing health care gaps in America.

It seems inevitable that the world food crisis, combined with climate change and rising energy prices, will spur a renewed and contentious debate over the issue of population.  Before that debate is renewed in its full intensity, everyone should read More:  Population, Nature, and What Women Want, a new book by Robert Engelman, vice president for programs at the Worldwatch Institute. 

What Engelman gives us, and what is so desperately need at this critical juncture in the debate over population, is historical perspective.  His book, in fact, takes up back to our ancestral roots to give us a better understanding of such things as human reproduction, the centuries’ old debate over population, and efforts by governments to “control” population by encouraging human procreation or restricting it.

My father once said to me, “The problem with your generation is that you think you invented sex.”  Along the same lines, it might be said that many of us today believe that birth control is a thoroughly modern invention, but as Engelman makes clear in his book, women throughout history have sought to control their fertility, as well as enhance it.  In response to shrinking resources or deteriorating conditions, women have often sought—though not always successfully—to space or limit their pregnancies.

Engelman, as a result, takes a “Zen’ approach to population. Based upon his historical research and his conversations with women in developing countries, he concludes that:

The best way to “control” population is to give up control, in fact to give control away to those who can best decide for themselves when to bear a child.  Enlightenment will arrive only after one has given up the search, and positive population outcomes only after the forcing stops.

He notes that many women in the world still lack access to modern contraceptive methods and that, if given that access, fertility rates will likely decline further. Giving girls the education they need and the gender equality they deserve, he argues, would also result in lower fertility rates.

At the same time, he voices the conviction that concerns about an eventual population implosion are overblown.  As the planet gets less crowded, he believes that women will want more children, enough at least to keep fertility rates at or near the “replacement rate” needed to stabilize population.

Engelman makes clear, however, that world population may already be, or may soon be, unsustainable. He says, “…the world food situation has become in recent years less reassuring, less comfortably a refutation to Malthus’s prediction….As hazardous as prediction is, it’s getting hard to be confident that farmers and families will easily feed the 9.2 billion people projected to be alive in 2050.”

In the last chapter, he notes that people in developing countries dream of acquiring the necessities that we take for granted. “But what happens,” he asks, “when the dreams of people everywhere become unsustainable—not because of the nature of the dreams, but because the numbers of the dreamers?” 

Good question.  His book, however, may help us to avoid having to answer that question.  Let’s hope.

This morning I received an emergency e-mail appeal from Mercy Corps.  Warning that “a perfect storm” of factors “is pushing global food prices up dramatically,” it appealed for help:

In Niger, prices of bread, powdered milk and wheat flour have spiked, exacerbating the West African nation’s precarious food situation.  Last December, more than three million Nigeriens didn’t have enough food to meet their minimum nutritional needs; today, shortages are pushing the country closer to famine.

Left unsaid in the appeal is the fact that Niger is tied with Guinea-Bissau for the highest total fertility rate in the world.  On average, a woman in Niger will have seven children over her lifetime.  Despite the threat of famine, Niger’s population is projected to rise from 14.2 million in 2007 to 26.3 million in 2025 and 53.2 million in 2050. 

The simple truth is that some of the countries hardest hit by the food crisis are among the least sustainable and fastest growing in the world.  Earlier this week, the Washington Post ran a feature story (“Birthrates Help Keep Filipinos in Poverty”) about the Philippines and the food crisis.  The story reports that:

There are many reasons why this country is poor, including feudal patterns of land ownership and corrupt government. But there is a compelling link between family size and poverty. It increases in lock step with the number of children, as nutrition, health, education and job prospects all decline, government statistics and many studies show.

Birth and poverty rates here are among the highest in Asia. And the Philippines, where four out of five of the country's 91 million people are Roman Catholic, also stands out in Asia for its government's rejection of modern contraception as part of family planning.

The great tragedy in the Philippines and many other countries severely affected by the food crisis, there are many couples who want to control their fertility but who do not have access to modern contraceptives, and their governments are not always to blame.  International support for family planning has been in the decline for more than a decade.

Tod Preston of Population Action International wrote a compelling blog post yesterday (“Family Planning in the Philippines: A Global Wake-Up Call for Policymakers”) that details the declining real dollar support for family planning and reproductive health services in the Philippines and elsewhere.  He concludes:

The great tragedy in all of this -- “outrage” might be a more accurate term -- is that the cuts in FP funding are depriving women and men, many of them impoverished, of something they fundamentally want: that most basic ability to choose how many children to have and when to have them. And by depriving them of this reproductive right, we’re contributing to an increasingly unsustainable and impoverished world.

If there is a ground zero to the food crisis, it’s probably in the Philippines. Concern is mounting that the Philippines will not be able to import enough rice this year and experts—inside and outside the Philippines—are warning that major food riots could erupt as a result of the shortfall.

Productivity in the rice fields is very high, but farmland is increasingly scarce in the Philippines. As a result, the Philippines typically imports about 15 percent of its rice needs, but it’s getting more and more difficult to buy rice in the global marketplace.  Four of the major rice producers—Egypt, India, Pakistan, and Vietnam—have imposed export restrictions this year, and rice prices are skyrocketing. In response to the food shortage, the government recently imposed a temporary ban on the conversion of farmland for property development.

It’s against that backdrop that the government of the Philippines announced today that its population reached 88.57 million last August, up from 76.5 million in 2000, the government.  The Reuter news story reports that:

The country's top economic planner said population control policies needed to be reviewed, but promoting artificial birth control, anathema to the Church, is not a likely option.

"The population is increasing and it means that government has to more vigorously implement its population policy, which is responsible parenthood and the advocacy for natural family planning," Economic Planning Secretary Augusto Santos told Reuters. "I think the population commission will have to review its policies," he added. "We really need greater efforts. It means we have to work harder to make the economy function more properly and more smoothly."

Fertility rates have fallen significantly in many parts of Southeast Asia—including Thailand, Vietnam and Indonesia—but the total fertility rate (TFR) in the Philippines (3.4) is third highest in the region.  The National Statistics Office indicates, however, that the annual population growth rate is declining.  It reported today that it was 2.04 percent between 2000 and 2007, lower than the average annual growth of 2.34 percent between 1990 and 2000.

The Reuter’s article noted, however, that the government’s population policy has its critics:

"I think it is a significant drop," said Benjamin de Leon, President of the Forum for Family Planning and Development Inc. "But I still have to see in this administration a policy that informs people of the need to space their children, the need to plan their families."
Solita Monsod, professor of economics at the University of the Philippines, said the problem did not lie with the Church. She said most Filipinos wanted to regulate their families and providing access to information and funding for civil service groups involved in family planning was key.

"Survey after survey has shown that when it comes to family planning, the Church does not make a difference," Monsod said. "The people don't have access. Give them what they want and then the population problem will take care of itself."

Yesterday, the UN’s International Assessment of Agricultural Knowledge, Science and Technology for Development (IAASTD) warned, “The way the world grows its food will have to change radically to better serve the poor and hungry if the world is to cope with a growing population and climate change while avoiding social breakdown and environmental collapse.” 

Citing the “increasingly intolerable price, paid by small-scale farmers, workers, rural communities and the environment,” an IAASTD report issued last week in South Africa called for a wide range of reforms aimed at boosting food production by small farmers in developing countries. 

In a separate report also released last week, IAASTD cautioned that “a vast swathe of central and western Asia and parts of Africa are running out of water.” The report indicated that:

About half the region's internal renewable water resources are already below the minimum threshold for development (500 cubic metres per person per year), it says. And some countries have begun using the region's large reserves of groundwater without concluding any formal agreements with their neighbours.

Meanwhile, Kazakhstan, the world’s fifth largest wheat exporter, yesterday imposed a ban on wheat exports until September in order to contain domestic food prices.  Also, the World Food Program warned yesterday that millions could go hungry in North Korea. WFP estimates that North Korea's annual food deficit could nearly double from 2007 to 1.66 million tons due to rising food prices and the devastating floods that hit the country last year.

World Bank president, Robert Zoellick, today warned that the surge in food prices could push 100 million people into deeper poverty.  Speaking to the International Monetary Fund-World Bank Spring Meetings in Washington, Zoellick said:

Based on a very rough analysis, we estimate that a doubling of food prices over the last three years could potentially push 100 million people in low-income countries deeper into poverty. This is not just a question of short-term needs, as important as those are; this is ensuring that future generations don’t pay a price too.

Zoellick’s remarks come on the heels of his appeal last week for a “New Deal” to address the food crisis. Zoellock last week said that surging food prices could mean “seven lost years” in the fight against worldwide poverty,  “While many are worrying about filling their gas tanks, many others around the world are struggling to fill their stomachs, and it is getting more and more difficult every day.”

Echoing similar concerns, Newsday today published “Long-term Solutions Needed to Feed the World,” a column that I wrote that looks at the demographic implications of the international food crisis. In the column, I note that:

The Food and Agricultural Organization maintains a list of "countries in crisis" currently requiring external food assistance. In February, 36 nations were on that list, including some of the poorest and fastest growing countries in the world. The total population of those nations, currently 1.1 billion, is expected to rise to 1.5 billion by 2025, and 2.0 billion by 2050. Will these countries, with their high incidence of poverty and their rapid population growth, be able to feed themselves?

The recent comments made by Zoellick suggest that some of these 36 countries may not be able to meet that challenge. If so, many of the world’s poor, many of whom have migrated to urban areas, will be standing in food lines...or worse. 

In past decades, food crises were local phenomena, generally precipitated by a bad harvest, and the solution was to expand emergency relief efforts. The current food crisis, by contrast, is not a local phenomenon; it’s global. 

Within the past week severe food riots have broken out in opposites sides of the world.  Five people have now died in Haitian rioting and a young boy was killed earlier this week in Egypt in rioting that has led to the arrest of more than 150 people. Rioting this week may also have broken out in Ethiopia.  Last week it was the Ivory Coast.

In total, a dozen or so countries have experienced food riots since the beginning of the year, and the United Nations is warning that more rioting should be expected.  The World Bank estimated last week that 33 nations may be prone to food riots.

One consequence of living in a global economy is paying global prices, and right now at least the global price of just about every basic food staple—from rice to milk to vegetable oil—is soaring. The rioting that we are witnessing is not a response to a local food shortage; it’s a reaction against rising food commodity prices by those who can no longer afford to pay those prices.

The point was driven home this week by Sir John Holmes, Under-Secretary General for Humanitarian Affairs and Emergency Relief, who spoke this week to an international conference in Dubai.  Here’s what he had to say:

Compounding the challenges of climate change, in what some have labeled the 'perfect storm,' are the recent dramatic trends in soaring food and fuel prices, which are poised to have a major impact on hunger and poverty across the world and are having an immediate impact on the cost of humanitarian operations. Since mid-2007, food prices have risen an estimated 40% as a confluence of factors have increased demand. These factors include rapid global population growth, ever greater numbers of people eating resource-intensive foods such as meat and milk, bio-fuel production, shortage of reserves, and increasing oil prices.

Current food price trends are likely to increase sharply both the incidence and depth of food insecurity; and as many households will spend more on food to the detriment of other household needs, price rises will also result in lower school attendance rates, poorer health care and asset depletion. The security implications should also not be underestimated as food riots are already being reported across the globe.

We have to ask the question: are we properly prepared for this? Not only are we adequately prepared for the next big storm or flood or drought that devastates countless lives and livelihoods, but also how close are we to a generalized crisis of hunger and malnutrition? How exposed is the global emergency system to overload and failure? More to the point, are the tens of millions of people living in impoverished, drought and disaster-prone areas ready? Because in the cruel calculus of natural disasters, it is always the poorest who are most vulnerable and least able to withstand the impact of a crisis.

For those countries most at risk of starvation, the World Food Programme and other international agencies can provide relief—if they receive the necessary funds from the U.S. and other donor countries—but there are, quite possibly, tens of millions of urban poor spread around the world who may face what officials in Bangladesh are calling a “hidden hunger,” or a “silent famine.”

Citing the “realities of demography, changing diets, energy prices and biofuels, and climate changes,” World Bank president Robert Zoellick earlier today called for “a New Deal for Global Food Policy.”  In a speech delivered this morning in Washington, Zoellick said:

As financial markets have tumbled, food prices have soared.   Since 2005, the prices of staples have jumped 80 percent.  Last month, the real price of rice hit a 19-year high; the real price of wheat rose to a 28-year high and almost twice the average price of the last 25 years.

The good news for some farmers adds a crushing load to the most vulnerable – children, as young as four or five, forced to flee the safety of their rural communities to fight for food in teeming cities; food riots threatening societal breakdown; mothers deprived of nutrition for healthy babies.   The World Bank Group estimates that 33 countries around the world face potential social unrest because of the acute hike in food and energy prices.  For these countries, where food comprises from half to three quarters of consumption, there is no margin for survival.

Zoellick said that the New Deal should:

…. focus not only on hunger and malnutrition, access to food and its supply, but also the interconnections with energy, yields, climate change, investment, the marginalization of women and others, and economic resiliency and growth.   Food policy needs to gain the attention of the highest political levels, because no one country or group can meet these interconnected challenges.

Paul Krugman, the noted New York Times economist and columnist, wrote in his blog today (“Grains Gone Wild”) that “the current food crisis may well be a bigger deal” than the financial crisis.  Here’s what he said:

What I don’t quite understand is why food prices have spiked so dramatically. Demand has been rising for a number of years; bio-fuels is a big thing, but how much bigger is it this year than a year or two ago? It can’t be speculation: that raises prices by inducing stockpiling, and stocks of wheat and rice are at or near record lows.

Important stuff.  We need to figure this out.

There are, of course, a host of factors that have contributed to the emerging food crisis.  Numerous observers, including UN secretary general Ban Ki-Moon, have referred to it as a “perfect storm.”  Among the factors cited most often are: 1) increased consumption of meat in China and other developing countries; 2) global population growth, 3) diversion of agricultural land to biomass production; 4) drought and other climate changes, 5) and the rising costs, mostly due to rising fuel prices, of fertilizing, cultivating and transporting crops.

Most of these factors are not going to go away anytime soon.  That’s why the World Food Programme, the Food and Agricultural Organization, and the World Bank have been warning that the food crisis could persist for 3-5 years…or longer.

A global recession might temporarily dampen appetite for meat, the Australian drought might ease, and the U.S. and European countries might someday reverse course on biomass subsidies, but factors like population growth and climate change do not turn around on a dime, and most experts believe that the era of cheap fuel is over.

As to “grain prices gone wild,” that’s what happens when growing demand hits an inelastic supply curve.  Global grain reserves have been dropping for several years. Reserves are now at the lowest level in decades. When reserves get that low, and supply doesn’t respond, it doesn’t take much to make grain prices soar. We don’t need to “figure that out.” That’s basic economics. 

But what, we need to do, as Krugman blog suggests is “figure out” what can be done about it. The first thing, of course, is don’t make matters worse.  But that’s what happening.  

More and more countries are restricting grain exports—and thereby restricting the amount of grain that grain-importing countries have access to. Today, India announced that it was banning exports of non-Basmati rice. That may help keep a lid on the price of rice in India, but it will make things worse for countries like Bangladesh, Indonesia and the Philippines. 

And, despite the food crisis, other countries are still increasing subsidies for biomass. Britain this month is boosting the biomass requirement for its motor fuels.  Meanwhile, the European Community, as a whole, is continuing to ramp up support for biofuels.

But what we really need to figure out is whether there is any relief in sight, or whether the current food crisis is just a taste of things to come.  Can we—in the face of climate change, rising fertilizer and fuels costs, growing water scarcity, and changing global diets—plow  enough new farmland and raise agricultural productivity enough to feed an additional 2.5 billion over the next 40 years? 

That's the big question.  And we need to figure it out sooner, rather than later.