The effect of education on adult mortality and disability: a global perspective

Contemporary research primarily in the West offers a strong case for the relationship between formal education and adult health; more education, measured either by level completed or years of schooling, is associated, often in a stepwise fashion, with lower levels of mortality, morbidity and disability. In this study, we attempt to provide a global assessment of that relationship as it pertains to adult disability, using sample data from 70 countries that participated in the World Health Survey. In each of five regions and some of the largest countries outside the West we find that an increase in formal education is associated with lower levels of disability in both younger and older adults. Using the regional education-based differentials and several estimates of growth in education levels, we project levels of disability to 2050 to estimate the health and human capital benefits obtained from investments in education. We find that considering education in the population projection consistently shows lower prevalence of disability in the future, and that scenarios with better education attainment lead to lower prevalence. It is apparent that the educational dividend identified in our projection scenario should be an important policy goal, which, if anything, should be more speedily advanced in those countries and regions that have the greatest need.

Microsimulation Population Projections with SAS

This open access book provides a step-by-step overview on how to build a microsimulation model with SAS. It shows how to convert an already existing multistate projection by age, sex, education and region into a microsimulation model. Two new dimensions are then added, either the labor force participation and the sector of activity, and/or some examples of outputs and alternative scenarios that would not be possible with standard demographic methods. The book also describes how to adapt the model for other countries or other purposes. It also provides details on how to extend and adapt the model for other purposes as well as other use of microsimulation with SAS. The book suggests codes that are easy to understand, so they can be replicated or adapted for other purposes. As such, this book provides a great resource for people with beginner to intermediate knowledge in SAS

Early Transition Trends and Differences of Higher Education Attainment in the Former Soviet Union, Central and Eastern European Countries

The past trends in tertiary education attainment of selected post-communist countries are investigated through population projections. Did a common higher education policy manifest itself through attainment levels, and how did the situation change after the collapse of the Soviet regime? The approach is based on comprehensive back-projections ranging from year 2000 to 1970. Descriptive findings for most countries show that the level of tertiary education attainment for women has surpassed that of men sooner than in Western Europe. Results are discussed in light of individual countries’ pre-war higher education models and former communist policy, and possible implications are derived for future study of higher education attainment

A four-dimensional population module for the analysis of future adaptive capacity in the Phang Nga province of Thailand

In this paper we describe an innovative aspect of the population module in the context of an ongoing comprehensive modelling effort to assess future populationenvironment interactions through specific case studies. A particular focus of our study is the vulnerability of coastal populations to environmental factors and their future adaptive capacity. Based on the four-dimensional cross-classification of populations by age, sex, level of education, and labour force participation, our approach builds on a recent body of research that has critically assessed the role of demographic differentials as determinants of differential vulnerability and adaptive capacity. We use Phang Nga, a province in the south of Thailand that was severely affected by the tsunami in 2004, to describe current levels of educational attainment and investigate past trends, which in turn serve as input for detailed education projections. These education projections, in combination with projections of economic activity and household survey results about disaster preparedness, feed into further analysis of future adaptive capacity. Given our specifications and assumptions, we find that the educational composition of the province's labour force will shift towards higher levels, and that the population of Phang Nga will be better prepared for future disasters

Projecting the impact of air pollution on child stunting in India—synergies and trade-offs between climate change mitigation, ambient air quality control, and clean cooking access

Many children in India face the double burden of high exposure to ambient (AAP) and household air pollution, both of which can affect their linear growth. Although climate change mitigation is expected to decrease AAP, climate policies could increase the cost of clean cooking fuels. Here, we develop a static microsimulation model to project the air pollution-related burden of child stunting in India up to 2050 under four scenarios combining climate change mitigation (2 °C target) with national policies for AAP control and subsidised access to clean cooking. We link data from a nationally representative household survey, satellite-based estimates of fine particulate matter (PM2.5), a multi-dimensional demographic projection and PM2.5 and clean cooking access projections from an integrated assessment model. We find that the positive effects on child linear growth from reductions in AAP under the 2 °C Paris Agreement target could be fully offset by the negative effects of climate change mitigation through reduced clean cooking access. Targeted AAP control or subsidised access to clean cooking could shift this trade-off to result in net benefits of 2.8 (95% uncertainty interval [UI]: 1.4, 4.2) or 6.5 (UI: 6.3, 6.9) million cumulative prevented cases of child stunting between 2020–50 compared to business-as-usual. Implementation of integrated climate, air quality, and energy access interventions has a synergistic impact, reducing cumulative number of stunted children by 12.1 (UI: 10.7, 13.7) million compared to business-as-usual, with the largest health benefits experienced by the most disadvantaged children and geographic regions. Findings underscore the importance of complementing climate change mitigation efforts with targeted air quality and energy access policies to concurrently deliver on carbon mitigation, health and air pollution and energy poverty reduction goals in India

Demographic and Human Capital Scenarios for the 21st Century: 2018 assessment for 201 countries

This volume presents different scenarios of future population and human capital trends in 201 countries of the world to the end of this century to inform the assessment of possible future migration patterns into the EU, as currently carried out by the Centre of Expertise on Population and Migration (CEPAM) Project (collaboration between JRC and IIASA). The study also goes beyond the conventional population projections, which only consider age and sex structures, by taking a multi-dimensional approach through adding educational attainment for all countries and also labour force participation for EU member states. The definition of scenarios in this study follows the narratives of the SSPs (Shared Socioeconomic Pathways) which are widely used in the global change research community

Demographic and Human Capital Scenarios for the 21st Century: 2018 assessment for 201 countries

This volume presents different scenarios of future population and human capital trends in 201 countries of the world to the end of this century to inform the assessment of possible future migration patterns into the EU as currently carried out by the Centre of Expertise on Population and Migration (CEPAM) Project (collaboration between JRC and IIASA). The study also goes beyond the conventional population projections which only consider the age and sex structures by taking a multi-dimensional approach through adding educational attainment for all countries and also labor force participation for EU member states. The definition of scenarios in this study follows the narratives of the SSPs (Shared Socioeconomic Pathways) which are widely used in the global change research community. The Medium scenario (SSP2) foresees that fertility and mortality follow a medium pathway that can be seen as most likely from today’s perspective. The scenario of Rapid Development (SSP1) assumes rapid increases in life expectancy, a faster fertility decline in high fertility countries and an education expansion path that follows the education goals as given by the SDGs (Sustainable Development Goals). The Stalled Development scenario (SSP3) presents divided world foreseeing a stall in educational expansion in developing countries as well as continued high fertility and high mortality. Moreover, these scenarios also serve policy considerations in many other fields ranging from the economic consequences of population ageing to development priorities in Africa, global population and environment interactions. This volume also serves as an update of the scenarios presented in the 2014 Oxford University Press book entitled “World Population and Human Capital in the 21st Century” (Lutz et al 2014), which includes the most comprehensive summary of different possible scientific arguments underlying the assumptions of future fertility, mortality, migration and education trends in different parts of the world with input from over 550 population experts. This new 2018 assessment also has a new 2015 baseline and adjusts the near term (up to 2030) fertility and mortality assumptions accordingly while maintaining the long term assumptions as justified in the 2014 book. In terms of migration, it combines three rough migration assumptions – zero migration, constant rates as observed over the past 60 years and double those rates – with medium fertility and mortality trends to illustrate the sensitivity of longer term population trends to alternative migration intensities. In terms of global level results, in the Medium scenario, world population would continue to increase until around 2070-80 when it would reach a maximum level of around 9.8 billion before starting a slow decline, reaching about 9.5 billion by the end of the century. This projected increase is lower than the recent United Nations projections based on a different model and higher than in the above mentioned 2014 book which uses the same long term assumptions. An important reason for increase in the outlook lies in the fact that child mortality, particularly in Africa, declined more rapidly than was previously assumed by all international projections. In demographic terms, a decline in child mortality has the same effect on the number of surviving children as an increase in fertility. Hence, already the population baseline of 2015 was markedly higher than had been projected on the basis of the 2010 baseline, which was used in the previous assessment. However, in the long run demography is not destiny and alternative scenarios show a broad range of possible futures. Assuming rapid social development (SSP1), in particular a rapid expansion of education following the Sustainable Development Goals, world population would after a further increase start to decrease, showing a peak population of around 8.9 billion in 2055-60 and a decline to 7.8 billion by the end of the century. Assuming on the other hand stalled social development (SSP3) and thus lower female education and higher fertility rates for each education group, world population already reaches the 10 billion mark around 2045 and then continues to grow over the rest of the century reaching 13.4 billion in 2100. This scenario is also likely to be associated with wide-spread poverty and weak resilience to already unavoidable environmental change. As to the European Union, projected population size under the Medium scenario of EU28 in 2060 is very close to the current baseline of 2015, namely around 507 million inhabitants. However, the trajectory of change would have a convex shape reaching a maximum 512 million people around the year 2035. While the initial increase is mostly a consequence of assumed immigration to the EU the following decline results from persistent sub-replacement fertility levels which will have developed a negative growth momentum through an age structure with fewer young people. Under the scenario of Zero Migration the population of the EU-28 would decline to around 460 million by 2060, while under the Double Migration scenario it would increase to 550 million. Under all scenarios the population of the EU28 shows significant ageing, which is more pronounced under low fertility and low immigration assumptions. However, the scenarios that explicitly consider education and labor force participation also show that the total labor force in Europe does not necessarily shrink, if labor force participation around the EU would approach that of Sweden today and that the future labor force could also be more productive. The population of Sub-Saharan Africa, on the other hand, is likely to more than double by 2060 from currently around 1 billion to 2.2 billion under the Medium scenario and even 2.7 billion under the stalled development SSP3 scenario. Hence, with the demographic transition in Asia well advanced, the future of world population growth will largely be decided in Africa with the future education of women as a main determinant of fertility playing a key role. There has been recent moderate progress in education expansion but continued progress is not guaranteed, despite the fact that today in virtually all countries the young generations are better educated than the older ones. But as shown by the stalled development (SSP3) scenario the combination of high population growth with no further schooling expansion can actually result in an increase of the proportion without any formal education even at the global level from 10 to 22 percent by the end of the century. This possible stall in education will not only accelerate population growth but also likely be associated with widespread poverty and high vulnerability to already unavoidable climate change. The combined trends of decreasing fertility and increasing life expectancy would lead to continued population ageing in the world in the future. The world will be significantly older. In all scenarios presented in the report, as well as those used by United Nations, the share of older people increases over time. For example, in our Medium scenario the percentage of those aged 65 and more increases from around 8% in 2015 to 20% by 2060. In the European Union, the share of older people will grow from around 20% in 2015 to 32% in 2060 according to medium scenario. In 2060 half of the population in this region will be at an age of at least 50 years. A particularly dynamic process would be observed in Eastern European member states where lower fertility and high life expectancy is accompanied with high volume of emigration accelerating ageing if the current trends continue. These structural changes would lead to significant socio-economic challenges for societies in the future.JRC.A.5-Scientific Developmen

Outcome of gastrointestinal surgery during COVID-19 lockdown in a tertiary care hospital, Nepal

Introduction: Perioperative strategies have been changing due to the COVID-19 pandemic to prevent the risk of postoperative complications and transmission of infection. This study was aimed to assess the outcome of gastrointestinal surgery and the risk of transmission by implementing COVID-19 testing criteria and surgical strategy. Method: This was a retrospective descriptive study conducted at the department of surgery at Patan Hospital, Nepal, during COVID-19 lock-down from 24 march to 15 June 2020. All patients who underwent gastrointestinal (GI) surgery were included. High-risk patients (as defined by the Hospital Incident Command System, HICS) were tested for COVID-19 preoperatively. Surgery was performed in COVID operating room with full protective gear. Low-risk patients were not tested for COVID-19 preoperatively and performed surgery in non-COVID OR. Data from patient’s case-sheets were analyzed descriptively for age, gender, comorbidities, hospital stay, RT-PCR results, surgeries, and postoperative complications. Result: There were total 44 GI surgeries performed; 31(70.5%) were emergency, 5(11.3%) semi-emergency and 8(18.2%) oncology. There were 11(25%) patients tested for COVID-19 preoperatively and were negative. Nine HCWs tested for COVID-19 randomly were negative. Severe postoperative complications developed in 3 patients, with one mortality. Conclusion: Among GI surgeries, there was no increase in postoperative complications and transmission of COVID-19 to the patients or HCWs following the implementation of standard testing criteria and surgical strategy

Dimensions of global population projections: what do we know about future population trends and structures?

The total size of the world population is likely to increase from its current 7 billion to 8–10 billion by 2050. This uncertainty is because of unknown future fertility and mortality trends in different parts of the world. But the young age structure of the population and the fact that in much of Africa and Western Asia, fertility is still very high makes an increase by at least one more billion almost certain. Virtually, all the increase will happen in the developing world. For the second half of the century, population stabilization and the onset of a decline are likely. In addition to the future size of the population, its distribution by age, sex, level of educational attainment and place of residence are of specific importance for studying future food security. The paper provides a detailed discussion of different relevant dimensions in population projections and an evaluation of the methods and assumptions used in current global population projections and in particular those produced by the United Nations and by IIASA