Vienna Institute of Demography

This article reviews research on the effects of economic recessions on fertility in the developed world. We study how economic downturns, as measured by various indicators, especially by declining GDP levels, falling consumer confidence, and rising unemployment, were found to affect fertility. We also discuss particular mechanisms through which the recession may have influenced fertility behavior, including the effects of economic uncertainty, falling income, changes in the housing market, and rising enrollment in higher education, and also factors that influence fertility indirectly such as declining marriage rates. Most studies find that fertility tends to be pro-cyclical and often rises and declines with the ups and downs of the business cycle. Usually, these aggregate effects are relatively small (typically, a few percentage points) and of short durations; in addition they often influence especially the timing of childbearing and in most cases do not leave an imprint on cohort fertility levels. Therefore, major long-term fertility shifts often continue seemingly uninterrupted during the recession—including the fertility declines before and during the Great Depression of the 1930s and before and during the oil shock crises of the 1970s. Changes in the opportunity costs of childbearing and fertility behavior during economic downturn vary by sex, age, social status, and number of children; childless young adults are usually most affected. Furthermore, various policies and institutions may modify or even reverse the relationship between recessions and fertility. The first evidence pertaining to the recent recession falls in line with these findings. In most countries, the recession has brought a decline in the number of births and fertility rates, often marking a sharp halt to the previous decade of rising fertility rates.

Importance: Cancers are a leading cause of mortality, accounting for nearly 10 million annual deaths worldwide, or 1 in 6 deaths. Cancers also negatively affect countries' economic growth. However, the global economic cost of cancers and its worldwide distribution have yet to be studied. Objective: To estimate and project the economic cost of 29 cancers in 204 countries and territories. Design, Setting, and Participants: A decision analytical model that incorporates economic feedback in assessing health outcomes associated with the labor force and investment. A macroeconomic model was used to account for (1) the association of cancer-related mortality and morbidity with labor supply; (2) age-sex-specific differences in education, experience, and labor market participation of those who are affected by cancers; and (3) the diversion of cancer treatment expenses from savings and investments. Data were collected on April 25, 2022. Main Outcomes and Measures: Economic cost of 29 cancers across countries and territories. Costs are presented in international dollars at constant 2017 prices. Results: The estimated global economic cost of cancers from 2020 to 2050 is $25.2 trillion in international dollars (at constant 2017 prices), equivalent to an annual tax of 0.55% on global gross domestic product. The 5 cancers with the highest economic costs are tracheal, bronchus, and lung cancer (15.4%); colon and rectum cancer (10.9%); breast cancer (7.7%); liver cancer (6.5%); and leukemia (6.3%). China and the US face the largest economic costs of cancers in absolute terms, accounting for 24.1% and 20.8% of the total global burden, respectively. Although 75.1% of cancer deaths occur in low- and middle-income countries, their share of the economic cost of cancers is lower at 49.5%. The relative contribution of treatment costs to the total economic cost of cancers is greater in high-income countries than in low-income countries. Conclusions and Relevance: In this decision analytical modeling study, the macroeconomic cost of cancers was found to be substantial and distributed heterogeneously across cancer types, countries, and world regions. The findings suggest that global efforts to curb the ongoing burden of cancers are warranted.

BACKGROUND Across the developed world couples are postponing parenthood. This review assesses the consequences of delayed family formation from a demographic and medical perspective. One main focus is on the quantitative importance of pregnancy postponement. METHODS Medical and social science databases were searched for publications on relevant subjects such as delayed parenthood, female and male age, fertility, infertility, time to pregnancy (TTP), fetal death, outcome of medically assisted reproduction (MAR) and mental well-being. RESULTS Postponement of parenthood is linked to a higher rate of involuntary childlessness and smaller families than desired due to increased infertility and fetal death with higher female and male age. For women, the increased risk of prolonged TTP, infertility, spontaneous abortions, ectopic pregnancies and trisomy 21 starts at around 30 years of age with a more pronounced effects >35 years, whereas the increasing risk of preterm births and stillbirths starts at around 35 years with a more pronounced effect >40 years. Advanced male age has an important but less pronounced effect on infertility and adverse outcomes. MAR treatment cannot overcome the age-related decline in fecundity. CONCLUSIONS In general, women have partners who are several years older than themselves and it is important to focus more on the combined effect of higher female and male age on infertility and reproductive outcome. Increasing public awareness of the impact of advanced female and male age on the reproductive outcome is essential for people to make well-informed decisions on when to start family formation.

BACKGROUND: Road injuries are among the ten leading causes of death worldwide and also impede economic wellbeing and macroeconomic performance. Beyond medical data on the incidence of road injuries and their resulting morbidity and mortality, a detailed understanding of their economic implications is a prerequisite for sound, evidence-based policy making. We aimed to determine global macroeconomic costs of road traffic injuries and their cross-country distribution. METHODS: We calculated the economic burden of all road traffic-related injuries for 166 countries by use of a macroeconomic model that accounts for the effect of fatal and non-fatal injuries on labour supply, age-specific differences in education and experience of those who are affected by road accidents, and the diversion of injury-related treatment expenses from savings, which results in lower investment. FINDINGS: We estimated that road injuries will cost the world economy US$1·8 trillion (constant 2010 US$) in 2015-30, which is equivalent to an annual tax of 0·12% on global gross domestic product. Although low-income and middle-income countries have the largest health burden, their share of the economic burden of road injuries is only 46·4% of the global loss, reflecting in part higher productivity (and earnings) in high-income countries, but also prominently higher treatment costs. Our results also indicate that treatment costs account for a greater proportion of the economic burden in high-income countries than in low-income countries. INTERPRETATION: The macroeconomic burden of road injuries is sizeable and distributed unequally across countries and world regions. This finding suggests a case for nuanced policy making. Our framework should provide a good starting point for the more detailed analysis of policies both at country level and across different countries. FUNDING: National Institute on Aging.

Introducing findings from the 2004 Survey of Health, Ageing, and Retirement in Europe (SHARE), this research complements the large number of recent U.S. studies on the role of grandparents in caring for their grandchildren. For 10 continental European countries, the authors investigate cross-national variations in grandparent-provided child care as well as differences in characteristics of the providers and recipients of care. Although they find strong involvement of grandparents in their grandchildren's care across all countries, they also identify significant variations in the prevalence and intensity of care along the geographic lines of different child care and (maternal or female) employment regimes in Europe. Rooted in long-standing family cultures, the observed patterns suggest a complex interaction between welfare state—provided services and intergenerational family support in shaping the work—family nexus for younger parents. The authors conclude with a brief discussion of possible consequences of grandmothers' increasing labor force participation for child care arrangements.

Widely available data on the number of people living outside of their country of birth do not adequately capture contemporary intensities and patterns of global migration flows. We present data on bilateral flows between 196 countries from 1990 through 2010 that provide a comprehensive view of international migration flows. Our data suggest a stable intensity of global 5-year migration flows at ~0.6% of world population since 1995. In addition, the results aid the interpretation of trends and patterns of migration flows to and from individual countries by placing them in a regional or global context. We estimate the largest movements to occur between South and West Asia, from Latin to North America, and within Africa.

Total fertility rates fell to previously unseen levels in a large number of countries beginning in the early 1990s. The persistence of TFRs below 1.3 raised the possibility of rapid population aging and decline. We discuss the recent widespread turnaround in so‐called lowest‐low‐fertility countries in Europe and East Asia. The number of countries with TFRs below 1.3 fell from 21 in 2003 to five in 2008. Moreover, the upturn in the TFR was not confined to lowest‐fertility countries, but affected the whole developed world. We explore the demographic explanations for the recent rise in TFRs stemming from fertility timing effects as well as economic, policy, and social factors. Although the current economic downturn may suppress TFRs in the short run, we conclude that formerly lowest‐low‐fertility countries will continue to see increases in fertility as the transitory effects of shifts to later childbearing become less important.

This chapter discusses the concept of the second demographic transition (SDT) and its relevance for explaining the ongoing changes in family and fertility patterns across Europe. It takes a closer look at the shifts in values and attitudes related to f

This study aims at understanding the role of education in promoting disaster preparedness. Strengthening resilience to climate-related hazards is an urgent target of Goal 13 of the Sustainable Development Goals. Preparing for a disaster such as stockpiling of emergency supplies or having a family evacuation plan can substantially minimize loss and damages from natural hazards. However, the levels of household disaster preparedness are often low even in disaster-prone areas. Focusing on determinants of personal disaster preparedness, this paper investigates: (1) pathways through which education enhances preparedness; and (2) the interplay between education and experience in shaping preparedness actions. Data analysis is based on face-to-face surveys of adults aged ≥15 years in Thailand (N = 1,310) and the Philippines (N = 889, female only). Controlling for socio-demographic and contextual characteristics, we find that formal education raises the propensity to prepare against disasters. Using the KHB method to further decompose the education effects, we find that the effect of education on disaster preparedness is mainly mediated through social capital and disaster risk perception in Thailand whereas there is no evidence that education is mediated through observable channels in the Philippines. This suggests that the underlying mechanisms explaining the education effects are highly context-specific. Controlling for the interplay between education and disaster experience, we show that education raises disaster preparedness only for those households that have not been affected by a disaster in the past. Education improves abstract reasoning and anticipation skills such that the better educated undertake preventive measures without needing to first experience the harmful event and then learn later. In line with recent efforts of various UN agencies in promoting education for sustainable development, this study provides a solid empirical evidence showing positive externalities of education in disaster risk reduction.

Nearly every European Country has experienced some increase in nonmarital childbearing, largely due to increasing births within cohabitation. Relatively few studies in Europe, however, investigate the educational gradient of childbearing within cohabitation or how it changed over time. Using retrospective union and fertility histories, we employ competing risk hazard models to examine the educational gradient of childbearing in cohabitation in eight countries across europe. In all countries studied, birth risks within cohabitation demonstrated a negative educational gradient. When directly comparing cohabiting fertility with marital fertility, the negative educational gradient persists in all countries except Italy, although differences were not significant in Austria, France, and West Germany. To explain these findings, we present an alternative explanation for the increase in childbearing within cohabitation that goes beyond the explanation of the Second Demographic Transition and provides a new interpretation of the underlying mechanisms that may influence childbearing within cohabitation.

Almost universally, women with higher levels of education have fewer children. Better education is associated with lower mortality, better health, and different migration patterns. Hence, the global population outlook depends greatly on further progress in education, particularly of young women. By 2050, the highest and lowest education scenarios--assuming identical education-specific fertility rates--result in world population sizes of 8.9 and 10.0 billion, respectively. Better education also matters for human development, including health, economic growth, and democracy. Existing methods of multi-state demography can quantitatively integrate education into standard demographic analysis, thus adding the "quality" dimension.

How persistent and universal has the two child family ideal been in Europe during the last three decades? We analyze responses of women of reproductive age from 168 surveys conducted in 37 countries in 1979–2012. A two‐child ideal has become nearly universal among women in all parts of Europe. Countries that used to display higher ideal family size have converged over time toward a two‐child model. Six out of ten women in Europe consider two children as ideal, and this proportion is very similar in different regions. The mean ideal family size has become closely clustered around 2.2 in most countries. Gradual shifts can be documented toward more women expressing an ideal of having one child (and, quite rarely, having no children) and a parallel decline in an ideal of three or more children. An increasing number of European countries saw their mean ideal family size falling to relatively low levels around 1.95–2.15. However, with the exception of one survey for eastern Germany and two of the surveys not included in our study owing to high nonresponse or low sample size, none of the analyzed surveys suggests a decline in mean ideal family size to levels considerably below replacement, i.e., below 1.9 children per woman.

We study the aggregate gap between intended and actual fertility in 19 European countries and the US based on a cohort approach. This complements prior research that had mainly used a period approach. We compare the mean intended number of children among young women aged 20 to 24 (born in the early 1970s), measured during the 1990s in the Fertility and Family Surveys, with data on completed fertility in the same cohorts around age 40. In a similar manner, we compare the share who state that they do not want a child with actual cohort childlessness. Our exploration is informed by the cognitive–social model of fertility intentions developed by Bachrach and Morgan (Popul Dev Rev 39(3):459–485, 2013). In all countries, women eventually had, on average, fewer children than the earlier expectations in their birth cohort, and more often than intended, they remained childless. The results reveal distinct regional patterns, which are most apparent for childlessness. The gap between intended and actual childlessness is widest in the Southern European and the German-speaking countries and smallest in the Central and Eastern European countries. Additionally, we analyze the aggregate intentions-fertility gap among women with different levels of education. The gap is largest among highly educated women in most countries studied and the educational gradient varies by region, most distinctively for childlessness. Differences between countries suggest that contextual factors—norms about parenthood, work–family policies, unemployment—shape women’s fertility goals, total family size, and the gap between them.

Europe has just entered a critical phase of its demographic evolution [HN1]. Around the year 2000, the population began to generate “negative momentum”: a tendency to decline owing to shrinking cohorts of young people that was brought on by low fertility (birthrate) over the past three decades. Currently, the effect of negative momentum on future population is small. However, each additional decade that fertility remains at its present low level will imply a further decline in the European Union (EU) of 25 to 40 million people, in the absence of offsetting effects from immigration [HN2] or rising life expectancy. Governments in Europe are beginning to consider a range of policy options to address the negative implications of population decline and rapid aging (1, 2). Social policies and labor laws aimed at halting the further increase in the mean age of childbearing—which contributes to low fertility—have substantial scope for affecting future demographic trends. They also have an additional health rationale because of the increasing health risks associated with childbearing in older women.

Taking care of older adults is among the major challenges currently faced by ageing populations. Researchers, designers, and engineers have proposed socially assistive robots as one way of helping elderly people stay in their homes longer. In a systematic literature review, this paper wants to investigate if and how evaluations of the acceptance of socially assistive robots by older people take into account sociodemographic factors. The results indicate that this only holds true for a few studies. Research that incorporates age, gender, education, and so forth; clearly shows that these key factors have a significant impact. However, the relations are complex and experience with technology mitigates the influence of sociodemographic factors on acceptance. Assistive devices should be adaptable to individual needs to be able to consider all these factors.

This paper examines causality and parameter instability in the long-run relationship between fertility and women's employment. This is done by a cross-national comparison of macro-level time-series data from 1960 to 2000 for France, West Germany, Italy, Sweden, the UK, and the USA. By applying vector error correction models (a combination of Granger-causality tests with recent econometric time-series techniques) we find causality in both directions. This finding is consistent with simultaneous movements of both variables brought about by common exogenous factors such as social norms, social institutions, financial incentives, and the availability and acceptability of contraception. We find a negative and significant correlation until about the mid-1970s and an insignificant or weaker negative correlation afterwards. This result is consistent with a recent hypothesis in the demographic literature according to which changes in the institutional context, such as changes in childcare availability and attitudes towards working mothers, might have reduced the incompatibility between child-rearing and the employment of women.

BACKGROUND: Data on the incidence of neuropathic pain (NeP) in Austria, its general characteristics and consequences for the quality of life (QOL) are still lacking. The prevalence in the United Kingdom is 8%. METHODS: A representative survey (n=7707) was carried out. Patients with NeP were identified using previously validated criteria and subsequently asked to complete a questionnaire on QOL and detailed pain characteristics. RESULTS: The prevalence of NeP was 3.3% (n=260). A higher prevalence was found in 41-50-year-olds (26%) and 51-60 year olds (24%). Pain was long lasting (>1 year: 66%; >5 years: 41%) and severe at onset (mean 6.8; numerical rating scale) as well as later (mean 4.7; 20% 8 or higher). Strong or predominant restriction of daily activities was reported in 65%, strong or predominant sleep disturbances in 60%, feelings of depression in 34% and anxiety in 25%. CONCLUSION: For the first time, data on the prevalence of NeP in Austria are available. Pain patterns in those affected are characteristic and impact on QOL as well as pain intensity are severe.

Adjusting aging forecasts to incorporate increases in longevity and health can provide better tools for policy-makers.

Contents: Introduction by Commissioner Vladimír Špidla to the four essays written in response to the communication on The Demographic Future of Europe; David A. COLEMAN: Demographic diversity and the ethnic consequences of immigration – key issues that the Commission's report left out; Jonathan GRANT and Stijn HOORENS: Does the Commission's report adequately address the key issues of the demographic future of Europe?; Wolfgang LUTZ: Adaptation versus mitigation policies on demographic change in Europe; Paul DEMENY: A clouded view of Europe's demographic future; Wolfgang LUTZ, Sergei SCHERBOV, Gui Ying CAO, Qiang REN and Xiaoying ZHENG: China's uncertain demographic present and future; Jeroen SPIJKER, Frans VAN POPPEL, Leo VAN WISSEN: Explaining new trends in the gender gap of mortality: Insights from a regional trend-analysis from the Netherlands; Franz SCHWARZ: Widening educational disparities in all-cause mortality: An analysis of Austrian data with international comparisons; Gustav FEICHTINGER, Maria WINKLER-DWORAK, Inga FREUND, Alexia PRSKAWETZ and Fernando RIOSMENA: On the age dynamics of learned societies – taking example of the Austrian Academy of Sciences; Dominik GRAFENHOFER, Christian JAAG, Christian KEUSCHNIGG and Mirela KEUSCHNIGG: Economic aging and demographic change; Diana HUMMEL and Alexandra LUX: Population decline and infrastructure: The case of the German water supply system; Wolfgang LUTZ, Anne GOUJON, Samir K.C. and Warren SANDERSON: Reconstruction of population by age, sex and level of educational attainment of 120 countries for 1970–2000; Anne GOUJON, Vegard SKIRBEKK, Katrin FLIEGENSCHNEE and Pavel STRZELECKI: New times, old believes: projecting the future size of religion in Austria; Dimiter PHILIPOV and Caroline BERGHAMMER: Religion and fertility ideals, intentions and behaviour: a comparative study of European countries; Isabella BUBER: Ageing in Austria: An overview of "Survey of Health, Ageing and Retirement in Europe" (SHARE) with special focus on aspects of health; Dalkhat EDIEV and Richard GISSER: Reconstruction of the historical series of life tables and of age-sex structures for the Austrian population in 19th-first half of 20th centuries; Maria Rita TESTA: Childbearing preferences and family issues in Europe: evidence from the Eurobarometer 2006 survey

Using demographic multi-state, cohort-component methods, we produce projections for 120 countries (covering 93% of the world population in 2005) by five-year age groups, sex, and four levels of educational attainment for the years 2005-2050. Taking int