This blog is intended to go along with Population: An Introduction to Concepts and Issues, by John R. Weeks, published by Cengage Learning. The latest edition is the 12th (it came out in 2015), but this blog is meant to complement any edition of the book by showing the way in which demographic issues are regularly in the news.

If you are a user of my textbook and would like to suggest a blog post idea, please email me at: john.weeks@sdsu.edu

Monday, July 24, 2017

My Very Own Near Death Experience

Sepsis; with organ failure. That was the diagnosis of my condition shortly after I was wheeled into the emergency room at Kaiser Permanente's brand new San Diego Medical Center by the paramedics on the morning of Monday, 3 July (three weeks ago today). My wife was told by the physicians that it was touch-and-go. One of the many physicians who attended me told me later that 40 years ago it would have simply been game over. I was conscious and not in pain, but it wasn't apparent to me at the time how serious the situation was. It should have been, though, because my wife had found me on the floor of our bedroom, where I had dropped down after realizing that I was very light-headed and might faint. The paramedics who responded to her 911 call thought their blood pressure cuff had broken since they couldn't get a reading. The look on the faces of the ER doctor and nurses suggested that that they were expecting me to be near death--and I was, even if I didn't know it then.

My body had been take over by a massive skin infection (cellulitis) focused in the groin area that stopped my bladder from working, nearly squeezed the life out of my kidneys and liver and had precipitously dropped my blood pressure (to 60/30), and raised my heart rate to 177, with an added irregularity to the heart rate. They pumped me full of saline, antibiotics, probiotics, heart meds and other things, all of which saved my life. It included a bit of midnight surgery to install a "central line" (a tube) into my heart to administer meds directly to the heart.

The U.S. Centers for Disease Control note that sepsis is more common among those under 1 and 65 and older, and more common among those with some kind of preexisting condition. While I am over 65, I do not have any chronic conditions that might predispose me to this. I was asked several times if I might have been bitten by a spider while working in the yard (not that I was aware of), or if I had traveled anywhere (yes, to Los Angeles a couple of weeks prior, but as different as LA may be from San Diego, it doesn't seem too dangerous!). None of the myriad tests/cultures they administered came up with any clue to the source.

NIH says this about the seriousness of sepsis:

Every year, severe sepsis strikes more than a million Americans.1 It’s been estimated that between 28 and 50 percent of these people die—far more than the number of U.S. deaths from prostate cancer, breast cancer and AIDS combined.
The number of sepsis cases per year has been on the rise in the United States. This is likely due to a combination of factors, including increased awareness and tracking of the condition, an aging population, the increased longevity of people with chronic diseases, the spread of antibiotic-resistant organisms, an upsurge in invasive procedures and broader use of immunosuppressive and chemotherapeutic agents.
Or, to quote my wife, Deanna: "it is the most serious cause of death you've never heard of."

I will always be grateful to the many wonderful physicians and nurses at Kaiser Permanente who saved my life. The love of my life, Deanna, kept me going throughout my ten days in the hospital, staying with me in my hospital room all day and night, questioning and advocating on my behalf. She is my strength and I genuinely owe my life to her as much as to the medical staff. Our daughter drove down from Long Beach to help out while I was in the hospital (and later with her whole family), and our younger son, Greg (often mentioned in these blog posts), flew out to from North Carolina to assist--later to be joined by the rest of his family. Indeed, he was there to take me and Deanna to the Emergency Room three times after my discharge. Our older son, John (also often mentioned in these blog posts), flew out twice from Switzerland to help out (the second time with our oldest granddaughter), and we've had visits from our oldest grandson who is currently doing an internship in Santa Monica. The kids and grandkids have been champions through this ordeal.


Will that which didn't kill me make me stronger? I hope so, but it is still too soon to tell.

Saturday, July 1, 2017

Birth Rate is Up in Switzerland; Down in the U.S.

It's not every day that the news from Switzerland is that the birth rate is going up. But, thanks to my son, John Weeks, for linking me to a story from there showing that there were more births in Switzerland last year than in any year since 1972!
The FSO said the increase was due to the growing number of babies born to foreign parents. However, it said it would be wrong to speak of a baby boom. Rather it was connected to the increase in the number of women of childbearing age in the country. The average number of children per woman was unchanged at 1.5 while the average age for giving birth for the first time was slightly higher than in 2015, at 30.8 years.
In fact, the total fertility rate in Switzerland has hovered right around 1.5 children per woman since the mid-1970s, according to UN data, so this is interesting news, but not too breathtaking.

Meanwhile, back here in the U.S., Justin Stoler sent me a link to a Washington Post story decrying the decline in the number of births in the U.S. 
According to provisional 2016 population data released by the Centers for Disease Control and Prevention on Friday, the number of births fell 1 percent from a year earlier, bringing the general fertility rate to 62.0 births per 1,000 women ages 15 to 44. The trend is being driven by a decline in birthrates for teens and 20-somethings. The birthrate for women in their 30s and 40s increased — but not enough to make up for the lower numbers in their younger peers.
Now, the headline for this story indicates that "some demographers are freaking out." The reporter interviews only two demographers, however, and neither is freaking out. Donna M. Strobino, a professor of population, family and reproductive health at the Johns Hopkins Bloomberg School of Public Health notes that the drop in births to younger women is a good thing, not a bad thing, as I have noted before.

The other person quoted in the story is William Frey from the Brookings Institution:
William Frey, a demographer and senior fellow at the Brookings Institution, points out that despite the recent decline, the U.S. fertility rate still remains relatively high compared to many other developed countries like Germany and Italy. The United States also still has more births than deaths. And we still have a growing labor force. All these things mean, he said, “I don’t think that’s cause for alarm.” 
Frey attributed the decline in birthrates to a women's “lifestyle” choice as well as the fact the economy has been in a funk. Times of economic downturn or uncertainty tend to cause a drop in birthrates, but when things turn around they tend to bounce back in a kind of catch-up period. 
“Every year I say when the economy is getting better then we’ll start having more children,” he said, “and I'm still expecting that to happen.”
So, the bottom line is that Switzerland's birth rate remains well below replacement level despite this recent rise, and the American birth rate remains just slightly below replacement level despite this recent drop. Everybody take a deep breath...