Sub-Saharan Africa is nearing a historic opportunity, but most of its nations are not ready.
Published on Africa Day 2023.
The population of India will have surpassed that of China by the end of this year, with each country counting 1.43 to 1.45 billion people. This milestone has led several observers to wonder whether the Indian economy can achieve a demographic dividend in the same way that China did after 1990. There is however widespread misunderstanding around the question of what constitutes a demographic dividend. This recent statement from a leading Indian daily is typical but inaccurate:
“A high population, especially in a younger age cohort, is generally seen as an asset rather than a liability for the economic fortunes of a country. The simple reason for this is that more people also means more working hands.”
“More people” or a “youth bulge” could in theory mean “more working hands” but only if there is a sufficient number of jobs being created. The fact that tens of millions of new young cohorts will come of age every year and will need to take jobs to make a living does not automatically mean that those jobs will be there for the taking. A benign economic outcome cannot be taken for granted merely because of a shift in demographics. If for example investment is weak or if literacy is low, having more people may result instead in greater poverty and other deteriorating conditions. In addition if there is a too-large “younger age cohort”, there may be new headwinds slowing the economy in cases where the number of dependents (the young and elderly) overwhelms the number of workers. All of this is to say that while the sheer total number of citizens is important, it is less important than the age distribution of the population and other non-demographic factors.
“For some people, risk is scary and dangerous, and means peril and loss. For others, it means risk assets and they have to pile on because they just see the upside. But risk is actually value-neutral. It is important to be aware of the bias that you bring to things. Do you see both sides and do you weigh them? Or are you likely to overweigh the downside or overweigh the upside?” ________ Michele Wucker
We all have an ambivalent attitude towards risk. In 1850, a young Emily Dickinson wrote to her friend Abiah Root “the shore is safer, Abiah, but I love to buffet the sea. I can count the bitter wrecks here in these pleasant waters, and hear the murmuring winds, but oh, I love the danger!”
In her new book You Are What You Risk, author and strategist Michele Wucker codifies this ambivalence to risk. In this podcast with Sami, Michele explains the concepts of “risk fingerprint” and “personal risk portfolio”, among others.
Topics include:
0:00 Introduction of Michele Wucker
2:13 Thesis of ‘You Are What You Risk’
5:20 Attitude towards risk: innate vs. acquired through experience
10:40 Taking a risk vs. following a path; Risk and entrepreneurship
14:10 About each person’s risk fingerprint
19:45 Taking risk as the only woman in the room
24:40 “Risk is value-neutral”
33:00 Matching risk fingerprints in interactions; Measuring risk
What are the odds that the coronavirus will recede on its own during the spring because of warmer temperatures or a higher ultraviolet (UV) index? This has been a question from the beginning.
There has been some research in support of the idea that the warmer season would force the virus to retreat. And there has been other research that concluded that the virus would retreat but not disappear, that it would survive in the southern hemisphere and that it could then stage a comeback in the northern hemisphere in the fall when cooler temperatures return.
Single Variables
Looking at the United States state by state, we find little correlation between the number of deaths per capita and the UV index. For example, Wisconsin with a UV index of 4 in March has so far suffered 25 deaths per million inhabitants, but Rhode Island also with a UV index of 4 saw as many as 60 deaths per million. At one extreme, New York, New Jersey, Michigan, Connecticut and Massachusetts, all with a March UV index of 4, had over 100 deaths per million. At the other extreme, South Dakota also with a March UV index of 4 had only 7 deaths per million. (All deaths figures are as of 12th April 2020 per Worldometer). Read more →
There is plenty that we do not know about the coronavirus. But let us take stock of the things that we do know for sure, and of some other things that we will soon know.
Real-world Exponentiality
By now, a child understands exponential growth. If you start with one apple on March 1st and double every three days, you will have a thousand apples on March 31st and a million on April 30th.
But in the real world, not the abstract world of math, there are constraints on that growth. Doubling your apples every three days is feasible for a month or so because you can probably find a thousand apples and also find a place to store them. But it would be more difficult to find, transport and store a million apples, unless you are willing to pack a six car garage with apples from floor to ceiling (accurate math). If you did, most of them would rot and your neighbors would call for psychiatric help, two other constraints on unbridled exponentiality. Read more →
“The paradox of the Gray Rhinos is that the further they are down the road, the less likely you are to do something about them. But that is the time when it will cost the least and you are most likely to be successful.” ____ Michele Wucker
Sami J. Karam speaks to best-selling author Michele Wucker about her 2016 book The Gray Rhino and how its method and lessons apply to the coronavirus pandemic. Gray Rhino threats are highly probable, highly impactful but often neglected until it is too late or until the cost of dealing with them becomes very high.
Topics include:
0:00 Introduction of Michele Wucker
1:05 When will we be able to travel to Asia or Europe again?
3:10 Explaining the concept and examples of Gray Rhino events
9:00 Various reactions to the spread of the pandemic
15:50 Was the virus predictable?
19:20 Why should we have been readier for the virus when it is so rare?
22:00 Why we ignore what is “over there”. Did it start “over there” or over here?
25:35 How could we have prepared for the pandemic?
31:00 The current catch-22: deaths by virus vs. deaths of despair
44:10 Stages of a Gray Rhino event applied to the pandemic
50:10 What other Gray Rhino events do you worry about? A triad of Gray Rhinos
55:45 How alarmists help avert deep crises
59:40 Conclusion
TO HEAR THE PODCAST, CLICK HERE OR ON THE TIMELINE BELOW:
We all heard that “demography is destiny”. But how many of us truly believe it? If demography was destiny, the world would look very different today. The two demographic giants China and India would be uncontested economic and military powers. The United States would be a regional power struggling to keep up. Larger European nations such as Britain, France and Germany would barely register on the economic map, while smaller ones such as Switzerland and Finland would be invisible. Nigeria and DR Congo would be African powerhouses. Brazil, Indonesia and the Philippines would be the shining stars of their continents. Read more →
Cardiologist Michel Accad advocates early testing for detection of heart disease.
“We do have very robust technology, non-invasive technology that is simple to use and reliable and that has been established for a long time, to try to detect heart disease before it actually causes any problems. Most of the time when heart disease becomes manifest with symptoms or sudden cardiac arrest or a heart attack, it has been present for many many years before that time. So there is an opportunity to make a diagnosis that is very specific.” Dr. Michel Accad, Athletic Heart of San Francisco.
Demography is one of the recurrent themes at populyst. In America Heading towards Zero Population Growth, I wrote that the population of the United States is growing at a slowing rate and that, except for immigration, it will not grow at all in the 2030s and 2040s. This prediction may however come into question if US life expectancy increases significantly in the next 20 years.
For this and other reasons, it is useful to periodically examine the progress being made in health and medical practice.
Heart disease remains the number one killer in the United States, accounting for 611,000 of the 2.6 million deaths in 2013. Strokes were responsible for an additional 129,000 fatalities, which means that cardio-vascular ailments led to 29% of all US deaths. By way of comparison, cancer in its various forms accounted for 23% of US deaths.
Death by heart attack is largely an older person phenomenon. According to the Center for Disease Control (CDC), as many as 40% of fatal heart attacks strike people aged over 85 and only 8% strike people aged under 55. This means that a hypothetical increase in US life expectancy, which currently stands at 79 years of age, must probably be accompanied by a measurable reduction in heart disease.
The table, compiled from CDC data, shows the percentage of heart disease and cancer fatalities per age group.
Detection and prevention are seen as essential ways to fight back against cancer. It has become widely accepted that after a certain age, people should undergo routine testing for detection of some cancers even if they appear on the surface to be completely asymptomatic. Some such tests are mammograms and colonoscopies. It is important to note that these tests are most often covered by insurance, a factor which certainly raised their adoption among patients and their doctors.
By contrast, historically, the approach to detection of heart disease has relied primarily on a nebulous review of the usual risk factors, mainly diabetes, blood pressure, cholesterol, smoking, and their frequently attendant obesity. More recently however, a growing number of cardiologists have started advocating proactive testing via CT Scans (aka CAT Scans) of all people over 45 or 50.
Michel Accad, MD.
One of the most vocal among this group is San Francisco-based Dr. Michel Accad, a practicing cardiologist who is also the founder and medical director of Athletic Heart of San Francisco.
In addition to early detection of coronary heart disease and other heart ailments, Dr. Accad also champions a more proactive approach to early detection of any risk of sudden cardiac arrest. Although relatively rare compared to coronary heart disease, sudden cardiac arrest can strike any person of any age during strenuous physical activity.
Dr. Accad’s years of experience coincided with rapid advances in technology and the two have converged today into the following messages:
1- It is a good idea for any person over the age of 45 to get a CT Scan. Because the first manifestation of heart disease can be catastrophic (one third of all heart attacks are fatal), it makes sense to try to detect the presence of any plaque in the arteries.
2- It is a good idea for any person of any age who is active in high-intensity physical activity to undergo tests designed to detect early any risk of sudden cardiac arrest.
As noted above, insurance typically covers cancer tests such as mammograms and colonoscopies. But CT scans designed to detect plaque in the arteries are not generally covered. Perhaps this is due to the fact that treatment of cancer can be far more expensive than treatment of heart disease, at least in its milder form. Dr. Accad notes nonetheless that the cost of CT scans is not prohibitive for a vast majority of patients.
I discussed all of these issues and questions of life expectancy with Dr. Accad in a podcast which you can hear through this link or by clicking the timeline below.
TO HEAR THE PODCAST, CLICK HERE OR ON THE TIMELINE BELOW:
Disclosure: Sami Karam and populyst have no business dealings with, and receive no compensation from, Dr. Michel Accad, Athletic Heart of San Francisco or any other parties named in the podcast.
Ann Wafula, 30, patiently waits to see the gynaecologist at Gilead Medical Centre, situated in the upmarket Upper Hill area of Nairobi.
The mother of a three-month-old baby boy, who is also her first born, is here to consult with the doctor on what contraceptives she should use, based on a hormonal test carried at the hospital.
In Hagadera, three hundred kilometres away to the east of Nairobi, 21-year-old Asha Abdalla is a proud mother of twin girls, delivered just a few days ago at a local dispensary. The twins are her second and third born, while her first born is aged barely two years. “I conceived when he was just nine months,” she explains. READ MORE.
As a large number of India’s population moves towards the 50 plus bracket, The Economist Intelligence Unit (EIU) Report 2012 shows that in the absence of proper healthcare infrastructure and adult vaccination programmes, the elderly population in the country are highly vulnerable to infectious diseases.
India’s population is undergoing a dramatic transition, the report says adding that the proportion of older people is expected to rise three- to four-fold in the next 40 years. India’s population of people aged 65 and over will be second only to China’s. Even conservative estimates predict that the number of people aged 60 and over will reach 323 million by 2050. By then, people in their fifties are expected to account for 30% of the population, while those in their sixties will make up 20%. READ MORE.
