CLINICAL STUDIES

Scăderea natalităţii ca factor important al îmbătrânirii demografice în România

 Decrease in birth rate as an important factor of demographic aging in Romania

First published: 16 martie 2021

Editorial Group: MEDICHUB MEDIA

DOI: 10.26416/Pedi.61.1.2021.4718

Abstract

Demographic aging is a particularly complex phenomenon that affects the entire population of the planet in varying degrees and forms, being determined by three key factors, namely decreased births/fertility, reduced mortality due to increased life expectancy at birth, and external mi­gra­tion, especially for departure areas. The aim of our pa­per is to study the declining birth rate and its impact on de­mo­gra­phic aging in our country, which will be of major im­por­tance in the coming decades, with the change in the struc­ture of the demographic pyramid.

Keywords
natality, population dynamics, demographic aging

Rezumat

Îmbătrânirea demografică reprezintă un fenomen deosebit de complex care afectează întreaga populaţie a planetei, în grade şi forme diferite, fiind determinată de trei factori esen­ţiali, res­pec­tiv scăderea natalităţii/fertilităţii, reducerea mor­ta­lităţii pe fondul majorării speranţei de viaţă la naştere şi mi­gra­ţia exter­nă, în special pentru zonele de plecare. Scopul lu­cră­rii noas­tre este de a studia scăderea natalităţii şi impactul aces­te­ia asupra îmbătrânirii demografice în ţara noastră, ceea ce va avea o importanţă majoră în următoarele decenii, cu mo­di­fi­ca­rea structurii piramidei demografice.

Introduction

Demographic aging is a phenomenon that began in Europe a few decades ago and is visible in our country, by decreasing the share of children and young people and increasing the share of older people, relative to the total population. The aim of our paper is to study the decrease in the birth rate and its impact on demographic aging in our country, which will be of major importance in the coming decades, with the change in the structure of the demographic pyramid.

Demographic situation in Europe

The increase in human life expectancy in the last two centuries is a remarkable achievement of modern civilization. This progress has been made during the demographic transition of societies from high mortality and fertility regimes to low mortality and fertility regimes(1). Demographic aging is a particularly complex phenomenon that affects the entire population of the planet in varying degrees and forms, being determined by three key factors, namely decreased births/fertility, reduced mortality due to increased life expectancy at birth, and external migration, especially for departure areas.

Globally, it seems that countries with a high socioeconomic status, with a high average per capita income, have an inverse correlation with the birth rate and fertility, due to easy access to contraceptive methods(2). Other causes of both female and male fertility decline are pollution, with industrialized countries being at risk, and the poor countries appear to be the most affected in this respect, due to the large number of factories(3). Another plausible explanation for this decline in birth rates would be the education of women and their emancipation through education and financial autonomy, which have led to the secular decline in birth rates in Europe and the West. Tragically, no effort will be able to reestablish the birth rate in European countries: the younger generation emigrates, those who remain marry later, have children later, and usually only one.

In this context, at the level of the entire European continent, which holds the sad record of having nine of the 10 oldest demographic countries on the planet, the European Commission presented on January 27, 2021 a Green Paper, launching a broad policy debate on the challenges and opportunities facing Europe’s aging society(4).

Demographic situation in Romania

Romania is the eighth largest country in the European Union (EU) in terms of area and the seventh in terms of population, although Romania’s population has steadily decreased in the last 28 years, from 23.20 million inhabitants in 1990 to 19.64 million in 2017(5). The constantly low birth rates in our country and the increase in life expectancy will lead to changes in the structure of the demographic pyramid in Romania, the most important change being the sharp transition to an aging demographic structure, an evolution that has become evident in other EU-27 countries(4).

In Romania, the number of children (0-14 years) decreased by 0.1% in 2019 compared to 2009 (15.7% versus 15.8%), and the active population (15-64 years old) decreased by 2.3%, respectively from 68.1% in 2009 to 65.8% in 2019. These data are worrying, although we are still above the EU average in 2019 (15.2% young people of 0-14 years old, and 64.6% active population)(4). Regarding people aged 65 and over, in the last 10 years in our country their share has increased by 2.4%, reaching 18.5%, compared to the EU average of 20.3%. However, it is found that life expectancy is lower in our country compared to other EU member states.

In addition to the declining of birth rates and fertility, Romania is also facing the phenomenon of youth migration in recent decades, so that our country registered the largest demographic changes in Europe after Bulgaria, the country’s population decreasing by about 14,000 people annually. If this trend is maintained, Romania’s population will decrease by 30% in a few decades(6). The migration phenomenon reached a peak of emigration in 2007 in Romania, the year of accession to the European Union, respectively 544,000 people left the country.

Romania’s population decline from 1992 to 2016 is based on three important causes, namely: international migration, family planning, which through its various forms has led to a steady reduction in the annual number of births during the transition period (the number of births in 2015 was 28% lower than in 1992), and the mortality was high throughout the period after 1992(7). Thus, in Romania, for the last 30 years, one of the main causal factors of demographic aging has been the decrease in fertility and, consequently, in the birth rate, the percentage held by the young population (0-14 years) constantly decreasing throughout the period 1990-2019 from 23.6% to 15.7%, a phenomenon recognized as “the aging of the population by narrowing the base of the pyramid”(7,8).

The trend of reducing mortality in general and in old age in particular due to advances in medical sciences and the improving living conditions has inevitably led to an increase in the share of the elderly population (65 years old and over) by about 8.3%, from 10.4% to 18.7% in the period 1990-2019, an aspect highlighted synthetically on the graph of the age pyramid by thickening the top of this graph in 2019, compared to 1990 (Figure 1).
 

Figure 1. The age pyramid of the Romanian population for the years 1990 and 2019
Figure 1. The age pyramid of the Romanian population for the years 1990 and 2019

The impact of external migration, which also contributed significantly to the aging of the departure area, cannot be overlooked, dramatically reducing the number of people of childbearing age, an element with detrimental influences on birth rates, Romania’s resident population decreasing by over 3,800,000 people in the last 30 years, according to official statistics in our country.

Another synthetic image on the evolution of the demographic aging phenomenon in Romania, in the period between 2002 and 2019, is provided by the ascending evolution of the population aging index (the number of elderly people, 65 years old and over, which returns to 100 young people, under 15 years old), being particularly interesting to observe, at the same time, the specific trend outlined for each sex (Figure 2).
 

Figure 2. The evolution of the demographic aging index by sex in the period 2002-2019
Figure 2. The evolution of the demographic aging index by sex in the period 2002-2019

As it can be seen from the analysis of the previous graph, the female population is characterized by a much higher degree of demographic aging compared to the male population in our country, and also by a higher rate of increase in the share of elderly people returning to 100 of young people under the age of 15. Thus, if in 2002 women aged 65 and over accounted for only 96% of the number of girls under 15, at the end of the period, respectively in 2019, their share increased by more than 50%, reaching a value of 146.4%. The aging phenomenon was similar but much attenuated for the male population, but the share remained below 100% for the study period, when men reached a level of aging similar to that recorded by women in 2002, which allows us to say that in our country there is a gap regarding the level of demographic aging for the two sexes of about 18 years, in favor of women.

Another important causal factor of the decrease of the birth rate is represented by the increase of the average age of the mother at the first birth, an indicator that registered a clear growth trend during the last 30 years (Figure 3). Unlike the male population, which has a relatively constant reproductive potential in the first 50 years of life, the female population is born with a limited number of eggs, of which only about 300 will mature and be released from the ovary, the rest being consumed through a degenerative process that occurs regardless of whether or not women become pregnant during their potentially fertile life. At the age of 40, a woman has only 3% of the ovarian reserve with which she was born with, the frequency of trisomies increases exponentially after the age of 35 and also the risk of miscarriage exceeds 50% after the age of 42. Consequently, the constant long-term increase in the average age of mothers at first birth obviously implies a reduction in fertility, birth rates and, thus, a deepening of the phenomenon of demographic aging in our country, with particular medical, social and economic adverse consequences.
 

Figure 3. The average age of the mother at the first birth and the birth rate of the Romanian population in the period 1990-2019
Figure 3. The average age of the mother at the first birth and the birth rate of the Romanian population in the period 1990-2019

Another unpleasant phenomenon that is felt in Romania and which is not characteristic to the rest of Europe refers to the infant mortality rate, of 9 deaths per 1,000 newborns, this rate being three times higher than the European average(7). The structure by cause of deaths under 1 year old highlights as the main causes of death congenital malformations, respiratory diseases and perinatal causes, groups of causes for which rigorous measures of disease monitoring and prevention could have considerable effects on lowering mortality rates(9). In recent decades, the birth rate has fallen alarmingly in our country (1.5 times in the period 1990-2018, as we have shown previously), but an encouraging fact is the even greater decline in infant mortality in the same period, respectively almost seven times. This aspect highlights the fact that, especially since 2002, the drastic decrease in the number of deaths under the age of 1 years old on the background of maintaining at approximately the same level the number of live births is based on the obvious progress in Romanian medical science and the professionalism of the staff directly involved in providing good quality services to the population of our country(10).

Conclusions

Demographic aging is a very complex phenomenon that affects the entire population of the planet in varying degrees and forms, and which unfortunately manifests itself in our country. In addition, Romania ranks first in Europe in terms of infant mortality, which is worrying, although significant progress in improving this is visible in the last two decades. In this context, the European Commission has presented a Green Paper launching a broad policy debate on the challenges and opportunities facing Europe’s aging society.

Conflict of interests: The authors declare no conflict of interests.

Bibliografie

  1. Aburto JM, Villavicencio F, Basellini U, Kjærgaard S, Vaupel JW. Dynamics of life expectancy and life span equality. Proc Natl Acad Sci USA. 2020;117(10):5250-5259.
  2. Dribe M, Hacker JD, Scalone F. The impact of socio-economic status on net fertility during the historical fertility decline: A comparative analysis of Canada, Iceland, Sweden, Norway, and the USA. Population Studies. 2014; 68(2):135–49.
  3. Nieuwenhuijsen MJ, Basagaña X, Dadvand P, Martinez D, Cirach M, Beelen R, et al. Air pollution and human fertility rates. Environment International. 2014;70:9–14.
  4. EUROSTAT. Available at: https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Population_structure_and_ageing/en
  5. Pop TL, Burlea M, Pecurariu OF, et al. Overview of the pediatric healthcare system in Romania. Turk Pediatrics Ars. 2020;55(Suppl 1):S69–S84.
  6. Mediafax. Available at: https://www.mediafax.ro/social/romania-cea-mai-mica-natalitate-din-ultimii-sase-ani-explicatii-unui-sociolog-despre-fenomenul-ingrijorator-18577870
  7. National Institute for Statistics. Romania 1998–2018. TIME-Online Database. Available online: http://statistici.insse.ro:8077/tempo-online/#/pages/tables/insse-table (accessed on 21 March 2021).
  8. Ţarcă M, Ţarcă V, Ţarcă M. Elements of demography. Ed. Junimea, Iaşi, 2006.
  9. National Institute for Public Health. Romania. Available at: https://cnsisp.insp.gov.ro/wp-content/uploads/2019/01/MORTALITATEA-INFANTILA-2017.pdf (accessed on 27 March 2021).
  10. Ţarcă E, Roşu ST, Cojocaru E, Trandafir L, Luca AC, Rusu D, Ţarcă V. Socio-Epidemiological Factors with Negative Impact on Infant Morbidity, Mortality Rates, and the Occurrence of Birth Defects. Health Care. 2021;9(4):384.