Race and the Fertility Paradox

Credit Image: © Andrew Matthews/PA Wire via ZUMA Press

It is well known that for a population to reproduce itself from one generation to the next, each woman must have, on average, 2.1 children, or 2,100 children per 1000 women. For this to happen, two things are necessary: women must not only be healthy and fertile, they must also be “willing” to have children. Societies differ greatly in both of these respects. At one extreme are the very healthy peoples of Europe and North Asia who are biologically capable of having very large families, but who are failing even to reproduce themselves. At the other are Sub-Saharan African populations that carry a range of diseases — some of which directly affect reproductive health — but who still manage to have many children.

Societies with the best medical facilities and the lowest mother and infant mortality have the fewest births. That is to say, the safest, healthiest places for mothers have the fewest children. Why is this?

One factor is division of labor by sex. Societies with traditional sex roles — women raise children and run the house; men are breadwinners — have many children. When both sexes work, women tend to have just one child. As a society moves from peasant farming towards manufacturing and services, it needs more paid labor, which means more people need schooling. Women get more education, enter the work force, and even participate in politics. Birth rates then plunge, but not even the best demographers thought they would plummet past replacement levels.

Hong Kong (0.91) and Singapore (1.04) have two of the lowest birth rates on earth; neither has even half of the required 2.1 children. The two lowest in Europe, Lithuania (1.17) and the Czech Republic (1.18) are just over half. Even with very low death rates, any society operating below replacement value will shrink. By contrast, the two highest fertility rates in the world are in some of the poorest countries in Africa: Somalia (6.91) and Niger (6.93).

European women, with an average lifetime fertility of 1.55 children each, are about 500 children per 1,000 women short of replacing themselves, which means severe shrinkage is just over the horizon. People are only now beginning to discuss this shrinkage, but there is no agreement on how to stop the West from evaporating.

Women in the 36 countries in black Africa average more than five children each, or more than twice the number needed for replacement. Even with very short life expectancies, these populations will grow. In the swathe of 25 Moslem countries that begins at Mauritania and sweeps east to Pakistan, women average 4.08 children, which means Moslems are in latent demographic competition with blacks. Differences in reproductive health — the prevalence of diseases that directly affect a woman’s fertility — may affect the outcome of this competition.

HIV-infection rates for women are a good indicator of reproductive health. The World Health Organization and UNAIDS have spent a lot of money tracking these numbers all around the world, and their figures are probably good estimates. Men can infect each other by homosexual contact, but women do not infect each other. Very few women take intravenous drugs, so virtually the only way they get the disease is from sex with men. Therefore, if a woman has the virus, it suggests many sex partners for herself, the man, or both. Large numbers of sex partners mean a high likelihood of other sexually transmitted diseases.

Unlike HIV/AIDS, other STDs tend not to be lethal, but they quickly raise sterility rates, and can affect the health and even mortality of babies. The number of women who are HIV-positive is a useful predictor of other STDs, and therefore a good barometer of reproductive health.

The world average female HIV infection rate is 1.4 percent, but there is great variation from country to country. At one extreme are Zimbabwe (14.3 percent) and Botswana (21.5 percent) and at the other are Japan (0.02 percent), Mongolia (0.04 percent), and Turkey (0.01 percent). To make the most extreme comparison, Botswanan women are 2,150 times more likely than Turkish women to be infected. They are probably that much more likely also to have other STDs that affect fertility.

A regional comparison shows that the infection rate for European women is less than 0.1 percent, that for Moslems is less than 0.3 percent, and the average rate for black Africa is 5.5 percent. The European and Moslem rates are not statistically different from each other, but both are significantly lower than the African rate. (It is surprising that Muslim societies, which are famous for sequestering women, should have essentially the same female infection rates as Europe. To the extent that infection rates really do measure the number of sex partners, Muslims must have many more partners than we are led to believe.)

There are likewise big regional differences in infant mortality: 94.7 per 1,000 live births in Sub-Saharan Africa, 52.9 in the Moslem swathe, and 10.2 in Europe. Much of this is explained by differences in medical standards, but part is explained by the health of the mothers. If all the mothers who had their babies in Africa had them in Europe, their infant mortality rate would drop, but not to the European level.

Clearly, race is part of the equation, but it is not always easy to separate it from geography, economy, or social organization. Rates for blacks outside of Africa can be used to control for these factors. There are four Caribbean islands that are more than 80 percent black: Haiti, Jamaica, the Bahamas, and Barbados. The average HIV-infection rate for women is 1.43 percent. This is more than four times the world average when Sub-Saharan Africa is removed.

The Center for Disease Control in Atlanta, Georgia, tracks American AIDS-infection rates by race and sex. It reports that Black women are 25 times more likely than whites and 31 times more likely than Asians to be infected. Similar differences are likely to be found in multiracial societies like Canada, Britain or France. Race therefore seems to have an independent effect on AIDS rates.

We have witnessed a substantial racial shift in reproduction. In white (and some Asian) countries, women work in what have become wealthy, industrial societies. Women are reproductively healthy and have excellent medical care, but are unwilling to have enough babies to keep their societies going. African women have the worst reproductive health and miserable hospitals, but have the most babies. Moslem countries are somewhere in between. In the long-run, Moslem countries — where high rates of child-bearing are combined with what appears to be quite good reproductive health — would seem to have the reproductive advantage.