Apuntes 06.02.

2024

- In pre-modern times fertility was deified and linked to gods

- Christianity and other religions in the Middle Ages are highly pronatalist. “Increase and multiply”
- In the case of Christianity, it stands against polygamy, divorce, abortion, and infanticide.
- According to Malthus economic output is linear, while population grows exponentially  now it
may be logarithmic
- European marriage pattern: postponing marriage, high celibacy rates, low number of illegitimate
children, a lot of possible births were averted (how?)
- Neo-Malthusians in the beginning of the XXth century: oppose redistribution policies because it
increases the incentives of poor people to have more children, hence, threaten the system.
- Later, in the 60s, neo-Malthusians talked about the lack of access to contraception as one of the
reasons for Africa’s poverty.
- Genetics stuff  Eugenics ☹. The term was popularized by Francis Galton: elites should have
more children, while working classes fewer
- Buck vs Bell 1927 trial, reached the Supreme Court even
- Frank Notenstein – Demographic Transition, with development the death rate goes down, which
is later followed by fertility, which also declines

Apuntes 13.02

- Data collection – boring

- Census – vital registration – sample surveys

Apuntes 20.02

- Lexis diagram (the one where the cohorts are represented as lines, while the length of the line
depends on the longevity of these groups)
- Life table: 10q40 probability of dying between 10 and 40 years

Apuntes 23.03

- Age, cohort and period effects

Apuntes 27.02 Reading:

- Causes for a reduction in mortality:

o Improved nutrition
o Public health
o Urbanisation
o Vacation
o Medical treatments (cardiovascular specifically)
o A more long-term effect of good nutrition of our parents: healthier parents have
healthier children, so the effect may be quite lagged
- Three phases of mortality reduction with different advancements
o Industrial revolution: improved nutrition and economic growth
o Late XIXth century: urbanization and improvement of public health
o Since 1930s: development of medicine and innovation
- It’s like an analysis of past demographic tendencies and their reasons and an intent to predict
the future based on this information (quite ambitious, ngl).
 - To do this they use “health inequalities”, which they call gradients for some reason. Therefore,
they concentrate their study on the evolution of these gradients (inequalities) among different
societal groups.
o No evidence that the gradient disappears with the rise in living standards
o Education may increase the gradient, since more educated people tend to get rid of
unhealthy practices faster than non-educated ones

01.03.2024

- The effect of higher cigarette consumption on mortality tends to be lagged, as it takes time for
cancer to develop
- The reduction in the disparity in mortality between men and women maybe due to drugs in the
60s and 70s being mainly tested on males, hence, being more effective for them.

05.03.2024

Fertility and stuff

- Usually, mortality starts decreasing before fertility does (empirically). This is the reason for
explosive population growth after the Industrial revolution
- Fertility transition
- Natural fertility: the hypothetical amount of children possible to have without any birth control
o How do you estimate that: by analysing the Amish and Hutterites, it seems
o Бля, кто-то навонял сука
- There are several measures of fertility:
o Crude birth rate: births in year t divided by population in year t
o General birth rate: births per woman of reproductive age in year t
o Ages specific fertility rate
o Total Fertility rate: mean number of children per woman (not births per se). But in
reality, the measure is slightly different: the average babies produced by 35 women,
whose age is consecutive to each other (first I ask a girl aged 15, then a girl aged 16 , and
so on till I reach a woman of 49 years old)  to solve this we could use UN predictions,
for instance, as I did for Casos
o Gross and net reproduction rate: total fertility rate, but we only take into account female
babies
o Child-woman ratio: very inaccurate, use only when there is a lack of data
- All these measures, obviously, have their positive and negative sides
- Now, why the fertility transition? Classical arguments yara yara yara
-

12.03.2024

- Indentured workers: imports of cheap labour force with no rights from abroad (basically
European migration to America, I suppose)
- Gastarbeiters in Europe between 1945 and 1970, reconstruction boom, large enterprises
- After WWII the importance of migration from Europe to the US declined drastically
- Patterns of migration:
o South  North
o South and South-East Asia to the Gulf
o Migration within Africa and the Middle East
 - Different definitions for migration in different countries, who do we consider a migrant (how
much time does a person has to stay)
- The amount of internally displaced is much larger than the number of emigrees.
- Now, we look into some migration measures:
o Crude net migration rate: all immigration minus emigrations
o Gross migration rate: immigration and migration (it’s like trade value)

19.03.2024

- Migration theories: macro (big chunks of population moving), micro (individual migration
decisions), mezzo level (households seek to maximise their income, the individual decisions are
less relevant).
- Push-pull model: people are pushed from origin region and/or pulled to new destination. For
example: people are attracted to where wages are higher  convergence of wages during the
first globalisation
- Neoclassical economics approach: migration is a rational decision of maximisation of a certain
utility function
o Most migrants migrate in search of work
- Network theory: initial migration may be random, however, after a big chunk of the population
has established in a certain place, more follow because there is an established diaspora already
(Venezuelans in Spain, Turks in Germany, Algerians to France)
- World system theory: core-periphery theory, people migrate from the poorer countries to the
richer one. Increases global inequality between countries
-

Nice apuntes
Midterm preparation

25.03.2024

Lecture 1:

- Demography studies all that is related to population (size, spatial distribution, composition)
- Brief history of population
o Prehistory: stagnant world population (around 4M), subsistence population limited by
the carrying capacity of the land
o Neolithic revolution: moderate growth
o Temporary loss in population: black plague
o 1 billion people in 1800, grew to 7 billion in 2011. However, in recent years the increase
in population has been mild. The trends show a decrease in the future.
- Why was the growth rate so low before?
o High mortality
o Low life-expectancy
- Overall, this lecture explains the main historical tendencies in demography, most of which are
already known to me. However, we have to memorise them to avoid repeating the same
mistakes.
- Urbanisation:
o In 1800, 1% lived in cities of 100K or more, now – 50% do
- Then, on the reduced class we saw some proofs of the existence of climate change.
Lecture 2:

- Demographic theories:
o Premodern:
 Deification of fertility;
 First preoccupation with possible issues of overpopulation;
 Importance of population stability in order to ensure the rule of the elite;
 Christianity: both pro-natalist and anti-natalist (increase and multiply, but
divorce and polygamy ban at the same time)
 Enlightenment: prosperity and population growth go hand-in-hand
o Malthusian model: classic story that resources have diminishing returns (logarithm).
While population grows exponentially.
 Preventive checks (birth control) vs positive checks (war, famine, and so on)
 Critique: Agriculture doesn’t grow linearly or logarithmically, there is room for
technological improvement of efficiency
o Eugenics, genetics, and other stuff
- Neo-Malthusians in the beginning of the XXth century: oppose redistribution policies because it
increases the incentives of poor people to have more children, hence, threaten the system.
- Later, in the 60s, neo-Malthusians talked about the lack of access to contraception as one of the
reasons for Africa’s poverty. Paul Ehrlich “Population Bomb”
- Genetics stuff  Eugenics ☹. The term was popularized by Francis Galton: elites should have
more children, while working classes fewer
- Buck vs Bell 1927 trial, reached the Supreme Court even (about forced sterilisation of certain
parts of the population).
- Frank Notenstein – Demographic Transition, with development the death rate goes down, which
is later followed by fertility, which also declines
- Stages of transition:

Lecture 3:

- Type of data:
o Census. Very detailed, participation is compulsory, periodic
 o Administrative data
 Population register (padrón municipal)
 Limited information by law
o Sample survey
- In the meantime between two censuses, we may estimate the population by summing the
population of the last census with the births and immigration and subtracting emigration and
deaths;
- Issues of age-heaping: truncating the age down
- Race, ethnicity, and religion are not natural things, but rather social ones, which may cause
issues for census questions.
- Advanced techniques:
o Indirect estimation

Basically, used in order to estimate the population at year y with only census data. If
population during census c1 at year 1950 is 1 million, while it increases to 2 million in
1970, in order to calculate the population at year 1960, we do the following:
 P1960=1M+(1960-1950)/(1970-1950)*(2M-1M)=1M+0,5M=1,5M  basically, it
assumes constant population growth
o capture-recapture  analysed further in the respective PS.

Problem set, next week, the one about homeless people in the Netherlands

- Issue with homeless people: they don’t appear on censuses, so it makes any estimation of
economic well-being of the overall population quite biassed (if the issue of homeless people is
considerable, of course.
- Different methods for population size estimations:
o Link-tracing: basically, snowballing homeless people by asking them to nominate other
people from their group.
o Indirect estimations: using shelter records, etc
o Census like: just going around asking homeless people
o Capture-recapture: if you meet x homeless people and mark them and two weeks later
meet y homeless people, z of whom are the same as the first time, then the population
would be p=y*x/z
 Also used in ecology and epidemiology (to identify prevalence of a disease).
- Assumptions:
o Probability of being included in group 1 is independent from the probability of being
included in group 2.
o Closed population
o Possible to perfectly link individuals in A and B (basically, if you are interviewing the
same group of people both times).
26.03.2024

Lecture 4: Demographic methods

- Ratio vs rate
o Ratio: both parts are taken from different groups.
o Rate: numerator has a subset of the population, the denominator has its entirety
- Mortality rate: deaths per 1000 people
- TFR (Total Fertility Rate): we get it by summing all the age specific birth rates
- Lexis diagram:
That shit:

- Period vs cohort: period effects are those that affect all people living in a certain year, while
cohort effects are those that affect people born in a certain year later in their life. In a Lexis
diagram, cohorts are the diagonal 45º lines, while ages are on the y axis (horizontal lines) and
periods are on the x axis (vertical lines)
o Cohort measures, in order to be accurate, have to wait for all people of the cohort to be
out of the child-bearing age or be dead (depending on whether we want to measure
fertility or mortality)  they are outdated before they are complete
 Person-years lived is the sum of all lifelines
o Period measures: Period Person Years Lived  sum of all time people were alive in a
certain year (usually just the population midyear multiplied by the length of the cohort)

- Life table:
 - We got to learn all the parts of this life table (even though I have already learned them in order
to do an imaginary research piece for Casos)
- Person-years lived between two points in time (x and n): nLx=n*(Ix-0,5*ndx)
- Life expectancy is a hypothetical measure
- I0 is the RADIX (baseline population, usually 100K)

Now, let’s look at the PS

- Explores the difference between age and cohort effects;

- Difficult to isolate such effects both from a mathematical point of view and a practical one. To
solve this the study uses 4-year groupings
- This problem set also addresses the issue of bimodality in the women’s mortality from ovarian
cancer. Basically, there seem to be two distinct types of that cancer, since there are two groups
of people: those who live very long and those who live very short.

Lecture 5: Mortality transition

- Reminder: after the first stage of the demographic transition, mortality starts falling
- Mortality decline reasons: about public health policies or societal change?
o Improved nutrition and housing
o Public health: scepticism about that, some say it’s more about broad economic and
societal change
o Urbanisation (more of a negative effect on health, overcrowded cities and stuff)
o Vaccination
o Medical treatments
o
- Risk of death influenced by:
o Genetics
 o Social, economic, and political infrastructure
o Lifestyle (including the job you carry out)
- Mortality from non-communicable diseases is much higher in the developed world than in the
underdeveloped, where communicable diseases tend to thrive.
- DALY – Disability Adjusted Life Years. Basically, years of healthy life lost due to disease and
disability. DALY= YLD (years lived with disability) *weight + YLL (years of life lost).
- Example (for an individual): life expectancy is 65. You die at 50 from diabetes. During ten years
you were 50% disabled. DALY=(65-50) + 10*0.5 =20 years
- QALY – Quality Adjusted Life Years. Basically, instead of counting each year of your life, you give
each of them a value from 0 (dead) to 1 (best of health)
- Longevity is roughly the same as life expectancy for demographers. Lifespan  the known
length of someone’s life (not an expectation, but rather the realization)

Problem set mortality:

- Preston curve: links economic development and mortality

- The main cause of death in developing countries are communicable diseases like respiratory
infections, for instance. SHE MAY ASK SMTH LIKE THIS FOR SURE

Lecture 6: Fertility transition

- Several stages (referred to in lecture 1):

- Some important terms:
o Fertility: realised live births per woman
o Fecundity: physiological ability to bear children
o Natural fertility: average hypothetical realized births per woman without deliberate birth
control. REFERS TO MARRIED WOMEN
 How do you estimate that: by analysing the Amish and Hutterites, it seems
- There are several period measures of fertility:
o Crude birth rate: births in year t divided by midyear population in year t
o General Fertility Rate: births per women of reproductive age in year t
o Age-specific fertility rate: births per woman of a specific age.
o Total Fertility rate: mean number of children per woman (not births per se). But in
reality, the measure is slightly different: the average babies produced by 35 women,
whose age is consecutive to each other (first I ask a girl aged 15, then a girl aged 16 , and
so on till I reach a woman 49 years old)  to solve this we could use UN predictions, for
instance, as I did for Casos. This measure is the one usually used to be compared with
the replacement rate
o Gross and net reproduction rate: total fertility rate, but we only take into account female
babies
o Child-woman ratio: very inaccurate, use only when there is a lack of data
o Cohort Fertility rate: like the thing I wanted to do for Casos (like a real TFR)  cannot be
plotted before women reach the end of reproduction age
- Explanation for fertility decline:
o Change of values: fertility limitation within marriage
o Quantity-Quality theory (economic explanation): rising opportunity cost of raising
children, as well as higher returns for investment, therefore, parents invest in less
children, but more educated ones.
 Child labour laws, wage rise, secularisation, education of women
o Secularisation and new women status
- Parents tend to have less, while also more educated children
 -
- Parents tend to respond to high mortality when taking fertility decisions.
- Имеет ли смысл вообще стараться повлиять на людей и заставить их рожать или рыночек
по-любому всё порешает
o Обычно рыночек и экономическое развития роляют больше в снижении
рождаемости.  policies promoting social development & gender equality work better
than coercion.
- The decrease in fertility was much faster for developing nations in the XXth century rather than
European states that developed in the XVIIIth and XIXth centuries.

Problem Set 6

- Africa is right now on the early

stages of the fertility transition.
- Difference between developed and
developing countries:

Lecture 7: Migration

- Evolution of migration flows over time:

o Colonial era migration: Africans to the Americas, some European to the Americas as well
o XIXth century: huge migration from Europe to the US, Argentina, and other American
countries
o 1945 – 1970: Gastarbeiters and stuff, Europe’s reconstruction
 -

- Most of the migrants are still labour migrants

- Important migrant flows:
o SouthNorth
o To the Persian Gulf
o With Africa and Asia
o Migration from poorer developing countries to emerging economies
- Issues with counting migrants:
o Foreign-born vs foreign national
o Children born to immigrants.
o No unified definition of the migrant variable.
- Migration measures:
o Crude rate of out-migration: people leaving the country as a percentage of its population
o Crude rate of In-migration: the same, but with people entering the country
o Migration saldo: rate of in-migration minus rate of out-migration
o Gross Migration Rate: immigration + emigration
o Migration ratio: net migration divided by natural population increase
o Percentage of population growth attributable to migration: net migration divided my
population increase in year t
- Theories:
o Functionalist explanation: push-pull model, migrants maximise a utility function
o Economic explanation (neoclassical theory): people are attracted to higher wages (also –
Heckscher Ohlin model for factor mobility)
o Network theory: people migrate following their networks of social interactions. It’s more
likely that you migrate to the US from Mexico if you have an Auntie there that may find
you a nice job
o

Problem Set 7:

- Borjas’ paper basically describes an economic model in order to predict the amount of migration
that goes to a certain country.
- He describes the two interpretation of prices: relative scarcity and proxy for productivity.
 - This model may sound unrealistic for several reasons:
o It assumes zero migration costs (almost impossible)
o Such an influx of migrants that may be unskilled could lead to a loss in productivity for
the receiving country

Lecture 7b (more migration):

- Continuing with the economic theory of migration: people move from low-wage, labour
abundant regions to high-wage, labour scarce regions.
- Structural theories: they critique the economic approach and its assumptions of:
o Rationality of actors
o Perfect information
o No attention to structural factors
- World Systems theory: migration as a consequence of core/periphery relations
- Institutional theory: perpetuation of migration, as it becomes integrated into the culture
- Consequences for sending countries: brain-drain, remittances

Más apuntes:

- Sex ratio at birth: male births / female births

- Stable population: a population with a fixed age structure and rate of natural increase (or
decrease). Basically, it’s a population where there aren’t any sudden explosions of births, which
may change the median of the population.

09.04.2024

Lecture 8: Urbanisation trends

- How do you define a city?

o Concentration of people who are employed in non-agricultural activities and a certain
density;
o People living there are engaging in something that isn’t agriculture: industry or services;
- Suggested definition of the European Commission:
o Urban centre: more than 50K people + population density of 1500 people per km 2
o Urban cluster: more than 5K people + more than 300 people per km2
o Rural: less than 5K
o Doesn’t let us to make differentiation between different types of cities: megacities and
agglomerations.
- UN definition:
o Agglomeration: at least 750,000 people
o Mega-city: 10 million and more (there are 35 right now)
- Urbanisation is a consequence of:
o Rural-urban migration
o Natural increase (untrue for historical cities)
o International urban migration
o Reclassification of places from urban to rural (play a role when we talk about
administrative statistics.
- For a very long time, death rates were higher in cities, while birth rates were lower
- Growth of ancient and medieval cities:
 o People migrate to cities  wages fall  producers happy and more likely to expand
their production  more income, more wealth, higher wages at the end, and, lastly,
more migration  the cycle repeats itself
- Advantages: Cities are places for economic exchange and trade. The needs of traders incentivise
the provision of services, which brings a lot of new employment.
- Disadvantages:
o Lotta people packed together, so there is a higher probability of disease;
o Optimising traffic.
o Waste and sewage issues
o Separation of industrial and residential zones
- Rural-urban migration:
o Pull factor  wage/utility gap
o Push factor  Green revolution releasing large swaths of labour from agriculture.
o Natural population growth was negative and pre-industrial times.
- Urbanisation in XXth century vs XIXth
o Faster in XXth
o Driven more by natural population growth, rather than redistribution
- Problems of cities in developing countries nowadays:
o Lack of housing
o Crowding
o The resulting slums
o Residential segregation
o Not enough jobs for the rate of people arriving  growth of the informal economy and,
hence, the black sector and crime rates
o Insufficient or deficient public transportation.
- It’s difficult to fight slums due to:
o Social networks already built in the favelas;
o Not enough space in the city.
- Problems of rich people:
o Too high housing prices.
o Traffic issues, pollution, heat islands in urban areas because of people heating up the air.
o Gentrification
o Ghettoisation
o Rural exodus (España vaciada)

Problem Set topic 8 (week 9)

- It took today’s developed countries much longer to urbanise when compared to today’s
developing countries.
- Role of economic development in urbanisation: pull-push factors, green revolution, higher wages
in the city, now more about natural demographic increase seems to contribute more than in
Europe in the past
- If the growth of urban population isn’t matched by capital investment, there will be congestion.
o So, natural population growth in cities coupled with migration has a positive effect on
the formation of slums
- More than 80% of Spaniards life in cities
-

16.04.2024

Lecture 9: Ageing society

- The concept of a stable population: stable in terms of demography means that the population
may be growing or shrinking but at a constant rate.
o Age-specific fertility and mortality rates don’t change over time (same age structure over
time)
o Stationary population: it’s a stable population where the stock doesn’t change over time
(almost impossible to find a stationary population in reality). It’s a useful theoretical
concept.
- Measuring age structure:
o Dependency ratio=(people aged less than 14 and more than 65)/(People between 15
and 64)
 Young age dependency ratio (only young people divided by the working
population)
 Old age dependency ratio (the same, but with pensioneers)
o The age distribution at the regional level is a result of two effects: domestic migration
and demographic transition (be it birth or death transition). The effect of mortality rates
may have an issue of reverse causality: there may be higher mortality rates once there
are many old people who die often.
- Fertility has the strongest effect on the age distribution
- A drop in mortality firstly affects the lowest part of the pyramid – the babies (decrease in child
mortality), only later it starts ascending the structure.  expansion of the base of the pyramid
and then we get a pyramid quite fat in the middle.
- Then, the decline in mortality starts affecting the older people and the pyramid becomes a bell
and then a vase.
- The effect of migration on the receiving country, especially a small one, makes the age structure
look like a юла (kids seldom migrate). After the migrants settle in, there is a “second generation
effect”, since the immigrants have more children, hence, expand the base of the pyramid.
- Population momentum: Типа инерции у населения, когда рождаемость понизилась ниже
2,3, но население всё ещё растёт.
o The world is very close to a replacement level of population growth.
- Forecasting population and age structure in the future.
o A little bit like guessing
o Linear rate of growth using census data (assuming constant population growth, weird)
o Exponential extrapolation: Malthus moment (assuming exponential population growth).
o Component model: you assume constant mortality and fertility rates
o Cohort-component model: using cohort specific mortality and fertility (read at home)
 We often assume zero migration since it tends to have an impact on the age
structure, which skews the results)
- Skepticism:
o Short-term predictions are all-right, nevertheless, going into the long-term gives large
errors. There may be external shocks that affect fertility (the demographic transition for
instance)
- Demographic dividend: on the first stage of demographic transition, when mortality has
decreased and fertility only starts reducing, the economy gets a higher amount of working
population and a larger chunk of active population, since now people have less kids to carry
about (we have to also consider the inclusion of women into the workforce).
o Issue: youth unemployment hinders the increase of the workforce.
- Another dividend during the transition: higher savings (some, as the Chinese, for instance,
should consider this a hinderance).
- Sex ratio (males divided by females, higher than 1 for the world)
 o More boys are born than girls

Problem Set Topic 9 (Week 10)  the one about pensions

- The article explores the state of pensions in developing countries and how to make them more
efficient:
o Diseases destroy working population.
o Increased social mobility leads to the breaking of community support groups.
- Solutions:
o Tighten the link between benefits and contributions (forced pensions)
o Introduce flat taxes to build a safety net
o Universal entitlement (unfeasible in the long-run, difficult to sustain for poor countries,
but very easy to implement, as it demands no effort from the government)
- Different demographic trends in Europe during its development and in Africa, so pension
systems have to be different as well. Europe’s mortality rate declined slower, while the fertility
rate didn’t reach the heights of today’s developing nation
- Then, several measures for reforming the pension system are proposed:
o Reducing benefits.
o Increasing the retirement age.
o Passing to a multi-pillar or even fully-funded, Chilean style system

Lecture 10: sustainability

- A question about the carrying capacity of earth: how much more people can it handle?
o Despite seeing that population will not uncontrollably grow, the issue of starvation isn’t
out of the table just yet. Depleting natural resources may become a problem in the
future.
- Extensification (looking for more land) vs intensification (using the land more efficiently): in
terms of extensification there isn’t much we have left to do, not much free farmland left (unless
we go into aquaculture).
- Green Revolution (60s and 70s in developing countries, especially India)
- GMOs: possibly the only solution for developing countries, however, their production is mostly
monopolised.
- Food production growth has so far outpaced population growth.
- Ecological footprint: the global hectares required to meet a population’s needs based on average
global productivity per hectare.

- Vicious circle model: degraded environment  higher fertility  worse environment

- Migration patterns are also often attributed to some degree to the environment.
Problem Set 10 (Week 11):

- They simulate several demographic evolution scenarios and their impact on the environment.
- The study showed that, essentially, even if we were to go as far as possible in controlling fertility
with every policy available, the result would still be ineffective in diminishing the immediate
global sustainability crises.
- A second paper analyses how CO2 emissions are affected by demographic factors, which is
proven to be a quite significant negative effect (ageing population contributes to the reduction
of emissions).
- In the long-run population reaches carrying capacity

30/04/2024 Lecture 11: Epidemiology 1

- Not only about contagious diseases (also includes cancer and diabetes for instance).
- John Snow: the father of field epidemiology.
- Clinical vs population (aetiology of the disease, in other words, where does the disease come
from and what increases the probability of an outbreak) epidemiology
- Incidence of a disease: the rate at which new cases occur. If there is a decline in incidence as
time passes, then there is no epidemic
- Prevalence: proportion of population that are cases at a point in time.
- How to confirm a case of a disease? Depends a lot on the definition.
- Observational studies:
o Issues with case-control studies:
 Recall bias
 Selection bias
 No information on incidence and prevalence.
o Strength of case-control studies:
 Good for the analysis of rare disease
o Cohort study (this is like the doctors’ study by Doll & Hill, the one I haven’t read; it’s like
following the same cohort of people over time).
o Other issues with observational studies: confounding, selection bias, selective reporting,
etc

 - Hawthrone effect: even if you don’t impose a stark COVID policy the people may adopt
behaviours similar to those countries, where the measure was imposed.
o Maybe lockdowns aren’t completely exogenous.
- Does coffee cause pancreatic cancer study. Why is it biassed?
o Selection bias (the control group had unusually low exposure to coffee drinking due to
gastrointestinal disorders.
o
- Solution  RCT: Randomised controlled trials. In RCT subjects are randomly allocated either to a
treatment or a control group
o It has some issues like small sample bias and expensiveness still, so we carry out meta-
analyses + systematic analysis.
- Cochrane library – a site with a lot of meta reviews simplified

Lecture 12: Epidemiology 2 (some maths)

- When does outbreak cause and epidemic?

- Predicting the spread of diseases (we assume closed population):
o Basic Reproduction Number (R0): the number of secondary infections caused by a newly
infected person (R0>1  maybe epidemic, if R0<1 the disease disappears)
o Attack rate: probability that a contact leads to an infection

S – population susceptible to getting infected (at the beginning of an epidemic it’s very close to N);

β – the number of contacts

1/Gamma – mean infectious period (mean time a person is infectious I assume)

 - Vaccination, one of the most effective means to control disease.

- Vaccine development:
o Step 1: Identify vulnerable structures of the virus, which could be effectively attacked by
the immune system (vaccines are like showing the immune system a sample of the
structure it has to fight)
o Step 2: test it toxicity and adverse effects.
- Vaccine production and delivery
- Vaccination gaps: there may be outbreaks of an epidemic that seemed tamed a long time ago.

03.06.2024 Last moment notes

- Boomsters: population growth is good for technological development

- Doomsters: we are gonna die from overpopulation (Ehrlich and other neo-malthusians)
- Fertility has a much larger impact on the composition of the pyramid than migration or
mortality.
- Environmental Kuznets curve: a U-shaped relationship between pollution and GDP per capita:
very high in the middle, low on the extremes.
- Mushroom cities: cities in developing countries growing thanks to migration and natural growth
(very fast)
- R0>1  epidemic; R0=1  endemic (disease always exists, but doesn’t grow), R0<1 (disease
dies out). Measles is the disease with the highest R0.
- Life tables are fit for any type of survival analysis.
- Migration transition theory: migration and economic development
- Rate vs ratio:
o Rate: numerator included in denominator
o Ratio: numerator not included in denominator (two different groups)