Demography (Greek demos: people, graphien: to write) examines the size and structure (age, gender, nationalities etc.) of human populations and their changes. Determinants of population dynamics are fertility, mortality and migration. Previous developments are reflected in the present structure of populations and proceed in its own specific dynamics.
Population Dynamics: Determinants and Projections
In Germany in the 20th century life time has elongated about 30 years and is currently in the average of the European countries. In parallel to the decrease of mortality fertility has decreased, too. Since the early 1970s the number of annual births is less than the number of deaths. Hence, without immigration the German population would have been reduced about 3 million people in the last 3 decades. But with the present demographic situation immigration will not be able to counterbalance the birth's deficiency. Statistical predictions appoint the year 2013 as the beginning of population's decline. Additionally, Germany must face a heightened demographic ageing and an increasing proportion of elderly persons with migration background.
Demographic research may help to determine future population dynamics and therefore may identify long-term effects of current developments - especially with regard to the health system.
Effects of Demographic Ageing and Health Policy
The increasing number of the elderly and their raising proportion in the population is a main issue of the demographic transition in Germany. Some changes have already happened and the addressed development will proceed accelerated. By year 2050 more than one third of the German population will be 60 years and older; today this group of people counts for about 25%. An exceptionally large rise is predicted for the proportion of people older than 80 years. This fact has a pivotal effect on the health system because prevalence of diseases, healthy behaviour, and demands for health services strongly depend on age. The expected transition in population?s age distribution will influence the pattern of benefits provided by the health system and of course the associated cost within the next decades.
Immigration, Integration and Health
In fact, Germany is an immigration country. In the last 3 decades immigration has positively influenced Germany's population dynamics. Nowadays more than 11 million people with migration background are living in Germany. Immigrants often reside under specific social conditions and show different health behaviour than people who are born in Germany. Little knowledge of the German language and other barriers complicate access to health services. The future German population structure will be significantly formed by further immigration and further integration of immigrants.
Global Divergence of Demographic Developments
Globalization influences more and more the demographic and social structures in Germany by international migration as well as economic, political and cultural interdependencies. Beyond these effects international comparisons and classifications become more important for the understanding of fertility, mortality and migration developments in Germany. Finally, Germany supports many developing countries in their endeavours for reproductive health and in the implementation of the ICPD (International Conference on Population and Development, Cairo 1994) programme of action.