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Sex Ratio, Age Structure and Population Ageing

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It is vital to examine the population composition, i.e. how the population being studied is structured. In demography, to understand the phenomena studied (firstly, births and deaths), it is common practice to examine the number of women in relation to the number of men and to distinguish the distribution of individuals by age. The most common representation of this gender and age composition is the “age pyramid”. It is important to know the age and gender composition, as this largely determines a population's demographic dynamics. Elements relating to gender and age composition will enable better understanding of the dynamics outlined in the following chapters. In this chapter therefore, we will present the composition of the Mediterranean population from the perspective of sex ratios on the one hand, and the age distribution of populations on the other. We will also consider the implications of differences between countries at the sub-national level.
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Chapter 3
Sex Ratio, Age Structure and Population
Ageing
Abstract It is vital to examine the population composition, i.e. how the population
being studied is structured. In demography, to understand the phenomena studied
(firstly, births and deaths), it is common practice to examine the number of women
in relation to the number of men and to distinguish the distribution of individuals by
age. The most common representation of this gender and age composition is the “age
pyramid”. It is important to know the age and gender composition, as this largely
determines a population’s demographic dynamics. Elements relating to gender and
age composition will enable better understanding of the dynamics outlined in the
following chapters. In this chapter therefore, we will present the composition of the
Mediterranean population from the perspective of sex ratios on the one hand, and the
age distribution of populations on the other. We will also consider the implications
of differences between countries at the sub-national level.
Keywords Age pyramid ·Population ageing ·Gender inequalities ·Sex ratio ·
Mediterranean
3.1 Introduction
While studying the spatial distribution of a population is an important aspect to
understanding it (see Chap. 2), it is also vital to examine its composition, i.e. how
the population being studied is structured. There are several indicators to describe
a population’s composition. In demography, to understand the phenomena studied
(firstly, births and deaths), it is common practice to examine the number of women
in relation to the number of men and to distinguish the distribution of individuals
by age. The most common representation of this gender and age composition is the
“age pyramid”.
It is important to know the age and gender composition, as this largely determines
a population’s demographic dynamics. For example, the birth rate is firstly the result
of the number of women of childbearing age (between puberty and menopause),
and secondly the intensity of fertility by age group (Chap. 5 examines to aspects of
© The Author(s) 2023
Y. Doignon et al., Population Dynamics in the Mediterranean,
SpringerBriefs in Population Studies,
https://doi.org/10.1007/978-3-031-37759-4_3
33
34 3 Sex Ratio, Age Structure and Population Ageing
differentials fertility). Elements relating to gender and age composition will enable
better understanding of the dynamics outlined in the following chapters. The birth
rate, as we have said, but also mortality (Chap. 7), migration (Chap. 8) and population
dynamics (Chap. 9).
In this chapter therefore, we will present the composition of the Mediterranean
population from the perspective of sex ratios on the one hand, and the age distribution
of populations on the other. We will also consider the implications of differences
between countries at the sub-national level.
3.2 Gender Inequalities in the Mediterranean
The human species is characterised by an almost equal numerical balance between
the sexes. On average, 105 boys are born for every 100 girls, but as the mortality
rate for boys is slightly higher than for girls, the ratio between the two sexes reaches
an equilibrium around the age of 20 and is maintained today until the age of 60.
Secondly, the gap tends to widen between men who die earlier on average, and women
(Chap. 7). Obviously, these orders of magnitude vary from one society to another, and
have evolved over time. These inequalities in mortality can be explained by natural
differences, but also by differences in personal behaviour and social constraints.
The male/female ratio, also known as the sex ratio, is the consequence of biological
constants that cannot be explained, but also of differentiated cultural practices. Thus,
in some countries there are imbalances in the sex ratio from birth. India and China
are regularly cited in this regard, with a sex ratio that favours girls (Guilmoto &
Oliveau, 2007). Around the Mediterranean, most countries have sex ratios at birth
that follow the norm of 105 boys per 100 girls. In the 1970s and 1980s, excess female
mortality was present in some countries on the Southern and Eastern shores (Locoh &
Ouadah-Bedidi, 2014; Tabutin & Schoumaker, 2005), but this is no longer visible
today (according to the World Population Prospects 2022 data at least). However,
other countries did show sex ratio imbalances at birth: Albania, Montenegro, and
Macedonia. All three countries show an unbalanced sex ratio at birth, indicating
strong discrimination against girls (Fig. 3.1).1
These imbalances were particularly high in the past, and are now decreasing.
Albania, for example, saw the sex ratio imbalance worsen in the mid-1990s, peaking
at 113 boys for every 100 girls in the mid-1980s, and declining steadily since. The
trends are different for these three countries, but they have all at some point had a
sex ratio at birth that has exceeded 108 in the last 30 years. In 2020, they reached a
level of around 107, higher than that observed in Southern Europe or the European
Union.
This preference for boys is complex to explain, as it is based on cultural practices
and lineage structures that are not explicit and are generally unconscious. Discrimi-
natory practice, while there is no doubt, is not being claimed here. Nevertheless, for
1 For at the sub-national level analysis of the sex ratio in former Yugoslavia, see Buisson (2016).
3.2 Gender Inequalities in the Mediterranean 35
1.05
1.06
1.07
1.08
1.09
1.10
1.11
1.12
1.13
1950 1960 1970 1980 1990 2000 2010 2020
Number of male births per one female birth
Macedonia
Albania
Montenegro
Kosovo
Southern
Europe
Europe
Fig. 3.1 Evolution of the sex ratio at birth in select South European countries (Source Worl d
Population Prospects 2022)
the preference for boys to be expressed by the disappearance of girls, there would
have to be legal and medical contexts that allow for it. Thus, the development of
ultrasound scans and abortion facilitated the use of prenatal selection. The develop-
ment of these practices from the 1990s onwards is, for instance, visible in regions
with a large Albanian population (Guilmoto & Duthé, 2013).
Nevertheless, traces of discrimination at birth may be erased over time in the
composition of the general population, through a higher mortality of boys and then
men, or through sex-differentiated migration, which can ultimately change the overall
sex ratio. From this perspective, international migration can severely impact the
overall sex ratio. This is the case for Albanian men who leave their country in greater
numbers than women, thus rebalancing the overall sex ratio.
Finally, in general, men’s mortality is higher than women’s, and even more so at
older ages (Chap. 7). As a result, countries with ageing populations generally have a
sex ratio in favour of women. Delbès et al. (2006) summed it up well about Europe
when they wrote that “women grow old alone, but men grow old with a partner”.
36 3 Sex Ratio, Age Structure and Population Ageing
3.3 An Ageing Population
Looking at a population in terms of its age structure enables understanding of the
demographic potential in terms of replacement level, ageing, development oppor-
tunities, etc. The determinants of age structure are both the births and deaths rates
(which are themselves the result of a cross between the fertility/age-specific mortality
rates and the structure of the population by age and sex), and the effect of inward
and outward migration. In 1950, the Mediterranean’s age pyramid had a broad base
and a rather thin top, which is a sign of a high average birth rate and an even higher
mortality rate at advanced ages (Fig. 3.2).
The higher the birth rate, the greater the number of young people and the wider the
base of the pyramid. This initially creates needs (in terms of educational infrastructure
in particular), but also rapidly opportunities (through the influx of workers into the
labour market). In 2020, the Mediterranean pyramid evolved. Its base was narrower,
with a lower weight of young people in the population. In addition, there are more age
groups above 30 than in 1950, and the top of the pyramid is much fuller. The weight
of older people has increased, and the population has aged, generating many socio-
demographic challenges (Blöss, 2018). This change in the age pyramid between
1950 and 2020 is the result of the demographic transition (Chap. 4), withasharp
drop in fertility, which fell below the generation replacement level in several countries
(Chap. 5), a significant drop in mortality and improved survival to old age (Chap. 7).
In societies in transition from a demographic regime of high births and high deaths
to a demographic regime of low births and low deaths (Chap. 4), there comes a time
when there are still few old people and few young people. This leaves plenty of room
15 10 5 0 5 10 15
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95-99
100+
%
MEN WOMEN
1950
2020
Fig. 3.2 Age pyramid of the Mediterranean in 1950 and 2020 (Source World Population Prospects
2022)
3.4 Ongoing Significant Differences in Age Structure Between Regions 37
for people of working age, creating what is known as a demographic window of oppor-
tunity for the economy: the number of working people is greater than the number of
people who depend on them (children and the elderly). A summary measure of t his
situation is the “dependency ratio”, which relates the population aged under 20 and
those aged 65 or over to the population aged 20–64. If the ratio is above 100, then
there are more inactive than active people, and if it is below 100, then the number
of active people is higher than the number of inactive people, suggesting a greater
possibility of productivity in society.
This dependency ratio in the Mediterranean decreases significantly between 1950
and 2020, from 105 to less than 75 (Fig. 3.3). This decrease indicates a lower amount
of young and old people in the population. This trend is primarily related to the
falling birth rate (Chap. 4), which narrows the base of the pyramid. As the number
of young people decreases, the dependency ratio decreases. However, there has been
a recent increase in the dependency ratio in Balkan countries, Southern European
countries and also in Israel. This is due to the ageing of the population, where
more people are surviving into old age, increasing the amount of the elderly in the
population. Countries on the Southern and Eastern shores retain higher dependency
ratios than countries on the Northern Shore (Ambrosetti, 2020), particularly in the
Near East, which is mainly due to a higher birth rate and thus a higher presence of
children in the population. Two countries stand out due to their ratio trajectories.
First of all, Israel has maintained a high ratio (>80%) since 1950, combining an
improvement in the longevity of its elderly with a relatively high fertility rate. The
second country is France, whose ratio is currently the highest on the Northern shore,
due to a combination of a birth rate that has not fallen to the same extent as elsewhere
in Europe, immigration that provides a steady supply of workers, and an ageing
population.
3.4 Ongoing Significant Differences in Age Structure
Between Regions
Looking at ratios at the country level is interesting and already shows remarkable
differences. It is nevertheless more pertinent to approach the subject at a finer level
in order to offer a more precise understanding of the age composition of the Mediter-
ranean area. We have therefore constructed age pyramids at a sub-national level for
each country that is as comparable as possible from one country to another in terms of
average area (Doignon, 2020; Doignon & Oliveau, 2015). In order to allow for carto-
graphic analyses, we have established a typology for age pyramids, which consists
of 7 profiles (from the youngest to the oldest) and uses a hierarchical ascending
classification (Fig. 3.4).2
The first profile type is an age pyramid with a very broad base and a narrow top.
It represents a very young population, with a high birth rate (characteristic of a fairly
2 The period represented is 2010–2015 due to data availability.
38 3 Sex Ratio, Age Structure and Population Ageing
50
75
100
125
150
175
1950 1960 1970 1980 1990 2000 2010 2020
Total dependency ratio (%)
France
Italy
Portugal
Spain
Malta
50
75
100
125
150
175
1950 1960 1970 1980 1990 2000 2010 2020
Tot al dependency ratio (%)
Egypt
Libya
Algeria
Morocco
Tunisia
50
75
100
125
150
175
1950 1960 1970 1980 1990 2000 2010 2020
Total dependency ratio (%)
Palestine
Syria
Israel
Jordan
Lebanon
Turkey
Cyprus
50
75
100
125
150
175
1950 1960 1970 1980 1990 2000 2010 2020
Total dependency ratio (%)
Kosovo
Albania
Montenegro
BiH
Macedonia
Greece
Slovenia
Croatia
Bulgaria
Serbia
Fig. 3.3 Total dependency ratio in the Mediterranean (1950–2021). (Source World Population
Prospects 2022. Note The total dependency ratio is the ratio of population aged 0–19 and 65 + per
100 population aged 20–64)
high fertility rate), and a low proportion of elderly people (on average less than 3%
of the population is aged 65 or over). It includes part of the Nile Valley in Egypt,
Palestine, Jordan, Syria, and also Turkish Kurdistan (with a higher fertility than the
rest of the country) and some Saharan regions of Algeria.
The second type corresponds to a situation where the birth rate has started to
decline, but is still high. People aged 65 and over still represent only 4.2% of the
population. This type of age pyramid is essentially found in much of the Maghreb,
and in the Nile delta in Egypt.
The third type is very similar to the second, but with the base of the pyramid
showing the beginning of a recovery, indicating that a decline in fertility is taking
place over time. It represents the situation in Libya, southern Morocco, the urban
regions of the Maghreb (Casablanca, Rabat, Agadir, Oran, Algiers, Tunis, etc.), a
large part of Tunisia, and Turkey, in the regions of Istanbul and Ankara, and on its
southern border.
The fourth type represents the average characteristics of the Mediterranean area.
The base of the pyramid is slightly sunken, indicating rather low fertility, and the
top is fuller than the previous types. The share of elderly people in the population is
about 9%. This type is found on all shores of the Mediterranean. It is characteristic
3.4 Ongoing Significant Differences in Age Structure Between Regions 39
Fig. 3.4 Age structure in the Mediterranean (2010–15) (Source National Institutes of Statistics and a uthors’ calculations)
40 3 Sex Ratio, Age Structure and Population Ageing
of Albania, Montenegro, Macedonia, Lebanon and Cyprus, along with a large part
of Turkey and certain localised rural areas of the Maghreb. Finally, some large urban
centres have this profile, such as Paris, Lyon and Toulouse in France (as well as
the departments bordering Switzerland, which attract many young workers), and Tel
Aviv and Haifa in Israel.
The fifth type embodies European ageing, with a rather low birth rate. People
aged 65 or over represent almost 15% of the population. This pattern is found in
the Iberian Peninsula, southern Italy, and much of the Balkans, almost equal to the
seventh type. The only exception is France on the Northern shore.
The French regions are represented by the sixth type which is specific to them.
Despite the ageing population (15% of the population is 65 years or older), the birth
rate remains high compared to other European countries (see Chap. 4), which gives
the age pyramid a typical shape, still somewhat narrow at its base, but with a full top.
The seventh and last type is an even older age pyramid than the fifth type. The
base of the pyramid is very narrow and the top is very wide. The proportion of people
aged 65 or over in the population reaches 19% (1 in 5 people). This seventh type is
found in the same regions as the fifth type, i.e. the Iberian Peninsula, Northern Italy
and the eastern Balkans.
As evidenced, the model of contrasting shores between north, south and east needs
to be rethought. The Mediterranean is a highly heterogeneous area. While profiles
1, 2 and 3 are not present in the north, they are differentially distributed in the south
and east and are clustered locally. Type 4 is thus present everywhere, although it
is over-represented in the east. Types 5 and 7 correspond only to certain countries
on the Northern Shore (Bulgaria, Greece, countries of the former Yugoslavia, Italy,
Spain, Portugal) and therefore do not constitute a particular model. Moreover, type
4 regions are interspersed. Finally, type 6 is a reminder of France’s demographic
uniqueness, even if the country is not perfectly uniform.
3.5 Implications and Consequences of Age Structure
Differences
This heterogeneity in age composition of Mediterranean populations is above all the
consequence of demographic transitions whose pace and intensity have differed and
still differ between countries (Chap. 4). What interests us here are the implications
of these observed differences.
Throughout Mediterranean societies, the relationship between men and women
will change. The situation remains difficult to summarise. On a global scale, the sex
ratio is unlikely to changes between now (98.9 males per 100 females in 2020) and
the next 30 to 50 years (99.5 males per 100 females in 2050 and 2070). However, this
stability hides a strong convergence of sex ratios between countries. In fact, countries
where women have been in the minority (general sex ratio of the population greater
than 100) are trending towards a better balance between the sexes. In fact, while in
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The reduction in the labour force could also lead to a greater demand for female
labour, which, together with better education, could lead women to renegotiate their
place, even within societies that some believe are still stuck in fairly traditional
patriarchal forms of organisation.
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42 3 Sex Ratio, Age Structure and Population Ageing
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