tag:theconversation.com,2011:/ca/topics/us-population-16561/articlesUS population – The Conversation2023-09-05T12:29:28Ztag:theconversation.com,2011:article/2074702023-09-05T12:29:28Z2023-09-05T12:29:28ZCalifornia and Florida grew quickly on the promise of perfect climates in the 1900s – today, they lead the country in climate change risks<figure><img src="https://images.theconversation.com/files/538547/original/file-20230720-23-tqmqx5.jpg?ixlib=rb-1.1.0&rect=91%2C257%2C771%2C522&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Iconic California from a 1920s orange box label.</span> <span class="attribution"><a class="source" href="https://calisphere.org/item/ark:/13030/kt1k4023mq/">Covina Citrus Industry Photographs</a></span></figcaption></figure><p>Images of orange groves and Spanish-themed hotels with palm tree gardens filled countless pamphlets and articles promoting Southern California and Florida in the late 19th century, promising escape from winter’s reach.</p>
<p>This vision of an “<a href="https://www.loc.gov/item/rc01000915/">American Italy</a>” captured hearts and imaginations across the U.S. In it, Florida and California promised a place in the sun for industrious Americans to live the good life, with the perfect climate.</p>
<p>But the very climates that made these semitropical playgrounds the American dream of the 20th century threaten to break their reputations in the 21st century.</p>
<figure class="align-center ">
<img alt="Women in 1920s-style bathing suits lounge on a beach in Florida." src="https://images.theconversation.com/files/538207/original/file-20230719-5903-aglwo5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/538207/original/file-20230719-5903-aglwo5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=378&fit=crop&dpr=1 600w, https://images.theconversation.com/files/538207/original/file-20230719-5903-aglwo5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=378&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/538207/original/file-20230719-5903-aglwo5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=378&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/538207/original/file-20230719-5903-aglwo5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=475&fit=crop&dpr=1 754w, https://images.theconversation.com/files/538207/original/file-20230719-5903-aglwo5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=475&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/538207/original/file-20230719-5903-aglwo5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=475&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A postcard illustrates the latest style for Miami beach bathing around 1920.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Miami_Beach_-_Bathing_in_the_Atlantic_Ocean.jpg">Asheville Post Card Co./Wikimedia</a></span>
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</figure>
<p>In California, home owners now face <a href="https://swcasc.arizona.edu/sites/default/files/2022-08/HeatWaves.pdf">dangerous heat waves</a>, <a href="https://www.ppic.org/publication/droughts-in-california/">extended droughts</a> that threaten the water supply, and <a href="https://www.pnas.org/doi/10.1073/pnas.2213815120">uncontrollable wildfires</a>. In Florida, sea level rise is worsening the <a href="https://coast.noaa.gov/states/fast-facts/recurrent-tidal-flooding.html">risks of high-tide flooding</a> and storm surge from hurricanes, in addition to turning up the thermostat on already humid heat. Global warming has put both Florida and California at the top of the list of states <a href="https://xdi.systems/xdi-benchmark-gdcr/">most at risk from climate change</a>.</p>
<p>My <a href="https://history.exeter.ac.uk/staff/hknightlozano/">books and research</a> have explored how these two states were sold to the U.S. public like twin Edens. Today, descendants of those early waves of residents are facing a different world.</p>
<h2>Selling semitropical climates</h2>
<p>As railroads first reached Southern California and the Florida peninsula in the 1870s and 1880s, land, civic and newspaper boosters in each state worked to overturn beliefs that people only thrived in colder climes. In the decades after the Civil War, white Americans living in the North and Midwest had to be persuaded that sun-kissed climates would not do them more harm than good. </p>
<p>Employed by the transcontinental railroads, influential writers like <a href="https://www.loc.gov/item/14022123/">Charles Nordhoff</a> contested eastern notions of Southern California as barren desert where “Anglo-Americans” would inevitably succumb to the “disease” of laziness. </p>
<p>Challenging persistent ideas of a malarial swampland, promoters in Florida, including the state’s <a href="https://ufdc.ufl.edu/UF00055131/00001/images/1">own Bureau of Immigration</a>, similarly put a growing emphasis on climate as a vital resource for fruit growers and health seekers.</p>
<figure class="align-center ">
<img alt="Photograph of orange grove and passenger train in Southern California, ca. 1880." src="https://images.theconversation.com/files/532656/original/file-20230619-25-tl07qb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/532656/original/file-20230619-25-tl07qb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=489&fit=crop&dpr=1 600w, https://images.theconversation.com/files/532656/original/file-20230619-25-tl07qb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=489&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/532656/original/file-20230619-25-tl07qb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=489&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/532656/original/file-20230619-25-tl07qb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=615&fit=crop&dpr=1 754w, https://images.theconversation.com/files/532656/original/file-20230619-25-tl07qb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=615&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/532656/original/file-20230619-25-tl07qb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=615&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">In the late 1800s, state promoters published pamphlets selling settlers and tourists on California’s semitropical climate.</span>
<span class="attribution"><a class="source" href="https://digitallibrary.usc.edu/asset-management/2A3BF1K2OD8">California Historical Society Collection, 1860-1960, University of Southern California Libraries and California Historical Society.</a></span>
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<p>Climate became integral to California’s and Florida’s growing reputation as idealized U.S. destinations. Moreover, it was deemed unlike other natural assets: an inexhaustible resource. </p>
<p>Tourists and settlers gave weight to these claims. “The drawing card of Southern California,” a tourist from Chicago visiting Pasadena wrote in the Chicago Tribune in 1886, “is the beautiful, even climate.” Peninsula Florida was “blessed by nature with a semi-tropical climate,” a visitor wrote in the Atlanta Constitution in 1890. He saw its destiny to attract those who would “bask in the sunlight of a genial clime.”</p>
<p>This proved a compelling vision. In the 1880s, both Southern California and eastern Florida saw booms in settlement and tourism. Southern California’s population more than trebled during the decade to over 201,000, while peninsular Florida’s doubled to over 147,000. </p>
<p><iframe id="pWYUj" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/pWYUj/5/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>Affluent white Americans weighed up the merits of each: for citrus-growing, winter recuperation, land investment. The differences were, of course, numerous. One state was western, the other southern; one more mountainous, the other flat. Some boosters critiqued their subtropical rival’s climate. </p>
<p>Southern California was too arid, a writer in the Florida Dispatch claimed, a desert “parched for want of water.” Florida, meanwhile, had too much of the stuff, editorials in California replied: a wetland fit for reptiles but potentially deadly to new residents who would wilt in its torrid summers.</p>
<p>Yet Southern California and Florida became connected through economic futures founded upon climate promotion and related industries of citrus, tourism and real estate. If rivals, they shared distinct market ambitions. </p>
<p>“California and Florida can [together] control the citrus trade,” the Los Angeles Times declared in 1885, arguing for mutual benefits in the promotion of oranges. The pair had much to gain from persuading Americans to eat their fruit.</p>
<figure class="align-center ">
<img alt="Two men stand next to a large billboard reading: 50 foot lots at altos Del Mar. $745 and up." src="https://images.theconversation.com/files/538205/original/file-20230719-17-kl9ahe.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/538205/original/file-20230719-17-kl9ahe.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=462&fit=crop&dpr=1 600w, https://images.theconversation.com/files/538205/original/file-20230719-17-kl9ahe.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=462&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/538205/original/file-20230719-17-kl9ahe.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=462&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/538205/original/file-20230719-17-kl9ahe.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=580&fit=crop&dpr=1 754w, https://images.theconversation.com/files/538205/original/file-20230719-17-kl9ahe.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=580&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/538205/original/file-20230719-17-kl9ahe.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=580&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Swampland was drained for subdivisions across Florida in the early 20th century.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Billboard_for_the_Sale_of_Subdivision_Real_Estate_Lots_WDL4030.png">State Library and Archives of Florida</a></span>
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<p>Developers in both also changed the landscape by rerouting water to create communities in once-inhospitable places. In California, the spread of irrigation to turn “desert into garden” enabled the growth of citrus towns such as Riverside, while <a href="https://digital-collections.csun.edu/digital/collection/SFVH/id/2487">vast aqueducts</a> conveyed water to thirsty cities like Los Angeles. </p>
<p>In Florida, flawed schemes sought to “reclaim” – essentially drain – wetlands, including the Everglades, where boosters like <a href="https://www.google.co.uk/books/edition/Truck_Farming_in_the_Everglades/Cej6AAAAQBAJ?hl=en&gbpv=1&printsec=frontcover">Walter Waldin</a> sold Americans on a once-in-a-lifetime “opportunity to secure a home and a livelihood in this superb climate.”</p>
<h2>An inexhaustible resource</h2>
<p>The roaring ‘20s saw a new influx of sun-seeking, automobile-driving Americans drawn by boosters <a href="https://calisphere.org/item/f3a6852eb71dad0a09c79300a870fd84/">to the beaches</a> and <a href="https://www.floridamemory.com/items/show/157550">orange groves</a> of Los Angeles County and South Florida.</p>
<figure class="align-center ">
<img alt="A drawing of a carnival midway with a Farris wheel, roller coaster, malt shop and ocean in the background." src="https://images.theconversation.com/files/538209/original/file-20230719-573-yu20ct.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/538209/original/file-20230719-573-yu20ct.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=385&fit=crop&dpr=1 600w, https://images.theconversation.com/files/538209/original/file-20230719-573-yu20ct.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=385&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/538209/original/file-20230719-573-yu20ct.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=385&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/538209/original/file-20230719-573-yu20ct.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=484&fit=crop&dpr=1 754w, https://images.theconversation.com/files/538209/original/file-20230719-573-yu20ct.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=484&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/538209/original/file-20230719-573-yu20ct.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=484&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A postcard of a beachfront amusement park at Mission Beach in San Diego celebrates leisure time in sunny California in the 1930s or 1940s.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Amusement_Center,_Mission_Beach,_San_Diego,_Calif_(79119).jpg">Boston Public Library Tichnor Brothers collection/Wikimedia</a></span>
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<p>Comparing Florida and California had become a national pastime as popular as mahjong and crossword puzzles, according to Robert Hodgson, a subtropical horticulturist at the University of California, in 1926. </p>
<p>Hodgson traveled to Florida to act as a judge at an agricultural show in Tampa where, the Los Angeles Times reported in a dig at Florida, he visited everything “from the dizziest pink stucco shore subdivision to the latest aspiring farming colony reclaimed from the alligators.”</p>
<figure class="align-center ">
<img alt="Rows of perfect orange trees beside a pristine lake" src="https://images.theconversation.com/files/538203/original/file-20230719-11357-f80mjo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/538203/original/file-20230719-11357-f80mjo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=380&fit=crop&dpr=1 600w, https://images.theconversation.com/files/538203/original/file-20230719-11357-f80mjo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=380&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/538203/original/file-20230719-11357-f80mjo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=380&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/538203/original/file-20230719-11357-f80mjo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=478&fit=crop&dpr=1 754w, https://images.theconversation.com/files/538203/original/file-20230719-11357-f80mjo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=478&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/538203/original/file-20230719-11357-f80mjo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=478&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A postcard dated 1925 shows an orange grove in Florida.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:%22An_Orange_Grove_in_Florida%22_(10724609885).jpg">State Library and Archives of Florida/Wikimedia</a></span>
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<p>Snipes aside, climate and the lifestyle they offered to middle-class Americans set Southern California and Florida apart. Hodgson wrote that they were similarly “blessed by the gods” through a “joint heritage of something like 90% of the subtropical climatic areas of the United States.”</p>
<p>Climate, moreover, was unlike other natural resources. Whereas precious metals or forests could be mined or cut down, climate was different: an infinite resource. It “can never be exhausted by man in his ignorance or cupidity,” he explained. </p>
<h2>Climate as crisis</h2>
<p>This history of climate-based advertising puts into stark relief the challenges faced by California and Florida in the era of climate crisis. </p>
<p>Today, both confront recurring natural disasters that are exacerbated by human-caused climate change: <a href="https://www.pnas.org/doi/10.1073/pnas.2213815120">wildfires in California</a>, <a href="https://theconversation.com/the-2020-atlantic-hurricane-season-was-a-record-breaker-and-its-raising-more-concerns-about-climate-change-150495">hurricanes</a> and <a href="https://coast.noaa.gov/states/fast-facts/recurrent-tidal-flooding.html">flooding in Florida</a>, and increasingly dangerous heat in both.</p>
<figure class="align-center ">
<img alt="Palm trees stand above the wreckage of a fire-burned building and homes. The air is still smoky." src="https://images.theconversation.com/files/538768/original/file-20230721-15-u8u6fj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/538768/original/file-20230721-15-u8u6fj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=443&fit=crop&dpr=1 600w, https://images.theconversation.com/files/538768/original/file-20230721-15-u8u6fj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=443&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/538768/original/file-20230721-15-u8u6fj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=443&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/538768/original/file-20230721-15-u8u6fj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=556&fit=crop&dpr=1 754w, https://images.theconversation.com/files/538768/original/file-20230721-15-u8u6fj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=556&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/538768/original/file-20230721-15-u8u6fj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=556&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Fire season has become an almost year-round threat in many parts of California.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/trees-are-seen-through-the-haze-at-the-burnt-out-vista-del-news-photo/887220562">Mark Ralston/AFP via Getty Images</a></span>
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<p>Extensive <a href="https://theconversation.com/the-fastest-population-growth-in-the-wests-wildland-urban-interface-is-in-areas-most-vulnerable-to-wildfires-173410">home-building in wildfire</a> and <a href="https://theconversation.com/coastal-home-buyers-are-ignoring-rising-flood-risks-despite-clear-warnings-and-rising-insurance-premiums-179603">coastal zones</a> has compounded these risks, with insurance companies now <a href="https://theconversation.com/why-insurance-companies-are-pulling-out-of-california-and-florida-and-how-to-fix-some-of-the-underlying-problems-207172">refusing coverage</a> for properties at risk of fires or storm damage, or making it prohibitively expensive. </p>
<figure class="align-center ">
<img alt="A woman in a dress carrying her shoes and a man in red and white striped shorts walk down a street that is filled with water to above their ankles." src="https://images.theconversation.com/files/538769/original/file-20230721-19-df5a18.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/538769/original/file-20230721-19-df5a18.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/538769/original/file-20230721-19-df5a18.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/538769/original/file-20230721-19-df5a18.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/538769/original/file-20230721-19-df5a18.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/538769/original/file-20230721-19-df5a18.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/538769/original/file-20230721-19-df5a18.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Street flooding during high tides has become more common in Miami Beach, Fla., as sea level rises. Hurricanes on top of higher seas are increasingly destructive.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/people-walk-through-a-flooded-street-that-was-caused-by-the-news-photo/490535380?adppopup=true">Joe Raedle/Getty Images</a></span>
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<p>Once marketed successfully as the United States’ two semitropical paradises, Southern California and Florida now share disturbing climate-influenced futures. </p>
<p>These futures bring into question how historic visions of economic growth and the sun-kissed good life that California and Florida have promised can be reconciled with climates that are no longer always genial or sustainable.</p><img src="https://counter.theconversation.com/content/207470/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Henry Knight Lozano received funding from the United Kingdom's Arts and Humanities Research Council (AHRC) as part of this research project.</span></em></p>From semitropical playgrounds to life-endangering climate risks: Going back over a century, California’s and Florida’s growth has been predicated on climate – and promises of the good life.Henry Knight Lozano, Senior Lecturer in American History & Director of Liberal Arts, University of ExeterLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1968712023-02-15T13:23:22Z2023-02-15T13:23:22ZHow records of life’s milestones help solve cold cases, pinpoint health risks and allocate public resources<figure><img src="https://images.theconversation.com/files/510099/original/file-20230214-2190-iexpcg.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2117%2C1412&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Civil registries in the U.S. are spread across different local jurisdictions.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/several-certificate-of-vital-records-for-birth-royalty-free-image/1197564062">eric1513/iStock via Getty Images Plus</a></span></figcaption></figure><p>After 65 years, Philadelphia police announced in December 2022 that they had identified the remains of <a href="https://www.nbcphiladelphia.com/investigators/after-65-years-philadelphia-police-identify-the-boy-in-the-box/3445387/">Joseph Augustus Zarelli</a>, a 4-year-old boy who was murdered in 1957. Because no one had ever come forward to reliably identify Joseph, he became “<a href="https://www.hmdb.org/m.asp?m=194953">America’s Unknown Child</a>,” a moniker that captured the tragic anonymity of his early death.</p>
<p>Recent advances in DNA analysis and forensic genealogy <a href="https://www.cbsnews.com/philadelphia/news/boy-in-box-joseph-zarelli/">provided the needed breakthrough</a> to build a genetic profile that connected the boy to surviving members of his mother’s family. But linking that genetic profile to Joseph’s identity required finding his name, a piece of information stored alongside his mother’s on his nearly <a href="https://www.inquirer.com/news/philadelphia/joseph-zarelli-boy-in-the-box-dna-genealogy-cold-case-20221216.html">70-year-old birth record</a> in the Pennsylvania Department of Health’s vital records system. </p>
<p>While the revolutionary science of genetic genealogy has received <a href="https://www.cbsnews.com/philadelphia/news/boy-in-the-box-philadelphia-murder-mystery-dna-explainer/">well-earned recognition</a> for its contribution to solving this long-standing mystery, the integral role of the more staid vital records system has mostly gone unnoticed. </p>
<p>Vital records are the stalwart administrative backdrop to life’s milestone events: birth, adoption, marriage, divorce and death. When a child is born in the U.S., the parents and hospital staff complete and sign a <a href="https://www.cdc.gov/nchs/data/dvs/birth11-03final-acc.pdf">certificate of live birth</a> that includes nearly 60 questions about the parents, the pregnancy and the newborn. A local registrar issues a formal birth certificate upon receiving the record as proof of a live birth.</p>
<p>Other vital events follow a similar process. Collectively, the U.S. vital records system comprises <a href="https://www.ncbi.nlm.nih.gov/books/NBK219884/">records of hundreds of millions of events</a> dating back to the beginning of the 20th century.</p>
<p>As a <a href="https://scholar.google.com/citations?hl=en&user=J2RmiawAAAAJ">family demographer</a>, I use information from these vital records to understand how childbirth, marriage and divorce are changing in the United States over time. The scope and quality of these records reflect remarkable administrative coordination from the local to the national level, but examples from other countries illustrate how much more the records could yet tell us. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/E087KJy5f64?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">While DNA evidence was instrumental to identify “America’s Unknown Child,” vital records also played an important role.</span></figcaption>
</figure>
<h2>Vital records mark unique events</h2>
<p>Originally, vital records were intended to publicly register events in order to <a href="https://www.ncbi.nlm.nih.gov/books/NBK219870/">legally recognize</a> the status of the people involved. The two people named on a valid marriage certificate, for example, share the legal protections and obligations of marriage until death or divorce. But over time, vital records have also come to serve as proof of identity. For both purposes, the integrity of the vital records system is critical. </p>
<p>Practically speaking, the system requires a perfect symmetry between people and events. Every recorded event needs to be associated with a unique person or pair of people, in the case of marriage and divorce, and every person or pair needs to be associated with a unique recorded event. Because of this singularity, a <a href="https://travel.state.gov/content/travel/en/passports/how-apply/citizenship-evidence.html">valid birth certificate</a> is required as proof of an individual’s unique identity to obtain a Social Security card, driver’s license or passport. </p>
<p>The uniqueness of each event also underlies <a href="https://www.cdc.gov/nchs/nvss/births.htm">how birth, marriage, divorce and death rates are calculated</a>. Double-counted events will artificially inflate these rates, while uncounted events will reduce them. Valid rates are important because governments and businesses rely on accurate measures of population change for <a href="https://ncvhs.hhs.gov/wp-content/uploads/2018/01/NCVHS_Vital_Records_Uses_Costs_Feb_23_2018-1.pdf">planning and investment</a>. </p>
<h2>America’s local approach to vital records</h2>
<p>In the U.S., the vital records system isn’t a single entity. Rather, there is a collection of state and local vital records offices operating independently but in cooperation with the federal government. </p>
<p>Each U.S. state and territory, as well as New York City and Washington, D.C., is its own vital registration jurisdiction, amounting to <a href="https://www.naphsis.org/systems">57 areas in all</a>. And within each jurisdiction, local offices receive and process records and issue certificates. Nationally there are <a href="https://oig.hhs.gov/oei/reports/oei-07-99-00570.pdf">over 6,000 local registrar offices</a> issuing birth certificates in the city or county where a birth occurred. </p>
<p>In nearly all states, marriage licenses and divorce decrees are certified and filed at the courthouse in the county where the event happened. This local registration system explains why Nevada has the highest marriage rate in the nation: of the <a href="https://weddings.vegas/marriage-services/marriage-statistics/">over 77,000 marriage licenses issued</a> in 2021 in Clark County – home to Las Vegas, America’s wedding capital – more than 60,000 couples provided a home mailing address outside of Nevada.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/510128/original/file-20230214-18-l8wspj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Marriage license of Elvis and Priscilla Presley, with Elvis' portrait printed in the center" src="https://images.theconversation.com/files/510128/original/file-20230214-18-l8wspj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/510128/original/file-20230214-18-l8wspj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=474&fit=crop&dpr=1 600w, https://images.theconversation.com/files/510128/original/file-20230214-18-l8wspj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=474&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/510128/original/file-20230214-18-l8wspj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=474&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/510128/original/file-20230214-18-l8wspj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=596&fit=crop&dpr=1 754w, https://images.theconversation.com/files/510128/original/file-20230214-18-l8wspj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=596&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/510128/original/file-20230214-18-l8wspj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=596&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Couples who flocked to get married in Las Vegas on 7/7/07 got a copy of Elvis and Priscilla Presley’s marriage license.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/detail-view-of-a-copy-of-elvis-and-priscilla-presleys-las-news-photo/75259026">Ethan Miller/Getty Images</a></span>
</figcaption>
</figure>
<p>This highly decentralized approach has at least two significant implications. First, because different agencies are responsible for recording different events, there is no straightforward way to assemble an administrative profile for an individual over a lifetime. This challenge is further complicated when records are stored in different jurisdictions as people move and experience events in different places. Name changes – for example, through marriage – and inconsistencies in spellings, dates or other details also potentially impede record matching.</p>
<p>Second, in the absence of a single national repository for vital records, it takes substantial coordination to produce national statistics about vital events. Currently, U.S. jurisdictions send individual-level birth and death records to the <a href="https://www.cdc.gov/nchs/nvss/index.htm">National Center for Health Statistics</a> annually, and these records provide the basis for national birth and death statistics overall, including demographic characteristics like age, sex, race and ethnicity. This coordination is costly, time-consuming and often delayed. </p>
<p>In part because of the administrative burden, <a href="https://www.cdc.gov/nchs/nvss/marriage-divorce.htm">states stopped sending</a> detailed individual-level marriage and divorce records to the National Center for Health Statistics in 1995, and now provide only annual counts of these events. As a result, the only accessible way to examine national demographic patterns in marriage or divorce is through surveys, which are subject to nonresponse and reporting errors.</p>
<h2>Centralized approaches to vital recordkeeping</h2>
<p>In contrast to America’s decentralized system, <a href="https://unstats.un.org/unsd/demographic/sources/popreg/popregmethods.htm">many countries in Northern Europe</a> have centralized and integrated the collection and maintenance of administrative records related not only to vital events but also to circumstances like change in residence, employment and health care. This approach ensures that residents are <a href="https://www.ohchr.org/sites/default/files/Documents/Issues/Children/BirthRegistration/SwedenPopulationRegistration.pdf">continuously registered</a> to receive mail, vote, pay taxes, enroll in school and receive benefits such as housing subsidies at the correct address. It also means that public agencies have full information about their population to inform planning and budgeting.</p>
<p>A centralized system also facilitates rapid turnaround of population statistics. At peak periods during the COVID-19 pandemic, for example, the U.S. <a href="https://covidtracking.com/analysis-updates/how-lagging-death-counts-muddied-our-view-of-the-pandemic">lagged behind many other countries</a> in estimating national death rates as the Centers for Disease Control and Prevention awaited reported counts from public health offices in individual states overwhelmed by the pace and volume of deaths. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/510118/original/file-20230214-28-1q5c7c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Close-up of infant's footprints on birth certificate" src="https://images.theconversation.com/files/510118/original/file-20230214-28-1q5c7c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/510118/original/file-20230214-28-1q5c7c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/510118/original/file-20230214-28-1q5c7c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/510118/original/file-20230214-28-1q5c7c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/510118/original/file-20230214-28-1q5c7c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/510118/original/file-20230214-28-1q5c7c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/510118/original/file-20230214-28-1q5c7c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Vital records like birth certificates document your singularity as an individual.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/infants-footprints-on-birth-certificate-royalty-free-image/79250940">Tetra images/Getty Images Plus</a></span>
</figcaption>
</figure>
<p>Vital records integrated with population register data also allow
social scientists, epidemiologists and other researchers to use deidentified linked records to study how <a href="https://ncrr.au.dk/danish-registers">early life conditions shape an individual’s life over time</a>. Using linked records from the Netherlands, for example, researchers have demonstrated that children who were in utero <a href="https://doi.org/10.1080/09603123.2021.1888894">during the 1944 Dutch famine</a> were more likely to have health problems throughout their lives than those born earlier or later.</p>
<p>The U.S. has made some progress toward developing a more centralized and integrated vital records system. A <a href="https://www.cdc.gov/nchs/nvss/linked-birth.htm">national file linking births to infant deaths</a> has helped scientists study how risk factors like preterm birth and low birth weight contribute to infant mortality. And public health and medical research studies can obtain cause of death information for participants in the <a href="https://www.cdc.gov/nchs/ndi/index.htm">National Death Index</a>, a compilation over 100 million death records since 1979. </p>
<p>But further progress is unlikely to happen any time soon. The current system, while cumbersome and incomplete, is well established and reliable. And at a time when the majority of Americans <a href="https://www.pewresearch.org/politics/2022/06/06/americans-views-of-government-decades-of-distrust-enduring-support-for-its-role/">lack trust in government</a>, there is little political will or public enthusiasm for a change. </p>
<p>For Joseph Zarelli, the durability of the local vital records system in Philadelphia was enough to answer a question that went unanswered for 65 years: A certificate of live birth registered in 1953 reconnected America’s Unknown Child to his name.</p><img src="https://counter.theconversation.com/content/196871/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Paula Fomby receives funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. </span></em></p>Vital records document the birth, death, marriage and divorce of every individual. A more centralized system in the US could help public health researchers better study pandemics and disease.Paula Fomby, Professor of Sociology and Research Associate in Population Studies, University of PennsylvaniaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1045232018-11-07T11:36:16Z2018-11-07T11:36:16ZWhat’s behind the dramatic rise in 3-generation households?<figure><img src="https://images.theconversation.com/files/244152/original/file-20181106-74751-1p78jr0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">In 2016, nearly 10 percent of American kids were living in three-generation households, like this one in Detroit, Michigan.</span> <span class="attribution"><a class="source" href="http://www.apimages.com/metadata/Index/Associated-Press-Domestic-News-Michigan-United-/50aee7228de4da11af9f0014c2589dfb/174/0">AP Photo/Paul Sancya</a></span></figcaption></figure><p><a href="http://doi.org/10.1007/s13524-018-0719-y">In a recent study</a>, I discovered that the number of kids living with their parents and grandparents – in what demographers call a three-generation household – has nearly doubled over the past two decades.</p>
<p>Why has this been happening? And is it a good thing or a bad thing?</p>
<p>The answers are complex. The reasons for the trend are as broad as social forces – like a decline in marriage rates – to unique family circumstances, like the loss of a parent’s job. </p>
<p>The trend is worth studying because by better understanding who children live with, we can design better policies aimed at helping kids. Programs targeting kids usually overlook these other people living under the same roof. But odds are that if grandma’s there, she matters, too. </p>
<h2>The flexible family unit</h2>
<p>A three-generation household is just one type of a living arrangement that falls under the umbrella of what demographers call a “shared household” or a “doubled-up household.”</p>
<p>In a shared household, a child lives with at least one adult who isn’t a sibling, parent or parent’s partner. It could include a cousin, aunt, uncle, grandparent or family friend.</p>
<p>In 2010, about <a href="https://www.census.gov/prod/2012pubs/p60-242.pdf">1 in 5 children</a> were living in a shared household, a 3 percentage-point increase from 2007. In a 2014 study, I tracked the same kids over time and found that by age 10, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4870020/">nearly half</a> of children in large U.S. cities had lived in a shared household at some point in their lives.</p>
<p>Then, to probe further, <a href="http://fordschool.umich.edu/phd-students/christina-cross">my colleague</a> and I used two large census data sets to study trends by the type of shared living arrangements.</p>
<p><a href="http://doi.org/10.1007/s13524-018-0719-y">We found</a> that, overall, the percentage of children in shared households had increased since 1996.</p>
<p>But the rise was nearly entirely driven by an increase in just one type of household: three-generation households – sometimes referred to as multigenerational households – in which children live with at least one grandparent and one or both parents.</p>
<p>We also found that the share of children living in three-generation households has risen from 5.7 percent in 1996 to 9.8 percent in 2016.</p>
<p>In other words, roughly <a href="https://drive.google.com/file/d/1XhNZoDC-rfYVtz-Ety4e88qp6DCH_IxG/view">1 in 10</a>, or 7.1 million, kids lives in a multigenerational household. At birth, about <a href="https://www.demographic-research.org/volumes/vol30/60/30-60.pdf">15 percent</a> of U.S. kids now live with a parent and grandparent – a rate that’s double that of countries like the U.K. and Australia.</p>
<p>Meanwhile, there was no real change in the percent of children living with aunts and uncles, other relatives or non-relatives. <a href="https://drive.google.com/file/d/1XhNZoDC-rfYVtz-Ety4e88qp6DCH_IxG/view">Nor did we find</a> any evidence of an increase in “grandfamilies,” also known as “skipped-generation households.” These are homes in which a grandparent is raising a grandchild without the child’s parents living with them. Counter to <a href="https://www.pbs.org/newshour/nation/more-grandparents-raising-their-grandchildren">some media reports</a>, the share of children living in grandfamilies has held steady at roughly two percent since 1996.</p>
<h2>A trend rooted in more than the recession</h2>
<p>What propelled the rise in multigenerational households? </p>
<p>We found that shared living arrangements did increase during the recession, but it wasn’t just because of the recession. Research on unemployment during the Great Recession has found that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325982/">the economic downturn didn’t have much of an effect</a> on whether <a href="http://www.socsci.uci.edu/%7Embitler/papers/Bitler-Hoynes-GR-fin.pdf">parents expanded their household ranks</a>.</p>
<p>In fact, the share of multigenerational households was rising before the Great Recession – it actually <a href="https://paa.confex.com/paa/2018/mediafile/ExtendedAbstract/Paper19171/Pilkauskas_historical_trends_3G_Extended_Abstract.pdf">started in the 1980s</a>.</p>
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<p>Furthermore, these shared living arrangements continued to increase even as the economy recovered. </p>
<p>All of this suggests there other, more deeply rooted, reasons for the increase.</p>
<p><a href="https://drive.google.com/file/d/1XhNZoDC-rfYVtz-Ety4e88qp6DCH_IxG/view">My study identified</a> three possible drivers. </p>
<p><a href="https://www.washingtonpost.com/news/wonk/wp/2015/06/23/144-years-of-marriage-and-divorce-in-the-united-states-in-one-chart/?utm_term=.6e471140c01b">Declines in marriage</a> and <a href="https://www.washingtonpost.com/news/wonk/wp/2014/12/18/the-unbelievable-rise-of-single-motherhood-in-america-over-the-last-50-years/?utm_term=.898bc40a265f">increases in single parenthood</a> mean more moms and dads are living with their parents, who can help with childcare and paying the bills.</p>
<p>Next, a growing share of U.S. children are non-white. Because minority families <a href="https://www.ncbi.nlm.nih.gov/pubmed/29770726">are much more likely to share households</a>, this population shift seems to explain some of the increase.</p>
<p>And finally, there’s the fact that more people are receiving Social Security. Because Social Security gives grandparents a steady source of income, it could be that these grandparents are stepping in to help their grandchildren if their own children’s incomes are too low.</p>
<p>But this only explains some of the increase. </p>
<p>There may well be a range of other factors at play: <a href="http://www.jchs.harvard.edu/sites/default/files/Harvard_JCHS_State_of_the_Nations_Housing_2018.pdf">rising housing costs</a>, <a href="https://www.nytimes.com/interactive/2017/08/07/opinion/leonhardt-income-inequality.html?_r=0">growing inequality</a>, <a href="https://fred.stlouisfed.org/series/SPDYNLE00INUSA">increased longevity</a>, or even just an increase in the number of <a href="https://www.census.gov/content/dam/Census/library/publications/2017/demo/p70br-147.pdf">grandparents</a> and <a href="https://www.ncbi.nlm.nih.gov/pubmed/29361076">step-grandparents</a>.</p>
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<p>We also know that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3765068/">low-income</a> parents, younger parents and parents with less education are more likely to live in a three-generation household.</p>
<p>At the same time, some of the <a href="https://drive.google.com/file/d/1XhNZoDC-rfYVtz-Ety4e88qp6DCH_IxG/view">fastest growth</a> in these households has been among more traditionally advantaged groups – children with married mothers, higher income mothers and older mothers. </p>
<p>More research is needed to really understand why these households have increased and the extent to which public policies, like <a href="https://www.nber.org/papers/w24594">reduced welfare availability</a> or <a href="https://www.epi.org/publication/declining-federal-minimum-wage-inequality/">declines in the real minimum wage</a>, are driving this trend.</p>
<h2>Not an ideal arrangement</h2>
<p>While the exact reasons for the trend are still unclear, the fact remains that more kids are living in three-generation households. </p>
<p>What should we make of it? </p>
<p>Studies have found <a href="https://www.ncbi.nlm.nih.gov/pubmed/12048958">positive</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4963814/">negative</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3706187/">no effects</a> of three-generation households on children. </p>
<p>For example, sharing a household has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4870020/">documented economic benefits</a>, like rental savings. But it can also make households crowded, which isn’t <a href="https://www.ncbi.nlm.nih.gov/pubmed/27103537">the best</a> environment for kids.</p>
<p>The findings are <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/cdep.12016">mixed</a> because living arrangements are a complex topic. Motivation is difficult to distill. Sometimes people live together by choice – say, to be closer to family. Other times it’s by necessity – prompted by a crisis like a divorce, health problem or job loss. </p>
<p>From a policy perspective, who is in the household will likely impact the effectiveness of programs designed to help parents and kids. For example, programs that seek to improve the parenting skills of low-income moms generally focus only on moms. They’ll teach mothers to use positive parenting skills, like avoiding spanking their kids. But what if grandma still uses corporal punishment?</p>
<p>We also know that, in general, people would <a href="http://jhr.uwpress.org/content/XL/2/354.full.pdf+html">prefer</a> to <a href="https://poverty.umich.edu/files/2018/09/Pilkauskas_Michelmore_EITC_Housing_Sept2018.pdf">live independently</a> and that it can be challenging to <a href="https://www.sssp1.org/index.cfm/pageid/2039">negotiate responsibilities</a> when living with others.</p>
<p>In other words, it’s a situation that most families would probably avoid if they could. So the fact that more people are living together suggests other larger societal and policy shifts are driving this trend.</p><img src="https://counter.theconversation.com/content/104523/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Natasha Pilkauskas has received funding from the National Academy of Education/Spencer Foundation, American Education Research Association and the Institute for Research on Poverty. </span></em></p>Over the past 20 years, the number of American households that have grandparents, their kids and their grandkids living under the same roof has nearly doubled.Natasha Pilkauskas, Assistant Professor of Public Policy, University of MichiganLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/975922018-07-02T10:45:49Z2018-07-02T10:45:49Z3 reasons why the US is vulnerable to big disasters<p>During the 2017 disaster season, three severe hurricanes devastated large parts of the U.S. </p>
<p>The quick succession of major disasters made it obvious that such large-scale emergencies can be a strain, even in one of the world’s richest countries. </p>
<p>As a complex emergency researcher, I investigate why some countries can better withstand and respond to disasters. The factors are many and diverse, but three major ones stand out because they are within the grasp of the federal and local governments: where and how cities grow; how easily households can access critical services during disaster; and the reliability of the supply chains for critical goods. </p>
<p>For all three of these factors, the U.S. is heading in the wrong direction. In many ways, Americans are becoming more vulnerable by the day. </p>
<h2>Where Americans live</h2>
<p>Large shares of the U.S. population live in the parts of the country most vulnerable to major disasters, mainly coastal areas prone to hurricane damage. Hurricanes Katrina, Sandy, Harvey and Irma all hit heavily populated coasts.</p>
<p><a href="https://census.gov/newsroom/press-releases/2018/popest-metro-county.html#popest-tab2">Seven of the 10 largest metropolitan areas</a> in the U.S. are on or near the coast, accounting for more than 60 million people. In fact, the vast majority of counties with more than 500,000 inhabitants are concentrated on the coast. </p>
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<p>More than 5 million Americans also live on islands like Puerto Rico and Hawaii, where a hurricane, volcanic eruption or tsunami can be devastating.</p>
<p>California has been spared landfall of a major tropical cyclone, but <a href="https://www.nasa.gov/topics/earth/features/earth20121017a.html">torrential rainfall still causes severe damage</a> along the coast. On top of this, most of California’s coastal cities are adjacent to the San Andreas Fault, which <a href="https://www.sfchronicle.com/thetake/article/1906-San-Francisco-earthquake-Old-photos-offer-12836621.php">caused the death of around 3,000 people</a> in 1906. Geologists agree that <a href="https://theconversation.com/the-san-andreas-fault-is-about-to-crack-heres-what-will-happen-when-it-does-58975">another large earthquake is bound to occur</a>. </p>
<p>Large concentrations of people pose problems, too. To support large populations in small spaces, cities need advanced large-scale infrastructure – not only to house people, but to deliver utilities like electricity and gas, as well as to tame water with dams, levies and spillways.</p>
<p>While such infrastructure is impressive, its occasional failure can have grave consequences. In several of the most severe American disasters, infrastructure collapse caused substantial damage. In New Orleans, the Lower Ninth Ward was violently <a href="https://www.smithsonianmag.com/smithsonian-institution/broken-promise-levees-failed-new-orleans-180956326/">flooded when levies collapsed</a>. In the 1906 San Francisco earthquake disaster, gas mains ruptured, <a href="http://www.historynet.com/the-great-1906-san-francisco-earthquake-and-fire.htm">fueling a deadly fire that tore through the city for days</a>.</p>
<p>The large cities on the coasts are consistently growing larger. The 10 largest metropolitan areas on the coast alone <a href="https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml">have grown by almost 5 million people since 2010</a>, an increase of nearly 7 percent. </p>
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<p>Experts project that by 2040, <a href="https://www.bizjournals.com/bizjournals/news/2016/10/11/projectionsdatabase.html">these 10 metropolitan areas will add a whopping 16.7 million more people</a>, making the total population around 92.5 million people – most of whom will be particularly vulnerable to disaster.</p>
<h2>Access to emergency funds</h2>
<p>In a disaster, people often need money to cover medical care, food, water and other crucial needs. In a frustrating catch-22, however, access to funds can be severely limited if power outages take out ATMs and credit card terminals. That was the case <a href="https://www.washingtonpost.com/news/posteverything/wp/2017/10/03/in-san-juan-we-wait-hours-to-buy-groceries-were-the-lucky-ones/">in Puerto Rico after Hurricane Maria</a>. </p>
<p>A 2015 Federal Reserve survey found that even with access to bank accounts and ATMs, almost <a href="https://www.federalreserve.gov/2015-report-economic-well-being-us-households-201605.pdf">half of Americans</a> would be unable to find US$400 for an emergency without borrowing or using a credit card. </p>
<p>Today, there’s almost <a href="https://www.federalreserve.gov/faqs/currency_12773.htm">three times the amount of U.S. currency</a> in circulation as <a href="http://www.businessinsider.com/chart-currency-in-circulation-2012-10">there was in 1997</a>. But a large share of U.S. dollar bills are actually used abroad. U.S. dollars are the <a href="https://www.stlouisfed.org/publications/central-banker/spring-2007/how-us-currency-stacks-upat-home-and-abroad">legal or de facto currency in many countries</a>, as well as a <a href="https://www.theatlantic.com/business/archive/2012/11/-100-bills-make-up-80-of-all-us-currency-but-why/265518/">preferred currency for savings around the world</a>. Consequently, the amount of cash in circulation that is actually available to make transactions in disasters is relatively low. </p>
<p>The problem with access to cash to cover emergency expenses is especially acute for minority Americans. The same Federal Reserve survey showed that even for Americans with the same income, <a href="https://www.washingtonpost.com/news/wonk/wp/2016/05/25/the-shocking-number-of-americans-who-cant-cover-a-400-expense/">blacks and Hispanics are far less likely to have access</a> to the $400 emergency funds than whites.</p>
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<p>Blacks and Hispanics are also <a href="https://www.washingtonpost.com/news/wonk/wp/2017/09/28/black-and-hispanic-families-are-making-more-money-but-they-still-lag-far-behind-whites/">more likely to be poor than whites non-Hispanics</a>, and <a href="https://www.brookings.edu/blog/social-mobility-memos/2017/09/18/hurricanes-hit-the-poor-the-hardest/">poor families are far more susceptible to disasters</a>.</p>
<p>Worse still, the proportion of minorities in metropolitan areas are often far above the national average, compounding the vulnerability of minorities. In fact, in all but one of the 10 largest metropolitan areas on the coast, the minority population is growing faster than the white non-Hispanic population. </p>
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<h2>Supply chains</h2>
<p>Even if Americans do have the funds necessary to pay for critical goods, those goods may not be available during a disaster. </p>
<p>Without access to pharmaceuticals, medical equipment and fuels, many people would die. Many of these critical goods are exclusively produced overseas; in fact, <a href="https://www.littlebrown.com/titles/michael-t-osterholm/deadliest-enemy/9780316343695/">the 30 most critical pharmaceuticals, such as insulin for Type 1 diabetes and heparin for blood thinning, are all produced in whole or in part abroad</a>. Sometimes the goods are produced in a single geographic area or even by a single facility. </p>
<p>That makes the supply of these critical goods very vulnerable to natural disasters or other emergencies. If a global pandemic affects China or India as well as the U.S., there would be almost no way to source the critical goods necessary to save Americans infected by the disease. </p>
<p>At the same time that production of many critical goods are moving abroad, stockpiles and storage are exceptionally low for most goods. Goods often arrive at the consumer continuously, just in time for when they are needed. The rapidly growing international transportation industry can deliver quickly and reliably, leaving little reason for hospitals to spend on substantial storage of most goods.</p>
<p>Some U.S. hospitals receive critical pharmaceuticals <a href="http://www.cidrap.umn.edu/news-perspective/2004/07/beyond-debate-about-pandemic-severity-lies-critical-business-continuity">as often as three times per day</a>. On a regular day, it’s possible for an efficient system to keep emergency rooms stocked, but during a disaster – when workers are absent, transportation is slowed and production abroad is potentially knocked out – Americans are left incredibly vulnerable. There’s little margin for error, and that margin shrinks apace with the expansion of “just-in-time” systems.</p><img src="https://counter.theconversation.com/content/97592/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Morten Wendelbo does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Large-scale emergencies can be a strain, even in one of the world’s richest countries. Population growth, income inequality and fragile supply chains may make the problem worse.Morten Wendelbo, Research Fellow and Policy Sciences Lecturer, Texas A&M UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/910452018-03-01T11:40:44Z2018-03-01T11:40:44ZHow the devastating 1918 flu pandemic helped advance US women’s rights<figure><img src="https://images.theconversation.com/files/208319/original/file-20180228-36671-jjv25p.jpg?ixlib=rb-1.1.0&rect=26%2C50%2C961%2C702&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">More women than men were left standing after the war and pandemic.</span> <span class="attribution"><a class="source" href="https://lccn.loc.gov/2011661525">Library of Congress</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>When disaster strikes, it can change the fabric of a society – often through the sheer loss of human life. The 2004 Indian Ocean tsunami <a href="https://www.theguardian.com/world/2005/jan/05/tsunami2004.internationalaidanddevelopment3">left 35,000 children</a> without one or both parents in Indonesia alone. The Black Death <a href="https://www.livescience.com/2497-black-death-changed-world.html">killed more than 75 million people</a> worldwide and <a href="http://www.history.com/topics/black-death">more than a third of Europe’s population</a> between 1347 and 1351. </p>
<p>While disasters are by definition devastating, sometimes they can lead to changes that are a small silver lining. The 2004 tsunami <a href="http://www.worldbank.org/en/news/feature/2012/12/26/indonesia-reconstruction-chapter-ends-eight-years-after-the-tsunami">ended a civil conflict in Indonesia</a> that had left 15,000 dead. The 14th century’s plague, <a href="https://www.rwjf.org/en/culture-of-health/2013/12/the_five_deadliesto.html">probably the most deadly disaster in human history</a>, set free many serfs in Europe, forced wages for laborers to rise, and caused a fundamental shift in the economy along with an increased standard of living for survivors.</p>
<p>One hundred years ago, a powerful strain of the flu swept the globe, infecting one third of the world’s population. The aftermath of this disaster, too, led to unexpected social changes, opening up new opportunities for women and in the process irreversibly transforming life in the United States.</p>
<p>The virus disproportionately affected young men, which in combination with World War I, created a shortage of labor. This gap enabled women to play a new and indispensible role in the workforce during the crucial period just before the ratification of the 19th Amendment, which <a href="https://www.loc.gov/rr/program/bib/ourdocs/19thamendment.html">granted women suffrage in the United States</a> two years later.</p>
<h2>Why did the flu affect men more than women?</h2>
<p><a href="https://theconversation.com/the-greatest-pandemic-in-history-was-100-years-ago-but-many-of-us-still-get-the-basic-facts-wrong-89841">Known as the Spanish flu</a>, the 1918 “great influenza” left <a href="https://www.cnn.com/2018/01/29/health/1918-flu-history-partner/index.html">more than 50 million people dead</a>, including around <a href="https://www.smithsonianmag.com/history/journal-plague-year-180965222/">670,000</a> in the United States.</p>
<p>To put that in perspective, World War I, which concluded just as the flu was at its worst in November 1918, killed around 17 million people – <a href="http://www.bbc.com/news/magazine-25776836">a mere third of the fatalities caused by the flu</a>. <a href="http://www.nytimes.com/books/first/k/kolata-flu.html">More American soldiers died from the flu</a> than were killed in battle, and many of the deaths attributed to World War I were caused by a combination of the war and the flu.</p>
<p>The war provided near perfect conditions for the spread of flu virus via the respiratory droplets exhaled by infected individuals. Military personnel – predominantly young males – spent months at a time in close quarters with thousands of other troops. This proximity, combined with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/">the stress</a> of war and the malnutrition that sometimes accompanied it, created weakened immune systems in soldiers and allowed the virus spread like wildfire.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/208320/original/file-20180228-36703-1k4dxiw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/208320/original/file-20180228-36703-1k4dxiw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/208320/original/file-20180228-36703-1k4dxiw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=760&fit=crop&dpr=1 600w, https://images.theconversation.com/files/208320/original/file-20180228-36703-1k4dxiw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=760&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/208320/original/file-20180228-36703-1k4dxiw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=760&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/208320/original/file-20180228-36703-1k4dxiw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=955&fit=crop&dpr=1 754w, https://images.theconversation.com/files/208320/original/file-20180228-36703-1k4dxiw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=955&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/208320/original/file-20180228-36703-1k4dxiw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=955&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">When soldiers shipped out, influenza virus could be stowing away onboard.</span>
<span class="attribution"><a class="source" href="http://www.apimages.com/metadata/Index/Eawatchf-AP-I-APHSL-USA-WWI-American-Troops/276539db593a4899b405f9ca175e85fb/1/0">AP Photo</a></span>
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<p>Overcrowding in training camps, trenches and hospitals <a href="https://www.theguardian.com/science/grrlscientist/2014/jul/30/influenza-pandemic-1918-viruses-biology-medicine-history">created an ideal environment</a> for the 1918 influenza strain to infect high numbers of people. In fact, the conditions of war helped the virus perfect itself <a href="https://wwwnc.cdc.gov/eid/article/12/1/05-0979_article">through several waves of infection</a>, each more deadly than the last.</p>
<p>Many troops were doomed before they even reached Europe, contracting the flu on the packed troop ships where a single infected soldier could spread the virus throughout. When soldiers returned to the U.S., they scattered to every state, bringing the flu along with them. </p>
<p>It was more than just male conscription in war, however, that led to a greater number of men who were infected and died from the flu. Even at home, among those that were never involved in the war effort, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740912/">death rate for men exceeded that of women</a>. Demographic studies show that nearly <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740912/">175,000 more men died than women in 1918</a>.</p>
<p>In general, epidemics tend to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740912/">kill more men than women</a>. In disease outbreaks throughout history, as well as almost all of the world’s major famines, women have a longer life expectancy than men and often <a href="http://www.pnas.org/content/early/2018/01/03/1701535115">have greater survival rates</a>.</p>
<p>The exact reason why men tend to be more vulnerable to the flu than women continues to elude researchers. The scoffing modern term “man flu” refers to the perception that men are overly dramatic when they fall ill; But recent research suggests that there <a href="https://doi.org/10.1136/bmj.j5560">may be more to it</a> than just exaggerated symptoms.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/208321/original/file-20180228-36674-1uzoi6r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/208321/original/file-20180228-36674-1uzoi6r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/208321/original/file-20180228-36674-1uzoi6r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=426&fit=crop&dpr=1 600w, https://images.theconversation.com/files/208321/original/file-20180228-36674-1uzoi6r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=426&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/208321/original/file-20180228-36674-1uzoi6r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=426&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/208321/original/file-20180228-36674-1uzoi6r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=535&fit=crop&dpr=1 754w, https://images.theconversation.com/files/208321/original/file-20180228-36674-1uzoi6r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=535&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/208321/original/file-20180228-36674-1uzoi6r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=535&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">The flu’s aftermath furthered a trend started by the war effort.</span>
<span class="attribution"><a class="source" href="http://www.apimages.com/metadata/Index/Associated-Press-Domestic-News-Pennsylvania-Uni-/a8dcff1102e5da11af9f0014c2589dfb/2/0">AP Photo</a></span>
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<h2>Flu brought more women into the workforce</h2>
<p>The severity of the epidemic in the U.S. was enough to temporarily shut down parts of the economy in 1918. In New England, <a href="http://www.cidrap.umn.edu/sites/default/files/public/downloads/cidrap_coal_report.pdf">coal deliveries were so severely affected</a> that people, unable to keep their homes heated, froze to death at the height of winter. During the 1918 flu outbreak, researchers estimate businesses in Little Rock, Arkansas, saw <a href="https://www.stlouisfed.org/%7E/media/Files/PDFs/Community-Development/Research-Reports/pandemic_flu_report.pdf?la=en">a decline of 40 to 70 percent</a>. </p>
<p>The worker shortage caused by the flu and World War I opened access to the labor market for women, and in unprecedented numbers they took jobs outside the home. Following the conclusion of the war, the number of women in the workforce was <a href="http://www.american-historama.org/1913-1928-ww1-prohibition-era/women-in-the-1920s.htm">25 percent higher than it had been</a> previously and by 1920 <a href="https://www.dol.gov/wb/info_about_wb/interwb.htm">women made up 21 percent</a> of all gainfully employed individuals in the country. While this gender boost is often ascribed to World War I alone, women’s increased presence in the workforce would have been far less pronounced without the 1918 flu.</p>
<p>Women began to move into employment roles that were previously <a href="https://www.thoughtco.com/women-in-world-war-1-1222109">held exclusively by men</a>, many of which were in manufacturing. They were even able to enter fields from which they had been banned, such as the textile industry. As women filled what had been typically male workplace roles, they also began to <a href="http://time.com/3774661/equal-pay-history/">demand equal pay</a> for their work. Gaining greater economic power, women began more actively advocating for various women’s rights issues – including, <a href="http://history.house.gov/Exhibitions-and-Publications/WIC/Historical-Essays/No-Lady/Womens-Rights/">but not limited to, the right to vote</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/208322/original/file-20180228-36703-txw39t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/208322/original/file-20180228-36703-txw39t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/208322/original/file-20180228-36703-txw39t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=341&fit=crop&dpr=1 600w, https://images.theconversation.com/files/208322/original/file-20180228-36703-txw39t.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=341&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/208322/original/file-20180228-36703-txw39t.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=341&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/208322/original/file-20180228-36703-txw39t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=428&fit=crop&dpr=1 754w, https://images.theconversation.com/files/208322/original/file-20180228-36703-txw39t.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=428&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/208322/original/file-20180228-36703-txw39t.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=428&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Once a woman’s the boss, how can you deny her the vote?</span>
<span class="attribution"><a class="source" href="http://www.apimages.com/metadata/Index/Watchf-AP-A-DC-USA-APHS350732-Women-s-Suffrage/3dd9b4d05c8647d1aeb2e4610cdeae7a/3/0">AP Photo</a></span>
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<h2>How the flu helped change people’s minds</h2>
<p>Increased participation in the workforce allowed many women to obtain <a href="https://www.warandgender.com/wgwomwwi.htm">social and financial independence</a>. Leadership positions within the workforce could now be occupied by women, especially in the garment industry, but also <a href="http://teachersinstitute.yale.edu/curriculum/units/2002/3/02.03.09.x.html">in the military and police forces</a>. The U.S. even got its <a href="https://www.afscme.org/for-members/womens-leadership-training/leadership-tools/body/Women_in_Labor_History_Timeline.pdf">first woman governor</a>, when Nellie Taylor Ross took her oath of office, in 1923, in Wyoming. An increased ability to make decisions in their personal and professional lives empowered many women and started to elevate their standing.</p>
<p>With the war over and increased female participation in the labor force, politicians could not ignore the critical role that women played in American society. <a href="https://www.nytimes.com/2018/01/30/world/europe/1918-flu-war-centennial.html">Even President Woodrow Wilson</a> began to argue in 1918 that women were part of the American war effort and economy more broadly, and as such, should be afforded the right to vote. </p>
<p>Outside of work, women also became more involved in community decision-making. Women’s changing social role <a href="http://time.com/3774661/equal-pay-history/">increased support</a> for women’s rights. In 1919, the National Federation of Business and Professional Women’s Clubs was founded. The organization <a href="https://www.afscme.org/for-members/womens-leadership-training/leadership-tools/body/Women_in_Labor_History_Timeline.pdf">focused on</a> eliminating sex discrimination in the workforce, making sure women got equal pay and creating a comprehensive equal rights amendment.</p>
<p>The 1918 influenza pandemic was devastating. But the massive human tragedy had one silver lining: It helped elevate women in American society socially and financially, providing them more freedom, independence and a louder voice in the political arena.</p><img src="https://counter.theconversation.com/content/91045/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>With many men ‘missing’ from the population in the aftermath of the 1918 flu, women stepped into public roles that hadn’t previously been open to them.Christine Crudo Blackburn, Postdoctoral Research Fellow, Scowcroft Institute of International Affairs, Bush School of Government and Public Service, Texas A&M UniversityGerald W Parker, Associate Dean For Global One Health, College of Veterinary Medicine & Biomedical Sciences; and Director, Pandemic and Biosecurity Policy Program, Scowcroft Institute for International Affairs, Bush School of Government and Public Service, Texas A&M UniversityMorten Wendelbo, Research Fellow, American UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/722422017-07-04T23:02:02Z2017-07-04T23:02:02ZWe’re not ready for the ‘silver tsunami’ of older adults living with cancer<figure><img src="https://images.theconversation.com/files/171838/original/file-20170601-25704-9fkx9u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The number of adults living with cancer will likely triple in size by 2030.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/234242599?src=9d1geb1Zo7b72MzCAt7u9g-2-70&size=huge_jpg">Ruslan Guzov/Shutterstcok.com</a></span></figcaption></figure><p>In the next few decades, the number of adults living with cancer is expected to <a href="http://jco.ascopubs.org/cgi/doi/10.1200/JCO.2014.55.8361">triple in size</a>.</p>
<p>Age is the single greatest risk factor for cancer. By 2030, according to the Centers for Disease Control and Prevention, the population of Americans over the age of 65 <a href="https://www.cdc.gov/aging/pdf/State-Aging-Health-in-America-2013.pdf">will double</a>.</p>
<p>The good news is that early detection, innovative treatments and supportive care have turned many cancers into chronic illnesses, one disease among other chronic health conditions that older adults may experience. But these coexisting health conditions are likely to complicate the treatment and management of older adults’ cancer. </p>
<p>Our current understanding of appropriate care for older adults with cancer and their unique needs is limited. As an expert in cancer survivorship and aging, I see several specific areas that warrant our attention. </p>
<h1>Generational differences</h1>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/171854/original/file-20170601-25658-jy9gsz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/171854/original/file-20170601-25658-jy9gsz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/171854/original/file-20170601-25658-jy9gsz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/171854/original/file-20170601-25658-jy9gsz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/171854/original/file-20170601-25658-jy9gsz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/171854/original/file-20170601-25658-jy9gsz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/171854/original/file-20170601-25658-jy9gsz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">In 2009, Morton Genser, who was 72 at the time, took multiple pills a day to regulate his diabetes, blood pressure and other illnesses.</span>
<span class="attribution"><span class="source">AP Photo/Wilfredo Lee</span></span>
</figcaption>
</figure>
<p>Cancer in older adults is complex. For the elderly, cancer is often <a href="http://www.futuremedicine.com/doi/abs/10.2217/1745509X.3.5.625?journalCode=ahe&">one of several coexisting health conditions</a> that they may be managing, such as heart disease, arthritis or diabetes. Eighty percent of older adults with cancer report two or more additional health conditions. One in four cancer survivors between 65 and 74 years old have more than five concurrent health conditions.</p>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/21402176">Older adults with multiple chronic conditions</a> are more likely to have poorly coordinated care, adverse interactions between medications and worse health outcomes. They also tend to use more health care services and, on average, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3785194/">take six or more</a> prescription medications. </p>
<p>In older adults, the late health effects of cancer can be different or exacerbated by age. For example, cancer-related fatigue, reductions in cognitive function and chemotherapy-induced peripheral neuropathy <a href="http://jco.ascopubs.org/cgi/doi/10.1200/JCO.2014.55.8361">can pose unique issues</a>. The interplay between these treatment-related effects and common age-related issues presents challenges for care of older adults with cancer.</p>
<p>The psychological and social experience of cancer can also differ markedly for young and older adults. Roles, responsibilities and support systems change as people age. Many young adults with cancer are dealing with competing demands of work or family. Having fewer demands as an older adult might make the disease more manageable in some respects. </p>
<p>But a decrease in social networks and support – such as retirement or living farther away from family – may have negative effects. Many older adults will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2799049/">minimize their distress</a>, so not to burden their families and caregivers. This leads to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3052769/">underdiagnosis</a> of treatable distress. </p>
<p>These effects can be exacerbated by health care providers with competing priorities, short office visits and no organizational support for psychosocial distress screening. </p>
<h1>Health care providers</h1>
<p><a href="https://www.ncbi.nlm.nih.gov/books/NBK215395/">In 2008</a>, the National Academy of Medicine warned of a looming shortage of geriatric oncologists and nurses, as well as a lack of interest among medical professionals in geriatric oncology. </p>
<p>The <a href="https://www.ncbi.nlm.nih.gov/pubmed/20859376">number of oncology office visits</a> required by older adults with cancer is projected to surpass the available oncologic workforce by 2020. What’s more, older adults may see <a href="https://www.cdc.gov/aging/pdf/State-Aging-Health-in-America-2013.pdf">up to 12 different health care specialists</a> in a given year. </p>
<p>Who should coordinate this care? Oncologists are experts in the diagnosis and treatment of cancer, but many older adults have competing health concerns that require more than just an oncologist. Geriatricians are trained in managing multiple health conditions and optimizing functional performance in older adults, but may be less familiar with managing cancer. </p>
<p>We need to make a concerted effort to foster collaborative care partnerships between geriatricians and oncology – including geriatric nurses in both fields, as they are on the front lines interacting with older cancer patients. A team of health professionals could jointly share responsibility for managing the health of older adults with cancer, exchanging patient data and information between the team. </p>
<p>Research shows that <a href="https://www.ncbi.nlm.nih.gov/pubmed/21402176">this type of collaborative model</a> leads to better cancer follow-up care, health outcomes and effective management of coexisting health conditions. </p>
<h1>Focus on the family</h1>
<p>Cancer is a disease that reverberates across the family system, leaving no one untouched. In fact, research suggests that caregivers and family members often <a href="https://www.researchgate.net/publication/285549457_Assessing_cancer-related_distress_in_cancer_patients_and_caregivers_receiving_outpatient_psycho-oncological_counseling">report higher levels of distress</a> than does the individual with cancer. </p>
<p>With more and more cancer care delivered on an outpatient basis, coupled with the changing nature of cancer as a chronic disease, there is a growing burden on family to help a loved one manage their disease. Moreover, many older family members may themselves be dealing with a chronic illness and other life stressors, adding to the burden. </p>
<p>Research suggests that providing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791523/">psychological and educational support</a> for cancer caregivers and family members may improve not only the health of patients, but the health of caregivers. </p>
<h1>What’s next?</h1>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/171860/original/file-20170601-25684-195dvzk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/171860/original/file-20170601-25684-195dvzk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/171860/original/file-20170601-25684-195dvzk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/171860/original/file-20170601-25684-195dvzk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/171860/original/file-20170601-25684-195dvzk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/171860/original/file-20170601-25684-195dvzk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/171860/original/file-20170601-25684-195dvzk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Care for older adults is becoming more limited.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/andyde/4762068019/in/photolist-8fNQV2-hrya4W-8tN7X7-gXKh8i-TPrMvz-7x2adB-dQwLK4-SFHbSa-9EcfT2-VaJTtf-8GVwpa-7bUSd6-9DJPBM-TzuM9Y-xPuKc-7zdGfi-7bYRvN-dgZUG3-TemLG9-Temnqu-4R4JgR-fAAPfh-8CSH8u-9XF7ag-bb3f8k-4djzh2-TWP65Y-dQwLH6-7LdJSB-f3aFLv-pcEc3L-7bYHHQ-aCZwBo-7bUYoa-6cKCFj-8tN895-T8JU9w-osemh-UVFBg1-omnJ9H-oUsA4-SHqXs1-brvFo-5ZykLS-qddPij-2kiJtH-8pyT3t-2kiJzH-2jmYLG-EptQv">Andyde/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>Planning for the health care needs of our aging cancer survivors represents a significant public health challenge.</p>
<p>What we know about caring for cancer survivors is largely based on the experiences of <a href="https://www.ncbi.nlm.nih.gov/pubmed/26278341">adult survivors of child-onset cancer</a> and proactive groups of middle-aged breast cancer survivors. There is an urgent need for additional research on the needs and care of the burgeoning geriatric population. </p>
<p>In 2010, the U.S. Department of Health and Human Services <a href="https://www.hhs.gov/sites/default/files/ash/initiatives/mcc/mcc_framework.pdf">released a report on multiple chronic conditions</a>. It recommended including older adults with multiple chronic conditions in clinical trials, facilitating self-care management and promoting multiple chronic condition curricula in the health care sector. It also suggested educating the federal, private and public sectors about issues related to multiple chronic conditions.</p>
<p>While this national initiative is encouraged, it’s clear that the growing number of older adults with cancer outpaces current efforts. If we want to successfully respond to the demand, we must find ways to quickly conduct meaningful and targeted research on this unique population. This can help us develop best practices and offer high-quality care.</p><img src="https://counter.theconversation.com/content/72242/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Keith M. Bellizzi receives funding from the National Cancer Institute and the University of Connecticut.</span></em></p>The number of adults living with cancer is expected to triple in size by 2030. How can we prepare for this public health challenge?Keith M. Bellizzi, Associate Professor of Human Development and Family Studies, University of ConnecticutLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/690952017-02-21T01:25:21Z2017-02-21T01:25:21ZDiversity is on the rise in urban and rural communities, and it’s here to stay<figure><img src="https://images.theconversation.com/files/157226/original/image-20170216-32685-k4bo9v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Schoolchildren play on a New York subway.</span> <span class="attribution"><span class="source">AP Photo/Mark Lennihan</span></span></figcaption></figure><p>Racial and ethnic diversity is no longer confined to big cities and the east and west coasts of the United States. </p>
<p>In the 2016 U.S. <a href="http://www.citylab.com/politics/2016/11/how-americas-metro-areas-voted/508355/">presidential election</a>, racially and ethnically diverse metropolitan areas were more likely to vote for Hillary Clinton. Whiter metro and rural areas supported Donald Trump. This pattern reinforced the stereotype of “white rural” versus “minority urban” areas. </p>
<p>However, our research shows that the populations of communities throughout the nation are being transformed. The share of racial and ethnic minorities is <a href="https://www.brookings.edu/book/diversity-explosion/">increasing</a> rapidly and irreversibly. These changes will have major impacts on the economy, social cohesion, education and other important <a href="http://link.springer.com/article/10.1007/s13524-013-0197-1">parts of American life</a>. </p>
<h2>Nearly all communities are becoming more diverse</h2>
<p>In everyday language, “diversity” often refers to racial and ethnic variation. But demographers have developed a mathematical definition of this concept: The greater the number of racial-ethnic groups in the community, and the more equal in size the groups are, the greater the diversity. Using this definition, we have <a href="https://www.russellsage.org/sites/all/files/logan/logan_diversity_chapter13.pdf">estimated</a> that diversity has increased in 98 percent of all metropolitan areas, and 97 percent of smaller cities in the U.S. since 1980.</p>
<p>The trend is not limited to urban America. Dramatic increases are evident in <a href="http://onlinelibrary.wiley.com/doi/10.1111/ruso.12141/epdf">rural places</a> as well. Nine out of 10 rural places experienced increases in diversity between 1990 and 2010, and these changes occurred in every region of the country. Even within metropolitan settings, the traditional divide between diverse cities and <a href="http://journals.sagepub.com/doi/pdf/10.1177/0042098009346862">white suburbia</a> has been eroded. <a href="https://www.brookings.edu/book/twenty-first-century-gateways/">Immigrant-rich suburbs</a> are rising around cities like Los Angeles and Washington, D.C., which rival urban enclaves as destinations for Asians and Latinos.</p>
<p>Of course, some communities have changed more than <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1728-4457.2016.00125.x/epdf">others</a>. Despite these differences, a common trend is for a place’s racial-ethnic composition to change from white dominance to a <a href="https://www.sociologicalscience.com/download/volume-2/march/SocSci_v2_125to157.pdf">multigroup mix</a>, with some combination of whites, blacks, Latinos and Asians. This led to an increase in “<a href="http://journals.sagepub.com/doi/pdf/10.1177/1078087416682320">no-majority” communities</a> – including more than 1,100 cities and towns, 110 counties and four states: California, Texas, New Mexico and Hawaii. In these places, none of the major racial-ethnic groups constitutes as much as 50 percent of all residents. </p>
<h2>Immigration and diversity</h2>
<p>The racial and ethnic diversity we see today stems from the large and sustained wave of immigration that followed the <a href="http://www.migrationpolicy.org/article/fifty-years-1965-immigration-and-nationality-act-continues-reshape-united-states">Immigration and Nationality Act of 1965</a>. Between 1965 and 2015, the proportion of non-Hispanic whites in the country dropped from 84 to 62 percent, while the shares of Hispanics and Asians rose. The Pew Research Center found that these changes were largely <a href="http://www.pewhispanic.org/2015/09/28/chapter-2-immigrations-impact-on-past-and-future-u-s-population-change/">driven by immigration</a>, not births. Only one-third of Hispanics and one-tenth of Asians would be living in the United States in 2015 had there been no immigration since 1965. Today, Hispanics account for 18 percent and Asians 6 percent of the U.S. population.</p>
<p>Domestic and international <a href="http://link.springer.com/article/10.1007/s13524-016-0479-5">migration</a> during the 1990s and 2000s also contributed to the spread of diversity across American communities. Racial and ethnic minorities tended to move to whiter areas, and white young adults tended to move to more diverse urban areas. Notably, Latino immigrants were first concentrated in just a handful of states such as California, Texas, Florida, Illinois and New York. They started to spread across the country during the 1990s to areas known as “new destinations,” like North Carolina, Georgia and Iowa.</p>
<p>By that time, many Hispanic immigrants had acquired legal status and were free to move to new <a href="http://www.jstor.org/stable/3401474">job opportunities</a> in agriculture, construction and manufacturing in the Southeast and Midwest, as well as service sector jobs in high-amenity vacation <a href="http://www.tandfonline.com/doi/abs/10.1080/00045608.2015.1052338?scroll=top&needAccess=true&journalCode=raag20">destinations</a>, such as in Colorado. </p>
<h2>Diversity is now self-sustaining</h2>
<p>Despite the initial importance of migration, racial and ethnic diversity is now self-sustaining. Minority groups will soon be maintained by “natural increase,” when births exceed deaths, rather than by new immigration. </p>
<p>This is especially true for Hispanics. According to the Pew Research Center study mentioned earlier, about a quarter of the U.S. population is projected to be Hispanic by 2065, up from 18 percent in 2015. This trend would not change if immigration somehow were halted completely after 2015, the final year in Pew’s study. The sustainability of the Latino population is even evident in rural and urban areas in the Southeast and Midwest, where natural increase in the Latino population, rather than international or domestic migration, is now responsible for <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1728-4457.2008.00222.x/abstract">more than half</a> of Hispanic growth. </p>
<p>But, how can the share of Hispanics continue to grow without new immigration? </p>
<p>A small part of the answer is that Latinos have slightly more children than non-Hispanic whites. On average, Hispanic women have <a href="https://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_12.pdf">2.1 children</a> compared with 1.8 among non-Hispanic white women. However, fertility among Hispanic women <a href="http://link.springer.com/article/10.1353/dem.0.0023">declines</a> with each new generation in the U.S., so this factor is unlikely to play a major role in the long run.</p>
<p>The main engine of America’s future diversity gains will be “cohort succession,” a process in which older majority-white generations are replaced by younger minority-majority generations. As shown in the charts below, which we created from U.S. Census Bureau population <a href="http://www.census.gov/content/dam/Census/library/publications/2015/demo/p25-1143.pdf">projections</a>, children and young adults, many of whom are the children of immigrants, are currently much more diverse than older adults. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/153483/original/image-20170119-26539-1th1ymi.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/153483/original/image-20170119-26539-1th1ymi.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=288&fit=crop&dpr=1 600w, https://images.theconversation.com/files/153483/original/image-20170119-26539-1th1ymi.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=288&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/153483/original/image-20170119-26539-1th1ymi.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=288&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/153483/original/image-20170119-26539-1th1ymi.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=363&fit=crop&dpr=1 754w, https://images.theconversation.com/files/153483/original/image-20170119-26539-1th1ymi.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=363&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/153483/original/image-20170119-26539-1th1ymi.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=363&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p>Fast-forward to 2050. Today’s older generations will have died. The more diverse younger generations will have grown up and had their own diverse children and grandchildren. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/153484/original/image-20170119-26539-gbncp3.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/153484/original/image-20170119-26539-gbncp3.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=288&fit=crop&dpr=1 600w, https://images.theconversation.com/files/153484/original/image-20170119-26539-gbncp3.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=288&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/153484/original/image-20170119-26539-gbncp3.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=288&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/153484/original/image-20170119-26539-gbncp3.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=363&fit=crop&dpr=1 754w, https://images.theconversation.com/files/153484/original/image-20170119-26539-gbncp3.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=363&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/153484/original/image-20170119-26539-gbncp3.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=363&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
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<p>The seeds for future gains in diversity have already been planted.</p>
<h2>Fear and distrust</h2>
<p>Many Americans respond to these changes with <a href="https://thesocietypages.org/specials/the-whitelash-against-diversity/">fear</a> and <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1467-9477.2007.00176.x/full">distrust</a>. Some whites have an <a href="https://doi.org/10.1093/sf/89.4.1385">aversion</a> to living near people of color. A small number of no-majority places and other highly diverse municipalities and <a href="http://www.jstor.org/stable/pdf/10.1086/649498.pdf">neighborhoods</a> like the Chicago suburb of Calumet Park and the Los
Angeles suburbs of Lynwood and Monterey Park have already become more <a href="http://link.springer.com/article/10.1007/s11113-014-9343-8">homogeneous</a>, as one minority group has grown and whites have moved away. These places are exceptions to the trend of growing diversity, but other communities may follow suit. Some people want to “turn back the clock” by limiting immigration, a sentiment <a href="http://www.politifact.com/truth-o-meter/article/2016/nov/09/politifact-sheet-donald-trumps-immigration-plan/">Donald Trump</a> tapped into during his presidential campaign. </p>
<p>Trump <a href="https://www.washingtonpost.com/news/post-politics/wp/2016/08/22/donald-trump-to-african-american-and-hispanic-voters-what-do-you-have-to-lose/?utm_term=.5b8485be6137">described</a> black and Hispanic communities as impoverished, dangerous inner-city neighborhoods. This was <a href="https://www.washingtonpost.com/news/wonk/wp/2016/08/24/the-problem-with-trumps-question-to-black-voters-what-the-hell-do-you-have-to-lose/?utm_term=.5998eba676e7">an exaggeration</a>, but it may have stoked rural white voters’ <a href="http://www.slate.com/articles/news_and_politics/cover_story/2016/11/rural_americans_just_chose_a_president_who_won_t_help_them.html">fears</a> of racial-ethnic diversity. </p>
<p>Although all-minority communities are often disadvantaged, communities with <a href="http://www.russellsage.org/research/reports/racial-ethnic-diversity">high levels</a> of diversity with a mixture of racial and ethnic groups do not fit Trump’s image. Highly diverse communities are more common in <a href="http://link.springer.com/article/10.1007/s40980-016-0030-8">coastal states</a> and across the South. They have larger populations and a critical mass of foreign-born inhabitants, both of which contribute to their reputation as comfort zones for minorities and immigrants. </p>
<p>Diverse communities also tend to offer attractive housing and labor market opportunities, including an abundant rental stock, higher median income and a job opportunities in a variety of occupations. Some are also hubs for <a href="https://s4.ad.brown.edu/Projects/Diversity/Data/Report/report08292012.pdf">government or military jobs</a>. Overall, the evidence suggests that highly diverse communities are good places to live, and often support industries that employ immigrants, and racial and ethnic minorities.</p>
<p>Throughout history, notions of who belongs in American society have <a href="http://www.hup.harvard.edu/catalog.php?isbn=9780674018136">expanded</a> again and again to incorporate new groups. History could repeat itself for today’s immigrants if they are given a fair chance. Many people fear immigrants and the social burdens they seem to bring with them, including poverty, limited education and low English proficiency. But this overlooks the many contributions immigrants make, and the fact that immigrants’ socioeconomic disadvantages will almost certainly <a href="https://www.russellsage.org/publications/parents-without-papers">diminish</a> if they are given equal opportunities in U.S. schools and workplaces.</p><img src="https://counter.theconversation.com/content/69095/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jennifer Van Hook received funding for her research from the National Institutes of Health. She is affiliated with the Population Research Institute at the Pennsylvania State University and is a non-resident fellow of the Migration Policy Institute. </span></em></p><p class="fine-print"><em><span>Barrett Lee receives funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHHD), an agency within the U.S. National Institutes of Health. A grant from NICHHD has funded much of the diversity research referred to in the Conversation article. </span></em></p>Nine out of 10 rural places experienced increases in diversity from 1990 to 2010. Data show a more diverse future is guaranteed across all of America, and there’s no going back.Jennifer Van Hook, Liberal Arts Research Professor of Sociology and Demography, Penn StateBarrett Lee, Professor of Sociology and Demography, Penn StateLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/720452017-02-21T01:19:47Z2017-02-21T01:19:47ZWhere is ‘rural America,’ and what does it look like?<figure><img src="https://images.theconversation.com/files/156796/original/image-20170214-26003-11mzytw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The view from Wyoming County, Pennsylvania.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/nicholas_t/15993534217/in/photolist-qni3vX-pkebdP-7wFxiM-37gQ5c-f6X5SN-pCn9Nv-6H2oWW-gb2tgW-pVcvgm-RVzNrB-CfnZTK-n5ssnZ-9U5wqi-5CC2UK-qBYzxc-qBUP21-nNkKzr-8Qiokn-pj9uU5-qEDCFN-bEmQsY-pAXQ7D-e4FUiB-rHLHQT-nNkKwv-oEvJSV-48iAfe-xFmo-ftPCW5-2SM7Q3-rdoQZC-cdFsLJ-cwC9mh-DDHQy-f7de1d-nJvLHA-eppKA-5dBvER-dT9ksq-9GkDTy-cwCcRo-iXfXfj-obrhyK-bsj27s-d2hjis-qkpH5w-p37AXm-kasUgZ-DkXw-gBT7Yc">Cropped from nicholas_t/flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>Rural people and issues generally receive little attention from the urban-centric media and policy elites. Yet, rural America makes unique contributions to the nation’s character and culture as well as provides most of its food, raw materials, drinking water and clean air. The recent presidential election also reminds us that, though rural America may be ignored, it <a href="https://theconversation.com/backwater-blues-how-populism-reveals-rural-resentment-in-the-us-and-europe-70748">continues to influence</a> the nation’s future.</p>
<p>“Rural America” is a deceptively simple term for a remarkably diverse collection of places. It includes nearly 72 percent of the land area of the United States and 46 million people. Farms, ranches, grain elevators and ethanol plants reflect the enduring importance of agriculture. </p>
<p>But, there is much more to rural America than agriculture. It includes manufacturing parks, warehouses and food processing plants strung along rural interstates; sprawling exurban expanses just beyond the outer edge of the nation’s largest metropolitan areas; regions where generations have labored to extract, process and ship coal, ore, oil and gas to customers near and far; timber and pulp mills deep in rural forests; industrial towns struggling to retain jobs in the face of intense global competition; and fast-growing recreational areas proximate to mountains, lakes and coastlines. </p>
<p>As a demographer studying rural America, I have documented both remarkable continuity and dramatic changes in the size, composition and distribution of the population spread across the vast rural landscape.</p>
<h2>Where is rural America?</h2>
<p>Clearly farms on the Great Plains are rural and the city of Chicago is not, but where is the boundary between what is rural and what is urban? There is no simple answer. The U.S. Department of Agriculture, the federal agency with primary responsibility for rural America, has multiple definitions of what is rural. The Census Bureau has yet another. </p>
<p>I rely upon a widely used USDA definition in which “rural areas” include everything that is outside a metropolitan area. These 1,976 counties were home to <a href="https://www.ers.usda.gov/webdocs/publications/eib162/eib-162.pdf?v=42684">46.2 million residents</a> in 2015. </p>
<p>“Metropolitan areas” include counties with a city of 50,000 residents or more, together with adjacent counties – mostly suburban – closely linked to these <a href="http://www.census.gov/population/metro/data/metrodef.html">urban cores</a>. More than 275.3 million people live in these 1,167 urban counties. </p>
<h2>Demographic trends in rural America</h2>
<p><a href="https://www.census.gov/population/censusdata/table-4.pdf">More that 90 percent</a> of the U.S. population was rural in 1790. By 1920, that number had dwindled to just under 50 percent. Today, only 15 percent of the population resides in rural counties.</p>
<p>Growing economic and social opportunities in urban areas, coupled with mechanization and farm consolidation, caused millions of people to leave rural areas over the past century. The magnitude of the migration loss varied from decade to decade, but the pattern was consistent: <a href="http://scholars.unh.edu/cgi/viewcontent.cgi?article=1004&context=carsey">more people left rural areas than arrived</a>.</p>
<p>Hundreds of rural counties have far fewer people today than they did a century ago. In many, young adults have been leaving for generations, so few young women remain to have children. As a result, deaths exceed births in these counties, producing a downward spiral of <a href="http://scholars.unh.edu/cgi/viewcontent.cgi?article=1137&context=carsey">population decline</a>. </p>
<p>There were brief periods when the rural population rebounded in the 1970s and the 1990s. But, generally, the growth of the urban population throughout the 20th century has <a href="http://scholars.unh.edu/cgi/viewcontent.cgi?article=1158&context=carsey">far exceeded</a> that in rural areas. Between 2000 and 2015, the rural population grew by just 3.1 percent. Urban areas grew by 16.3 percent.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/156792/original/image-20170214-25962-wvs1ys.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/156792/original/image-20170214-25962-wvs1ys.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/156792/original/image-20170214-25962-wvs1ys.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=464&fit=crop&dpr=1 600w, https://images.theconversation.com/files/156792/original/image-20170214-25962-wvs1ys.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=464&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/156792/original/image-20170214-25962-wvs1ys.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=464&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/156792/original/image-20170214-25962-wvs1ys.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=583&fit=crop&dpr=1 754w, https://images.theconversation.com/files/156792/original/image-20170214-25962-wvs1ys.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=583&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/156792/original/image-20170214-25962-wvs1ys.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=583&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Hundreds of rural counties continue to lose population, but growth is widespread near urban areas and in recreational areas.</span>
<span class="attribution"><span class="source">Provided by author</span></span>
</figcaption>
</figure>
<p>Demographic trends vary across the rural landscape. Rural population gains have been widespread in the west and southeast, at the periphery of large urban areas, and in recreational areas of the upper Great Lakes, the Ozarks and northern New England. Migration, largely from urban areas, fueled this growth. Migrants who venture just beyond the urban edge enjoy the lower density and housing costs of rural areas, but retain easy access to urban services and opportunities. In contrast, urban migrants to rural recreational counties enjoy a relaxed lifestyle in communities rich in scenic and leisure amenities.</p>
<p>In contrast, population losses were common in agricultural regions of the Great Plains and Corn Belt, in the Mississippi Delta, in the northern Appalachians, and in the industrial and mining belts of New York and Pennsylvania. Many people continue to leave these regions because economic and social opportunities are limited.</p>
<p>Recently, the <a href="https://theconversation.com/the-u-s-economy-is-in-desperate-need-of-a-strong-dose-of-fiscal-penicillin-66106">Great Recession</a> and its aftermath disrupted established rural demographic trends. Both immigration and internal migration diminished, as residents were “frozen in place” by houses they couldn’t sell and by a national job market that provided fewer incentives to move. Fertility rates also dropped to record lows during the recession and <a href="https://carsey.unh.edu/publication/us-births-low">have yet to recover</a>.</p>
<p>Fewer births diminished population gains in almost all rural areas, but <a href="http://w3001.apl.wisc.edu/b01_16">migration patterns varied</a>. Surprisingly, rural places that had once been fast-growing – rural countries adjacent to urban areas and recreational counties – seemed to slow down more. Meanwhile, the remote rural areas that had historically lost many people to migration were less affected, because fewer were willing to risk a move in such uncertain times. It’s not yet clear whether the reduced number of births and diminished migration to rural America in the era of Great Recession will continue.</p>
<p>Other demographic changes are underway in rural America as well. The population is <a href="http://theconversation.com/diversity-is-on-the-rise-in-urban-and-rural-communities-and-its-here-to-stay-69095">rapidly becoming more diverse</a>. Minorities represent 21 percent of the rural population, but produced 83 percent of the growth between 2000 and 2010. Hispanics are particularly important to this growing <a href="http://link.springer.com/article/10.1007%2Fs11113-016-9403-3">rural diversity</a>.</p>
<p>Children are in the vanguard of this change. The rural minority child population has grown significantly recently, while the number of <a href="http://scholars.unh.edu/cgi/viewcontent.cgi?article=1211&context=carsey">non-Hispanic white children</a> diminished.</p>
<p>The rural population is also growing older. The median age in rural counties is 41.5. That’s already more than three years older than in urban counties. More than 16 percent of the rural population is over 65, compared to 12.5 percent of the urban population. While these older rural residents age in place, <a href="https://www.demographic-research.org/volumes/vol32/38/32-38.pdf">young adults continue to leave</a> and the rural child population is diminishing.</p>
<h2>Rural and urban America are intertwined</h2>
<p>Few people appreciate that the fates of rural and urban America are inextricably linked. Improving the opportunities, accessibility and viability of rural areas is critical – both to the 46 million people who live there and to the much larger urban population that depends on rural America’s contributions to their material, environmental and social well-being. A vibrant rural America broadens the nation’s economic, intellectual and culture diversity. </p>
<p>Yet, rural areas face unique demographic, economic and institutional challenges. Distances are greater and places are more isolated. The advantages derived from businesses and services clustering together are limited. As a result, programs to expand health insurance and reform education may affect rural people and communities differently than in the 50 largest metropolitan areas. Such challenges are frequently overlooked in a policy and media environment dominated by urban interests. </p>
<p>Policymakers need to design comprehensive policies that can address the multifaceted challenges rural communities face. Fast-growing rural counties need programs capable of managing their growth and development. </p>
<p>In contrast, rural areas with diminishing populations need policies to ameliorate the adverse impacts of this migration. Sustained population loss can affect the availability of critical services like health care, education and emergency services. Resources such as broadband, capital and expertise can facilitate new development.</p>
<p>In the wake of the election upset which hinged, <a href="http://www.pewresearch.org/fact-tank/2016/11/17/behind-trumps-win-in-rural-white-america-women-joined-men-in-backing-him/">in part</a>, on rural voters, more media companies have <a href="https://www.washingtonpost.com/pr/wp/2016/12/16/the-washington-post-announces-america-desk-reporting-team/?utm_term=.a38b7284fa62">dispatched correspondents to rural areas</a>. They, and everyone else with a newfound interest in rural America, need to understand that the people, places and institutions in this vast area are far from monolithic. Rural America has been, and continues to be, buffeted by a complex mix of economic, social and demographic forces.</p><img src="https://counter.theconversation.com/content/72045/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kenneth Johnson's research has been supported, in part, by his Andrew Carnegie Fellowship from the Carnegie Corporation, by the Carsey School of Public Policy and by the New Hampshire Agricultural Experiment Station. The opinions expressed here are his own and do not represent the official views of the agencies supporting his research.</span></em></p>‘Rural America’ is a deceptively simple term for a remarkably diverse collection of places. Understanding – and improving – these parts of the country is critical for all Americans.Kenneth Johnson, Professor of Sociology and Senior Demographer, University of New HampshireLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/679202016-11-07T11:01:00Z2016-11-07T11:01:00ZVoters in Texas, North Carolina, Ohio and Florida are changing the swing state map<p>As final predictions roll in before Election Day, everyone is looking to see who will win important swing states. Candidates work harder to win over voters in states like Ohio and Florida, because their voting behavior is less predictable. But this year, the map has shifted in unexpected ways.</p>
<p>We asked four of our experts to weigh in on why, and what we might expect from their states in future elections. Here’s what they said.</p>
<h2>Texas, a battleground state?</h2>
<p><strong>James Henson, University of Texas at Austin</strong></p>
<p>Some of the electoral projection sites have <a href="http://www.realclearpolitics.com/epolls/2016/president/2016_elections_electoral_college_map.html">switched Texas’ classification</a> from “solid Republican” to “lean Republican.” This is based on a series of polls taken in mid- to late October showing Donald Trump’s lead over Hillary Clinton dwindling to low single figures. Some even <a href="http://thehill.com/blogs/ballot-box/presidential-races/302414-texas-becomes-tossup-realclearpolitics-declares">declared Texas a battleground state.</a> Still more polling <a href="http://www.realclearpolitics.com/epolls/2016/president/tx/texas_trump_vs_clinton-5694.html#polls">in the last week</a> has moved in Trump’s favor, quieting talk of the possibility of an unanticipated partisan shift in the the Lone Star state. </p>
<p>Recent <a href="http://www.realclearpolitics.com/articles/2016/11/01/why_polling_swings_are_often_mirages_132225.html">analysis of national polling data</a> by Doug Rivers of YouGov and Stanford University, and Benjamin Lauderdale of the London School of Economics, explains some of this to-and-fro in Texas polling. They found response bias in national polls, meaning voters whose favored candidate was getting bad press were reluctant to respond to pollsters. Nonetheless, comparing Trump’s support among critical subgroups in the <a href="https://texaspolitics.utexas.edu/polling/search/year/2012/month/10/">October 2016 University of Texas/Texas Tribune Poll</a> to Mitt Romney’s and John McCain’s support in the same poll conducted in October 2012 and 2008, respectively, suggests why Trump has been performing less well in the polls in Texas than GOP candidates in the last two presidential elections. </p>
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<p>Romney led Obama by 14 points among women in October 2012. Now, Trump and Clinton are tied among women. Romney led among men by 17 points; Trump leads by 7. Romney led among Texans with a 4-year degree by 29 points; Trump leads by only 2 points. Romney led among suburban voters by 21 points; Trump leads by 12.</p>
<p>Trump’s underperformance reflects in part that the poll was conducted at a bad time for him – after the release of the “Access Hollywood” tapes and the second debate, and with the third debate taking place during the data collection period. But even as his overall numbers in Texas appear to be rebounding, he is unlikely to completely overcome his underperformance among key groups in the Texas GOP coalition. Trump remains favored to win the state, but should be expected to fall short of Romney’s margin in 2012, which was more than 15 percent.</p>
<h2>North Carolina losing its southern drawl</h2>
<p><strong>Jason Husser, Elon University</strong></p>
<p>North Carolina was reluctant to become a swing state. </p>
<p>Republicans won all but one presidential election in North Carolina from <a href="http://www.ncsbe.gov/Election-Results">1968 to 2004</a>. George W. Bush captured a commanding lead of almost 13 percent in 2000 and 2004. However, the state saw a seismic political shift when Obama won by 0.3 percent in 2008 and lost by only 2 percent in 2012. North Carolina remains a toss-up in 2016.</p>
<p>The single trend best explaining North Carolina’s shift from red to purple is interstate migration. The population of North Carolina has changed dramatically due to nonnative North Carolinians moving into the state. The portion of eligible voters in North Carolina who were actually born in North Carolina <a href="http://demography.cpc.unc.edu/2016/11/02/the-north-carolina-electorate-north-carolina-born-voters/">decreased</a> from 75 percent in 1980 to 68 percent in 1990, and 54 percent in 2014. </p>
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<p>These new residents have a greater tendency to vote for Democrats than for Republicans. Urban counties in North Carolina are both Democratic strongholds and are growing in population <a href="http://demography.cpc.unc.edu/2016/03/24/5-things-you-should-know-about-the-2015-county-population-estimates/">faster</a> than the state average. A large portion of the people moving to North Carolina <a href="http://demography.cpc.unc.edu/2015/02/23/which-state-do-most-people-move-from-when-coming-to-nc/">come from</a> less conservative states like New York and Virginia.</p>
<p>We see this pattern in cultural indicators beyond census figures. Native North Carolinians are far more likely to have a southern accent than nonnatives, according to data that I have collected as director of the Elon University Poll. In my <a href="https://www.elon.edu/e/CmsFile/GetFile?FileID=694">latest Elon Poll</a>, I had interviewers code each respondent’s accent at the end of every conversation. Clinton led Trump by 38 points among those with no southern accent. But among those with a strong southern accent, Clinton was down 38 points.</p>
<p>Younger generations replacing older generations, increases in turnout among African-Americans and other factors have also contributed to a shift from red to purple, but migration is what most contributed to North Carolina becoming a critical battleground state. The competitiveness of North Carolina in 2016 is in large part due to new residents trekking south toward the Old North State.</p>
<h2>As Ohio goes, so goes the nation – right?</h2>
<p><strong>Nathaniel Swigger, The Ohio State University</strong></p>
<p>In recent elections, Ohio has been considered a bellweather that mirrors nationwide results. For example, in <a href="http://elections.nytimes.com/2008/results/president/map.html">2008</a> and <a href="http://elections.nbcnews.com/ns/politics/2012/all/president/#.WBn_7uArI2w">2012</a> President Obama’s margin of victory in Ohio was roughly the same as his margin nationwide. The partisan balance in the electorate has made it an important, competitive swing state <a href="http://www.gallup.com/poll/188969/red-states-outnumber-blue-first-time-gallup-tracking.aspx">for decades</a>.</p>
<p>The story of Ohio elections is a <a href="http://www.politico.com/2012-election/results/president/ohio/">familiar story</a> in American politics: Urban areas are dominated by Democrats; rural areas are dominated by Republicans. The urban-rural split in Ohio is primarily due to the concentration of Democratic blocs such as <a href="http://engagedscholarship.csuohio.edu/urban_facpub/1338/">young voters</a> and <a href="http://blackdemographics.com/states/ohio/">African-Americans</a> in cities. </p>
<p>However, while cities like Columbus and Cincinnati are thriving, rural areas and the state as a whole <a href="http://aede.osu.edu/sites/aede/files/publication_files/6-30-15%20Rural%20Quality%20of%20Life.pdf">are not</a>. Demographic trends in Ohio should worry Democrats beyond 2016. Ohio ranks near the bottom in <a href="http://www.cleveland.com/datacentral/index.ssf/2014/01/ohio_ranks_45th_for_population.html">population growth</a> and has an aging population. </p>
<p>While the country as a whole is becoming more diverse, this is not really true of Ohio. The state is only about 13 percent African-American and 3 percent Latino, whereas Latinos make up about 17 percent of the national population. <a href="https://www.census.gov/quickfacts/table/PST045215/39">Those numbers</a> haven’t risen much. If the polls are accurate, the Clinton coalition will consist of <a href="http://www.bloomberg.com/politics/articles/2016-10-26/clinton-dominates-trump-among-millennial-voters-in-harvard-poll">young people</a>, <a href="http://www.politico.com/story/2016/09/poll-clinton-trump-hispanic-voters-228508">Latinos</a>, <a href="http://thehill.com/blogs/ballot-box/presidential-races/293752-trumps-popularity-with-african-american-voters-polling-at">African-Americans</a> and <a href="http://www.bloomberg.com/politics/articles/2016-11-03/clinton-s-growing-lead-with-college-educated-whites-could-doom-trump">college-educated white</a> voters. In the state of Ohio, none of those groups are likely to grow in size in the foreseeable future. </p>
<p>If these trends continue, Ohio is more likely to become a dependable red state like Indiana.</p>
<h2>Florida still swinging strong</h2>
<p><strong>Susan MacManus, University of South Florida</strong></p>
<p>Florida has long been one of the nation’s most fought-over swing states. Candidates want to win it. That may be because since 1964, only once – in 1992 – did the state vote differently in presidential contests than the nation at large. It is a highly competitive state where the margin of victory for the winner of the past <a href="http://www.sayfiereview.com/featured_column?column_id=36">three</a> <a href="http://www.sayfiereview.com/featured_column?column_id=48">statewide</a> <a href="http://www.sayfiereview.com/featured_column?column_id=54">elections</a> has been 1 percent. </p>
<p>As Clinton and Trump surely know, Florida has seen several major demographic changes since the 2012 presidential race.</p>
<p>The growing number of voters registered with no party affiliation now makes up 24 percent of <a href="http://www.sayfiereview.com/featured_column?column_id=53">Florida voters</a>. There has been an influx <a href="http://www.naplesnews.com/story/news/politics/elections/2016/10/29/floridas-hispanic-vote-grows-puerto-ricans-help-democrats/92841174/">Puerto Ricans</a> who lean Democratic. And, there is a rise of millennials and GenXers. They now make up <a href="http://www.sayfiereview.com/featured_column?column_id=55">49 percent of the state’s registered voters</a>. </p>
<p>What does all of this mean? Florida is once again shaping up to be a highly competitive state. Polling <a href="http://www.realclearpolitics.com/epolls/2016/president/fl/florida_trump_vs_clinton_vs_johnson_vs_stein-5963.html">shows</a> the candidates have been within the margin of error for quite some time. </p>
<p>Victory in the Sunshine State will come down to which side can better motivate and mobilize supporters in the final days of the campaign, as it has for more than 50 years.</p><img src="https://counter.theconversation.com/content/67920/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>How southern accents, Puerto Ricans and bias at the polls could change the map of traditional swing states as we know it.James Henson, Director of the Texas Politics Project and Lecturer, The University of Texas at AustinJason Husser, Director of the Elon University Poll, Elon UniversityNathaniel Swigger, Associate Professor of Political Science, The Ohio State UniversitySusan MacManus, Professor of Government and International Affairs, University of South FloridaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/679212016-11-02T01:48:08Z2016-11-02T01:48:08ZCounting 11 million undocumented immigrants is easier than you think<p>News organizations widely report that there are 11 million unauthorized immigrants living in the United States. But where does this figure come from?</p>
<p>Donald Trump has <a href="http://www.politifact.com/truth-o-meter/statements/2016/sep/01/donald-trump/donald-trump-repeats-pants-fire-claim-about-30-mil/">falsely</a> <a href="http://www.nytimes.com/2016/09/02/us/politics/transcript-trump-immigration-speech.html?_r=0">asserted</a>: “It could be three million. It could be 30 million. They have no idea what the number is.”</p>
<p>In the third debate, Hillary Clinton <a href="http://www.politico.com/story/2016/10/full-transcript-third-2016-presidential-debate-230063#ixzz4OffyXX4a">said</a>, “We have 11 million undocumented people. They [undocumented parents] have 4 million American citizen children. 15 million people.”</p>
<p>The confusion is warranted. After all, the U.S. Census Bureau does not ask people about their immigration status, so how can we know much about the unauthorized foreign-born population?</p>
<p>Well, demographers have figured out a simple and effective way to estimate the number of unauthorized immigrants. In the last five years, my colleagues Frank D. Bean, James D. Bachmeier and I have conducted a <a href="http://onlinelibrary.wiley.com/doi/10.1111/imre.12059/full">series</a> <a href="http://link.springer.com/article/10.1007/s13524-014-0280-2">of</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3783022/">studies</a> that evaluate this method and its assumptions. Our research on the methods used to estimate the size of this group indicates that these estimates are reasonably accurate. </p>
<p>Here’s how it works.</p>
<h2>A simple formula</h2>
<p>Beginning in the late 1970s, a group of demographers consisting primarily of Jeffrey Passel, Robert Warren, Jacob Siegel, Gregory Robinson and Karen Woodrow introduced the “residual method” for estimating the number of unauthorized immigrants living in the country. At the time, Passel and his collaborators were affiliated with the U.S. Bureau of the Census and Warren with the Office of Immigration Statistics of the Immigration and Naturalization Service. Much of this work was published in the form of internal reports, but some of it <a href="http://link.springer.com/article/10.1353/dem.2001.0023">appeared</a> <a href="http://link.springer.com/article/10.2307%2F2061304?LI=true">in</a> <a href="http://link.springer.com/article/10.2307/2060964">major</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3744247/">journals</a>. </p>
<p>The residual method uses an estimate of the total foreign-born population in the country (F), based on U.S. Census data. Researchers then subtract from it the number of legal immigrants residing here (L), estimated from government records of legal immigrants who receive “green cards” minus the number that died or left the country. The result is an estimate of the unauthorized population (U):</p>
<blockquote>
<p>F – L = U</p>
</blockquote>
<p>Various adjustments are typically made to this formula. Most adjustments are minor, but a particularly important one adjusts for what researchers call “coverage error” among the unauthorized foreign-born. Coverage error occurs when the census data underestimate the size of a group. This can occur when people live in nonresidential or unconventional locations – such as on the streets or in a neighbor’s basement – or when they fail to respond to the census. Coverage error could be particularly high among unauthorized immigrants because they may be trying to avoid detection. </p>
<p>Currently, the Department of Homeland Security and the Pew Hispanic Center are the two major producers of estimates of the unauthorized foreign-born population. <a href="http://www.pewhispanic.org/2016/09/20/overall-number-of-u-s-unauthorized-immigrants-holds-steady-since-2009/">This report</a>, compiled by Passel, who now works at Pew, summarizes many of the estimates. It shows that the estimated number increased steadily from 3.5 million in 1990 to 12.2 million in 2007, but declined between 2007 and 2009 and has since stabilized at around 11 million. </p>
<h2>How accurate are the estimates?</h2>
<p>The residual method has been widely used and accepted since the late 1970s. Within a reasonable margin of error, it predicted the number of unauthorized immigrants to legalize under the <a href="https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=6&ved=0ahUKEwj5zuLz04XQAhWK5YMKHakIAtUQFghDMAU&url=http%3A%2F%2Fwww.migrationpolicy.org%2Fpubs%2FPolicyBrief_No3_Aug05.pdf&usg=AFQjCNFOVPKqsUXZgTniF1X2LeHb4KkKWQ&sig2=skLrfWMkId1ZSVgUBNqUAw&cad=rja">Immigration Reform and Control Act of 1986</a>, which, among other things, granted permanent residency status to unauthorized immigrants who had been living in the country since 1982. The residual method predicted that about <a href="https://www.researchgate.net/publication/283644989_DA_Evaluation_Project_D2_Preliminary_Estimates_of_Undocumented_Residents_in_1990">2.2 million</a> met the residency requirement and the actual number to come forward was about 1.7 million.</p>
<p>Both Department of Homeland Security and Pew have used the residual method to produce estimates of the unauthorized population since 2005. Despite using slightly different data and assumptions, <a href="http://www.pewresearch.org/fact-tank/2016/09/21/unauthorized-immigrant-population-stable-for-half-a-decade/">Pew’s</a> and the <a href="https://www.dhs.gov/sites/default/files/publications/ois_ill_pe_2012_2.pdf">Department of Homeland Security’s</a> estimates have never differed by more than 600,000 people, or 5.5 percent of the total unauthorized population.</p>
<p>Nevertheless, many skeptics question a key assumption of the residual method, which is that unauthorized immigrants participate in census surveys. Both Pew and the Department of Homeland Security inflate their estimates to account for the possibility that some unauthorized immigrants are missing from census data. Pew inflates by 13 percent and the Department of Homeland Security by 10 percent. But is this enough?</p>
<p>My colleagues and I <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4029097/">estimated coverage error</a> among Mexican immigrants, a group that composes 60 percent of all unauthorized immigrants. Even if they are not counted in a census, populations leave “fingerprints” of their presence in the form of deaths and births. Because people give birth and die with known regularity regardless of their legal status, we were able to use birth and death records of all Mexican-born persons to determine the number of the Mexican-born persons living in the U.S. We also looked at changes in Mexican census data between 1990 and 2010 to gauge the size of Mexico’s “missing” population, most of whom moved to the United States. </p>
<p>We then compared these estimates based on births, deaths and migration with the number of estimated Mexican immigrants in census data.</p>
<p>Based on this analysis, we found that the census missed as many as 26 percent of unauthorized immigrants in the early 2000s. We speculated that this could have been due to the large numbers of temporary Mexican labor migrants who were living in the United States at the time. Because many worked in construction during the housing boom and lived in temporary housing arrangements, it may have been particularly difficult to accurately account for them in census surveys. However, when the Great Recession and housing crisis hit, many of these temporary workers went home or stopped coming to the U.S. in the first place, and coverage error declined. By 2010, the coverage error may have been as low as 6 percent. </p>
<p>If current levels of coverage error for all unauthorized immigrants were as high as 26 percent, then the number living in the country could be as high as 13 million. But if coverage error were as low as 6 percent, then the figure could be as low as 10.3 million.</p>
<p>What this boils down to is that we have a pretty good idea of the number of unauthorized immigrants living in the United States. It most likely falls within a narrow range somewhere between 10.3 million and 13 million. If coverage error has declined as much as we think it has, then the truth is at the lower end of this range. Despite widespread beliefs, unauthorized immigration is not increasing out of control and certainly is not as high as 30 million. Instead, it has probably really has stabilized somewhere around 11 million.</p><img src="https://counter.theconversation.com/content/67921/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jennifer Van Hook received funding for her research on coverage error from the National Institutes of Health and the Science and Technology Directorate of Department of Homeland Security through the BORDERS Research Center at the University of Arizona. She is affiliated with the Population Research Institute at the Pennsylvania State University and is a non-resident fellow of the Migration Policy Institute. </span></em></p>How can we possibly know how many millions of people are living in the U.S. illegally? Demographers have actually refined a simple formula that’s worked pretty well since the 1970s.Jennifer Van Hook, Liberal Arts Research Professor of Sociology and Demography, Penn StateLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/403602015-05-01T10:02:44Z2015-05-01T10:02:44ZWhy do so few black males go into STEM areas? Here’s what made DeAndre give up<figure><img src="https://images.theconversation.com/files/79995/original/image-20150430-30711-9gc0b0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Negative stereotypes hamper the success of black males in STEM fields.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/s/black+male+science/search.html?page=2&thumb_size=mosaic&inline=149239352">Student image via www.shutterstock.com</a></span></figcaption></figure><p>Dressed in a black hoodie and sagging jeans, DeAndre (name changed) swaggers down the street, singing loudly the gritty lyrics of a gangsta rap.</p>
<p>This routine typifies DeAndre’s journey to and from school. Many of those watching DeAndre’s behavior during his school commute could assume him to be a thug and a gangster.</p>
<p>Such a narrative, a result of the <a href="http://link.springer.com/article/10.1007/s11256-013-0265-2">racialized and gendered narratives</a> that black male adolescents live with in urban areas, is part of DeAndre’s schooling as well as out-of-school experiences. </p>
<p>Black males are presumed to lack intelligence when it comes to academics, particularly <a href="http://uex.sagepub.com/content/49/4/363.short">mathematics</a>. </p>
<p>For more than ten years, I have been <a href="http://uex.sagepub.com/content/49/4/363.short">researching</a> the lives and experiences of black STEM (science, technology, engineering and mathematics) high school students all the way up the pipeline to black STEM faculty. I have looked at the achievements of black students in mathematics within their first eight or nine years of schooling. </p>
<h2>Negative messages</h2>
<p>I have found that black males who consistently outperform their peers in mathematics, are also victims of <a href="http://link.springer.com/article/10.1007/s11256-014-0317-2#page-1">covert racial stereotypes</a> and <a href="http://aer.sagepub.com/content/48/6/1347.short">racial microaggressions</a>.</p>
<p>The truth is DeAndre is a high school junior and a high-achiever in mathematics and science from an urban area. DeAndre is not hardened, but he is fragile. </p>
<p>His STEM identity is especially tenuous. </p>
<p>DeAndre is not alone. There are <a href="http://journalofafricanamericanmales.com/issues/jaame-issue-archives/vol2no1">thousands of young men</a> like DeAndre in urban cities across the country, who are STEM high-achievers and have the potential to succeed as STEM professionals. </p>
<p>However, too often they receive negative messaging about their continued success in STEM. Such <a href="http://books.google.com/books?hl=en&lr=&id=44fCBDIPrZYC&oi=fnd&pg=PA193&dq=counselor+discouraging+Black+males+in+STEM&ots=4zy3XrEOMN&sig=muzQTkQVe2dvjys-eMetklU_nRk#v=onepage&q=counselor%20discouraging%20Black%20males%20in%20STEM&f=false">messages</a> from teachers or counselors <a href="http://hipatiapress.com/hpjournals/index.php/remie/article/view/remie.2013.15">downplay or minimize</a> their mathematics abilities. The low expectations from these talented boys serve to further <a href="http://ed-osprey.gsu.edu/ojs/index.php/JUME/article/view/178">discourage</a> them from pursuing STEM fields. </p>
<h2>Academic challenges</h2>
<p>As a result, <a href="http://beta.census.gov/content/dam/Census/library/publications/2013/acs/acs-24.pdf">black participation</a> in STEM fields has been left far behind. </p>
<p><a href="https://www.census.gov/prod/2013pubs/acs-24.pdf">In 2011</a>, whites held 71% of STEM jobs, Asians held 15% and blacks only 6%. In 2009 white students obtained 65.5% of the STEM undergraduate degrees. However, STEM undergraduate degrees for blacks have <a href="http://www.nsf.gov/statistics/seind12/c2/c2s2.htm">remained flat for the last 9 years</a>. </p>
<p>Blacks received just 6% of all <a href="http://www.huffingtonpost.com/2011/10/24/stem-education-and-jobs-d_n_1028998.html">STEM bachelor’s degrees</a> and less than half of those went to black males. Overall blacks received <a href="http://nces.ed.gov/pubs2010/2010015.pdf">4% of master’s degrees, and 2% of PhDs in STEM</a>, despite constituting 12% of the US population. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/79829/original/image-20150429-6250-13d61j3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/79829/original/image-20150429-6250-13d61j3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/79829/original/image-20150429-6250-13d61j3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/79829/original/image-20150429-6250-13d61j3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/79829/original/image-20150429-6250-13d61j3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/79829/original/image-20150429-6250-13d61j3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/79829/original/image-20150429-6250-13d61j3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Black kids face many challenges related to schooling.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/cat.mhtml?lang=en&language=en&ref_site=photo&search_source=search_form&version=llv1&anyorall=all&safesearch=1&use_local_boost=1&search_tracking_id=OUgCl0HU1Q9CkyFOG1ECzg&searchterm=black%20boys%20school&show_color_wheel=1&orient=&commercial_ok=&media_type=images&search_cat=&searchtermx=&photographer_name=&people_gender=&people_age=&people_ethnicity=&people_number=&color=&page=1&inline=154179290">Boy image via www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>When it comes to academic success, young black students face many other challenges that are only made worse by the negative messaging. </p>
<p>There are societal messages that equate black maleness with criminality, with teachers often being afraid of their black male students.</p>
<p>Often enough, as my own <a href="http://uex.sagepub.com/content/49/4/363.short">research </a> shows, unequal access to treatment results in <a href="http://www.sciencedirect.com/science/article/pii/S0277953613003778%20and%20%20http://isw.sagepub.com/content/52/4/459.short">poorer health</a> outcomes for black kids.</p>
<p>The early academic years for these students are riddled with long-term (two months or longer) illnesses that negatively impact their schooling and result in attending at least one summer school term. </p>
<p>Some of <a href="http://aer.sagepub.com/content/49/3/487.full">these students</a> also <a href="http://uex.sagepub.com/content/49/4/363">change schools</a> <a href="http://books.google.com/books?hl=en&lr=&id=mF_me7HYyHcC&oi=fnd&pg=PA3&dq=Whither+Opportunity%3F:+Rising+Inequality,+Schools,+and+Children%27s+Life+Chances&ots=wsca4NG2s6&sig=ISm6f11uBDoLUy6p8p8eWLjm6y4#v=onepage&q=Whither%20Opportunity%3F%3A%20Rising%20Inequality%2C%20Schools%2C%20and%20Children%27s%20Life%20Chances&f=false">quite often</a>. </p>
<p>DeAndre, for example, has a higher rate of school transfer; his current school is his third high school in three years. This lack of continuity for high achieving black male students can lead to additional pressures to prove their intellectual abilities in mathematics to an unwelcoming or skeptical school culture.</p>
<p>Fighting racial stereotypes can also <a href="http://link.springer.com/article/10.1007/s11256-013-0265-2#page-1">wear them down.</a> DeAndre is weary of racial stereotypes in general and stereotypes about black males in particular.</p>
<p>DeAndre’s coarse behavior during his school commute is actually performed to repel or deflect potential violence via <a href="http://link.springer.com/article/10.1007/s11256-013-0265-2#page-1">aggressive posturing</a>, as evident in his “swagger.” In reality, he hasn’t been in any “real” fight since second grade and is filled with trepidation every time he walks home from school. </p>
<h2>Such few options</h2>
<p>Young black students also work toward what is called “performing whiteness.” This in their words means: talking ultra proper English while enunciating every syllable, dressing preppy, not talking about their families, pretending to go on vacations, not telling too many jokes and proving to their white female teachers that they are not to be feared but to be loved and nurtured. </p>
<p>The result is that their intrinsic motivation for learning mathematics and steadfast internal drive get constantly eroded by a host of structural and environmental challenges.</p>
<p>In addition to all these above challenges, they are often at schools that do not offer enough academic opportunities to support their interests. DeAndre’s school does not offer AP classes that would position him more favorably for a STEM college major. </p>
<p>Another problem that black kids face is an absence of role models. The successful black role models that students like DeAndre are exposed to are mostly athletes and rappers. DeAndre does not want to be an athlete or a rapper. </p>
<p>Even so, the likelihood of DeAndre going on to pursue STEM remains frail. </p>
<p>Instead DeAndre has chosen to be a social worker. Through this justice-orientated work, DeAndre wants to address the social and racial inequities in his neighborhood. We don’t know if he will use STEM in the future or not.</p>
<p>If DeAndre has managed to come this far, it is thanks to the support he has received from family members. DeAndre has fond memories of playing dominoes with his grandfather and mathematically complicated card games with his aunts. </p>
<p>His first mathematics teacher was his father. Today, DeAndre is like a human calculator, spitting out complicated number algorithms. </p>
<h2>Diversity vital to STEM</h2>
<p>As we work to minimize the fragility factors affecting youth like DeAndre, we often overlook what protects DeAndre’s STEM and academic identity. The socialization in mathematics that does happen in many black households remains unappreciated by schools as it does by the predominantly white social structures. </p>
<p>My experience of investigating lives, such as those of DeAndre has convinced me of the need for rigorous research that contributes to a more accurate and nuanced portrayal of black males in STEM. </p>
<p>The vitality of United States will be derived in large part from fostering the STEM identities of young men like DeAndre who reside within our urban communities. Their participation is important for innovation – and for a more equitable society. </p>
<p>Our DeAndres should not see a conflict between pursuing a STEM college trajectories and an unyielding sense of responsibility for the improvement of their home communities.</p><img src="https://counter.theconversation.com/content/40360/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ebony O McGee received funding for the research from the National Academy of Education and the Spencer Foundation.</span></em></p>Black male kids who start out by excelling in STEM gradually lose interest due to low teacher expectations and racial stereotyping. The result? Blacks hold only 6% of all STEM jobs.Ebony O. McGee, Assistant Professor of Education, Diversity and Urban Schooling, Vanderbilt UniversityLicensed as Creative Commons – attribution, no derivatives.