Downloaded by guest on September 24, 2021 PNAS a Aassve Arnstein countries high- income in births and the pandemic between COVID-19 relationship the of assessment Early COVID-19 par- observed. Spain with however, ( (−9.1%), considered, Portugal Italy countries Europe: and 22 predicted southern (−8.4%), the that in of declines beyond out strong rates 7 ticularly birth in trends crude past in by drop accompanied significant been a countries, has pandemic high-income by The of States. selection United a the uses from including report brief statistics Evidence This vital scarce. decline. been on far the data fertility so has that about data birth suggested actual bring 2021) from have 26, will March scholars review pandemic for pandemics, (received COVID-19 2021 past 29, June on approved and Drawing MA, Cambridge, University, Harvard Waters, C. Mary by Edited 14853 NY Ithaca, University, Kingdom; Universit Sciences, Political and Social ra eeso f20–09adcmaal ota fthe of that to comparable and (13). flu 2008–2009 Spanish might of births Recession US between Great monthly that, 2021, by suggest dropped February aggregate They have and in States. 2020 United changes the November predict in dur- to searches rates Google pandemic fertility on COVID-19 data use plans the (13) their abandoned ing al. planning or et delay those Wilde to of (12). decided Spain, 2020 entirely 73% in France, that child a indicate Germany, have first to Kingdom, in the on United outbreak of data the COVID-19 stage Survey and early the births. the on of effects during wave adverse collected to intentions, point fertility sub- HICs a (11). from of home COVID-19 of the set impact within the childcare of to sup- assessments return Preliminary family immediate lacking the the as beyond or such port and cause, they above that effects disruption increase economic independent that have events may catastrophic mortality aftermath, declines immediate fertility their modest show while in crises vastly Second, economic are (HICs). modern control, of countries studies fertility high-income develop- and in socioeconomic levels today fertility as estimates different it, use, First, with limited reasons. and, of ment, two are flu for Spanish speculate, from to difficult proved and (9), Lanka Sri Indonesia (8), (4), compa- Norway India (10). in (7), world, Taiwan Zealand (3), 1,000 the New Britain swept per (6), in Japan flu 20 (5), recorded Spanish birth to were As 1918 in effects (2). in decline rable drop population a 13% 1,000 a States, per 1919, United 23 pandemic the from A in pandemic influenza rates largest caused, H1N1 The 1918–1919 flu), (1). the (Spanish back levels century, fell last precrisis usu- the below mortality mo, of to once 12 or to surpluses to mo conception either 9 by within adverse troughs to followed birth due ally to peaks led mortality shocks era, external Malthusian that the crises pop- fertility in Throughout human and recurred mortality of births. combined driver the key In and a change: been ulation conceptions have pandemics fact, affect extend in pandemics history, to of deaths implications population beyond the that suggests O al .DneaCnr o eerho oilDnmc n ulcPlc,Universit Policy, Public and Dynamics Social on Research for Centre Dondena F. Carlo htcnw xetfo h OI-9pnei?I has It pandemic? COVID-19 the from expect we can What eya n h OI-9pnei a asdoe 3 over caused wisdom demographic has Received pandemic worldwide. COVID-19 deaths the million on, year ne 01Vl 1 o 6e2105709118 36 No. 118 Vol. 2021 d | eateto aaeetadTcnlg,Universit Technology, and Management of Department fertility | 5— eln uhlre hnta fthe of that than larger much decline ∼15%—a a,b,1 pandemics Nicol , .%.Sbtnilhtrgniisare, heterogeneities Substantial −6.6%). | it rates birth Cavalli o ` omril ug ocn,216Mln Italy; Milan, 20136 Bocconi, Luigi Commerciale a ` | b,c aybust baby eii Mencarini Letizia , omril ug ocn,216Mln tl;and Italy; Milan, 20136 Bocconi, Luigi Commerciale a ` a,d ulse uut3,2021. 30, August Published 1 oeiaie ies . C BY-NC-ND) (CC 4.0 NoDerivatives License distributed under is article access open S.P.This and interest.y paper. competing L.M., y the no S.S. N.C., wrote declare S.S. authors and tools; and The S.P., S.P., analytic L.M., L.M., new N.C., N.C., A.A., contributed and A.A., S.P. data; analyzed research; and designed L.M. research; N.C. performed and A.A. contributions: Author rnso B eln,die,i at ymdfiain nage in modifications by part, secular to in due driven, be structure. seasonality. decline, might to CBR births robust of in trends estimates decline returns measured apart the Com- Clearly, y 2019. of 1 and months same CBRs November the a paring to in find relative we CBRs in States in March), decline and 11.2% United 7.1% February to of the (conceptions Austria 2020 For December in Spain. 5.2% and from Portugal range Netherlands decreases The significant countries and all see Germany, for 1; Finland, (Table CBRs Denmark, in for difference pan- except negative the a during and suggests in before mean (CBRs) starting demic rates the is, birth of that crude comparison monthly later, year-to-year for mo simple 9 A effects 2020. observe November to expect 2020, thus emergency. February health We the public in declared international (WHO) an started outbreak Organization coronavirus Health having World as the after pandemic days the define We Results housing, childcare, for market. labor implications the policy and dynamics. have population likewise, change will, our shape It pandemics to how likely is of births with understanding association of its pandemics assessing past, to total the compared the profile of epidemiological (34%) different 19’s 37% available worldwide. about (deaths) recent cases for most COVID-19 com- accounting the reported HICs, a paper, 22 COVID-19 this offering for in between of data compile, relationship aim we the births, the on and With view year. early same previous the prehensive with the compared (14). when Novem- of 2021, in 2020 January month 5.1% rate in of from the 8.9% average, to that end 2020 on find ber (15) increased, the al. births et in at Sobotka decline countries, decline of 17 of of 2019, set to rate a compared Across 2020 accelerating for computed an was with births States, in United drop the 3.8% In a claims. these of assessments empirical early * † owo orsodnemyb drse.Eal [email protected] Email: addressed. be may correspondence whom To ahor nMy2,22.Aalbefrom: Available 2020. 21, May on Dashboard of-novel-coronavirus-(2019-ncov) Available international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak- (2019-nCoV). coronavirus novel of at outbreak the regarding Committee gency aulPlach Samuel , uhr’cmuaini ae ndt eree rmteWOCrnvrs(COVID-19) Coronavirus WHO the from retrieved data on based is computation Authors’ H,Saeeto h eodmeigo h nentoa elhRgltos Emer- Regulations. Health International the of meeting second the on Statement WHO, oa,nwyrlae ia eitainsaitc lo for allow statistics registration vital released newly Today, https://www.who.int/news/item/23-01-2020-statement-on-the-meeting-of-the- omril ug ocn,216Mln Italy; Milan, 20136 Bocconi, Luigi Commerciale a ` c ufil olg,Uiest fOfr,O11FOfr,United Oxford, 1NF OX1 Oxford, of University College, Nuffield Data a o eal nsml eeto) Statistically selection). sample on details for n ehSanders Seth and , https://doi.org/10.1073/pnas.2105709118 . . y raieCmosAttribution-NonCommercial- Commons Creative https://covid19.who.int e eateto cnmc,Cornell Economics, of Department e b ∗ eatetof Department ie COVID- Given . | f3 of 1 †
SOCIAL SCIENCES BRIEF REPORT Table 1. Year-to-year t test comparison for CBRs by country limited number of countries. It should be noted, however, that Prepandemic During pandemic currently available data offer information on the first wave of COVID-19 and thus only a glimpse into the overall decline dur- Mean SD Mean SD Difference ing the pandemic. Our data coverage also provides insights into various stages of the first wave. For some countries, for exam- Austria 9.05 0.20 8.58 0.78 −0.47* ple, we observe a recovery in CBRs in March 2021, referring Belgium 9.79 0.18 9.01 0.78 −0.78*** to conceptions in June 2020 (e.g., France and Spain; Fig. 2). Czechia 9.56 0.25 9.34 0.07 −0.22 Denmark 10.02 0.27 10.15 0.58 0.13 For these countries, June 2020 marked the point when the first Finland 8.09 0.34 8.41 0.60 0.32 wave of the pandemic subsided, and might consequently reflect a rebound following postponement during the very first months France 10.63 0.45 9.91 0.66 −0.72* Germany 8.56 0.16 8.87 0.49 0.30 of the outbreak. Such an upswing is not observed for the United States, where, however, the most recent available data point is Hungary 9.27 0.56 9.15 0.30 −0.11 December 2020 (conceptions of March). One piece of evidence Iceland 11.98 0.23 11.67 0.99 −0.31 suggesting the beginning of a fertility decline comes from Wilde Israel 21.50 0.45 20.15 0.34 −1.35** et al. (13). They estimate fertility in the United States falling by Italy 6.92 0.19 6.17 0.15 −0.75*** 15% between November 2020 and February 2021, with an accel- Japan 6.60 . 6.33 . (−0.27) Netherlands 9.41 0.33 9.66 0.45 0.25 eration in fertility decline over this period. Thus, given currently available data, we cannot be certain about the continued path Norway 8.52 0.59 8.26 0.26 −0.26 of CBR trends, although, with two additional pandemic waves in Portugal 8.18 0.51 7.26 0.61 −0.92* the fall of 2020 and winter 2021, it is likely that our current esti- South Korea 5.53 0.54 5.04 0.57 −0.49 mates represent lower bounds for the overall declines during the Singapore 6.67 0.46 6.24 0.68 −0.43 pandemic. Slovenia 8.52 0.53 8.27 0.54 −0.24 When assessing changes over the pandemic, we also find Spain 7.40 0.34 6.57 0.62 −0.83** positive, albeit not significant, coefficients for 9 out of the 22 Sweden 10.67 0.82 10.53 0.96 −0.13 sample countries. These are Slovenia, South Korea, the Nordic Switzerland 9.28 0.37 8.84 0.56 −0.44 European countries (Norway, Denmark, Finland, and Sweden), United States 11.07 0.28 10.27 0.09 −0.79* Total 9.27 2.86 8.93 2.77 −0.35 Germany, The Netherlands, and Switzerland. Several factors might explain the resilience of these countries’ CBRs, including Pandemic data include CBRs from November 2020 to March 2021 for country-specific trends. This appears to be the case, for instance, Denmark, Finland, France, Hungary, The Netherlands, Singapore, Slovenia, for Finland, whose CBRs had been recuperating since 2019, after Spain, and Sweden; to February 2021 for Germany, Portugal, South Korea, a multiyear decline; increases in 2020–2021 came in the con- and Switzerland; to January 2021 for Belgium, Israel, and Italy; to Decem- ber 2020 for Austria, the Czech Republic, Iceland, Norway, and the United text of limited pandemic impact (Fig. 2). For some countries, States; and to November 2020 for Japan. Prepandemic data include CBRs for such as Switzerland and The Netherlands, we observe rebounds corresponding months 1 y before the pandemic. in CBRs even in the absence of pandemic-induced declines. *P < 0.10; **P < 0.05; ***P < 0.01. When compared to the large fall in southern Europe, the rel- ative stability of CBRs in northern Europe points to the role of policies in support of families and employment in reducing To address these potential confounders, in Fig. 1, we report any impact on births. These factors are likely to affect CBRs in coefficient from a set of within-country ordinary least squares the subsequent pandemic waves. Future studies should be under- (OLS) models, where we regress CBRs from 2016 to 2021 on taken as additional data become available, in order to assess a dummy which takes a value of one starting November 2020. the full population implications of the pandemic, the potentially These models include month fixed effects and account for exist- ing trends in CBRs, therefore partly controlling for the evolution of age structure as well (see Model for further details). Once these factors are taken into account, we find negative coefficients Hungary for 13 out of 22 countries, significant at the 5% level in seven Italy Spain cases: Hungary, Italy, Spain, Portugal, Belgium, Austria, and Sin- Portugal gapore. The coefficient for the United States hints at a decline Belgium there as well, with a point estimate only just insignificant at the Austria 5% level (β = −0.240; 95% CI: −0.483 to 0.002). The largest Singapore declines were recorded in Hungary, with a 0.79-point reduction France in CBRs (−8.5% compared to the same period 1 y before); in United States Italy (−0.63 points or −9.1%); in Spain (−0.62 points or −8.4%); Israel and in Portugal (−0.54 points or 6.6%). The remaining nine Japan countries present positive coefficients, but their CIs overlap the Czech, Rep. Slovenia zero line. Norway Denmark Discussion South Korea In this brief report, we present an early assessment of the rela- Finland tionship between the COVID-19 pandemic and births for a set Sweden of 22 HICs. Descriptive evidence points to a negative effect of Germany the pandemic on CBRs, which are found to fall, in absolute Netherlands Switzerland terms, in 18 out of 22 countries in our sample. When model- ing confounding factors, including seasonality and longer-term -1 -.5 0 .5 1 trends, substantial heterogeneities arose, with only seven coun- Fig. 1. Changes in CBRs by country. Shown are point estimates and 95% tries showing a significant decline in CBRs beyond that predicted CIs for within-country models. For illustrative purposes, Iceland (β = −0.61) by past trends. This might suggest that declines appear in a was excluded due to large CIs (−2.23, 1.01).
2 of 3 | PNAS Aassve et al. https://doi.org/10.1073/pnas.2105709118 Early assessment of the relationship between the COVID-19 pandemic and births in high-income countries Downloaded by guest on September 24, 2021 Downloaded by guest on September 24, 2021 al seseto h eainhpbtenteCVD1 admcadbrh nhigh-income in births and pandemic COVID-19 the between countries relationship the of assessment Early al. et Aassve nexus various the the to relation and pandemic. in COVID-19 interventions, effects the of long-run waves policy and short- of model: between OLS impact the on trends moderating based Time being estimated 2016–2019. month are in respective lines) month the red respective in and CBRRatio the blue CBR for light the mean (fitted to 2016– the in refers to month line respective 2020). equal (November the black births for for dashed cutoff mean pandemic the The the is to line vertical ratio red The a 2019. as CBRs are Shown 2. Fig. .N isn .Tre,M .Bkr 0 er g n11:NwZaadsbirth de Zealand’s Baby-boom du New responsable est-elle 1919: 1918 de in Espagnole Grippe ago La Mamelund, years S.-E. 100 8. Baker, G. M. in Turner, deficit birth N. subsequent Wilson, and N. pandemic influenza 7. 1918 The Yu, Indonesia. Y.-L. in Chandra, 1918-19 S. of pandemic 6. influenza the from Mortality Chandra, S. experience. 5. Indian the pandemic health influenza 1918-1919 child The and Mills, infant D. on I. pandemic influenza 4. 1918-1919 the of effects The Reid, A. of sequelae 3. birth Short-term Paneth, N. Mamelund, S.-E. Christensen, J. Chandra, S. in 2. experience” European The perspective: historical a in crises “Mortality Bacci, L. M. 1. .8 .9 1 1.1 .8 .9 1 1.1 .8 .9 1 1.1 .8 .9 1 1.1 1/16 1/16 1/16 1/16 90e ovg?L a ’npy etr[nFrench]. [in neuter pays d’un cas Le Norvege? en 1920 pandemic. influenza an with (2019). associated shock reduction Japan. Stud. Rev. Hist. Derbyshire. in analysis. State-level States: United the in Epidemiol. pandemic influenza 1918-1920 the (Oxford Eds. Paniccia, R. Cornia, 38–58. pp. A. 2000), G. Press, Economies, University Transitional in Crisis Mortality The 8–9 (2013). 185–193 67, 1/17 1/17 1/17 1/17 Bsrltv ote21–09aeaefrslce countries. selected for average 2016–2019 the to relative CBRs eorpi Res. Demographic t = –0(1986). 1–40 23, 5529 (2018). 2585–2595 187, β Switzerland Pandemic 1/18 1/18 1/18 1/18 e.Hist. Med. Portugal Finland Italy 1/19 1/19 1/19 1/19 t 95 (2005). 29–54 49, 1–2 (2015). 313–326 33, + 1/20 1/20 1/20 1/20 γ 1 Time 1/21 1/21 1/21 1/21 t + γ 2 Time .8 .9 1 1.1 .8 .9 1 1.1 .8 .9 1 1.1 .8 .9 1 1.1 1/16 1/16 1/16 1/16 t 2 + 1/17 1/17 1/17 1/17 γ ouainF Population 3 Time UnitedStates Netherlands .Z e.J. Med. Z. N. 1/18 1/18 1/18 1/18 France t 3 Spain + 1/19 1/19 1/19 1/19 6 (2004). 269 59, t ninEo.Soc. Econ. Indian . 1/20 1/20 1/20 1/20 57–62 132, Popul. m J. Am. 1/21 1/21 1/21 1/21 4 .N oe,Bb ut aln etlt nU onisi soitdwith associated is counties US in Sobotka fertility T. Falling 15. What bust: fertility: US Baby of Cohen, future the N. P. and 14. COVID-19 Lohmann, Italy, S. in Chen, plans W. fertility on Wilde, COVID-19 J. of 13. impact The Rosina, A. Arpino, and B. pandemic COVID-19 Luppi, The F. Bacci, Taiwan. Livi 12. M. in Plach, S. pandemic Mencarini, L. influenza Cavalli, 1918 N. Aassve, the A. and 11. decline Fertility Yu, Y.-L. Chandra, S. 10. ahcuty eetmt h olwn model: following the estimate we country, P each Model. up available data birth and to 2020. November population according least both group, at had high-income to that the and follows: in Bank, to World included as belong the only that computed We countries were 12. sample year 1,000* our Population)* per Births/MidYear population Live 1,000 (Monthly at per available CBRs Popu- Revision), Monthly (UN) (2019 Nations births Prospects United live Population http://data.un.org/Data.aspx?q=population&d=PopDiv&f=variableID%3a12. the (Finland, monthly World (min: from mid-March on Division’s 0.37% estimates lation information of until population update matched compiled for midyear average We updates we with an +1.1%). observed data for we max: Sweden), the period, updated. −0.36%; and for collection marginally Spain, data Italy, be countries our France, for to 12 of counts likely of mo birth are 2 5 live and we last countries, provisional issues, the most are In quality For 2021 and data (15). and Croatia, sample For 2020 Lithuania), our and there. Latvia, from account (Estonia, Singapore Romania countries into for February Baltic dataset and taken the revisions 2021 excluded our being (January data Finland with parallel, not and 2020) theirs, 2021) in December from to collection 2020 and slightly (January data 2021 only 17, similar differs May now a on at a implemented retrieved for available Having were sources These publicly national countries. to from are of births 2015 live which number April Database, on select Fertility from statistics Human term) the high-quality from to compiles retrieved were (carried These 2020. conceptions June to corresponds which Data. Methods and Materials 1 01 hr eso fti ae a presented. was paper this of version and a COVID-19 where on and 2021, Meeting model; 10−11, Expert our May UN of of the identification Fertility in the participants into and insights organizers the for the estimates; on Miller UN information D. demographic of providing case; revision for Finnish the Jalovaara M. on for and information Demography reviewers Rotkirch for anonymous A. Zhang two Family 2020 and G. editor comments; Horizon Institutional PNAS their Union’s the thank Programme, European We 694145. Innovation the Grant under and funding Research for Council Research ACKNOWLEDGMENTS. (https://www.humanfertility.org/cgi-bin/stff.php). Availability. of number Data the over when births as of results same number the CBR. the qualitatively, the fer- yields, of using general age, the ratio reproductive the the with of using is, women estimated model that the are rate, of tility SEs pandemic. Estimation Heteroscedasticity-robust estimator. the Huber−White trend. (α during time effects to Coefficients cubic fixed year. prepandemic plots and month from month 1 include CBRs Fig. also in We 2020. change November average from one month−year to in CBR country-specific .S hnr,D aahhnr,Teiflez admco 9811 nSiLanka: Sri in 1918-1919 of pandemic influenza The Sarathchandra, D. Chandra, S. 9. i 3 eut rmtenwSF aasre.Scri Pern](01.https://doi.org/ (2021). [Preprint] SocArXiv series. data 2021). July STFF 23 (Accessed new 10.31235/osf.io/mvy62 the from https:// results (2021). [Preprint] SocArXiv 2021). reductions. July (4 mobility doi.org/10.31235/osf.io/qwxz3 and Economics, prevalence Labor COVID-19 of Institute IZA 13776, Pap. (Discuss. Google? 2020). from learn we can Kingdom. United (2020). the and Spain, France, Germany, fertility. human Biol. Soc. Biodemography propagation. and timing, (2014). cost, demographic Its =1 γ euemnhylv it aafo aur 06t ac 2021, March to 2016 January from data birth live monthly use We i oass h eainhpbtentepnei n itsin births and pandemic the between relationship the assess To Time t i tal et + α Science, m ,Bb uti h aeo h OI-9pnei?First pandemic? COVID-19 the of wake the in bust Baby ., rvosypbihddt eeue o hswork this for used were data published Previously + t hr h eedn variable, dependent the where , 7–7 (2020). 370–371 369, .. .. n ..akoldeteEuropean the acknowledge S.P. and L.M., A.A., 6–7 (2015). 266–272 61, https://www.humanfertility.org/cgi-bin/stff.php. γ i hsetmt h ier udai,and quadratic, linear, the estimate thus https://doi.org/10.1073/pnas.2105709118 t and , m ,while ), Pandemic nunaOhrResp. Other Influenza β eorpi Res. Demographic ofcet,ta s the is, that coefficients, Time CBR sadmyequal dummy a is t t = ersnsthe represents PNAS β CBR Pandemic 1399–1412 43, t 267–273 8, sthe is , | f3 of 3 t +
SOCIAL SCIENCES BRIEF REPORT