The last half-century in Southeast Asia was characterized by rapid population change.
Family size is less than half of its 1970 values, the mean age at death has nearly doubled. In
Chapter X of this volume, Jones lays out the dramatic shifts in mortality and fertility that
brought on these changes. For most populations in the region, these transitions were
unprecedented in pace.
In this chapter, we argue that the diversity of population trends within countries in
Southeast Asia presents a new set of challenges for continued growth and policy
development. In 2005, infant mortality was 18 per thousand in Vientiane and 122 per
thousand in Sekong, Lao PDR (GSO 2005). 20% of young children in Jakarta are overweight
or obese while more than a third of children in the Eastern Indonesian islands—and nearly
half in Nusa Tenggara Timur—are stunted (USAID 2010). One in 25 people in the Central
Highlands of the Philippines are elderly; 1 in 10 are elderly in the Red River Delta. Future
policymakers will need to navigate the dual burden of incentivizing investments in children
in impoverished areas, while facilitating transfers to the elderly in wealthier, aging, urban
and peri-urban centers. Agricultural policy, including food production, pricing, and
distribution will need to address the needs of a population that is simultaneously
malnourished and overfed. Health services will need to address a coterminous rise in rates
of liver, cervical, and breast cancer alongside the emergence of drug-resistant tuberculosis.
In several countries, policy related to harnessing the resources of highly-educated
emigrants will now need to functionally integrate low-skilled immigrants as well.