For these reasons, the most effective way to lower long-term care costs, and to delay or prevent nursing-home placement, is through home and community based services (HCBS). In-home services such as home health and personal care cost roughly half of the $230 average per day for a skilled nursing facility in the United States. Community-based services, such as adult day care, cost one-quarter of the expenses for nursing home care. For many older Nebraskans, HCBS are already available, particularly for those in metropolitan areas who can afford to pay for services out-of-pocket. However, the affordability and the availability of private-sector HCBS providers for low-income and/or rural elders is limited. The best option for lowering long-term-care costs is to expand lower-cost HCBS in the public sector. This includes working in continued partnership with Area Agencies on Aging, which receive federal funding under the Older Americans Act to provide services such as nutrition, transportation and care management.
The additions to the present edition chiefly consist of some further documents and inferences relating to the state of the population in those countries, in which fresh enumerations, and registers of births, deaths and marriages, have appeared since the publication of my last edition in 1817. They refer principally to England, France, Sweden, Russia, Prussia, and America, and will be found in the chapters which treat of the population of these countries. In the chapter on the Fruitfulness of Marriages an additional table has been given, (vol. i. p. 498.) which, from the per centage increase of population in the interval between those decennial enumerations which are now taking place in some countries, shews the period of their doubling, or the rate at which they are increasing. At the end of the Appendix my reasons for not replying to the late publication of Mr. Godwin are shortly stated. In other parts of the work some inconsiderable alterations and corrections have been made which it is unnecessary to specify; and a few notes have been added, the principal of which is one on the variations in the price of corn in Holland under a free trade, and the error of supposing that the scarcity of one country is generally counterbalanced by the plenty of some other.—Vol. ii. p. 207.
In every country some of these checks are, with more or less force, in constant operation; yet, notwithstanding their general prevalence, there are few states in which there is not a constant effort in the population to increase beyond the means of subsistence. This constant effort as constantly tends to subject the lower classes of society to distress, and to prevent any great permanent melioration of their condition.
These effects, in the present state of society, seem to be produced in the following manner. We will suppose the means of subsistence in any country just equal to the easy support of its inhabitants. The constant effort towards population, which is found to act even in the most vicious societies, increases the number of people before the means of subsistence are increased. The food, therefore, which before supported eleven millions, must now be divided among eleven millions and a half. The poor consequently must live much worse, and many of them be reduced to severe distress. The number of labourers also being above the proportion of work in the market, the price of labour must tend to fall, while the price of provisions would at the same time tend to rise. The labourer therefore must do more work, to earn the same as he did before. During this season of distress, the discouragements to marriage and the difficulty of rearing a family are so great, that the progress of population is retarded. In the mean time, the cheapness, of labour, the plenty of labourers, and the necessity of an increased industry among them, encourage cultivators to employ more labour upon their land, to turn up fresh soil, and to manure and improve more completely what is already in tillage, till ultimately the means of subsistence may become in the same proportion to the population, as at the period from which we set out. The situation of the labourer being then again tolerably comfortable, the restraints to population are in some degree loosened; and, after a short period, the same retrograde and progressive movements, with respect to happiness, are repeated.
The sum of all these preventive and positive checks, taken together, forms the immediate check to population; and it is evident that, in every country where the whole of the procreative power cannot be called into action, the preventive and the positive checks must vary inversely as each other; that is, in countries either naturally unhealthy, or subject to a great mortality, from whatever cause it may arise, the preventive check will prevail very little. In those countries, on the contrary, which are naturally healthy, and where the preventive check is found to prevail with considerable force, the positive check will prevail very little, or the mortality be very small.
The advancement of populations is measured using the demographic transition theory which consists of four main phases, with unique characteristics that countries are grouped within.
On examining these obstacles to the increase of population which I have classed under the heads of preventive and positive checks, it will appear that they are all resolvable into moral restraint, vice, and misery.
Rise in human population can cause problems such as pollution and congestion; these might be resolved or worsened by technological and economic changes....
The positive checks to population are extremely various, and include every cause, whether arising from vice or misery, which in any degree contributes to shorten the natural duration of human life. Under this head, therefore, may be enumerated all unwholesome occupations, severe labour and exposure to the seasons, extreme poverty, bad nursing of children, great towns, excesses of all kinds, the whole train of common diseases and epidemics, wars, plague, and famine.
Edwards is a world-renowned biologist who led the fight in the 1960s to counter the propaganda program waged by environmentalists and population-control advocates to ban further use of DDT.
Another far more effective method of reducing the world population was devised in the early 1960s by a group of environmentalists and population-control adherents.
If this restraint do not produce vice, it is undoubtedly the least evil that can arise from the principle of population. Considered as a restraint on a strong natural inclination, it must be allowed to produce a certain degree of temporary unhappiness; but evidently slight, compared with the evils which result from any of the other checks to population; and merely of the same nature as many other sacrifices of temporary to permanent gratification, which it is the business of a moral agent continually to make.
Das Bagai’s death marked the beginning of a gradual shift in both public opinion and official policy on denaturalization. In 1927, the Supreme Court refused to hear a case against a naturalized Indian man, thereby sending a message to the lower courts to stop revoking citizenship on the basis of race. By then, it was clear that, as a practical matter, no good would come of judicial wrangling over whiteness, and also that attempting to maintain a white population through naturalization policy was a losing battle. Moreover, immigration laws were rapidly becoming ideologically untenable as well. At the start of the Second World War, the United States was the only developed nation other than Germany to explicitly restrict citizenship on the basis of race—a common ground that became increasingly uncomfortable as Nazi atrocities came to light. Midway through the war, Congress repealed the Chinese exclusion laws. Immediately afterward, it lifted all race-based citizenship requirements.
A faithful history, including such particulars, would tend greatly to elucidate the manner in which the constant check upon population acts; and would probable prove the existence of the retrograde and progressive movements that have been mentioned; though the times of their vibration must necessarily be rendered irregular from the operation of many interrupting causes; such as, the introduction or failure of certain manufactures; a greater or less prevalent spirit of agricultural enterprise; years of plenty, or years of scarcity; wars, sickly seasons, poor-laws, emigrations and other causes of a similar nature.