Health and demographic change | AQA A-Level Sociology
Updated: Aug 31
For Specification 7192
AQA A-Level Sociology | Free Revision Notes
Estimated study time: 80 minutes
Health and demographic change A-Level Sociology revision examines two aspects of development identified directly in the AQA specification. Health can be both an indicator and outcome of development, while development may change birth rates, death rates, life expectancy, population structure and migration. These processes can also affect development in return. This lesson builds on employment and education [Employment and education] and global inequality [Global inequality], while preparing for gender and development [Gender and development].
Learning Objectives 🎯
By the end of this revision page, you should be able to:
Explain why health is an important aspect and measure of development.
Explain how globalisation may improve or worsen health in developing societies.
Define demographic change and explain the process of demographic transition.
Explain how development may affect birth rates, death rates, fertility, life expectancy, age structure and migration.
Analyse how demographic changes may themselves influence economic development and global inequality.
Evaluate different sociological interpretations of the relationships between health, population change and development.
Revision Notes 📚
Health and demographic change A-Level Sociology revision: the core relationship
The AQA specification explicitly identifies:
health
demographic change
as aspects of development.
These two areas are closely connected.
Improved development may contribute to better health, while improved health can itself alter the demographic structure of a society.
For example:
development → improved health → falling mortality → increased life expectancy → changing population structure
At the same time:
changing population structure → changes in labour supply, migration and economic activity → effects on development
The relationship is therefore two-way rather than a simple process where development causes demographic change.
Health as an aspect of development
AQA does not require students to define development purely through economic growth.
In 2023, AQA's development question explicitly contrasted traditional economic measures with a wider understanding of development involving changes such as:
health
gender equality
sustainability
Health is therefore important because improvement in people's health can itself be treated as evidence of development.
A society can become more developed in health even where the change is not immediately reflected in economic output.
Economic development versus health development
A narrow definition of development might emphasise:
economic growth
national income
industrialisation
A broader approach also considers:
whether people live longer
whether mortality falls
whether health care becomes more available
whether infectious disease is reduced
whether health inequalities are reduced
AQA's 2023 mark scheme identifies health alongside economic growth, poverty, inequality, education, gender equality and sustainability as appropriate dimensions of development.
This creates an important evaluation point:
Economic growth does not automatically prove that people's health has improved.
Health can be an outcome of development
Development may improve health where greater resources or global connections increase access to:
medicines
healthcare
medical knowledge
immunisation
AQA tested this relationship directly in 2022 through the question:
Outline and explain two ways in which globalisation may affect health in developing countries.
The mark scheme recognised both positive and negative effects, meaning health development should not be treated as automatic.
Globalisation and access to medicines
One possible positive effect is greater availability of medicines and healthcare.
AQA's 2022 mark scheme states that globalisation may make medicines and healthcare more available to people in developing countries.
The development chain is:
globalisation → medicines and healthcare circulate more widely → greater access to treatment → improved health → development
This connects health directly with globalisation, political and economic relationships [Globalisation, political and economic relationships].
Global spread of medical knowledge
AQA also recognises the global spread of medical and healthcare knowledge.
Knowledge can move between societies through increasing global interconnectedness.
The process may be:
global interconnectedness → medical knowledge spreads → health practices and treatment improve → better health outcomes
This shows that globalisation is not only about trade or corporations. It also involves flows of knowledge.
Global immunisation programmes
AQA's 2022 mark scheme identifies the reduction of infectious diseases through global immunisation programmes.
This provides a clear example of global processes potentially improving health.
The analytical chain is:
international health activity → immunisation → infectious disease reduced → mortality may fall → health development
This also demonstrates how health change may lead to demographic change.
International NGOs and health
AQA specifically identifies international NGOs such as Médecins Sans Frontières as organisations that may contribute to improved health.
This links health development with non-governmental organisations [Non-governmental organisations].
NGO involvement may provide:
healthcare
medical expertise
health resources
within developing societies.
The broader sociological point is that health development may be influenced by organisations and relationships operating beyond individual national governments.
Aid and health
AQA also recognises the effects of aid on health.
Aid can potentially provide resources that contribute to healthcare or other improvements.
However, the previous lesson showed that aid itself is contested.
Therefore:
aid → health resources → possible health improvement
does not mean that every form of aid necessarily improves development.
The wider relationship is explored in aid and development [Aid and development].
Trade, debt and health
The 2022 mark scheme also explicitly includes the effects of:
trade
aid
debt
on health.
This reinforces an important sociological principle:
Health outcomes are connected to wider economic and political relationships.
A health question in Global Development is therefore not simply a question about disease or medicine.
It may involve inequalities in economic resources and power.
Health and global inequality
Health can also be used as evidence of global inequality.
If populations in different societies experience different levels of:
life expectancy
mortality
access to healthcare
then global inequalities exist in health as well as income.
AQA's 2023 education mark scheme also recognises global health inequalities as an aspect of wider global inequality.
This means health should be understood as both:
an aspect of development
an aspect of inequality
Globalisation may also worsen health
AQA's 2022 assessment makes clear that globalisation does not have only positive health effects.
The mark scheme identifies:
diseases associated with affluence
more sedentary lifestyles
faster international spread of disease
as possible negative consequences.
The 2022 examiner report similarly notes that many successful students presented one positive and one negative health effect.
Diseases associated with affluence
AQA specifically identifies increases in diseases of affluence such as diabetes.
Globalisation may alter:
diets
consumption
lifestyles
in developing societies.
This can create a more complicated relationship between development and health.
Economic development and global integration may increase material resources while also contributing to lifestyles associated with particular health problems.
Changing diet and lifestyle
The 2022 mark scheme states that globalisation may change lifestyle and diet, affecting health.
The possible chain is:
globalisation → changing patterns of work, consumption or diet → changing health risks
This provides a useful evaluation of the assumption that economic modernisation automatically improves health.
Sedentary lifestyles
AQA also recognises health effects associated with a more sedentary lifestyle as work changes in the globalised economy.
A sedentary lifestyle involves less physical activity.
The broader analytical point is:
economic change → changing forms of work → changing behaviour and lifestyle → possible health consequences
Development can therefore create new health challenges at the same time as reducing older ones.
Global spread of infectious disease
Greater global interconnectedness can also enable diseases to spread rapidly across societies.
AQA's 2022 mark scheme explicitly uses COVID-19 as an example of diseases spreading more quickly around the world.
The analytical chain is:
greater international movement and interconnectedness → infectious disease spreads between societies more rapidly → health risks become increasingly global
This is an important counterpoint to global immunisation and the international spread of medicines.
The same globalisation process can have opposite effects
Globalisation therefore illustrates a major theme of the lesson.
Potential improvement in health | Potential worsening of health |
Medicines become more available. | Diseases can spread internationally more quickly. |
Healthcare knowledge spreads. | Sedentary lifestyles may increase. |
NGOs can provide healthcare. | Diet and consumption changes may create new health risks. |
Immunisation can reduce infectious disease. | Diseases associated with affluence may increase. |
All of these possibilities are explicitly recognised in AQA's 2022 mark scheme.
Avoid assuming health change is always positive
Development may replace one pattern of health problems with another.
For example:
infectious diseases decline
while:
health problems associated with lifestyle change increase
This means a sociological judgement should consider the overall pattern of health change, rather than simply claiming that modernisation improves health.
Health can influence development in return
Health is not only an outcome of development.
AQA's wider development materials connect:
health
education
employment
demographic change
as aspects of development.
This means health can also affect the ability of people to participate in other development processes.
For example, where health improves, this may interact with:
life expectancy
mortality
population structure
The clearest direct link supported by AQA assessment is therefore from health to demographic change.
Health and mortality
Mortality refers to deaths within a population.
AQA's 2020 demographic-change mark scheme identifies falling mortality rates as one change associated with development.
Health improvements may contribute to this change.
The relationship can therefore be expressed as:
development and improved health → falling mortality → demographic change
Health and life expectancy
Life expectancy is the length of life people can expect within a population.
AQA explicitly identifies an increase in life expectancy as a demographic change associated with development.
This makes life expectancy particularly useful because it can be understood as:
evidence of changing health
evidence of demographic change
a wider indicator of development
Health is therefore central to demographic transition
Changes in health and mortality can contribute to wider demographic transformation.
As mortality falls and life expectancy rises, the size and age structure of the population may change.
Later changes in fertility and birth rates may further alter population structure.
AQA captures this overall process through the concept of demographic transition.
What is demographic change?
Demographic change refers to changes in the characteristics and structure of a population.
AQA's assessment materials identify demographic changes involving:
birth rates
death or mortality rates
fertility
family size
life expectancy
age structure
migration
For Global Development, students need to understand both:
how development can produce demographic change
and:
how demographic change can affect development and inequality
Development can lead to demographic change
AQA directly assessed this in 2020:
Outline and explain two ways in which development can lead to demographic changes.
The highest band expected students to explain two developed changes, with examples such as:
demographic transition from high birth and death rates to low birth and death rates
increased migration from rural to urban areas
This gives a clear starting point for the topic.
The demographic transition
The demographic transition describes a shift from:
high birth rates + high death rates
towards:
low birth rates + low death rates
as development occurs.
The concept is valuable because it brings several demographic changes together into one process.
Development may therefore change both:
how many people are being born
how many people are dying
Falling death rates
AQA explicitly includes falling mortality rates as a demographic consequence of development.
Improvements in health provide one important connection.
The process may be:
development → health improvements → mortality falls → demographic structure changes
This may initially increase population growth if birth rates remain relatively high.
Increasing life expectancy
As mortality falls, life expectancy may increase.
AQA explicitly identifies this as a demographic consequence of development.
Longer life expectancy can alter the age structure of a society.
Over time, this may contribute to a greater proportion of older people within the population.
Falling birth rates
AQA also identifies falling birth rates as a demographic change associated with development.
The birth rate concerns the number of births occurring within a population.
As development takes place, the number of births may fall.
This is one part of the movement from high to low birth and death rates within demographic transition.
Lower fertility rates
AQA separately identifies lower fertility rates.
Fertility concerns patterns of childbearing.
The important distinction is that birth rate and fertility are related but should not simply be treated as identical terms.
Both may fall as societies experience demographic transition.
Women having fewer children
AQA gives women having fewer children as one acceptable basic application in the 2020 question.
This contributes to:
lower fertility
smaller family size
changing population growth
It also creates an important link with the next lesson, gender and development [Gender and development].
Smaller family sizes
Smaller family sizes are another change explicitly identified by AQA.
The demographic chain may be:
development → lower fertility → fewer children per family → smaller family sizes
This shows how population-level change can affect household-level patterns.
Changing age structure
Development may also change the age structure of a population.
AQA's 2020 mark scheme specifically identifies:
changing age structure, including an ageing population.
As people live longer and fertility declines, the proportion of the population at different ages can change.
This may create new social and economic consequences.
Ageing populations
An ageing population is one in which older people form a growing proportion of the population.
Within Global Development, the important issue is not simply describing an ageing society.
Instead, students should explain:
how development produces changing age structures
what these changes may mean for further development
This demonstrates the two-way relationship between demographic change and development.
Migration
Migration is another demographic process explicitly identified by AQA.
The 2020 mark scheme recognises increased migration, including movement from rural to urban areas, as one way development can produce demographic change.
More recent AQA material also focuses on emigration from developing countries for employment opportunities.
Migration therefore has both internal and international dimensions.
Rural-to-urban migration
AQA's 2020 mark scheme specifically identifies increased movement from rural to urban areas.
This creates a clear link between demographic change and urbanisation and the environment [Urbanisation and the environment].
The process may be:
development and economic change → employment or opportunities become concentrated in urban areas → rural-to-urban migration → urban population grows
Urbanisation is therefore partly a demographic process.
International migration
AQA's 2025 demographic item focuses on people emigrating from developing countries for employment opportunities.
This connects demographic change directly with employment and education [Employment and education].
Migration can alter:
the population of the country of origin
its labour supply
household incomes
the distribution of skills
relationships between societies
Development causes demographic change, but demographic change also affects development
This two-way relationship is one of the most important ideas to learn.
Direction 1
development → demographic change
Examples:
falling mortality
increasing life expectancy
falling fertility
smaller family sizes
migration
Direction 2
demographic change → development
Examples recognised in AQA's 2025 assessment include:
a young population contributing to economic growth
migrants sending remittances home
skilled emigration limiting economic growth
Young populations
AQA's 2025 item states that many developing societies have populations that are relatively young.
A young population may be interpreted positively if it provides a large potential workforce.
The 2025 mark scheme states that relatively young populations may provide opportunities for economic growth, thereby reducing global inequality.
The development chain is:
young population → large potential workforce → increased economic activity → economic growth → reduced global inequality
The importance of workers
The 2025 examiner report confirms that successful students made this connection explicitly.
Good answers often explained that a young population could provide workers who could help a country develop.
This is a useful reminder that a demographic feature only becomes sociological analysis when the development mechanism is explained.
Do not simply write:
"A young population helps development."
Explain how.
A young population is not automatically beneficial
The AQA mark scheme presents the young-population argument as one possible route to economic growth.
It does not mean that every society with a young population will automatically develop.
The potential benefit depends on whether the population can participate productively in economic activity.
A useful evaluation question is therefore:
Are suitable economic and employment opportunities available for the population?
This connects demographic structure with the previous lesson on employment and education [Employment and education].
Migration and remittances
Migration can also contribute positively to development through remittances.
Remittances are money sent home by migrants working elsewhere.
AQA's 2025 mark scheme states that remittances sent by migrant workers may improve living standards in developing countries, thereby reducing global inequality.
The chain is:
emigration for work → migrant earns income → money sent home → household living standards improve → inequality may narrow
Remittances and development
Remittances demonstrate why emigration does not necessarily mean a complete economic loss to the country of origin.
Even when a worker moves abroad, part of their income may continue to support people at home.
The 2025 examiner report notes that answers using the migration hook were often stronger because students could clearly explain how remittances may reduce poverty in the country of origin.
Migration can therefore reduce global inequality
If earnings from employment in another society are transferred to households in a developing society, living standards may improve.
The potential process is:
international migration → income transfer → reduced poverty → narrower global inequality
However, AQA also recognises an opposing effect.
Skilled emigration
Emigration may involve workers with specific skills.
AQA's 2025 mark scheme states that the emigration of skilled workers can limit opportunities for economic growth and therefore reinforce global inequality.
The process becomes:
skilled worker emigrates → country of origin loses human capital → economic-development opportunities reduced → global inequality reinforced
This directly links demographic change with education.
Skilled migration and education
The previous lesson showed that AQA also recognises developing societies paying to educate professionals who then emigrate.
This creates a particularly strong integrated chain:
developing society invests in education → skilled professional qualifies → professional emigrates → human capital leaves → economic or social development at home may be restricted
This may be especially important where the emigrant is a health professional.
Health professionals connect the whole lesson
Health professionals provide a useful example because they connect:
education
migration
health
demographic change
development
If health professionals emigrate, the demographic change involves migration.
The economic effect involves the loss of skilled labour.
The health effect may involve reduced benefit from the society's investment in training healthcare workers.
This demonstrates how different aspects of development overlap.
Migration has contrasting effects
AQA therefore supports both positive and negative interpretations of emigration.
Possible positive effect | Possible negative effect |
Migrants gain employment abroad. | Country of origin may lose workers. |
Remittances may improve living standards. | Skilled workers may take human capital with them. |
Poverty may fall in households receiving remittances. | Economic growth may be restricted by loss of skills. |
Global inequality may narrow. | Global inequality may be reinforced. |
This is exactly the type of two-sided argument AQA rewards.
Demographic change and global inequality
The 2025 question directly links demographic change with global inequality.
This means demographic change cannot simply be revised as a list of population statistics.
Students need to be able to explain why changes matter socially and economically.
The main AQA examples are:
young population → workers → economic growth → reduced inequality
migration → remittances → improved living standards → reduced inequality
skilled emigration → loss of human capital → restricted growth → inequality reinforced
Demographic change can reduce inequality
An optimistic interpretation emphasises the development opportunities created by population change.
A young workforce may:
participate in economic development
contribute to production
while migration may:
allow workers to find employment
generate remittances
From this perspective, demographic change can support economic development.
Demographic change can reinforce inequality
A more critical interpretation emphasises potential costs.
Skilled migration may:
remove human capital
reduce productive capacity
limit development opportunities
This means demographic change can widen or maintain inequalities even where individual migrants improve their own economic circumstances.
The effect depends on which demographic process is occurring and how it interacts with wider economic structures.
Development and the demographic transition
The 2020 mark scheme presents demographic transition as a major way development changes population patterns.
The broad sequence is:
birth and death rates are relatively high
mortality falls
birth and fertility rates later fall
birth and death rates become relatively low
population structure changes
For AQA purposes, the essential idea is the transition from high birth and death rates to low birth and death rates, rather than memorising a rigid stage model beyond what the mark scheme supports.
Demographic transition is a pattern, not proof of development
A common mistake is to assume that every demographic change automatically demonstrates development.
Instead, the transition should be treated as one relationship between development and population change.
For example:
falling mortality may indicate improved health
increased life expectancy may indicate improvement
an ageing population may create a new demographic structure
But each of these may have different social and economic consequences.
Falling mortality and population growth
Falling mortality means fewer people die.
If birth rates remain high for a period while mortality falls, the population can become younger and grow.
AQA's 2025 item then shows one possible consequence of a young population: a larger potential workforce.
This creates a longer chain:
development → health improves → mortality falls → relatively young population grows → potential workforce expands → further economic development
The relationship can therefore become self-reinforcing.
Falling fertility and ageing
Later reductions in fertility can change age structure again.
AQA recognises:
lower fertility
smaller family sizes
ageing populations
as possible demographic consequences of development.
The broad chain is:
lower fertility + greater life expectancy → age structure changes → larger proportion of older people
This demonstrates that development may eventually create new demographic circumstances rather than simply producing continuous population growth.
Development changes population structure rather than simply population size
This distinction is important.
Demographic change includes more than whether a population is growing or shrinking.
It involves:
age structure
fertility
mortality
migration
life expectancy
family size
Therefore, avoid reducing demographic change to "population growth".
Population growth and development
AQA's wider development mark schemes explicitly recognise population growth as relevant to development debates.
The effect of population growth should not simply be assumed.
A growing young population may create a larger workforce, but the benefits depend on whether:
employment opportunities exist
education and skills are available
economic development can use that labour productively
This provides a useful evaluative connection between demographic change and other aspects of development.
Health and demographic change are interconnected
The two halves of the lesson come together clearly.
Improved health may contribute to:
falling mortality
increasing life expectancy
These demographic changes may then alter:
population size
age structure
labour supply
The process is therefore:
health development → demographic change → new economic and social development opportunities or challenges
Globalisation connects health and demographic change
Globalisation can affect both.
Health
AQA recognises:
medicines
medical knowledge
immunisation
NGOs
lifestyle change
spread of disease
Demography
Globalisation is closely connected with international migration for employment, which AQA directly assessed in 2025.
This means globalisation may simultaneously change:
how people live
how healthy they are
where they live
Health and economic development
A common assumption is that economic development leads to better health.
The source material gives some support for this because development can increase access to medical knowledge, medicines and healthcare.
However, AQA also recognises that economic and lifestyle change may increase:
diseases associated with affluence
sedentary lifestyles
The relationship is therefore not simply:
more wealth = better health
Wider measures of development
Health is especially important when challenging economic definitions of development.
AQA's 2023 mark scheme accepts measures and concepts including:
economic growth
poverty
inequality
health
education
gender equality
sustainability
Human Development Index
well-being
This shows that development is multidimensional.
Health may therefore improve even when industrialisation is limited.
Indeed, AQA's 2025 industrialisation item explicitly states that development in health can be achieved without assuming industrialisation is essential.
Modernisation interpretations
A modernisation interpretation emphasises transformation associated with development.
Applied to this lesson, modernisation can be connected with:
demographic transition
falling mortality
falling fertility
increasing life expectancy
economic and social change
AQA's wider Global Development mark schemes repeatedly recognise modernisation as an explanation of development, while demographic transition is explicitly accepted as a consequence of development.
From this perspective, changing population patterns may be interpreted as part of wider modernisation.
Modernisation and health
Modernisation approaches may also interpret improved:
medicine
healthcare
health knowledge
as part of development.
Globalisation can assist this by spreading these resources internationally.
The positive chain is:
modernisation/globalisation → medical knowledge and healthcare spread → health improves → mortality falls → demographic transition
This provides an integrated explanation of health and demographic change.
Evaluating modernisation
AQA's 2022 health material provides several challenges.
The same global economic and cultural changes associated with modernisation may also produce:
sedentary lifestyles
diseases associated with affluence
faster spread of infectious disease
Therefore, modernisation may change the type of health problems societies experience rather than simply eliminating ill health.
Dependency interpretations
Dependency theory emphasises unequal relationships between societies.
AQA recognises dependency as a major explanation of development and underdevelopment and places health alongside inequality within wider definitions of development.
A dependency interpretation can therefore focus on whether global economic relationships create equal access to the resources needed for health and development.
The 2022 mark scheme's inclusion of trade, aid and debt in relation to health reinforces the importance of economic relationships.
Dependency and health inequalities
From a dependency perspective, health differences between societies may be understood as connected to wider global inequalities rather than simply the absence of modern medicine.
The key questions become:
Which societies have access to health resources?
How do trade, aid and debt affect health?
Does globalisation distribute medical benefits equally?
This challenges explanations that treat health development purely as an internal process.
Dependency and migration
Skilled migration also provides a useful critical perspective.
A developing society may invest in educating or training skilled workers who then move to another society.
AQA explicitly recognises both:
skilled emigration reducing opportunities for economic growth
developing societies losing professionals they have educated
This can reproduce inequality between societies if skilled human capital moves from developing to more economically advantaged destinations.
Optimistic and critical interpretations of migration
Migration therefore illustrates the wider theoretical divide.
Optimistic interpretation
migration → employment → remittances → improved living standards → reduced inequality
Critical interpretation
skilled migration → human capital leaves → development capacity reduced → inequality reinforced
Both are explicitly recognised by AQA.
The strongest answer evaluates the conditions determining which effect is more important.
Demographic change is not inherently good or bad
This is one of the central conclusions of the lesson.
A young population may:
provide workers
increase potential economic growth
but the benefit depends on economic opportunities.
Migration may:
provide employment and remittances
but also:
remove skilled workers.
Longer life expectancy may represent improved health while also producing a changing age structure.
Therefore, demographic change must always be connected to its social and economic consequences.
Health improvements can create new demographic challenges
Improved health can reduce mortality and increase life expectancy.
These are positive indicators of development.
However, they also change the population structure.
This does not make health improvement negative. It means successful development can generate new demographic circumstances that societies then need to manage.
This is why the relationship between development and demography should not be understood as a simple straight line.
Demographic change can become a resource for development
A young population illustrates how population change can become an economic resource.
AQA's 2025 mark scheme directly recognises the possibility that a young population can contribute towards economic growth.
The key condition is whether that potential labour supply can participate in productive economic activity.
This brings together:
demography + employment + education + economic development
Demographic change can also remove resources
Skilled emigration demonstrates the opposite process.
Workers themselves can represent human capital.
If highly skilled workers leave, the country of origin may lose part of the human resource needed for development.
Thus:
population movement can either add economic resources through remittances or remove productive resources through skilled emigration
This is a very strong evaluative contrast.
Health and education
Health is also connected with education.
AQA's 2023 education mark scheme states that lack of education can hold back progress in reducing global health inequalities.
This means:
education → possible health improvement
while:
health improvement → demographic change
Development processes are therefore interconnected.
Health and gender
Health also has an important gender dimension.
AQA's 2024 development item states that development may provide women with better health, while the mark scheme recognises maternal health and mortality among relevant concepts in the gender-development debate.
This prepares directly for gender and development [Gender and development].
Health development should therefore be assessed partly by asking whether improvements are shared equally between social groups.
Health, inequality and power
The AQA core theme of social differentiation, power and stratification can be applied directly.
Health development may be unequal if:
societies have different access to health resources
global economic relationships affect health
some groups gain greater access to healthcare than others
Similarly, demographic changes may distribute opportunities unevenly.
For example, migration may improve an individual worker's life chances while reducing the skilled labour available in the country of origin.
Health and demographic change as evidence of development
A society experiencing:
lower mortality
longer life expectancy
improved access to health care
may show important forms of development even without dramatic industrial growth.
AQA's 2025 industrialisation item explicitly recognises that development in health can occur without industrialisation.
This provides a strong criticism of development theories that equate modernisation only with economic transformation.
Demographic change as an outcome of successful development
Some demographic changes may indicate that earlier development has taken place.
For example:
falling mortality + increasing life expectancy
may indicate improved health.
lower fertility + smaller family sizes
may reflect wider demographic transition.
However, the changes should be interpreted carefully rather than treated as automatic measures of success.
Demographic change as a cause of future development
Demographic conditions also shape what happens next.
AQA's 2025 assessment demonstrates this clearly:
young populations may provide workers
migration may generate remittances
skilled migration may reduce human capital
Demography therefore influences the possibilities for future development.
The demographic-development feedback loop
A useful overall model is:
development → improved health → lower mortality and longer life expectancy → demographic change → new workforce, migration and age-structure patterns → further effects on development
This loop can produce both:
opportunities
constraints
depending on the circumstances.
Do not treat population size as the whole issue
Demography is much broader than "too many people" or "population growth".
AQA requires and assesses a range of changes including:
birth rates
death rates
fertility
life expectancy
age structure
migration
A strong answer identifies the specific demographic process before explaining its effect.
Do not assume causation runs one way
Two statements can both be true:
development causes demographic change
and:
demographic change affects development
AQA has directly assessed both directions:
2020: development → demographic changes
2025: demographic changes → global inequality
Students need to be able to reverse the chain depending on the exact wording of the question.
Comparing the two directions
Development affects demography | Demography affects development |
Mortality may fall. | Young populations may provide workers. |
Life expectancy may rise. | Remittances may improve living standards. |
Birth rates may fall. | Skilled emigration may reduce human capital. |
Fertility may fall. | Migration changes labour supply. |
Family size may decrease. | Population structure affects economic opportunities. |
Population may age. | Demographic patterns may alter global inequality. |
Migration may increase. | Migration can redistribute income and skills. |
Comparing health outcomes of globalisation
Positive interpretation | Critical interpretation |
Medicines become more widely available. | New lifestyle-related diseases may increase. |
Health knowledge spreads internationally. | Sedentary lifestyles may increase. |
International NGOs can improve health. | Infectious diseases may spread globally more rapidly. |
Immunisation can reduce infectious disease. | Health gains may not be evenly distributed. |
Globalisation may improve access to healthcare. | Trade, aid and debt can affect health in complex ways. |
Comparing sociological interpretations
Interpretation | View of health and demographic change | Evaluation |
Modernisation | Health improvements and demographic transition may form part of wider transformation towards development. | Globalisation and modernisation can also create new health problems. |
Dependency theory | Health and demographic differences need to be understood through unequal relationships between societies. | Global connections can also spread medicines, knowledge and other health benefits. |
Multidimensional development | Improvements in health are development in their own right, not merely consequences of economic growth. | Economic resources may still be important for supporting health improvements. |
Optimistic demographic interpretation | A young population and migration may create workers, remittances and economic opportunities. | Benefits depend on employment opportunities and which workers migrate. |
Critical demographic interpretation | Skilled migration may remove human capital and reinforce global inequalities. | Migration may simultaneously improve household living standards through remittances. |
Evaluating health as development
A useful framework is to ask:
1. Has health actually improved?
Look at changes such as mortality and life expectancy.
2. Who has benefited?
Health development may be unequal.
3. What caused the improvement?
Consider:
healthcare
medicines
medical knowledge
NGOs
global immunisation
4. Have new health problems emerged?
Consider:
lifestyle change
sedentary work
diseases of affluence
global disease transmission
5. What demographic consequences follow?
Improved health may change mortality, life expectancy and age structure.
Evaluating demographic change
Ask:
1. Which demographic variable has changed?
Avoid writing vaguely about "population".
Identify:
births
deaths
fertility
age structure
migration
2. What caused the change?
Is it linked to development?
3. What are the consequences?
Does it affect:
workers
economic growth
inequality
living standards
human capital?
4. Who benefits?
Remittances and skilled migration may affect different groups differently.
5. What is the direction of causation?
Is the question asking:
development → demographic change
or:
demographic change → development?
Building strong analytical chains
For health:
globalisation → medicines become more available → access to treatment improves → health improves → wider development
For immunisation:
global health programmes → infectious disease reduced → mortality falls → life expectancy may increase → demographic change
For lifestyle:
globalisation → work and lifestyle become more sedentary → health risks change → diseases associated with affluence increase
For demographic transition:
development → falling mortality and fertility → birth and death rates move from high to low → population structure changes
For a young population:
relatively young population → larger workforce → greater productive potential → economic growth → global inequality may narrow
For remittances:
migration for work → earnings abroad → remittances sent home → living standards improve → poverty and global inequality may fall
For skilled emigration:
skilled workers migrate → country loses human capital → economic growth opportunities reduced → global inequality may persist
Turning description into analysis
Weak:
Development increases life expectancy.
Better:
Development may improve health, reducing mortality and increasing life expectancy. This changes the age structure of the population.
Stronger:
However, changing age structures can themselves affect future development, showing that demography is both an outcome of development and a factor influencing what happens next.
Another example: young populations
Weak:
Developing countries have lots of young people.
Better:
A relatively young population can provide a large supply of workers.
Stronger:
If employment opportunities are available, these workers can contribute to production and economic growth, potentially narrowing global inequality. The 2025 examiner report notes that this explicit link was what distinguished stronger answers.
Another example: migration
Weak:
Migration helps development.
Better:
Migrants may send remittances to their country of origin, improving household incomes.
Stronger:
However, if migrants are highly skilled, the country of origin may lose human capital. Migration can therefore reduce inequality through remittances while reinforcing it through the loss of skilled workers.
Exam focus: health
Health was directly tested in Global Development in 2022:
Outline and explain two ways in which globalisation may affect health in developing countries.
This means students should be prepared to explain both:
positive global health effects
negative global health effects
A particularly strong revision pair is:
global immunisation or medicines
versus
lifestyle-related disease or faster disease transmission
Exam focus: demographic change
Demographic change has been tested from both causal directions.
2020
AQA asked how development can lead to demographic changes.
2025
AQA asked how demographic changes may affect global inequality.
This means you should not memorise one fixed answer on demographic transition.
You need to be able to apply demographic knowledge flexibly.
Health, demography and global inequality
The strongest overall understanding connects all three.
Health inequalities between societies may contribute to differences in:
mortality
life expectancy
These demographic differences may then influence:
population structure
labour supply
economic opportunities
Demographic processes such as skilled migration may then reinforce economic and health inequalities between societies.
Development is therefore an interconnected process rather than a collection of separate indicators.
Overall sociological judgement
Health is a major aspect of development because improvement in people's health is important in its own right and can produce demographic consequences through falling mortality and increased life expectancy. Globalisation may contribute positively through medicines, medical knowledge, NGOs and immunisation, but AQA also recognises negative effects such as sedentary lifestyles, diseases associated with affluence and faster international transmission of disease.
Development also produces demographic transition, including falling birth and death rates, lower fertility, longer life expectancy, smaller family sizes, changing age structures and migration.
Crucially, causation works in both directions. Young populations and remittances may contribute to development, while skilled emigration may remove human capital and reinforce global inequality. The strongest conclusion is therefore that health and demographic change are simultaneously indicators, causes and consequences of development, and their significance depends on how the benefits and costs are distributed.
Key Words 🔑
Key word | Student-friendly definition | How it may be used in an exam |
Health | People's physical and wider health outcomes, treated by AQA as an aspect of development. | Evaluate development using outcomes beyond economic growth. |
Demographic change | Change in the size, structure or characteristics of a population. | Introduce changes in birth rates, mortality, fertility, age structure or migration. |
Demographic transition | The movement from relatively high birth and death rates towards relatively low birth and death rates as development occurs. | Explain a major relationship between development and population change. |
Mortality rate | A measure relating to deaths within a population. | Explain how improved health and development may lead to falling mortality. |
Fertility | Patterns of childbearing within a population. | Explain why development may lead to fewer children and smaller families. |
Life expectancy | The length of life people can expect within a population. | Use as evidence of health and demographic development. |
Ageing population | A population in which older people form an increasing proportion. | Explain one consequence of changing fertility, mortality and life expectancy. |
Migration | Movement of people between places or societies. | Analyse rural-to-urban migration, international employment migration and development. |
Remittances | Money migrants send back to people in their country of origin. | Explain how migration may improve living standards and reduce global inequality. |
Human capital | The knowledge and skills available within a population. | Explain why skilled emigration may restrict development in the country of origin. |
Hints from the Examiner Reports 💡
Examiner hint: In the 2022 health question, many successful students deliberately used one positive and one negative effect of globalisation. Positive answers often developed healthcare, inoculations or medicines, while negative answers used international disease transmission or diseases associated with affluence.
Examiner hint: Specific, relevant examples helped strengthen the 2022 health answers. AQA reports that better responses often illustrated their explanation with a particular health problem or incident.
Examiner hint: Keep the focus on health in developing countries. The 2022 mark scheme identifies drift into a general account of globalisation as a feature of weaker responses.
Examiner hint: In the 2025 demographic question, many students knew the information in the item but did not make the final connection to global inequality. This was particularly difficult with the young-population hook.
Examiner hint: For a young population, spell out the entire chain. Strong 2025 responses explained that young people could become workers who contribute to economic development, rather than simply saying that a young population is beneficial.
Examiner hint: The migration hook was often better developed in 2025 because students linked emigrants' remittances directly to reduced poverty in their country of origin.
Examiner hint: Always answer the direction of causation in the question. AQA's 2020 question asked how development causes demographic change, while the 2025 question reversed the relationship and asked how demographic change affects global inequality.
Common Mistakes ⚠️
Mistake: Treating health as only a consequence of economic development
Why this is incorrect: AQA explicitly treats health as an aspect of development in its own right.
How to improve: Explain that improved health can itself represent development, as well as being influenced by economic change.
Mistake: Assuming globalisation always improves health
Why this is incorrect: AQA recognises positive and negative health effects.
How to improve: Balance medicines, healthcare knowledge and immunisation against lifestyle changes and global disease transmission.
Mistake: Assuming modern lifestyles always improve health
Why this is incorrect: AQA recognises sedentary lifestyles and diseases associated with affluence as possible negative effects.
How to improve: Explain how economic and lifestyle changes can produce new health risks alongside improvements.
Mistake: Confusing demographic change with population growth
Why this is incorrect: Demographic change also includes mortality, fertility, life expectancy, age structure and migration.
How to improve: Name the specific demographic variable you are analysing.
Mistake: Defining demographic transition as simply falling population
Why this is incorrect: AQA describes it as a transition from high birth and death rates to low birth and death rates.
How to improve: Use birth and death rates explicitly when explaining the concept.
Mistake: Assuming a young population automatically causes development
Why this is incorrect: The economic benefit depends on whether young people can participate in productive employment.
How to improve: Develop the chain through workers and economic growth.
Mistake: Saying migration is either wholly positive or wholly negative
Why this is incorrect: AQA recognises both remittances and skilled emigration.
How to improve: Compare:
remittances → improved living standards
with:
loss of skilled workers → reduced human capital
Mistake: Forgetting the country of origin
Why this is incorrect: A demographic question about emigration may be asking about its consequences for the society people leave.
How to improve: Ask what happens to income, labour and skills in the country of origin.
Mistake: Describing demographic change without linking it to development
Why this is incorrect: The specification requires demographic change as an aspect of development.
How to improve: Finish every point with an economic or social development consequence.
Mistake: Assuming causation always runs from development to demography
Why this is incorrect: AQA has explicitly tested the reverse relationship.
How to improve: Underline the direction in the question before planning your answer.
Exam-Style Questions ✍️
Question 1
What is meant by demographic transition? (1 mark)
Question 2
Explain one reason why improved health may be regarded as evidence of development. (4 marks)
Question 3
Explain two demographic changes that may occur as a society develops. (6 marks)
Question 4
Outline and explain two ways in which globalisation may affect health in developing societies. (10 marks)
Question 5
Outline and explain two ways in which development may lead to demographic change. (10 marks)
Question 6
Read Item A and answer the question that follows.
Item A
A developing society has experienced improvements in healthcare and falling mortality. People are living longer, while families are having fewer children than previously.
Applying material from Item A, analyse two ways in which health development may contribute to demographic change. (10 marks)
Question 7
Read Item B and answer the question that follows.
Item B
A developing society has a relatively young population. Many people also leave the country to find employment elsewhere. Some migrants send money home, while others have skills that are in short supply in their country of origin.
Applying material from Item B, analyse two ways in which demographic changes may affect development. (10 marks)
Question 8
Read Item C and answer the question that follows.
Item C
Some sociologists see improving health and changing population patterns as signs that societies are developing. Global connections may spread medicines, health knowledge and employment opportunities.
However, globalisation can also spread diseases and lifestyles associated with new health problems. Migration may provide remittances but can also lead to the loss of skilled workers.
Applying material from Item C and your knowledge, evaluate sociological interpretations of the relationship between health, demographic change and development. (20 marks)
Answers and mark scheme
Question 1
Answer: The transition from relatively high birth and death rates to relatively low birth and death rates as development occurs. (1 mark)
Award one mark for an accurate definition.
Question 2
Up to 4 marks for one developed explanation.
A strong answer could explain that development is broader than economic growth. Improvements in health, such as lower mortality or longer life expectancy, show that people's lives have improved and can therefore be treated as development in their own right.
For higher marks, students should connect the health change explicitly to the meaning of development.
Question 3
Award marks for two developed changes.
Possible answers include:
Falling mortality
Development may improve health, resulting in fewer deaths and lower mortality.
Lower fertility
Development may lead women to have fewer children, producing lower fertility and smaller family sizes.
Other relevant answers include:
falling birth rates
increased life expectancy
ageing population
changing age structure
increased migration
Students should explain each change rather than simply list it.
Question 4
A high-level answer should develop two distinct ways.
Possible positive effects include:
Medicines and healthcare
Globalisation can make medicines and healthcare more available in developing societies, potentially improving health.
Medical knowledge and immunisation
Medical knowledge may spread globally and international immunisation programmes may reduce infectious disease.
Possible negative effects include:
Lifestyle change
Globalised patterns of work, diet and consumption may contribute to more sedentary lifestyles and diseases associated with affluence.
Disease transmission
Greater international interconnectedness can enable infectious diseases to spread rapidly between societies.
Other valid material may include:
international NGOs
trade
aid
debt
AQA explicitly recognises these areas.
Question 5
A high-level answer should develop two demographic consequences.
Possible answers include:
Demographic transition
Development may contribute to a transition from relatively high birth and death rates towards lower birth and death rates.
Life expectancy
Improving health can reduce mortality and increase life expectancy, changing the age structure of the population.
Other valid effects include:
falling birth rates
lower fertility
smaller families
ageing population
rural-to-urban migration
increased migration
Students should explain how development produces the change.
Question 6
A strong response should develop both item hooks.
Possible way 1: falling mortality and life expectancy
The item states that healthcare has improved and mortality is falling. Fewer deaths mean more people survive for longer, increasing life expectancy and changing the age structure of the population.
Possible way 2: fewer children
The item states that families are having fewer children. This indicates lower fertility and can contribute to smaller family sizes and the transition towards lower birth rates.
The strongest answers will recognise that these changes form part of wider demographic transition.
Question 7
A high-level response should develop two separate consequences.
Possible way 1: young population
The item states that the society has a relatively young population. If young people enter productive employment, they can provide a large workforce and contribute to economic growth and development.
Possible way 2: migration
The item provides two possible migration effects.
Migrants may send remittances home, increasing household income and improving living standards.
Alternatively, the emigration of skilled workers may reduce the human capital available to the developing society, restricting opportunities for economic and social development.
For high marks, students should explain the consequence rather than simply identify migration.
Question 8
A strong 20-mark response should evaluate the relationships between all three elements: health, demographic change and development.
Arguments that health improvement indicates development may include:
health is explicitly an aspect of development
improved access to medicines
better access to healthcare
spread of medical knowledge
international NGOs
global immunisation programmes
lower mortality
increased life expectancy
Modernisation interpretations may argue that:
improved healthcare and health knowledge form part of wider social transformation
falling mortality and fertility contribute to demographic transition
changing population patterns may accompany development
young populations can provide workers for economic growth
Evaluation may include:
globalisation also creates negative health consequences
sedentary lifestyles may increase
diseases associated with affluence may grow
diseases can spread rapidly between societies
health benefits may not be distributed equally
Arguments concerning demographic transition may include:
falling birth rates
falling death rates
reduced mortality
increased life expectancy
lower fertility
smaller family sizes
ageing populations
migration
Demographic change may contribute positively to development through:
a young population providing workers
migration providing employment opportunities
remittances improving living standards
possible reductions in global inequality
Critical evaluation may include:
a young population only creates a development advantage if suitable employment opportunities exist
skilled emigration may remove human capital
developing societies may finance the education of workers who then contribute economically elsewhere
migration can therefore reduce and reinforce inequality simultaneously
Dependency interpretations may focus on:
global health inequalities
unequal access to resources
the effects of trade, aid and debt on health
unequal movement of skilled labour between societies
the possibility that global relationships reproduce development inequalities
A wider definition of development may argue that:
improvements in health are important even without rapid industrialisation
longer life expectancy and lower mortality represent meaningful social development
economic measures alone therefore give an incomplete picture
Students should also recognise two-way causation:
development → health and demographic change
but also:
health and demographic change → further effects on development
For the highest marks, avoid writing one section on health followed by an unrelated section on population. Make the links explicit.
A reasoned conclusion might argue that health and demographic change are among the clearest examples of why development is multidimensional. Improved health can reduce mortality and alter population structures, while demographic changes can create both economic opportunities and constraints. Globalisation can strengthen these development processes through medicines, knowledge, migration and remittances, but it can also create new health risks and drain skilled labour. The relationship is therefore best understood as a two-way and uneven process rather than an automatic progression from underdevelopment to development.
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