Chapter 6

Family Formation and Dissolution

<figure><img src="image_43.png" /></figure>

Check for
updates

**Abstract** The question of the unity of the family models in the Mediterranean has been the subject of much debate in the field of generations history. Some researchers have put forward the much disputed hypothesis of a past unity in the Mediterranean area in relation to marriage and the family. In modern times, however, we are dealing with very heterogeneous situations in this area. *A priori*, the populations on the different shores of the Mediterranean do not have much in common, with diversified Western family models on one side, and a very specific Arab-Muslim family model on the other. Although different on both sides of the Mediterranean, family models have nevertheless undergone profound changes over the last 70 years: some discuss a “marriage revolution” for the populations of the Southern and Eastern shores, others a second demographic transition in the European countries. In the same way that researchers envisage a convergence of family models in the world towards the Western family model could there be a convergence of Mediterranean family models due to these contemporary family changes? Without directly answering this question, this chapter will attempt to provide some food for thought. Therefore, among the many possible elements for analysing family models, we decided to focus on the formation and dissolution of marriages. We will present the evolution of demographic indicators relating to these two phenomena, starting with marriage and divorce rates, followed by indicators relating to age at marriage and the significance of permanent celibacy. Unlike, the other demographic phenomena, we were unable to use the large international databases to study all the Mediterranean countries since 1950 for these family formation and dissolution related topics. We had to instead collate data from different data providers to create long series.

**Keywords** Marriage · Divorce · Family formation · Family dissolution · Age at marriage · Permanent celibacy · Family model · Mediterranean
## 6.1 Introduction

The question of the unity of the family models in the Mediterranean has been the subject of much debate in the field of generations history (Sacchi and Viazzo, 2014). Some researchers have put forward the much disputed hypothesis of a past unity in the Mediterranean area in relation to marriage and the family (Goody, 1983). In modern times, however, we are dealing with very heterogeneous situations in this area. *A priori*, the populations on the different shores of the Mediterranean do not have much in common, with diversified Western family models on one side, and a very specific Arab-Muslim family model on the other.

Although different on both sides of the Mediterranean, family models have nevertheless undergone profound changes over the last 70 years: some discuss a “marriage revolution” for the populations of the Southern and Eastern shores (Tabutin and Schoumaker, 2005), others a second demographic transition in the European countries (Lesthaeghe, 2014). In the same way that researchers envisage a convergence of family models in the world towards the Western family model (Goode, 1963; Thornton, 2001) could there be a convergence of Mediterranean family models due to these contemporary family changes? Without directly answering this question, this chapter will attempt to provide some food for thought. Therefore, among the many possible elements for analysing family models, we decided to focus on the formation and dissolution of marriages. We will present the evolution of demographic indicators relating to these two phenomena, starting with marriage and divorce rates, followed by indicators relating to age at marriage and the significance of permanent celibacy. Unlike, the other demographic phenomena, we were unable to use the large international databases to study all the Mediterranean countries since 1950 for these family formation and dissolution related topics. We had to instead collate data from different data providers to create long series.

## 6.2 Major Marriage and Divorce Trends

### 6.2.1 Marriage

Historically, marriage is an important institution, but it does not necessarily occupy the same place in every society. It is therefore interesting to first analyse the frequency of marriages in Mediterranean countries, which has undergone major changes since 1950. We are using a nuptiality rate which relates the number of marriages in a time period to the population aged 15 years or older.<fnref n="1" />

<footnote n="1">¹ Usually, the crude nuptiality rate relates the number of marriages to the average total population in the same year. However, we prefer to relate it to the population of marriageable age (15 years or older). This makes it possible to control somewhat for the effect of the age structure and to compare more easily the nuptiality rate intensity in the Mediterranean countries.</footnote>
First, nuptiality rates are heterogeneous in the Mediterranean at the beginning of the observation period, no real difference between the Northern shore and the Southern and Eastern shores (Fig. 6.1). Indeed, they range from 9% (Malta) to 28% (Jordan) in the early 1960s. The lowest values (around 10%) are found in Southern Europe (Malta, France, Spain, Italy), and also in Cyprus and Libya. For higher values, countries from different shores are mixed. For example, the highest values (above 14%) are Jordan, Egypt, Bosnia-Herzegovina and Serbia. During this period, many European countries experienced a “golden age” of marriage. The nuptiality rate experienced a strong post-war increase, which lasted until the mid-1960s in Northern Europe and the 1970s for Southern Europe. In Spain, for example, in the 1956–1975 period, the nuptiality rate was almost at its highest for the twentieth century (Muñoz-Pérez & Recaño-Valverde, 2011). It is interesting to note that the vast majority of Mediterranean countries exceeded the nuptiality rate levels reached during the “golden age” of marriage by Southern European countries. This is because marriage is a religious duty in Islam, and it is universal (Locoh & Ouadah-Bedidi, 2014), meaning that the vast majority of adults are married.

The evolution of the nuptiality rate, up to the present day, has varied from region to region, but there has been a general downward trend. Southern Europe shows the simplest pattern, since from the 1970s onwards, the nuptiality rate has been decreasing continuously, until stabilising eventually at a low level (with the exception of Malta). In most cases, the nuptiality rate in Southern European countries has reduced by more than a factor of 2 and is now among the lowest in the European Union.

The Balkan countries generally follow the same trend, but with some exceptions. In terms of timing, the decline in the nuptiality rate does not begin in the 1970s everywhere: sometimes earlier (Slovenia as early as the 1950s) and sometimes later (Albania in the early 2000s). Moreover, the nuptiality rate achieved at present is highly variable from one country to another, with sometimes very low levels (Slovenia, Bulgaria) similar to those in Southern Europe, and sometimes rather high levels (>10%); such as in Albania and especially in Kosovo; the other Balkan countries showing intermediate levels (between 5 and 8%). Over the entire period, the nuptiality rate has strongly decreased, as it has been divided by 2 (or more) in the majority of Balkan countries, and by more than 3 in Slovenia.

In North Africa, the evolution of the nuptiality rate has generally taken place in three distinct phases. First, rates increased (except in Egypt and Algeria where they decreased) until the 1970s; then they decreased until reaching levels below 10%. In contrast to previous trajectories, however, there has been a significant increase in the nuptiality rate towards high levels during the 2000s. This last phase coincides with the recent increase in fertility in these countries (see Chap. 4). Egypt stands out, over the entire period, for having a higher nuptiality rate than the other North African countries.

Finally, the trajectories of the Near Eastern countries are on the decline over the period, with sometimes uneven developments (Jordan, Lebanon, Cyprus). However, the declines in these countries are generally smaller than those observed elsewhere
<figure><img src="image_44.png" /><figcaption>**Fig. 6.1** Nuptiality rate in the Mediterranean (1950–2019) (*Sources* Demographic Statistics Database, National Office of Statistics, Eurostat, Demographic Yearbook [UN], World Population Prospect 2022. Calculations made by the authors. *N. B.* 1 The number of marriages is related to the population aged 15 years and over [not to the total population]. *N.B.* 2 Jordan’s values between 1950 and 1970 are off graph. *N.B.* 3 The evolution of the indicator is using averages calculated for 5-year periods)</figcaption></figure>
in the Mediterranean. Only Palestine and Syria are exceptions, with the former expe-
riencing an increase since the mid-2000s in line with North African countries, and
the latter having a higher nuptiality rate today than in the 1950s.

These analyses show differentiated developments. They have finally led to a diver-
gence since the 1980s, as the relative disparities are now higher. In 2015–2019, the
nuptiality rate in the Mediterranean was spread over a wide range of values, from
single to triple. This means that the frequency of marriages in societies is significantly
different on either side of the Mediterranean. Moreover, unlike at the beginning of
the period, the three Mediterranean shores are visibly different today. Indeed, the
countries on the Northern Shore have the lowest values, and those on the Southern
and Eastern shores the highest (despite the decrease in their nuptiality rate since the
1950s–1960s). There are some exceptions, with high values for Albania and Kosovo,
and intermediate values for Israel and Cyprus.

This geographical contrast is partly explained by the age structure. For the same
population, the age groups with the highest probability of marrying (20–40 years)
will account for a larger share in the young population, resulting in a higher number
of marriages, and thus a higher nuptiality rate than the older population. Thus, as
the countries on the Southern and Eastern shores (but also Albania and Kosovo)
are on average younger than the countries on the Northern Shore (including Israel
and Cyprus) (see Chap. 2), it is not surprising that their nuptiality rates are higher.
However, this difference in nuptiality rates between these two groups of countries
can also be explained by other factors that we will discuss later in the chapter, such
as the rate of remarriage.

6.2.2 Divorce

Divorce analysis measures the frequency of divorces in a population. We use divorce
rates to conduct a comparison.<fnref n="2" />

The evolution of the divorce rate in the Mediterranean highlights several inter-
esting elements (Fig. 6.2). The first is the higher level of divorce in Muslim-majority
countries compared to Catholic-majority (or traditional) countries, especially before
the 1980s. This is not surprising, as divorce/repudiation is a regulatory mechanism
in the Arab-Muslim matrimonial system (Fargues, 1986). Unlike Catholicism, Islam
allows a marriage to be broken via a mechanism other than by death. Divorce/
repudiation is therefore a very common practice in Islam, although in reality it is an
indicator of male dominance. Indeed, before the introduction of modern family law
in some countries, divorce (repudiation) was initiated by the man (Locoh & Ouadah-
Bedidi, 2014). However, this high divorce rate does not lead to an over-representation
of divorced people in the population. On the contrary, there are few divorced people,

<footnote n="2">² As with marriage, we relate the number of divorces to the population aged 15 or over, and to the total population.</footnote>
as remarriages are very common and quick. In Egypt, for example, divorcees repre-
sent less than 2% of the 15–59 year olds in 2017, for both men and women. By way
of comparison, in France, in 2016, they represent about 6% for men and 8.5% for
women, while the divorce rate is lower. This link between divorce and remarriage
also helps to explain the higher nuptiality rate in the countries of the Southern and
Eastern shores and is observed in the previous sub-section, a significant part of which
is due to remarriage.

Despite this characteristic of the Arab-Muslim matrimonial system, disparities
exist within the countries concerned from the beginning of the observation period.
Even if divorce has been declining since the beginning of the twentieth century
(Fargues, 1986), some countries still had very high levels (more than 4%<fnref n="3" />) in the
1950s, for example Egypt and Jordan, or Libya in the early 1970s. Others have lower
levels (less than 2%), such as Tunisia, Turkey, Syria and Lebanon. In general, these
levels contrast with the divorce rates of the Northern shore countries, which generally
did not exceed 1% in the 1950s, with the exception of Serbia and Albania.

In terms of divorce rate changes, what is important now is the heterogeneity of trajectories. In Southern Europe, the divorce rate was rather low in the 1950s. It then gradually increased, starting in the late 1960s in France, in the mid-1970s in Portugal, and in the early 2000s in Spain. A maximum of around 2.7% was reached by these three countries, before experiencing a decline in the 2010s. Italy has only recently experienced an increase in its divorce rate. Malta only allowed divorce in 2011, the last European country to do so, and has low levels at present. In the Balkans, the divorce rate is on the whole increasing over the whole period (though sometimes alternating between increasing and decreasing). However, the Balkan countries do not reach Southern European levels, as their divorce rates are generally between 1 and 2%. Serbia and Kosovo are the only countries to see a decrease in divortiality over the study period.

The trajectories are quite different on the Southern and Eastern shores. The evolu-
tion generally takes place in two stages, with varying timing: a decrease and then
an increase in the divorce rate. Some of the declines are impressive: Egypt's divorce
rate, for example, fell by a factor of 3 during a 50-year period before doubling in the
10 years that followed. Cyprus and Lebanon are exceptions to this general pattern, as
their divorce rates only increase throughout the period, a trajectory similar to those
in Southern Europe. Tunisia also shows a different trajectory, as its divorce rate
has essentially stagnated since the 1960s. Today, the countries of the Southern and
Eastern shores reach rather high levels of divorce since the vast majority exceed 2%.
In other words, divorces are more frequent today in Egyptian, Palestinian or Jorda-
nian societies than in France, Spain or Portugal, which have nevertheless experienced
an unprecedented increase in their divorce rate since 1970.

<footnote n="3">³ A level of 4‰ may seem low compared to other crude rates, such as crude birth or death rates. This is due to the choice of denominator for the indicator, in this case the population aged 15 years or over. If we had chosen 15–60 year olds, the indicator would have been even higher. In addition, the number of divorces, or marriages, is generally lower than the number of births or deaths.</footnote>
<figure><img src="image_45.png" /><figcaption>**Fig. 6.2** Divorce rates in the Mediterranean (1950–2019) (*Sources* Demographic Statistics Database, National Office of Statistics, Eurostat, Demographic Yearbook [UN], World Population Prospect 2022. Calculations made by the authors. N.B. 1 The number of divorces is related to the population aged 15 years or more (and not to the total population). N.B. 2 The evolution of the indicator is based on averages calculated for periods of 5 years. N.B. 3 The sharp increase in Turkey in the late 1990s is due to a break in the series)</figcaption></figure>
These different trajectories lead to a convergence of the divorce rate in the Mediterranean, but in a different way from that observed for the total fertility rate (Chap. 4) or life expectancy at birth (in this chapter). For the latter, it is a convergence by catching up that is observed. Here, on the contrary, there is a convergence caused by the decline in high divertiality of the Southern and Eastern shores and the growing low divertiality of the Northern shore. Divorce rates in the Mediterranean today are mainly between 1 and 2.5%. The current relative disparities, although not negligible, are less significant than in the 1950s–1960s. Thus, at the end of the 2010s, there is still a contrast between the shores of the Mediterranean, even though some Southern European countries (France, Spain, Portugal), and to a lesser extent Albania, have similar (or even higher) levels of divorce than several Muslim countries.

These major trends point to far-reaching social changes in the Mediterranean. Generally speaking, and despite the variety of marriage trajectories, marriages are less frequent today than 60–70 years ago. In the 1960s, the vast majority of Mediterranean countries had a nuptiality rate of over 10%, today it is less than a third. At the same time, the frequency of divorce has increased in countries where it was low, and decreased in countries where it was high.

## 6.3 Changes in Marriage

In order to appreciate the changes in marriage in the Mediterranean, we will examine two important dimensions, namely the evolution of the age at marriage and permanent celibacy.

### 6.3.1 An Increase in Age at Marriage

One of the most dramatic changes is the increase in age upon first marriage for both men and women (Fig. 6.3). In this chapter, we use the singulate mean age at marriage (SMAM<fnref n="4" />) indicator to estimate the age upon first marriage.

In the 1950s–1960s, there were only four countries with an age upon first marriage for women<fnref n="5" /> above 24. This age has increased everywhere in the Mediterranean, so much so that at present only Palestine and Egypt are below the age of 24.<fnref n="6" />

Before the 1970s, women could sometimes marry very young. This was particularly the case in North Africa where the age upon first marriage for women was

<footnote n="4">⁴ The SMAM is an indirect method for estimating age upon first marriage from age-specific marital status.</footnote>

<footnote n="5">⁵ Only the age upon first marriage of women is shown here, as the age at first marriage of men shows a broadly similar trend.</footnote>

<footnote n="6">⁶ Turkey also has an age upon first marriage for women below 24 years, but following a recent decrease.</footnote>
<figure><img src="image_46.png" /><figcaption>**Fig. 6.3** Age upon first marriage of women in the Mediterranean (1950–2019) (*Sources* World Marriage Database [2019], Demographic Statistics Database, Demographic Yearbook [UN]. Calculations made by the authors. *N. B.* age upon first marriage is estimated with the singulate mean age at marriage [SMAM])</figcaption></figure>

below 20 in the 1950s (except in Egypt), in the Near East (Turkey, Jordan), and in some Balkan countries (Albania, Bulgaria). Conversely, the countries where women married later (over the age of 22) were mainly in Southern Europe, but also in the Balkans (Yugoslavia, Greece) and the Near East (Cyprus, Palestine).
The age upon first marriage of women has therefore gradually increased to some-
times very high levels. In Southern Europe, there was first a decline in the age of
marriage in the 1960s, which represented the “golden age” of marriage. It was not
until the late 1970s or early 1980s that women’s age at marriage began to increase;
now, it is generally above 30 years. The trends are similar in the Balkans. The differ-
ence with Southern Europe lies in the levels reached in the 2010s. They are much
lower in the Balkans, where they generally do not exceed the age of 27 years. The
only exceptions are Slovenia, Bulgaria and Greece, the first two of which reach ages
above 32.

In the Near East and North Africa, the age upon first marriage of women is
increasing significantly, sometimes reaching very high levels today. This is the case,
for example, in Algeria, Libya, Lebanon and Tunisia where the age is 28. Only Egypt
and Palestine have had a moderate increase or even a stagnation in their age upon first
marriage for women at around 22 years. From the 2000s onwards, the indicator starts
to decrease in some countries (Algeria, Tunisia, Palestine, Jordan, Egypt, Morocco),
generally those with a recent increase in fertility. Finally, the dichotomy between the
Mediterranean shores of the 1950s and 1960s no longer exists today. In fact, it is now
conceivable that the age upon first marriage for women is similar across different
countries of the Mediterranean shores.

This increase in age at marriage can be explained by several factors. Firstly, the
progression in education is decisive in this area, since by spending more time at
school (primary, then secondary and increasingly university), individuals postpone
the age at which they get married. Secondly, economic crises lead to uncertain and
precarious living conditions, encouraging the postponement of marriage. In a neo-
local system,<fnref n="7" /> young couples form their own household upon marriage, and do not
move in with the husband’s parents. To do so, they must have sufficient resources
to move out of the parental home and form a new household. Worsening socio-
economic conditions (high youth unemployment, declining living standards, etc.)
can hamper household formation for young couples, who have to wait longer to
gather the necessary resources to establish their own household. Similarly, the rising
cost of housing in large cities, and the increasing cost of marriage (dowry, festivities,
etc.) in Arab-Muslim societies, also delay the union formation among young couples,
and by extension the age at which they marry.

This increase in the age upon first marriage has two direct effects. The first is the
decrease in the age gap between spouses, which is the result of a more rapid increase
in the age upon first marriage for women than for men. In the 1950s, Arab-Muslim
countries could have age gaps between spouses of more than 6 years,<fnref n="8" /> while in other
countries they were less than 4 years. However, despite this decrease, the age gaps

<footnote n="7">⁷ A neo-local system implies that newlyweds form a new household, separate from of the husband’s or wife’s parents.</footnote>

<footnote n="8">⁸ The age gaps between spouses presented here are calculated from the singulate mean age at marriage (SMAM), which generally underestimates the actual gap compared to those calculated with micro-data (Ausubel et al., 2022).</footnote>
<figure><img src="image_47.png" /><figcaption>**Fig. 6.4** Age difference of male and female singulate mean age at marriage (SMAM) in the Mediterranean in the 2010s (Sources World Marriage Database [2019], Demographic Statistics Database, Demographic Yearbook [UN]. Calculations made by the authors. *Reading tip*: the dotted lines represent an age gap between spouses. For example, the points on the line “+2 years” are countries where men are on average 2 years older than their spouses. The colour of a dot represents the regional area to which a country belongs)</figcaption></figure>

between spouses in Arab-Muslim countries and in Albania, remain the largest in the Mediterranean (Fig. 6.4).

This is not surprising since the large age gap between spouses is one of the important characteristics of Arab-Muslim marriage, which has some of the highest levels in the world (Weeks, 2020). The age gap in the Mediterranean is on average just under 4 years, with a minimum of about 1.6 years in France and Slovenia. Surprisingly, this gap has been increasing recently in some countries, for example in Egypt, Algeria and Morocco, where it is again as high as 6 years (Ausubel et al., 2022).

The second consequence of the increase in the age upon first marriage concerns early marriage. An important feature of traditional Arab-Muslim marriage is the early marriage of girls (Rashad et al., 2005). In the 1960s in Morocco and Algeria, for example, more than half of all women were married before the age of 20. It was 40% in Tunisia, Egypt and Libya, and 30% in Turkey and Jordan. Early marriage also concerns countries on the Northern shore, as it was 30% in Albania and 20% in Bulgaria. With the increase in the age upon first marriage, and especially thanks to better education, fewer and fewer women are married before the age of 20. Early marriage has almost disappeared from the Mediterranean, since in the vast majority of countries the proportion of women married between the ages of 15 and 20 is less
than 10%. The only notable exceptions are Egypt and Palestine, where the proportion has recently increased to 27 and 15% respectively. These situations show that trend reversals are possible even in cases where that seemed like a given.

### 6.3.2 Permanent Celibacy

In demography, the notion of celibacy is linked to the legal marital status of individuals. A single person is a person who is not married, but who may well be in a relationship. A permanent celibate is generally defined as a person aged 45–49 who has never married. They may, however, have already been in a relationship, or be in a legal union other than marriage (e.g. civil union). We have seen previously that the age upon first marriage has increased everywhere in the Mediterranean, this however implies that the population is marrying later on average, and not necessarily that it is marrying less. In this context, permanent celibacy makes it possible to estimate the proportion of a generation that has lived a large part of adult life without marrying, and in turn to assess the extent to which marriage remains an important institution for family formation.

Permanent female celibacy has generally increased in the Mediterranean (Fig. 6.5). In the 1950s, the vast majority of countries had levels below 5%. In contrast, high levels of permanent female celibacy could be found in Southern Europe, where levels reach 15% in Italy, Spain and Portugal, and even almost 25% in Malta. The evolution of permanent female celibacy in Southern Europe is singular in the Mediterranean, since it decreased until the 1990s, and then increased very rapidly to exceed the levels of the 1950s. At the end of the 2010s, permanent female celibacy reached 20% in Portugal and Italy, and over 30% in France. Only Malta has seen a continuous decline in its proportion of permanent single women. Spain, on the other hand, has experienced a very moderate increase in comparison with other Southern European countries: permanent female celibacy barely exceeded 10% in the 2010s.

In the other Mediterranean countries, there is also a clear trend towards an increase in permanent female celibacy. This increase is often moderate, but sometimes significant. In the majority of countries, the current level of permanent female celibacy does not exceed 8%. However, several countries on both sides of the Mediterranean exceed 10%. In a number of countries, permanent celibacy is also at a high level: about 15% in Algeria, Morocco, Lebanon and Bulgaria, and even 28% in Slovenia. These levels should be compared with those reached by Western European countries at the beginning of the twentieth century. A characteristic of the family model in this region was late marriage and a high proportion of permanent celibacy. In 1900, it was generally above 10% for women, and reached 12% in France, 10% in Germany, 15% in Britain, and up to 20% in Portugal (Engelen & Puschmann, 2011). In this respect, the current levels reached by some Mediterranean countries are comparable and can be considered high, even unprecedented in the case of Arab-Muslim countries.
<figure><img src="image_48.png" /><figcaption>**Fig. 6.5** Permanent female celibacy in the Mediterranean (1950–2019) (Sources World Marriage Database [2019], Demographic Statistics Database, Demographic Yearbook [UN], MICS. Calculations made by the authors)</figcaption></figure>

We can see how there is no homogeneity within the Arab-Muslim countries, or even within each shore. Similar levels of permanent female celibacy can be found in countries on all shores.

With the increase in the age of marriage and the end of early marriage in most countries, we are witnessing the emergence of singlehood in society, and in particular among women. In many Mediterranean countries, people who have never married
<figure><img src="image_49.png" /><figcaption>**Fig. 6.6** Share of single people aged 15–59 (both sexes) in Portugal and Algeria (Sources World Marriage Database [2019], Demographic Statistics Database. Calculations made by the authors)</figcaption></figure>

represent a larger share at each age group. The evolution is sometimes striking in some countries, for example in Algeria and Portugal (Fig. 6.6).

Whereas celibacy often only applied to a minority of age groups in the 1970s, it now concerns a much larger proportion, and sometimes a majority, of people in an age group. The 25–29 year olds in Algeria, for example, were only 20% single in 1977, but over 55% in 2012. We note that in this age group, but also in others, that the share of singles is higher in Algeria than in Portugal. These two countries illustrate how celibacy has become a mass phenomenon as it concerns a significant part of the population, in generally larger proportions than before.

### 6.3.3 Summary of Family Models

Finally, we propose a simple typology of current family models based on the following two characteristics: permanent female celibacy and female age at marriage (measured by the SMAM). Of course, a more complete typology of family models would take into account many other factors. The aim here however is to summarise the trends outlined above. The result is shown in Fig. 6.7.

There is a general difference between a matrimonial regime with rather low permanent female celibacy and where women marry relatively early, and a matrimonial regime with high permanent female celibacy and high age at marriage. Paradoxically, there is no distinction, either between the different shores of the Mediterranean, or between Arab-Muslim societies and Western societies. Rather, there is a difference between the Western Mediterranean and Eastern Mediterranean. On the Southern and Eastern shores, the “Petit Maghreb”<fnref n="9" /> differs from the Near East; and on the Northern shore, Southern Europe and Slovenia stand out from the Balkan countries.

<footnote n="9">⁹ This term refers to the western part of North Africa, i.e. Morocco, Algeria and Tunisia.</footnote>
<figure><img src="image_50.png" /><figcaption>**Fig. 6.7** Typology of current family models in the Mediterranean (*Sources* World Marriage Database [2019], Demographic Statistics Database, MICS. Calculations made by the authors. *N.B.* The dates used in each country are those most recently</figcaption></figure>
Thus defined by these two dimensions, the current family model in the Balkan countries resembles that of the Near Eastern countries more than that of the Southern European countries.

This geography is reminiscent of the Hajnal line (Hajnal, 1965), which divides the European continent along a north-east/south-west axis, from St. Petersburg to Trieste. It distinguishes two historically persistent European family models. To the west of this demarcation, women marry at a rather late age, the age gap between spouses is rather small, and a large share of adults have never married. Conversely, to the east of this line, women marry much younger, the age gap between spouses is greater and marriage is almost universal, with little permanent celibacy. In our case, it is as if the Hajnal line was extended into the Mediterranean Sea to distinguish a western and an eastern basin. Of course, this general dichotomy is not so clear cut, as intermediate situations exist. Morocco and Israel's current family model is characterised by a low age of marriage for women and a high level of permanent celibacy for women. To contrast, Malta, Greece and Libya are in exactly the opposite situation.

This typology of family models in the Mediterranean is based on the current situation, but it would be a mistake to consider the resulting geography as destined to remain fixed. Indeed, as we have seen throughout this chapter, phenomena are still evolving in many countries, and trend reversals sometimes occur, for example the recent drop in the age at marriage in the Maghreb. Furthermore, we have deliberately constructed a typology with only two dimensions in order to identify types that are relatively simple to understand. Of course, it is not our intention to claim that countries in a given category have a family model that is similar in every respect, as a family model is much more complex than the two dimensions considered here. If we had included the age gap between spouses, for instance, the typology would have further distinguished Arab-Muslim populations from others.

## 6.4 Conclusion

If we take a step back, we can see that the Mediterranean countries are experiencing similar family changes, despite differences in timing or intensity. In a way, therefore, there is a convergence of the demographic indicators used. The evolution of the nuptiality rate shows a decrease in the frequency of marriages. The relative disparities in divorce rates are smaller today than they were in the 1950s. Age at marriage and permanent celibacy (and celibacy in general) have increased, sometimes significantly. And the age gap between spouses has generally narrowed.

We must measure the importance of these family changes, which constitute a real revolution in several respects. In the populations of the Southern and Eastern shores, the main characteristics that made Arab-Muslim marriage distinct have profoundly changed over the last 60 years: marriage has become less universal, early marriage has disappeared in most countries, the divorce rate has been decreasing, and the age gap between spouses has been reduced. A similar observation can be found in
the Balkan countries, which were traditionally characterised by universal and early
marriage. With regard to the countries of Southern Europe, family changes since
the 1970s are a break with the period of the “golden age” of marriage, which was
ultimately a parenthesis in relation to past trends. These countries traditionally had
a late marriage family model that was not universal.

References

Ausubel, J., Kramer, S., Shi, A. F., & Hackett, C. (2022). Measuring age differences among different-sex couples: Across religions and 130 countries, men are older than their female partners. *Population Studies*, 76, 465–476. https://doi.org/10.1080/00324728.2022.2094452

Demographic Statistics Database. United Nations Statistics Division. https://unstats.un.org/unsd/demographic-social/products/dyb/index.cshtml

Engelen, T., & Puschmann, P. (2011). How unique is the Western European marriage pattern? A comparison of nuptiality in historical Europe and the contemporary Arab world. *History of the Family*, 16, 387–400. https://doi.org/10.1016/j.hisfam.2011.07.004

Fargues, P. (1986). Traditions matrimoniales dans les sociétés arabes. *Population et Sociétés*, 198. https://www.ined.fr/fichier/s_rubrique/18983/pop_et_soc_francais_198.fr.pdf

Goode, W. J. (1963). *World revolution and family patterns*. Free Press.

Goody, J. (1983). *The development of the family and marriage in Europe*. Past and Present Publications. Cambridge University Press. https://doi.org/10.1017/CBO9780511607752

Hajnal, J. (1965). European marriage patterns in perspective. In D. V. Glass & D. E. C. Eversley (eds.), *Population in history: Essays in historical demography, volume I: General and great Britain* (pp. 101–143). Edward Arnold; Aldine Publishing.

Lesthaeghe, R. (2014). The second demographic transition: A concise overview of its development. *Proceedings of the National Academy of Sciences*, 111, 18112–18115. https://doi.org/10.1073/pnas.1420441111

Locoh, T., & Ouadah-Bedidi, Z. (2014). *Familles et rapports de genre au Maghreb, Evolutions ou révolutions*. Document de travail 213. Institut National d'Etudes Démographiques. https://www.ined.fr/fichier/s_rubrique/22779/document.travail.2014.213.magreb.genre.fr.pdf

Muñoz-Pérez, F., & Recaño-Valverde, J. (2011). A century of nuptiality in Spain, 1900–2007. *European Journal of Population*, 27, 487–515. https://doi.org/10.1007/s10680-011-9234-1

Rashad, H., Osman, M., & Roudi-Fahimi, F. (2005). Marriage in the Arab World. Population Reference Bureau, 8. https://u.demog.berkeley.edu/~jrw/Biblio/Eprints/PRB/files/MarriageInArabWorld_Eng.pdf

Sacchi, P., & Viazzo, P. P. (2014). Family and household. In P. Horden & S. Kinoshita (eds.), *A Companion to mediterranean history* (pp. 234–249). Wiley Blackwell Companions to History. Wiley & Sons. https://doi.org/10.1002/9781118519356

Tabutin, D., & Schoumaker, B. (2005). The demography of the Arab World and the middle East from the 1950s to the 2000s. *Population*, 60, 611–724. https://doi.org/10.3917/popu.505.0611

Thornton, A. (2001). The developmental paradigm, reading history sideways, and family change. *Demography*, 38, 449–465. https://doi.org/10.2307/3088311

Weeks, J. (2020). *Population: An introduction to concepts and issues* (13th ed.). Cengage.

World Marriage Data. (2019). United Nations, Department of Economic and Social Affairs, Population Division. https://population.un.org/MarriageData/Index.html

World Population Prospects. (2022). United Nations, Department of Economic and Social Affairs, Population Division. https://population.un.org/wpp/
**Open Access** This chapter is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

The images or other third party material in this chapter are included in the chapter's Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the chapter's Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

<figure><img src="image_51.png" /></figure>
Chapter 7
# Mortality Profiles

<figure><img src="image_52.png" /></figure>

Check for
updates

**Abstract** The Mediterranean is currently characterised by rather low mortality. Indeed, life expectancy at birth exceeds the global average in almost all countries of the region. But this was not always the case. Mortality in the Mediterranean has fallen sharply since 1950: average life expectancy at birth was 78 years in 2019 compared to only 53 years in 1950. This dramatic increase in life expectancy at birth is a sign of great convergence between Mediterranean countries, but also of a profound shift in mortality patterns concerning both causes of mortality and ages at which people die. Despite these general trends of overall convergence in mortality, disparities persist between countries. This chapter takes a look at the evolution of mortality in the Mediterranean since 1950. We will start by describing trends in overall mortality by studying the indicator of life expectancy at birth. We will then analyse mortality by major age groups: child mortality (0–5 years), adult mortality (15–64 years) and mortality at advanced ages (65 years or older). Finally, to explain the identified mortality differences, we will take a look at the health transition in the Mediterranean in relation to the major causes of mortality.

**Keywords** Mortality · Mortality profiles · Infant and child mortality · Adult mortality · Mortality at advanced ages · Health transition · Mediterranean

**7.1 Introduction**

The Mediterranean is currently characterised by rather low mortality. Indeed, life expectancy at birth exceeds the global average in almost all countries of the region. But this was not always the case. Mortality in the Mediterranean has fallen sharply since 1950: average life expectancy at birth was 78 years in 2019 compared to only 53 years in 1950. This dramatic increase in life expectancy at birth is a sign of great convergence between Mediterranean countries, but also of a profound shift in mortality patterns concerning both causes of mortality and ages at which people die. Despite these general trends of overall convergence in mortality, disparities persist
between countries. This chapter takes a look at the evolution of mortality in the Mediterranean since 1950.

We will start by describing trends in overall mortality by studying the indicator of life expectancy at birth. We will then analyse mortality by major age groups: child mortality (0–5 years), adult mortality (15–64 years) and mortality at advanced ages (65 years or older). Finally, to explain the identified mortality differences, we will take a look at the health transition in the Mediterranean in relation to the major causes of mortality.

## 7.2 Mortality at All Ages: Life Expectancy at Birth

### 7.2.1 A Very Heterogeneous Picture in 1950

In 1950, overall mortality levels were very disparate in the Mediterranean (Fig. 7.1). Life expectancies at birth ($e_0$)<fnref n="1" /> ranged from 34 to 68 years. This meant that some countries were already progressing well in the transition from high to low mortality rate, while others still had a way to go. The former had $e_0$s above 60 years as seen in Southern Europe and in the majority of the Balkans, along with some countries in the Near East (Israel, Lebanon and Cyprus to a lesser extent). On the other hand, the latter were characterised by much higher mortality levels. Life expectancies at birth in North African countries were thus generally less than 40 years and those in the Near East between 45 and 50 years, corresponding respectively to the mortality trends of France at the beginning of the nineteenth century and Italy in the 1920s. Balkan countries (Albania, Bosnia-Herzegovina, and Macedonia) were in an intermediate situation with $e_0$s approaching 50 years of age.

Despite sometimes high mortality levels, the situation in 1950 would indicate that the Mediterranean populations were all nevertheless engaged in the process of mortality transition. Indeed, before mortality began to decrease with the Industrial Revolution in the late 18th to the early nineteenth century, the $e_0$ generally did not exceed 30–35 years in Europe (Weeks, 2020). However, all the Mediterranean countries more or less exceeded this threshold in 1950, showing that the mortality transition had potentially begun before the Second World War. For example, Egypt and Algeria saw their mortality gradually decrease from the beginning of the twentieth century (Fargues, 1986; Tabutin et al., 2002). This characteristic of the mortality transition in the Mediterranean is surely explained by the “Mediterranean hygienisation”<fnref n="2" /> (Pouget, 2021). Indeed, rich exchanges of knowledge and medical practices have taken place between all the shores of the Mediterranean since the nineteenth century (Speziale, 2018). Doctors, nurses, sisters and missionaries were the vectors of the Pasteur revolution during the first half of the twentieth century.

<footnote n="1">¹ For ease of reading, we use the annotation “$e_0$” in this chapter to mean “life expectancy at birth”.</footnote>

<footnote n="2">² This text has been translated into English by the authors. The original text in French is as follows: “hygiénisation méditerranéenne”.</footnote>
<figure><img src="image_53.png" /><figcaption>**Fig. 7.1** Evolution of life expectancy at birth in the Mediterranean (1950–2021) (Source World Population Prospects 2022. Calculations made by the authors. Note The time units used are five-year periods)</figcaption></figure>

Nevertheless, even though mortality declined relatively early in the Mediterranean, the health situation in many countries was still dire in 1950: child mortality was particularly high and few people reached old age. Indeed, a life expectancy at birth of 35 years, as in Egypt in 1950, meant that about one in four children died before one year and only 30% of a generation reached the age of 65. By way of comparison, during the same period, the proportions were respectively 2 children
out of 10 and 50% in Macedonia ($e_0$ of 50 years), or 5 out of 100 and 68% in France ($e_0$ of 66 years). Thus, within the Mediterranean of the 1950s, there were very contrasting demographic realities, with populations located at an early stage of the mortality transition and others at an advanced stage.

### 7.2.2 General Convergence Since 1950³

Since 1950, mortality has declined significantly across the region, currently exceeding an $e_0$ of 70 years in all Mediterranean countries (Fig. 7.1). Mediterranean populations are all in a phase of low relative mortality: everywhere less than 2% of children die before the age of 1, and more than 75% of a generation reaches the age of 65. Great strides have been made to reduce mortality; previously, death was a serious threat to human society.

This decline in mortality has not occurred at the same rate everywhere though. It was particularly rapid for countries in a mortality transition that had just begun in 1950. France took almost 120 years to go from an $e_0$ of 40 to 70 years. Italy and Spain have done this in about 70 years, while Morocco and Egypt have done it in just under 60 years, Jordan in 40 years and Libya in 30 years. With this very rapid increase, the countries with the highest mortality in 1950 have bridged much of the gap that separated them from the populations most advanced in the mortality transition. It might be expected that some lagging countries would catch up with, or even overtake, the earlier countries and that the ranking of countries at the end of the period would be different from that at the beginning of the period. On the contrary, there is no upheaval in the hierarchy that prevailed in 1950. However, some trajectories are interesting to note, such as Lebanon and Turkey whose current $e_0$ equals (and exceeds) that of several Balkan countries, even though they experienced a more unfavourable situation in the 1950s. In 2019, Turkey's $e_0$ (77 years) was slightly higher than that of Serbia and Montenegro, whereas it was lower by more than 11 years in 1950. Also noteworthy is the particular situation of Bulgaria, which with an $e_0$ of 75 years is among the lowest life expectancies in the Mediterranean while it was among the highest in 1950.

A great convergence of mortality has therefore taken place and the current situation is much less heterogeneous than it was before. Mortality gaps in the Mediterranean have narrowed significantly since 1950. However, contrasts remain: 12 years separate the lowest $e_0$ (Egypt) and the highest (Italy) in 2019 and at least 5 years separate the $e_0$ of most North African countries ($e_0$ < 76 years) and that of Southern European countries ($e_0$ > 81 years).

<footnote n="3">³ In this chapter, even if some graphs represent the period 1950–2021, we will cover (unless otherwise stated) the period 1950–2019 in order to not take into account the mortality related to the Covid-19 pandemic (2020–2022). Indeed, the effects of this pandemic on life expectancy are not yet fully known. We would like to focus on the mortality situation of Mediterranean countries outside of any great shock (or almost).</footnote>
### 7.2.3 Decreases in Life Expectancy at Birth

This tremendous victory over death must not make us forget that this progress can be reversed. If the $e_0$ increased in all the Mediterranean countries between 1950 and 2019, the evolution was not always steady and some setbacks were experienced. For example, the convergence of the $e_0$ observed in the Mediterranean has slowed down, and even came to a halt in the 1990s, a period from which the curves evolve almost in parallel. This is the effect of a slowdown in the rates of increase in the risk of death by age, particularly in the countries with the lowest $e_0$. While the relative disparities between countries reduced by a factor of four between 1950 and 1990, they have remained almost at the same level since then.

We also observe declines in $e_0$ in several Mediterranean countries during the study period. The most notable are attributable to wars and conflicts: the Algerian war (1954–1962), the Lebanese war (1975–1982), the Yugoslav war (1992–1995), wars and political destabilisation in Libya in the 2010s and the Syrian conflict since 2011. The increase in mortality over a short period of time is sometimes striking: annual data from the *World Population Prospects 2022* show that Bosnia-Herzegovina lost about 20 years of $e_0$ between 1990 and 1993 for example. In addition, post-conflict recovery time varies from country to country. Whereas Bosnia-Herzegovina seems to have taken 2 years to regain its pre-war $e_0$, Lebanon took about 10 years. Syria, meanwhile, still has not reached its 2010 $e_0$, despite being in recovery for several years.

The COVID-19 pandemic has also led to a more or less significant decrease in $e_0$ almost everywhere in the Mediterranean in 2020–2021. The impact of the virus varied by country: they were not affected at the same time and did not suffer the same number of waves of excess mortality. According to *World Population Prospects 2022* data, Mediterranean countries lost an average of 1.5 years of $e_0$, with large disparities within the region (Table 7.1). The countries with the greatest loss of $e_0$ (greater than 2 years) are located in the southern Balkans, along with North Africa and Lebanon.

<table><caption>**Table 7.1** Loss of life expectancy at birth during the COVID-19 pandemic (2020–2021)</caption><thead><tr><td>Scale of e<sub>0</sub> loss</td><td>Country</td></tr></thead><tbody><tr><td>e<sub>0</sub> loss &lt; 1 year</td><td>Cyprus, Syria, Morocco, France, Israel, Libya, Malta, Portugal, Montenegro</td></tr><tr><td>1 year &lt; e<sub>0</sub> loss &lt; 2 years</td><td>Egypt, Greece, Italy, Croatia, Slovenia, Spain, Palestine, Jordan, Bosnia-Herzegovina, Turkey</td></tr><tr><td>2 years &lt; e<sub>0</sub> loss &lt; 3 years</td><td>Algeria, Tunisia, Kosovo, Serbia, Albania</td></tr><tr><td>e<sub>0</sub> loss &gt; 3 years</td><td>Bulgaria, Macedonia, Lebanon</td></tr></tbody></table>

*Source* World Population Prospects 2022. Calculations made by the authors
### 7.2.4 Gender Inequalities

As elsewhere in the world, inequalities in mortality between men and women are significant in the Mediterranean. Mortality risks for men are generally higher than those for women. This difference in favour of women may be attributed to a biological advantage in the form of immune function, although it is difficult to measure this effect (Weeks, 2020). Thus, in the Mediterranean, the $e_0$ of men is lower by 5 years on average than that of women. However, the extent of the gender gap is not the same in all countries. It depends on social factors relating to the status of women in society. Thus, when a small gap is noted, it reflects an excess mortality of women, which reflects a rather deteriorated status. The gender gap in $e_0$ is also a function of progress in the mortality transition: the gaps between men and women, which are rather reduced at the beginning of the transition, are accentuated during the transition by the faster increase in women's $e_0$, and they finally decrease when men's $e_0$ progressively catches up with that of women. To illustrate this relationship, we use the evolution of the gender gap of $e_0$ of France since 1806 in comparison with that of other countries of Southern Europe (Fig. 7.2).

Before the transition, the gap in $e_0$ between men and women was generally quite small. In France, the gender gap was almost stable until the early 1860s and it was less than 2 years (excluding exceptional periods). During the mortality transition, women's $e_0$ increased faster than men's, widening the gap. France has experienced a gradual increase in the gender gap since the 1860s. Apart from periods of war, it

<figure><img src="image_54.png" /><figcaption>**Fig. 7.2** Evolution of the gender gap in life expectancy at birth in some Southern European countries (Source Human Mortality Database, Human Life-Table Database. Calculations made by the authors)</figcaption></figure>
reached a maximum of slightly more than 8 years in the early 1990s, when it began
to decrease until the present time (bell curve). This decrease in the gender gap can be
explained both by a certain masculinisation of female behaviours (increase in tobacco
and alcohol consumption, etc.), but also by changes in the epidemiological profile that
we will discuss in the last part of this chapter. The other Southern European countries
in Fig. 7.2 have the same evolution model, with some differences compared to that
of the French. For Bulgaria, for example, once a maximum was reached, there was
no decrease in the gender gap, but a stagnation for 30 years.

The evolution of the gender gap of $e_0$ in the Mediterranean since 1950 highlights
a diversity of trajectories. We have classified them into 5 groups (Fig. 7.3).

The first brings together countries with the same bell-shaped trajectory presented previously, and whose gender gap has been decreasing for at least 20 years (or more). These are the countries of Southern Europe (except Malta), plus Croatia and Slovenia. Similar trajectories with stagnation (or a slight decrease) once the maximum has been reached make up the second group, which is almost exclusively comprised of Balkan countries. The third group concerns only countries on the Southern and Eastern shores, with gender gap trajectories increasing over the entire period. The fourth group includes Albania, Bosnia-Herzegovina and Cyprus, whose trajectories are downward over the entire period. Finally, the trajectories of the last group (Algeria, Kosovo, Lebanon and Palestine) do not have a clear evolution over the entire period. Across the board, the conflicts are clearly identifiable, showing how men's $e_0$ is more affected during these periods of instability.

The more rapid increase in the $e_0$ of women during the decline in mortality leads to
sometimes considerable time lags between the two genders. In Bosnia-Herzegovina,
for example, men in 2019 had an $e_0$ that women in the same country had reached
almost 25 years before. There are considerable disparities, with a gap of about
10 years for Morocco and Algeria, and 30 years for Serbia, Tunisia and Croatia.
The maximum was reached by Bulgaria with a lag of 60 years, meaning that in 2019
men reach an $e_0$ that women had in 1960.

7.3 The Different Mortality Profiles

Life expectancy at birth is a synthetic indicator of the mortality of a population. It gives indications of the health of a population at a given date, but potentially masks different age-specific mortality profiles for the same value (mean age at death). Different mortality patterns can correspond to the same life mean at birth. To better understand the mechanisms underlying the convergence of $e_0$ in the Mediterranean since 1950, as highlighted above, we will now analyse mortality broken down into 3 major age groups: infant and child mortality (under 5 years old), adult mortality (15–64 years) and mortality at advanced ages (65 years or more).
<figure><img src="image_55.png" /><figcaption>**Fig. 7.3** Evolution of the gender gap in life expectancy at birth in the Mediterranean (1950–2021) (Source World Population Prospects 2022. Calculations made by the authors. Note The time units used are five-year periods)</figcaption></figure>

### 7.3.1 Infant and Child Mortality (Under 5 Years Old)

For most of human history, infant and child mortality (i.e. children under 5 years old) remained at very high levels. It was not until the nineteenth century that it began to decline in European countries, then in other countries of the world according to
<figure><img src="image_56.png" /><figcaption>**Fig. 7.4** Child mortality in the Mediterranean (1950–2019) (Source World Population Prospects 2022. Graphic developed by the authors. Reading tip the dotted lines represent the change between 1950–1954 and 2015–2019. For example, points on the “/30” line have child mortality that has been divided by 30 between the two periods. The colour of a dot represents the regional area to which a country belongs)</figcaption></figure>

various timing. In 1950, the infant and child mortality rate (U5MR)<fnref n="4" /> at the global level stood at 225‰; in 2019, it reached the low level of 38‰ in 2019, thus representing a drastic reduction in a short time on a historical scale. Over the same period, in the Mediterranean, the U5MR decreased on average from 180 to 20‰.

In 1950, U5MR values spread over a wide spectrum, ranging from about 40‰ to over 350‰ (Fig. 7.4). This disparity meant that more than 90% of children reached the age of 5 in some countries, and only 55% in others. However, this proportion exceeded 70% in the vast majority of Mediterranean countries. This infant and child mortality strongly converged towards lower levels throughout the Mediterranean, with sometimes very large reductions in some countries. In 2019, the values were concentrated in a narrower spectrum than in 1950: there were indeed 10 Mediterranean countries above the world average in 1950, while there were none in 2019. No country (except Syria<fnref n="5" />) has a U5MR above 25‰. More than 97% of children survive up to 5 years across the Mediterranean. Infant and child mortality is now low.

<footnote n="4">⁴ For ease of reading, we use the expression “U5MR” (Under-five Mortality Rate) in this chapter to mean “infant and child mortality”.</footnote>

<footnote n="5">⁵ This is mainly due to the war, as Syria’s U5MR was below 20‰ at the end of the 2000s.</footnote>
In 1950, there was a contrast between countries that were well underway in the health transition and those that were still at an early stage. The former had a U5MR of less than 150‰, and included the countries of the Northern shore plus the more advanced countries of the Southern and Eastern shores (Israel, Lebanon and Cyprus). The latter had a U5MR higher than 200‰, and were mainly on the Southern and Eastern shores, but also on the Northern Shore (Albania, Macedonia and Bosnia-Herzegovina). This dichotomy can still be seen in 2019, but with much smaller gaps between countries. Figure 7.4 thus shows that the most spectacular increases in the decline of the UM5R concerned countries such as Libya, Turkey and Albania (countries located below the right marked "/30", indicating a division by 30 of infant and child mortality).

### 7.3.2 Adult Mortality (15–64 Years Old)

Whilst the highest risks of death are concentrated at the younger and older age groups, adult mortality (considered here as mortality between 15 and 65 years) should not be underestimated. Indeed, the odds of dying before age 65 were not negligible in 1950, even after surviving to the age of 5; in fact, differences are still observed today. Adult mortality also contributes to inequalities in life expectancy between men and women due to excess mortality following childbearing and pregnancy.

In 1950, all Mediterranean countries saw at least 25% of people who reached the age of 5 die before the age of 65. This proportion reached more than 60% in some countries (Tunisia, Morocco, Jordan, Libya). Since 1950, adult mortality has declined throughout the Mediterranean (Fig. 7.5).

The intensity of this reduction is not commensurate with the reduction in infant and child mortality. While the latter has been divided by a factor of 10 in almost all countries, adult mortality has been divided by a ratio of “only” between 2 and 5, which is nevertheless far from negligible. The current situation is much more enviable than it was 70 years ago, because in all the Mediterranean countries, at least 75% of people who have reached the age of 5 can expect to reach the age of 65.

In 1950, there was clear opposition between the Northern Shore (with Turkey, Cyprus, Israel and Lebanon) with adult mortality levels below 400‰, and the Southern and Eastern shores (with Bosnia-Herzegovina) with levels above 400‰. In 2019, we no longer see this geographical contrast. The highest levels (>200‰) are mainly on the Southern and Eastern shores (Egypt, Syria, Libya, Bulgaria). In contrast, lower levels of adult mortality are routinely found in countries on all shores of the Mediterranean. For example, adult deaths between 120‰ and 175‰ concern countries in North Africa (Tunisia, Morocco, Algeria), the Near East (Palestine, Jordan, Turkey) and the Balkans (Montenegro, Serbia, Croatia, Bosnia-Herzegovina, Macedonia, Kosovo). This means that similar adult mortality conditions can be shared by countries on both sides of the Mediterranean.
<figure><img src="image_57.png" /><figcaption>**Fig. 7.5** Adult mortality in the Mediterranean (1950–2019) (Source World Population Prospects 2022. Graphic developed by the authors. *Reading tip* The dotted lines represent the change between 1950–1954 and 2015–2019. For example, points on the “/4” line have an adult mortality that has been divided by 4 between the two periods. The colour of a dot represents the regional area to which a country belongs)</figcaption></figure>

### 7.3.3 Mortality at Advanced Ages (65 Years Old or Older)

In 1950, we saw that the high levels of infant, child and adult mortality in the Mediterranean meant that a significant part of a generation did not reach the age of 65 (with great variability between countries). Once this age is reached, how many more years can a person expect to live? To measure this, we use the life expectancy indicator at age 65 ($e_{65}$),<fnref n="6" /> which is the number of years an individual will live on average if they have the same probabilities of death as previous generations at the same time.

All Mediterranean countries had an $e_{65}$ between 10 and 14 years in 1950 (Fig. 7.6). It increased everywhere by 4.5 years on regional average from 12 to 16.8 years (in 2019). However, developments vary greatly from country to country. Over the study period, in contrast to infant and adult mortality, there is a trend over the period towards divergence in the $e_{65}$. Indeed, differences between countries increased, as many of the countries with the highest $e_{65}$ in 1950 were also those that’s experienced the highest increase (see Sect. 7.4 of this chapter). Southern European countries and Israel have all seen their $e_{65}$ increase by more than 50%, even though their $e_{65}$ was already among the highest in the region in 1950 (>13 years). They have thus

<footnote n="6">⁶ For ease of reading, we use the annotation “$e_{65}$” in this chapter to mean “life expectancy at 65 years”.</footnote>
<figure><img src="image_58.png" /><figcaption>**Fig. 7.6** Life expectancy at age 65 in the Mediterranean (1950–2019) (Source World Population Prospects 2022. Graphic developed by the authors. Reading tip: the dotted lines represent the change between 1950–1954 and 2015–2019. For example, points on the “+75%” line have a life expectancy at age 65 that was increased by 75% between the two periods. The colour of a dot represents the regional area to which a country belongs)</figcaption></figure>

widened the gap with the other Mediterranean countries, most of which have had a more moderate rate of growth.

Unusual trajectories are also a noteworthy. Bulgaria had the second highest e65 in the Mediterranean in 1950, but it only increased by 2 years, thus arriving at 17th place in 2019. Malta, meanwhile, saw its e65 almost double over the study period, moving from 24th to 3rd place.

As a result, countries' e65s are spread over a wider range of values in 2019 than in 1950. There were 9 Mediterranean countries with an e65 below the world average in 1950, and 15 in 2019. This situation illustrates the divergence in life expectancy at age 65 that has occurred in the Mediterranean between these two dates.

It is possible to distinguish 4 groups of countries in 2019, reflecting differences between the shores of the Mediterranean. The first group is made up of the countries of Southern Europe and Israel, with an e65 over 20 years; they clearly stand out from the other countries. Cyprus, Croatia and Greece form the second group. With an e65 between 19 and 20, they follow the previous group. The third group (Syria, Egypt, Morocco, Libya) has the lowest e65 (less than 15 years). The last group brings together all the other countries, from all sides, with an e65 between 15 and 18 years.
## 7.4 The Health Transition

This general convergence of the $e_0$ in the Mediterranean, linked to declines in mortality at different ages, actually reflects a profound change in the diseases causing mortality (epidemiological profile) in a population (Frenk et al., 1991; Omran, 1971).

Historically, the epidemiological profile has long been dominated by infectious diseases. In industrial countries, the increase in $e_0$ from the end of the eighteenth century until the 1960s was essentially due to the fight against infectious diseases (Vallin & Meslé, 2004). This progress can be attributed to various factors, both sociocultural and medical: the control of major epidemics, the disappearance of famines and food shortages due to food production and distribution improvement; the improvement of nutrition, health and hygiene policies; progress in the distribution of drinking water and sanitation systems; and finally vaccines and antibiotics. The main implication of the massive decline in infectious diseases was the drastic reduction in infant and child mortality, and more generally the decline in mortality under the age of 50. This is why the $e_0$ was able to increase beyond the ancestral level of 30–35 years.

In the Mediterranean, the general convergence of the $e_0$ is explained by the timing lags in this victory over infectious diseases. Countries with high $e_0$s in 1950 had been fighting these diseases for a long time and had virtually eliminated them. On the other hand, this was not the case for countries with low $e_0$s whose infectious diseases still kept infant and child mortality at high levels. These countries benefited from the transfer of public health knowledge and medical technologies developed in Europe and North America. By making them available to all their populations, their $e_0$ increased very rapidly and these countries have made up some of the ground lost to the pioneer countries. In 2019, infectious diseases also accounted for only 2% of deaths in the Mediterranean, with the prevalence of AIDS being low in this region. Current differences in infant and child mortality between countries are mainly explained by the management of neonatal conditions (prematurity, etc.).

The historic triumph over infectious diseases does not mean that they are definitely a thing of the past, as the COVID-19 pandemic has reminded us. We have seen the emergence of new infectious diseases since 1950, such as AIDS, Ebola, Zika, SARS, West Nile virus, H1N1, H5N1 and so on. They still pose major threats to populations, especially when air travel allows diseases to be spread around the world within hours.

With the control of infectious diseases, societies now face other causes of mortality: chronic diseases (cardiovascular, tumours/cancers, diabetes, etc.) and society diseases (smoking, alcoholism, suicide, homicides, road accidents, etc.). The inability to fight against these various diseases leads to a stagnation of the $e_0$ or at least a much more moderate increase in it. The $e_0$ of Western countries, for example, reached similar levels at the end of the 1950s thanks to their control of infectious diseases. On the other hand, there was a stagnation in their $e_0$ in the 1960s, as the main causes of mortality were more chronic diseases and societal diseases (Vallin & Meslé, 2014). It was not until the 1970s that effective ways of combating cardiovascular diseases were discovered. This “cardiovascular revolution” thus allowed a new progression of the $e_0$.
However, it is more difficult to reduce mortality from cardiovascular disease than it is for infectious diseases (Meslé & Vallin, 2006). Firstly, medical prevention is more complicated, as the population needs to be made aware of the important risk factors related to diet and lifestyle, in order to change their individual behaviours. This objective is hence more difficult to implement than the prevention of infectious diseases, which relies mainly on vaccination and antibiotics. Secondly, treatment technologies are much more expensive and are not attainable for all countries, which is especially the case for cardiovascular diseases and cancers.

In Europe, Western countries managed to fight against cardiovascular diseases and saw their $e_0$ increase. It is these countries that also saw increased life expectancy at advanced ages. Conversely, the countries of Eastern Europe were unable to take advantage of the new means of combating this type of disease, and thus had an $e_0$ which stagnated or even decreased (Vallin & Meslé, 2014). This may be due to economic difficulties, which have not allowed for the dissemination of treatment technologies, but also to the highly centralised political system which has proven to be less effective when individual responsibility was needed. Thus, from the 1970s onwards, there was a divergence in $e_0$ between the countries of Eastern and Western Europe, even though the former had closed most of their $e_0$ gap.

Similarly, the Mediterranean countries have not been equal in the face of cardiovascular diseases (Fig. 7.7).

The richer ones were able to take advantage of the new control methods and see their $e_0$ continue to increase (and now exceed 80 years). In contrast, for the other

<figure><img src="image_59.png" /><figcaption>**Fig. 7.7** Distribution of causes of death among non-communicable diseases (2019) (Source NCD Data [WHO])</figcaption></figure>
countries, economic difficulties and a certain political centralism may have been an obstacle and the increase in $e_0$ was more moderate. This inequality in the fight against cardiovascular diseases is reflected in the burden of these diseases in the Mediterranean (Fig. 7.7). In half the countries, these diseases account for more than 50% of deaths from non-communicable diseases.<fnref n="7" /> In contrast, they represent less than 30% in the most advanced countries in the fight against these diseases (e.g. Israel, France and Spain).

This inequality in mortality from cardiovascular diseases gives rise to different epidemiological profiles in the Mediterranean countries. In general, countries that manage to control cardiovascular diseases are more likely to face cancers and neurodegenerative diseases (Fig. 7.7). Cancers account for 25% of deaths from noncommunicable diseases on average in the region. They exceed 30% in countries such as France, Slovenia, Israel, Turkey or Portugal (although cancer mortality has been decreasing for some decades now) and represent less than 20% in all North African countries and in Albania, Bulgaria and Montenegro.

This unequal situation with regard to cardiovascular diseases and cancers is partly responsible for the divergence in $e_{65}$ observed between 1950 and 2019, and also for the current disparities in adult mortality. The progression of $e_{65}$ is correlated with the ability to manage chronic diseases that occur with age, cancers, neurodegenerative diseases and accidents.

Moreover, not all Mediterranean populations are affected with the same intensity by societal diseases. Arab-Muslim countries are generally much less affected by alcohol-related deaths (three times less than in other Mediterranean countries) and, to a lesser extent, by smoking-related deaths. In contrast, road traffic deaths are higher, particularly in Algeria, Libya and Jordan, which may explain some of the current disparities in adult mortality.

Finally, the Mediterranean countries are very unevenly affected by obesity, which is a risk factor for cardiovascular diseases and diabetes in particular. It is particularly high in countries on the Southern and Eastern shores, which affected one in three adults over the age of 18 on average in 2015, compared with one in five in other countries.

## 7.5 Conclusion

In 1950, Mediterranean societies experienced very different mortality conditions. Since then, there has been a great convergence of life expectancy at birth, driven by the decline in infant, child and adult mortality with the control of infectious diseases. All countries are now in a low mortality phase. However, the convergence of life expectancy at birth stopped about 30 years ago and the analysis of the data even

<footnote n="7">⁷ The WHO classifies deaths into three main categories: communicable, maternal, perinatal and nutritional diseases; noncommunicable diseases; and accidents. We focus on non-communicable diseases, as they comprise the bulk of chronic and societal diseases.</footnote>
reveals a divergence of mortality after 65 years. These trends can be attributed at least in part to the uneven capacities of Mediterranean countries to combat cardiovascular disease, neurodegenerative diseases and cancer. There is no doubt, however, that an improvement in these capacities could lead to a resumption of the convergence of mortality after age 65, and thus of life expectancy at birth. This is an important issue because the number of older people will continue to increase by 2060 (see Chap. 2).

## References

Fargues, P. (1986). Un siècle de transition démographique en Afrique méditerranéenne 1885-1985. *Population, 41*, 205-232. https://doi.org/10.2307/1533059

Frenk, J., Bobadilla, J. L., Stern, C., Frejka, T., & Lozano, R. (1991). Elements for a theory of the health transition. *Health Transition Review, 1*, 21–38. http://www.jstor.org/stable/40608615

Human Life-Table Database (HLD). Max Planck Institute, University of California at Berkeley (USA), French Institute for Demographic Studies (France). http://www.lifetable.de/

Human Mortality Database (HMD). Max Planck Institute, University of California at Berkeley (USA), French Institute for Demographic Studies (France). www.mortality.org/

Meslé, F., & Vallin, J. (2006). The health transition: Trends and prospects. In G. Caselli, J. Vallin, & G. J. Wunsch (Eds.), *Demography: Analysis and synthesis* (Vol. II, pp. 247–260). Elsevier.

Omran, A. R. (1971). The epidemiologic transition: A theory of the epidemiology of population change. *The Milbank Memorial Fund Quarterly, 49*, 509-538. https://doi.org/10.1111/j.1468-0009.2005.00398.x

Pouget, B. (2021). La Méditerranée et les grandes épidémies. Retour sur un demi-siècle de travaux historiques. *Cahiers de la Méditerranée, 103*, 173-189. https://doi.org/10.4000/cdlm.15133

Speziale, S. (2018). Les médecins européens, médiateurs scientifiques et culturels en Afrique méditerranéenne entre le XVIIIe et le XIXe siècle. *Cahiers De La Méditerranée, 96*, 231-248. https://doi.org/10.4000/cdlm.10953

Tabutin, D., Vilquin, E., & Biraben, J.-N. (2002). *L'histoire de la population de l'Afrique du Nord pendant le deuxième millénaire*. Document de Travail 15. Centre de recherche en démographie.

Vallin, J., & Meslé, F. (2004). Convergences and divergences in mortality. A new approach to health transition. *Demographic Research, 2*, 10–43. https://doi.org/10.4054/DemRes.2004.S2.2

Vallin, J., & Meslé, F. (2014). De la transition épidémiologique à la transition sanitaire: l'improbable convergence générale. In D. Tabutin & B. Masquelier (eds.), *Ralentissements, résistances et ruptures dans les transitions démographiques* (pp. 257-290). Actes de La Chaire Quetelet [2010]. Presses Universitaires de Louvain.

Weeks, J. (2020). *Population: An introduction to concepts and issues* (13th ed.). Cengage.

WHO Mortality Database. World Health Organization. https://platform.who.int/mortality

World Population Prospects. (2022). United Nations, Department of Economic and Social Affairs, Population Division. https://population.un.org/wpp/
**Open Access** This chapter is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

The images or other third party material in this chapter are included in the chapter's Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the chapter's Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

<figure><img src="image_60.png" /></figure>
Chapter 8

The Mediterranean Migration System

<figure><img src="image_61.png" /></figure>

Check for
updates

**Abstract** Together with the border between the US and Mexico, the Mediterranean is the largest migration area in the world. The stock of migrants resident in the Mediterranean countries was 42.6 million in 2020. About 2/3 of these international migrants are found in 4 countries (France, Spain, Italy, Turkey) and 20% in the rest of the Near East (Jordan, Lebanon, Israel, Syria, Palestine). The absolute number of these international migrants can vary greatly from one country to another; the migrants can thus represent a significant share of the overall population. The Mediterranean Basin has been historically characterised by a regular circulation of people within the region. The period after World War II till today (1948–2022) has been characterised by several changes in the Mediterranean migration system, which were largely driven by economic and political factors. Through a chronological approach, we can identify five periods that synthetise the evolution of migration in the Mediterranean region during this period.

**Keywords** International migrations • Migration system • High skilled migration • Irregular migration • Mediterranean

**8.1 Introduction**

Together with the border between the US and Mexico, the Mediterranean is the largest migration area in the world (Venier & Oliveau, 2023). The stock of migrants resident in the Mediterranean countries was 42.6 million (Fig. 8.1) in 2020. About 2/3 of these international migrants are found in 4 countries (France, Spain, Italy, Turkey) and 20% in the rest of the Near East (Jordan, Lebanon, Israel, Syria, Palestine). The absolute number of these international migrants can vary greatly from one country to another; the migrants can thus represent a significant share of the overall population. For example, they represent more than 20% of the population in Malta, Jordan, Lebanon and Israel.

46.1 million people (representing 16.4% of all international migrants) is the stock of emigrants whose country of origin is one of the Mediterranean countries and
<figure><img src="image_62.png" /><figcaption>**Fig. 8.1** Stock of migrants and share of total population (in %) in the Mediterranean (2020) (Source: International Migrant Stock [2020] [United Nations])</figcaption></figure>
who have emigrated all over the world (including other Mediterranean countries) from their country of origin. Indeed, a significant proportion of these Mediterranean emigrants moved within the Mediterranean region: 22.6 million emigrants moved from their home to another country belonging to the Mediterranean Basin.

The migration in the Mediterranean region is largely influenced by the unequal age structure of the resident population which is a consequence of the so-called demographic transition. As discussed elsewhere in this book (see Chaps. 3 and 4), the countries of the Mediterranean Basin are at a different transition stage. As a consequence, while the median age in most of the ageing countries of the North Mediterranean is over 40 years (except Albania and Montenegro), in the Southern and Eastern shores, the median age is less than 30 years, resulting in a much younger age structure. This favourable demographic situation, known as a youth bulge, has great potential from an economic point of view: according to the demographic dividend theorists, it may cause rapid economic growth due to a higher level of education and labour market participation (Bloom et al., 2017). However, countries of the Southern and Eastern region of the Mediterranean have not yet benefited from the demographic dividend. The youth population is much more educated and qualified compared to the generations of their parents, nonetheless, the economic opportunities for these generations are still yet to come. Indeed, the labour supply is higher than the demand, resulting in high unemployment rates. High inflation rates and increasing income inequalities characterise the economy of most of the countries. Therefore, the young generations belonging to the youth bulge, instead of benefitting from the demographic dividend, were at the heart of the protests, which culminated in the so-called Arab Spring, at the beginning of the second decade of the 2000 (Martin & Bardak, 2011). Political and economic problems affecting the Arab Mediterranean countries act as a major driver of migration to European and Near Eastern countries (Etling et al., 2020).

The Mediterranean Basin has been historically characterised by a regular circulation of people within the region. The period after World War II till today (1948–2022) has been characterised by several changes in the Mediterranean migration system, which were largely driven by economic and political factors (De Haas, 2011). Through a chronological approach, we can identify five periods that synthetise the evolution of migration in the Mediterranean region during this period: 1950–1995 (1950–1963; 1963–1973; 1973–1995), then 1996–2022 (1996–2010; 2011–present).

## 8.2 Migration in the Mediterranean (1950–1995)

One of the main characteristics of the first period (1948–1963) of this first large period is the post-war reconstruction of Northern and Western European countries. The main region of origin were Southern European countries. In the early 1960s, the number of immigrant residents in Western Europe attained the record number of 7.6 million. Another characteristic of this period is that migration in the Southern and Eastern Mediterranean countries was mostly internal.
The main characteristic of the following period (1963–1973) is a sharp decrease in the flows from Southern Europe to Western European countries and an increase in migration flows from Southern and Eastern Mediterranean countries to this region. More specifically France, Germany, Switzerland, Belgium and Austria were the main destination countries. France and Germany were the main receiving countries in Europe during this phase: in France there was a strong presence of migrants from the Maghreb, while in Germany the number of migrants from Turkey steadily increased, replacing migrants from Southern European countries, in particular from Italy.

The early 1970s, characterised by the oil crisis of 1973 mark a slowdown of migration flows in the Mediterranean and correspond to the beginning of the third period (1973–1995). These major changes were largely affected by the process of globalisation, implying a restructuring of the world economy (De Haas et al., 2020). One of the main consequences of this process has been the growth of inequalities within and between regions. The new economic and political configurations had a huge impact on international migration leading to new trends. Coming back to the Mediterranean area, the most important new trend is the change of migration policies in the European countries that have traditionally received migrants. Strongly affected by the economic crisis, they are no longer able (or at least do not have the political will) to receive foreign workers. This new political (and economic) configuration in the Northern shore of the Mediterranean is characterised by restrictive entry policies with the aim of stimulating *en masse* return of migrants to their countries of origin. This policy change has a massive impact in the nature and destination of migration flows. From the 1980s onwards, there is a strong increase in the flow of refugees and asylum seekers to Europe. Family reunification becomes very important because it allows to circumvent the restrictive entry regulations. Migration to this region does not stop, however it changes dramatically assuming different forms compared to the past. One of the main consequences of the new policy configuration is the transformation of the countries of Southern Europe from countries of origin into countries of destination of international migrations. Indeed, the countries of Southern Europe, long-standing labour exporters to other European countries and to America and Oceania, became host countries for migrants originating from countries on the Southern shore of the Mediterranean, from sub-Saharan Africa, from Latin America and, after the fall of the Berlin Wall, from Eastern Europe. Another important (unintended) consequence of the oil crisis is the emergence of Persian Gulf countries and Libya as important poles of attraction for international migration, particularly from South-East Asia and the Arab countries, due to strong economic growth. Moreover, in this period Egypt became one of the main regional labour suppliers because of the opening (*infitah*) to emigration decided by Anwar Sadat and the strong population growth.

Two important political changes, the fall of the Iron Curtain and the first Gulf War, characterised the end of the 1980s and the beginning of the 1990s, generating new migration flows and weakening existing ones. During this period, the countries of Southern Europe, particularly Italy and Spain, have become the favourite destination countries for several populations originating from the Southern shore of the Mediterranean, especially from the Maghreb countries.
Another important political event has characterised the mid-1980s. In 1985, member countries of the European Union signed the Schengen Agreements marking an important breakthrough for the region's migration: a zone of free movement was established within Europe (the effective implementation of the agreements only began in 1995). The internal borders of the Union no longer existed (except for the United Kingdom and Ireland): the internal space of the EU thus became a migration system that includes 26 countries (including non-EU European countries: Iceland, Norway, Switzerland and Liechtenstein). On the other hand, the EU's external borders became increasingly controlled and inaccessible to all those subject to the Schengen visa regime, particularly for countries of the Southern and Eastern shores of the Mediterranean (Wihtol de Wenden, 2013). From this period onwards, there is the emergence of a new phenomenon, as a direct consequence of the entry restrictions in the Schengen zone, significant flows of irregular migration was followed by massive regularisations.

Lastly, high skilled migration is also increasing; it is characterised not only by the mobility of highly skilled workers but also by the increasing mobility of students.

## 8.3 Migration in the Mediterranean in the XXI Century

A new migration phase in the Mediterranean region (1996–2010) started at the turn of the late 1990s and the first decade of the 2000s; thanks to a positive economic situation, a new migration sequence began (Fig. 8.2). It is a period during which new poles of attraction emerge beyond traditional ones.

In the Northern shore of the Mediterranean, Spain and Italy confirmed their role as poles of attraction for unskilled labour, especially migrants from Southern shore countries employed in agriculture, family services, restaurant services, small retail trade and construction. In the first decade of the 2000s, Spain and Italy became host countries for migration flows, particularly from Maghreb countries and Egypt. On the other hand, in these new hosting countries, there is a low incidence of migrants coming from the Eastern shore of the Mediterranean, in particular of migrants from Turkey. The other European countries that traditionally import foreign labour continue to welcome family migration and highly qualified migrants.

Important changes are taking place on the Southern and Eastern shores of the Mediterranean. In some cases, major transformations are taking place: for example, Turkey is turning into a destination country for migration flows. Other countries in the region are becoming transit countries to Europe for migrants from Sub-Saharan Africa and Asia. Migration to the Arab countries of the Gulf and to Jordan continues to be central, especially for Egypt and the Palestinian territories.

The first decade of the 2000s ends with two disruptive events that could have dramatically altered migration flows: the global economic crisis of 2008 and the Arab Spring in 2010. Contrary to the crisis of 1973, the global economic crisis that began in 2008 did not have a strong impact on migration: the decline in migration flows was rather small. Labour migration to Southern European countries, especially
<figure><img src="image_63.png" /><figcaption>**Fig. 8.2** Stock of international migrants in the Mediterranean countries (1990–2020) (Source International Migrant Stock [2020])</figcaption></figure>

Spain was largely affected by the crisis. However, other kinds of migration (family, asylum, etc.) did not change or even increase because of the crisis (Bonifazi & Strozza, 2019).

A major disruptive factor for the entire Mediterranean region (and beyond) involving migration and mobility is linked to the season of institutional transition, known as the Arab Spring, that began in 2010. The political unrest in several countries on the Southern and Eastern shores of the Mediterranean has radically changed the institutional landscape of the area. It has triggered non-linear and on-going regime-change processes and structured, in essence, the so called “refugee crisis”. In other words, while some policy makers have claimed that economic migrants make up the majority of those arriving, the wars in Syria and Iraq, as well as continuing violence and instability in Afghanistan and Eritrea, were the “real” main drivers of the crisis.

The new political configuration marks the beginning of the ongoing new era of migration (2011–present). At the beginning of the period, thousands of Tunisians
(60,000) and Libyans (26,000) escaped from their home countries which were under-
going a period of political instability to Europe. The Italian Island of Lampedusa
become the main entry channel to Europe. The so-called “refugees crisis” has shaken
the entire region. Between 2011 and 2014, the significant reduction of the state’s
control on the socio-economic settings of most of North African countries has acutely
affected the regional and international migration flow dynamics, further growing the
relevance of the Central Mediterranean Route (CMR) the itinerary referred to as the
migration flows coming from Northern Africa towards Italy and Malta across the
Mediterranean Sea. In the first stage of the new period, Italy and Malta in the CMR
have been at the front stage for rescuing and welcoming migrants.

However, the CMR became much less relevant in terms of flows by the end
of Operation Mare Nostrum (OMN), a year-long naval and air search-and-rescue
operation promoted by the Italian government in October 2013. Indeed, during 2015,
Greece served as the main portal of entry to Europe.

The International Organization for Migration's (IOM) Displacement Tracking Matrix flow-monitoring system counted 1,005,504 irregular arrivals across the Mediterranean in 2015, including migrants journeying by a or sea to Greece, Bulgaria, Spain, Italy, Malta or Cyprus, with just 3% coming by land. To contrast, there were 280,000 arrivals by land or sea for the whole of 2014. The 2015 surge of migration into Europe (going far beyond EU countries bordering the Mediterranean) was unprecedented in scope, producing a massive humanitarian crisis and creating a political and moral impasse for European governments.

From 2011 onwards, refugee flows toward Europe—which had recorded a declining trend since 2005, have increased: the European countries most affected by these new waves have been Germany, Sweden, Italy and France. According to the UN High Commissioner for Refugees (UNHCR) data, the main countries of origin of asylum seekers in 2019 were Syria, Iraq, Afghanistan, Serbia and Kosovo and Eritrea. It is important to stress that migrants are often taking unsafe journeys to Europe: according to IOM estimates, more than 8,000 people died in the Mediterranean Sea between 2014 and 2021 in an attempt to reach Europe (Missing Migrants Project, 2023).

Despite the large attention received by the new and unprecedented number of
arrivals and asylum applications faced by European countries, in reality the coun-
tries on the Southern and Eastern shores of the Mediterranean were the most af-fected,
not only numerically speaking, by the crisis. First of all, from the numerical point
of view, they have received the largest part of refugees and asylum seekers from
neighbouring countries. More specifically Lebanon, Turkey, Jordan and Egypt are
the countries welcoming the highest number of refugees. These coun-tries have been
in the past a major recipient of refugees from Palestine, Iraq and Sudan, and they are
now hosting Syrians, Palestinians and Somalis. Overall, in the Mediterranean region,
there was a steady increase of the total stock of refugees and asylum seekers during
the last 10 years: in 2010 they were around 3 million, while in 2017 they reached the
record figure of 14.8 million (Fig. 8.3).

As already mentioned, the major receiving countries are located in the Southern
and Eastern shore of the region: most of them are internally displaced in Syria
<figure><img src="image_64.png" /><figcaption>**Fig. 8.3** Stock of refugees in the Mediterranean countries (1951–2021) (Source Refugees/Migrants Emergency Response, UNHCR [2023])</figcaption></figure>

(7 million) or hosted in Lebanon (over 1 million), Turkey (almost 4 million), Egypt (almost 300 thousand) or Libya (around 375 thousand). In reality, only a minority of asylum seekers and refugees succeeded in reaching the richer countries of the Northern Shore: France (400 thousand) and Italy (354 thousand) being the major host countries among those bordering the Mediterranean. The top countries sending refugees are mainly Syria, Iraq, the horn of Africa (through Libya), Afghanistan, Kosovo and Albania. With the current crisis, Ukraine should also be added to the list of major sending countries at least for Northern Mediterranean receiving countries.

The unbalanced share of asylum seekers and refugees hosted in the Mediterranean countries is in part the results of political and economic agreements. For instance, Turkey has become from 2015–2016 a major receiving country of refugees in the Mediterranean region, together with Lebanon (and Jordan). Turkey has become more involved than ever in the reception of refugees because of the agreement made by the Turkish government with the European Union (EU) in March 2016. According to the so-called EU-Turkey “Joint Action Plan”, in exchange of its assistance in controlling EU borders from irregular migration, Turkey has received from the EU up to 6 billion euros, has been granted visa liberalisation and has been able to reinvigorate talks about its accession to the EU (Panebianco, 2022; Wihtol de Wenden, 2019). The agreement allows EU countries to send back to Turkey irregular migrants who crossed the Turkish borders to reach an EU country. Another important agreement was a bilateral one, involving Italian and Libyan governments. In 2017 the Italian government and Libyan authorities signed a Memorandum of Understanding (MoU) in order to train the Libyan Coast Guard and to control land borders. The MoU
has been endorsed by the EU, thus the Libyan Coast Guard is trained by European forces (not only Italian). These agreements with third countries were deemed necessary because the new configuration of migration in the region has caused a great discontent among EU states. In 2015, the countries most affected by the arrivals of refugees, namely EU countries on the Mediterranean shore (Italy, Greece, Malta, etc.) have been asking for a burden-sharing scheme for welcoming refugees among EU countries according to their wealth and population. After long negotiations the then EU commission President Jean-Claude Junker, proposed in May 2015 to implement a burden-sharing agreement. However, far from being cooperative, the response of the EU non-Mediterranean countries, and more specifically of Eastern European countries belonging to the Visegrad group (Poland, Hungary, Czech Republic and Croatia), was to close their borders to the entrance of newcomers across the Balkan route. Only after the summer of 2015, the proposal to relocate 160,000 refugees, was finally accepted by EU member states.

The agreements signed with Libya and Turkey are not new to EU policies; on the contrary, they are part of the well-established European migration policy of the past two decades. Indeed, migration policies of EU countries were based on the signature of bilateral and multilateral agreements with third countries, with the aim to externalise migration control (Triandafyllidou, 2013). This process is also characterised by a policy of border externalisation, implemented by externalising to third transit and sending countries some migration control responsibilities (Sterkx, 2008). Therefore, we have to stress that the EU approach has focused predominantly on “securitised” elements such as cooperation agreements on irregular immigration, external border controls making use of logistical and surveillance technologies, and development cooperation in third countries designed to stop irregular migration. However, given the enduring reality of gross global inequalities and continued economic and political instability in the Global South, we hypothesise that this approach will continue to push forced migrants to rely on smugglers, thereby increasing the risk of exploitation, abuse and death. The recent past has shown that in the presence of durable crisis, fighting off migrants and refugees will come to a dead end. We should be aware that there is a continuity (of migration flows) notwithstanding the crises of different nature. The Mediterranean area can be defined by a migration system (Ambrosetti and Strangio, 2016): a system of principles and rules of admission for aliens that is resilient to changes in economic conditions and other exogenous shocks.

## 8.4 Two Emerging Phenomena: High Skilled and Irregular Migration

More recent migration flows in Europe are characterised by high skilled migration. A common legislation on high skilled migration was adopted by the European Council with the Directive on the EU Blue Card (Directive 2009/50/EC of 25 May 2009 recently reformed by Directive (EU) 2021/1883 of 20 October 2021). The Directive
aims at facilitating the entry and the mobility of highly skilled migrants and of the members of their families and to harmonise procedures for entry and residence in the member countries. High skilled migration has increased in all EU countries since 2010. However it declined in 2020 because of the COVID-19 pandemic. Among the EU countries, those belonging to the Northern shore of the Mediterranean do not attract a lot of skilled migrants: among those countries only France is attractive for the category of researchers. A large part of EU Blue Cards are issued in Germany. Highly skilled migrants are mainly of Chinese, Indian, American and Russian origin.

Undocumented migration has been identified as one of the main characteristics of the “Southern European model of migration” (King, 2000). As such, undocumented migration is a phenomenon largely widespread and debated in the Mediterranean region. However, estimating the number of undocumented migrants is a complex exercise, made on the basis of several sources of data, including the number of applications for regularisation.

Estimates of undocumented migration is complicated by its very nature, addition-
ally at the European level, the definitions and categories are not uniform. In the past,
the European Commission has funded the Clandestino project (between 2007 and
2009). The project was responding to a specific need for reliable information; at that
time, media and the public had a growing interest in this type of migration, who is
using “creative” figures. The aim of the project was to harmonise data sources and
methodology used to study undocumented migration, in order to build a database on
undocumented migration and to guide policies on this difficult topic in Europe.

The Frontex Agency (the European Agency for the Management of Operational Cooperation at the External Borders of the Member States of the European Union) was created in 2004 by the European Council and it is operational since October 2005 with the aim to promote, coordinate and develop European border management. Within its tasks, Frontex collects data on flows of illegal crossings of external borders and flows of illegal migrant detections reported within European borders. According to Frontex data, illegal crossing of the external EU borders has been stable between 2009 and 2013 (around 100,000 passages). In 2014, because of the worsening of the Syrian crisis, approximately 283,000 illegal crossings were spotted by Frontex, with 60% (170,000) crossing the maritime border of the centre-road Mediterranean (Italy and Malta) (Frontex, 2015). Illegal border crossing increased in 2015, because of the above-mentioned refugees crisis, and it has reached the record figures of 1.82 million in 2015. Starting from 2016 on, the figures started to decrease when 511,047 illegal border crossings were detected. In 2017, the drop in illegal border crossing continued, decreasing by 60% with respect to 2016, reaching 204,719 detections. The figures followed a decreasing trend in 2018 with 150,114 illegal border crossings. In 2019 and 2020, the number of illegal border crossing was even smaller than 2018, reaching its lowest record in 2020 because of the COVID-19 pandemic. In 2021, the numbers of illegal border crossing increased to about 200,000.

It should be stressed that the data provided by Frontex refer to detections of illegal
border crossings, rather than the number of persons, as the same person may cross
the external EU border several times. Since 2015, with the worsening of the so-
called “refugees crisis”, the European Commission and international organisations
such as the UNHCR and the IOM, put additional efforts in the data production in the Mediterranean region. Data on death at seas and on flows of individuals crossing the borders are nowadays more systematically collected by these agencies. Therefore from 2015, arrivals by sea and land borders in the Northern shore of the Mediterranean are collected by UNCHR and available on their portal, broken down by country of origin, age and gender.<fnref n="1" /> 2015 was, as already mentioned in the previous section, a record year for illegal border crossings: more than 1 million. From 2016, there has been a continuous decrease in border crossings because of the above-mentioned agreements with Turkey and Libya. The lowest figures were recorded in 2020 because of the COVID-19 pandemic (95,720). A slow recovery has characterised the last two years with respectively 123,540 and 160,057 sea and land arrivals recorded.

Missing Migrants Project (2023) is an project of IOM aiming to record people who die in the process of migrating to an international destination, regardless of their legal status. It has been implemented in various regions of the world, including the Mediterranean region since 2014.<fnref n="2" /> Since 2014, 25,405 missing migrants and 8,216 deaths of migrants were recorded in Mediterranean by the Missing Migrants Project.

## 8.5 Conclusions

The Mediterranean migration system has undergone many changes since 1948. While migration from the Southern and Eastern shores to Western Europe was numerous from the 1960s onwards, European countries implemented restrictive entry policies with the oil crises of the 1970s. We are witnessing the emergence of new poles of attraction for international migration, such as the countries of Southern Europe, which have long been labour exporters, but also Libya, Turkey and Jordan. International migration is changing, with an increase in the migration of highly skilled people, including students. More recently, the Arab Spring of the 2010 decade has brought the Mediterranean into the “refugee crisis”. Migration flows of asylum seekers and refugees are becoming unprecedented, with a peak of almost 15 million in the late 2010s. The countries most affected by this “refugee crisis” are those on the Southern and Eastern shores.

Given the demographic, economic and political situation, the Mediterranean region's migration scenario of the future could be characterised by a strong migration pressure, particularly by young adults from the South-East to Europe. This migration of young adults could be beneficial for the ageing countries of the Northern shore of the Mediterranean. This would, for example, cope with their domestic labour shortages, in particular with the segmentation of the labour market and the need to find care workers to partially respond to structural demographic ageing. Even if international migration will not be able to deal with the massive demographic ageing of the Northern shore countries, it will certainly be able to do so in a partial way in certain

<footnote n="1">¹ https://data.unhcr.org/en/situations/mediterranean.</footnote>

<footnote n="2">² https://missingmigrants.iom.int/region/mediterranean.</footnote>
sectors. To realise this benefit, one path to follow could involve (re-)opening the legal channels of migration, for both humanitarian and economic migrants, making immigration a structural and not a transitory phenomenon. For European countries, this would be an alternative to the migration policy paradigm based on securitisation and solidarity with the poor, and would mitigate political discourse and policy actions dominated by security and emergency issues.

## References

Ambrosetti, E., & Strangio, D. (2016). Migration in the Mediterranean across disciplines. In E. Ambrosetti, D. Strangio, & C. W. de Wenden (Eds.), *Migration in the Mediterranean: Socio-economic perspectives* (pp. 3–14). Routledge Studies in the European Economy. Routledge.

Bloom, D., Kuhn, M., & Prettner, K. (2017). Africa’s prospects for enjoying a demographic dividend. *Journal of Demographic Economics*, 83, 63–76. https://doi.org/10.1017/dem.2016.19

Bonifazi, C., & Strozza, S. (2019). International migrations in the northern countries of the Mediterranean. Continuity and changes, before and after the crisis. In S. Capasso & E. Ferragina (Eds.), *Mediterranean migration and the labour markets: Policies for growth and social development in the Mediterranean area* (26 p.). Routledge.

De Haas, H. (2011). Mediterranean migration futures: Patterns, drivers and scenarios. *Global Environmental Change*, 21, S59–S69. https://doi.org/10.1016/j.gloenvcha.2011.09.003

De Haas, H., Castles, S., & Miller, M. (2020). *The age of migration: International population movements in the modern world* (6th ed.). The Guilford Press.

Etling, A., Backeberg, L., & Tholen, J. (2020). The political dimension of young people’s migration intentions: Evidence from the Arab Mediterranean region. *Journal of Ethnic and Migration Studies*, 46, 1388–1404. https://doi.org/10.1080/1369183X.2018.1485093

Frontex. (2015). *Annual risk analysis 2015*. European Agency for the Management of Operational Cooperation at the External Borders of the Member States of the European Union. https://frotnex.europa.eu/assets/Publications/Risk_Analysis/Annual_Risk_Analysis_2015.pdf

International Migrant Stock 2020. (2020). United Nations, Department of Economic and Social Affairs, Population Division. https://www.un.org/development/desa/pd/content/international-migrant-stock

King, R. (2000). Southern Europe in the changing global map of migration. In R. King, G. Lazaridis, & C. Tsardanidis (Eds.), *Eldorado or Fortress? Migration in Southern Europe* (pp. 3–26). Palgrave Macmillan UK. https://doi.org/10.1057/978033982525_1

Martin, I., & Bardak, U. (2011). *Union for the Mediterranean regional employability review. The challenge of youth employment in the Mediterranean*. European Training Foundation.

Missing Migrants Project. (2023). International Organization for Migration. https://missingmigra nts.iom.int/

Operational Data Portal Refugee Situations. Mediterranean Situation. (2023). UNHCR (United Nations High Commissioner for Refugees). https://data.unhcr.org/en/situations/mediterranean

Panebianco, S. (2022). The EU and migration in the Mediterranean: EU borders’ control by proxy. *Journal of Ethnic and Migration Studies*, 48, 1398–1416. https://doi.org/10.1080/1369183X.2020.1851468

Sterkx, S. (2008). The external dimension of EU asylum and migration policy: Expanding fortress Europe? In J. Orbie (Ed.), *Europe's global role: External policies of the European Union* (pp. 117–138). Routledge.

Triandafyllidou, A. (2013). *Circular migration between Europe and its neighbourhood: Choice or necessity?* Oxford University Press.
Venier, P., & Oliveau, S. (2023). Populations en mouvement: comment se redessine le peuplement mondial? In Y. Doignon & S. Oliveau (Eds.), *Dynamique du peuplement mondial. Comment la population habite le monde*, Encyclopédie Des Sciences. ISTE Editions.

Wihtol de Wenden, C. (2013). Migrations en Méditerranée, une nouvelle donne. *Confluences Méditerranée*, 87, 19–30. https://doi.org/10.3917/come.087.0019

Wihtol de Wenden, C. (2019). Migration flows in the Euro-Mediterranean region. The challenge of migration and asylum crisis in contemporary Europe and the global compact. In F. Francesca, A. Masi, C. Wihtol de Wenden, & D. Strangio (Eds.), *Migrations. Countries of immigrants, countries of migrants*. Canada, Italy (pp. 21–37). Migrazioni/Migrations. Edizioni Nuova Cultura.

**Open Access** This chapter is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

The images or other third party material in this chapter are included in the chapter's Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the chapter's Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

<figure><img src="image_65.png" /></figure>
<figure><img src="image_66.png" /></figure>

**Chapter 9**
# Population Dynamics and Their Components

**Abstract** The Mediterranean has an average annual population growth rate of around 1%, which is about the same as the world population growth rate. With a few rare exceptions, this growth is not principally fuelled by migration flows. However, it is closely linked to the demographic transition still underway in many Southern and Eastern Mediterranean Countries, i.e. by the excess of births over deaths (natural balance). In these countries, average annual natural change of about 1.6% (higher than the world average and a fortiori that of the Mediterranean as a whole) have been observed. This chapter gives an account of the evolution of the differentiated growth rates of the populations of the Mediterranean region since the 1950s, distinguishing between the development of natural, migration and overall growth rates. This will make it possible to characterise the countries whose growth has been stimulated more by natural than migration growth depending on the period, thus heralding the sustainability of future growth rates. To achieve this, the chapter will propose a ranking of growth rates for different countries over time, as well as the expected developments in terms of projections while discussing the assumptions.

**Keywords** Natural dynamics · Migration dynamics · Population dynamics · Population growth · Projections · Mediterranean

**9.1 Introduction**

The Mediterranean has an average annual population growth rate of around 1%, which is about the same as the world population growth rate. With a few rare exceptions, this growth is not principally fuelled by migration flows. However, it is closely linked to the demographic transition still underway in many Southern and Eastern Mediterranean Countries, i.e. by the excess of births over deaths (natural balance). In these countries, average annual natural change of about 1.6% (higher than the world average and a fortiori that of the Mediterranean as a whole) have been observed. This chapter gives an account of the evolution of the differentiated growth rates of the populations of the Mediterranean region since the 1950s, distinguishing between
the development of natural, migration and overall growth rates. This will make it
possible to characterise the countries whose growth has been stimulated more by
natural than migration growth depending on the period, thus heralding the sustain-
ability of future growth rates. To achieve this, the chapter will propose a ranking of
growth rates for different countries over time, as well as the expected developments
in terms of projections while discussing the assumptions.

9.2 Evolving Power Relations

The population of the Mediterranean countries amounted to approximately 571 million inhabitants in 2020. It has increased 2.5 times in 70 years. The annual rate of growth was on average very strong until the mid-1980s (exceeding rather continuously 1.4% per year) before beginning to decline (Fig. 9.1). At the start of the twenty-first century, the growth rate of the Mediterranean population was around 0.9% per year, the same rate as that of the world population. While all countries are experiencing a slowdown in their growth, the heterogeneity between major regional clusters is still notable. North Africa and the Near East still have annual population growth above 1.3%, despite a steady decline since the mid-1980s. In 1950, growth was of the order of 2% per year, a significant rate, because it represents a doubling of the population in 35 years. The evolution of population growth in the Near East highlights the impact of cyclical events, such as the insurgency in Syria (1978–1982), the war in Iraq in the 2000s and the reception of refugees in several Near Eastern countries. In contrast, Southern Europe and the Balkans have zero and negative growth respectively (-0.4%). The period when several Southern European countries became receiving countries with a positive net migration (see Chap. 8) can be seen on the graph with a significant increase in population growth in the 2000s, followed by a decrease after the 2007 crisis.

If we focus on countries with more than 10 million inhabitants, we notice that the
3 most populated countries in the Mediterranean in 1950 are all Southern European
countries (Italy, France, Spain), ahead of Egypt and Turkey (Table 9.1). There are
only 5 countries with more than 10 million inhabitants in the 27 Mediterranean coun-
tries. In 1980, two new countries (Morocco and Algeria) joined the group of most
populous countries, while the demographic breakthrough of Turkey and Egypt was
already visible, with Spain moving up from third to fifth place. In 2020, the order of
the shores reversed since Egypt and Turkey were the two most populous countries
in the Mediterranean largely ahead of the three Southern European countries, with
respectively about 109 and 85 million inhabitants (Blöss-Widmer, 2022). Together,
they represent 34% of the Mediterranean population, the same order of magnitude
as India and China represent in the world population. 5 new countries exceeded
the threshold of 10 million inhabitants in 2021: Syria, Tunisia, Jordan, Greece and
Portugal. Seven of the 12 countries with more than 10 million inhabitants are located
on the Southern and Eastern shores. This ranking highlights the reversal of the demo-
graphic order that prevailed in the 1950s. As a result of the demographic transition
<figure><img src="image_67.png" /><figcaption>**Fig. 9.1** Mediterranean comparative annual growth rate (%) by regional groups (1950–2020) (Source World Population Prospects, 2022. Calculations made by the authors)</figcaption></figure>

(see Chap. 4), the populations of the Southern and Eastern shores have increased sharply and their weight in the Mediterranean population has increased considerably. Indeed, the Northern shore represented 68% of the Mediterranean population in 1950, and the Southern and Eastern shores 32%. These proportions stood at 39% and 61% respectively in 2020. In other words, while the majority of the Mediterranean population was on the Northern shore in 1950, the situation is exactly the opposite at present where 60% of the Mediterranean population is on the Southern and Eastern shores. It should be noted that almost 40% of the Mediterranean population is located in North Africa, 24% in the Near East, 32% in Southern Europe, and only 7% in the Balkans.

Some countries have therefore experienced an impressive increase in their population since 1950 (Fig. 9.2). Egypt and Turkey have experienced growth rates of more than 2% per year for more than 30 years. Their population has multiplied by 5 and 4, respectively. The most spectacular trajectory is that of Jordan, which had less than 500,000 inhabitants in 1950, but more than 11 million in 2021. This increase represents a more than 25-fold increase in the population in 70 years. The countries of the Southern and Eastern shores have seen their population growth by more than 4 times since 1950, compared to 1.5 for the countries of the Northern shore.

This growth is largely a consequence of the various demographic transitions described in Chap. 4. It depends firstly on the level of the natural balance (number of births minus number of deaths), a component that varies according to the stages of the demographic transition. The rate of population change also increases by the size of the net migration (estimate of the difference between arrivals and departures from
<table><caption>**Table 9.1** Countries with more than 10 million inhabitants in 1950, 1980 and 2021 (population numbers in millions)</caption><thead><tr><th colspan="2">1950</th><th colspan="2">1980</th><th colspan="2">2021</th></tr></thead><tbody><tr><td>Italy</td><td>46</td><td>Italy</td><td>56</td><td>Egypt</td><td>109</td></tr><tr><td>France</td><td>42</td><td>France</td><td>54</td><td>Turkey</td><td>85</td></tr><tr><td>Spain</td><td>28</td><td>Turkey</td><td>44</td><td>France</td><td>65</td></tr><tr><td>Egypt</td><td>21</td><td>Egypt</td><td>44</td><td>Italy</td><td>59</td></tr><tr><td>Turkey</td><td>21</td><td>Spain</td><td>37</td><td>Spain</td><td>47</td></tr><tr><td></td><td></td><td>Morocco</td><td>20</td><td>Algeria</td><td>44</td></tr><tr><td></td><td></td><td>Algeria</td><td>19</td><td>Morocco</td><td>37</td></tr><tr><td></td><td></td><td></td><td></td><td>Syria</td><td>21</td></tr><tr><td></td><td></td><td></td><td></td><td>Tunisia</td><td>12</td></tr><tr><td></td><td></td><td></td><td></td><td>Jordan</td><td>11</td></tr><tr><td></td><td></td><td></td><td></td><td>Greece</td><td>10</td></tr><tr><td></td><td></td><td></td><td></td><td>Portugal</td><td>10</td></tr></tbody></table>

(Source World Population Prospects, 2022)

<figure><img src="image_68.png" /><figcaption>**Fig. 9.2** Comparative population evolution in Mediterranean by country (1950–2021) (Source World Population Prospects, 2022)</figcaption></figure>
each country for each period). These two elements, the components of population
dynamics, can jointly stimulate growth (positive natural balance and positive net
migration), work against each other (positive natural balance/negative net migration
or vice versa) or contribute to a general decline (negative natural and net migration).

In order to fully understand the population dynamics of the Mediterranean coun-
tries, it is therefore necessary to analyse its two components (natural and migration)
in order to derive several profiles of dynamics.

9.3 Natural and Migration Dynamics: Which Combinations Exist in the Mediterranean?

With regard to the natural component, the average annual rates of all countries have fallen considerably since 1950. The demographic transition generates an undeniable phenomenon of convergence of rate of natural change towards lower levels (see Chap. 4). However, there are still marked differences from one shore to the other: several demographic regimes still coexist in the Mediterranean. As for migration dynamics, they cannot be easily summarised for many countries, as they are essentially linked to the economic situation (economic, reception of refugees, etc.) and to specific migration policies (see Chap. 8). It can sometimes be of relative importance for the total population dynamics for certain countries. Figure 9.3 presents the two demographic components of the Mediterranean countries for 3 periods (1950–1954, 1990–1995 and 2015–2019).

9.3.1 Natural Dynamics: South and East

The majority of Mediterranean countries have been in constant natural growth since
the 1950s. The level of this natural growth averaged over 2% per year until the
early 1990s and then halved on average. These countries, stimulated by their natural
growth, belong very much to Northern Africa (Morocco, Algeria, Tunisia, Egypt,
Libya) and the Near East (Palestine, Turkey, Syria). The majority of these countries
are therefore, logically, those whose demographic transition began later, but much
more rapidly, than the others (Chap. 4). The gains in life expectancy due to declining
mortality in Northern Africa and the Near-East have been concentrated among the
youngest and adults, increasing their probability of survival and thus automatically
lowering deaths at all ages (see Chap. 7). This phenomenon, which increases the
probability of survival for everyone, contributes to a structural increase in births
from generations of fertile age newly preserved from death. It is also combined with
a fertility decline that occurs on a delayed mortality timing, still generating many
births (Chap. 5). The natural growth levels of Northern Africa and Near East countries
<figure><img src="image_69.png" /><figcaption>**Fig. 9.3** Participation of natural and migration components on total growth for Mediterranean countries at different periods (1950–1955, 1990–1995, 2015–2020) (*Source* World Population Prospects, 2022)</figcaption></figure>
are relatively high and similar, rising over the period from 2.6% per annum to 1.7% per annum.

Some countries have not broken with natural growth, despite the fact that demographic ageing started earlier. France, Cyprus, Malta, Montenegro, Macedonia, Kosovo and Albania have managed to maintain positive natural growth for reasons related to higher fertility by age of women, combined with age structures that are still favourable. However, with rates of no more than 0.5% per year for decades (except for Kosovo), the level of natural growth in these countries is much lower than in the Near-East or Northern Africa.

In contrast to the previous countries, nine Mediterranean countries have experienced a weak and downward natural dynamic since the 1950s, with episodes of natural decline (excess of deaths over births) that have appeared and continued for some for as long as 30 years (Chap. 4). None of these less dynamic countries are located on the Southern and Eastern shores, all are on the Northern shore: Slovenia, Spain, Italy, Bulgaria, Bosnia-Herzegovina, Serbia, Portugal, Greece, and Croatia. Their average annual rate of population dynamics over the period contrasts with previous countries, having increased from about 1.2% on average in the 1950s to -0.3% in 2015-2020. These countries are experiencing a slowdown in their natural dynamics as their populations age and younger generations reduce their fertility. Gap age effects have sometimes accentuated the phenomenon. It is from the years 1990-1995 that negative natural dynamics began to be observed in Italy, Croatia and Bulgaria, rapidly followed by Slovenia and Serbia (1995-2000), Portugal (2005-2010), Greece and Bosnia-Herzegovina (2010-2015) and Spain (2015-2020). Thus, while these 9 countries all had moderate but positive natural growth in the early 1990s, they were all (except Slovenia) in 2020 remarkable for their negative natural dynamics.

### 9.3.2 Migration Dynamics: Sending Versus Receiving Countries

Although the Southern and Eastern Mediterranean countries are known more as sending countries (negative migration balances) and those of Southern Europe as receiving countries (positive migration balances) (Chap. 8), a detailed analysis makes it possible to show this, to measure the temporalities and to reveal exceptions (Fig. 9.3).

Among the countries that have been in continuous natural growth for 70 years, a large part has been, at the same time and over a large part of the period, more senders of migrants than receivers (negative net migration). This includes Palestine, Egypt, Algeria, Turkey, Morocco, Tunisia, Macedonia, Montenegro, Albania, Kosovo and the Syrian. The intensity of negative net migration has been variable since the 1950s, contributing more or less to tempering the pace of total growth. All these countries, which are naturally dynamic but have had largely negative net migration since the
1950s, are therefore in North Africa, the Near East and some in the Balkans. No Southern European country has had a consistently negative net migration for 60 years, this regional grouping being more characterised by periods of migration alternation (receivers or senders in balance depending on the period) (Chap. 8).

Only 3 countries out of 17 with positive natural growth in the three periods also had positive migration growth: Israel, France and Jordan. France is truly an exception, since it is not only one of the three Mediterranean countries whose two components (natural and migration) are positive, but it is the only Southern European country to have this characteristic.

The countries of Southern Europe and the Balkans have experienced a natural downward trend over the past 60 years. Their migration attractiveness is often erratic, and partially (or not at all) compensates for periods of decline. A rather critical demographic dynamic of decline has thus gradually taken hold in Southern Europe and the Balkans. Two countries, for example, combine their natural dynamics (sustained until the 1990s and then much weaker, or even negative) with a migration dynamic that has constantly been negative for 60 years: Bulgaria and Bosnia-Herzegovina. These countries lost more people than they gained through migration over the whole period, which did not help to offset their negative natural dynamics. Other situations with negative net migration combined with depopulation (negative natural balances) have been noted in recent periods, such as in Serbia, Greece, Croatia, followed closely by Portugal, Slovenia, Spain and Italy where one of the components is negative. Depending on the economic situation, these countries are sometimes attractive and sometimes repulsive from a migration point of view. Positive migration balances over a few periods almost never compensate in level for the low number of births in view of the rise in deaths recorded as a result of demographic ageing.

## 9.4 Growth Outlook to 2060: What Can We Expect?

By 2060, the median scenario of the United Nations projections forecasts a Mediterranean population of nearly 685 million. Less than half of the countries are experiencing this growth, with the other half projected to lose more of its population each year than it gains from low fertility and population ageing. For the latter countries of Southern Europe and the Balkans, which are in decline, even the hypothesis of a net migration attraction forecast for some (Portugal, Italy, Greece, Spain, Slovenia and Malta) would not be enough to compensate for the negative natural balance that has lasted for a long time (Fig. 9.4).

As a result, the weight of the Southern and Eastern shores would continue to increase, since they will represent 72% of the Mediterranean population, compared to 61% at present (Table 9.2). One in two inhabitants of the Mediterranean by 2060 will be in Egypt, Turkey or Algeria. As for Italy, Spain, Portugal and Greece, all four would lose inhabitants, with the last two even falling back below the 10 million mark. Southern Europe would then represent less than 30% of the Mediterranean population, compared with 39% in 2020 and the Balkans less than 5%. According
<figure><img src="image_70.png" /><figcaption>**Fig. 9.4** Projection of participation of natural and migration components on the total growth for the Mediterranean countries (2060, median variant) (Source World Population Prospects, 2022)</figcaption></figure>

to the median scenario, many countries would have fewer inhabitants in 2060 than in 2020, the vast majority being on the Northern shore, but Lebanon also falls into this category.

Chapter 5 on fertility trends, however, has shown how much uncertainty still exists when it comes to making projections over somewhat distant horizons. Indeed: “Not only is there no longer a general theory capable of indicating the direction in which fertility should significantly evolve, but the future of mortality, which as we have seen weighs heavily on the projections, is the subject of a lively debate, without mentioning migration” (Vallin & Caselli, 2006). Demographic projections are less subject to uncertainty than economic projections, due to the nature of the projected quantities, the inertia of demographic phenomena, and the heavy trend they represent. However, as noted again recently by Adam (2021) in the article entitled “How far will global population rise? Researchers can’t agree”, it is common for the methods and scenarios used by the different research teams to<fnref n="1" /> lead to quite contrasting results.<fnref n="2" />

<footnote n="1">¹ We are thinking in particular of the scenarios of the United Nations (World Population Prospects 2022), of those of CEPAM (Joint Research Centre [European Commission], 2018), of Lutz et al. (2014) and of Vollset et al. (2020).</footnote>

<footnote n="2">² For example: “World population projections for the twenty-first century as produced by the United Nations Population Division and by the International Institute for Applied Systems Analysis (IIASA) have changed quite a bit over time as a function of different long-term fertility and mortality assumptions, and the incorporation of most recent observed empirical trends and analysis. In their most recent assessments, the UN (2017) projects continuous growth of world population for their medium variant, reaching more than 11 billion people by the end of the century. Whereas IIASA (...) with its medium scenario (SSP2), projected a peak population of 9.4 billion in 2065–2075, followed by a slight decline to 9 billion by the end of the century (...) This difference is mostly due to different methods of deriving long-term fertility assumptions for the different parts of the world, where the UN relies primarily on statistical extrapolation models and IIASA gives more weight to expert arguments and scientific reasoning” (Joint Research Centre [European Commission], 2018, 117).</footnote>
<table><caption>**Table 9.2** Population (in thousands) and share of Mediterranean population (in %) in 2020 and 2060, by countries and regional area</caption><thead><tr><th rowspan="2">Countries</th><th colspan="2">Population (in thousands)</th><th colspan="2">Share of Mediterranean population (in %)</th></tr><tr><th>2020</th><th>2060</th><th>2020</th><th>2060</th></tr></thead><tbody><tr><td>Egypt</td><td>107,465</td><td>174,311</td><td>19</td><td>25</td></tr><tr><td>Turkey</td><td>84,135</td><td>96,017</td><td>15</td><td>14</td></tr><tr><td>France</td><td>64,480</td><td>64,903</td><td>11</td><td>9</td></tr><tr><td>Algeria</td><td>43,452</td><td>63,554</td><td>8</td><td>9</td></tr><tr><td>Italy</td><td>59,501</td><td>48,233</td><td>11</td><td>7</td></tr><tr><td>Morocco</td><td>36,689</td><td>46,214</td><td>6</td><td>7</td></tr><tr><td>Spain</td><td>47,364</td><td>41,257</td><td>8</td><td>6</td></tr><tr><td>Syria</td><td>20,773</td><td>41,042</td><td>4</td><td>6</td></tr><tr><td>Jordan</td><td>10,929</td><td>16,131</td><td>2</td><td>2</td></tr><tr><td>Tunisia</td><td>12,162</td><td>14,512</td><td>2</td><td>2</td></tr><tr><td>Israel</td><td>8,757</td><td>14,332</td><td>2</td><td>2</td></tr><tr><td>Palestine</td><td>5,019</td><td>10,036</td><td>1</td><td>1</td></tr><tr><td>Libya</td><td>6,654</td><td>8,762</td><td>1</td><td>1</td></tr><tr><td>Portugal</td><td>10,298</td><td>8,683</td><td>2</td><td>1</td></tr><tr><td>Greece</td><td>10,512</td><td>8,506</td><td>2</td><td>1</td></tr><tr><td>Serbia</td><td>7,358</td><td>5,238</td><td>1</td><td>1</td></tr><tr><td>Lebanon</td><td>5,663</td><td>4,947</td><td>1</td><td>1</td></tr><tr><td>Bulgaria</td><td>6,979</td><td>4,656</td><td>1</td><td>1</td></tr><tr><td>Croatia</td><td>4,097</td><td>3,067</td><td>1</td><td>0</td></tr><tr><td>BiH</td><td>3,318</td><td>2,523</td><td>1</td><td>0</td></tr><tr><td>Albania</td><td>2,867</td><td>2,218</td><td>1</td><td>0</td></tr><tr><td>Slovenia</td><td>2,118</td><td>1,920</td><td>0</td><td>0</td></tr><tr><td>Macedonia</td><td>2,111</td><td>1,784</td><td>0</td><td>0</td></tr><tr><td>Kosovo</td><td>1,671</td><td>1,575</td><td>0</td><td>0</td></tr><tr><td>Cyprus</td><td>1,238</td><td>1,404</td><td>0</td><td>0</td></tr><tr><td>Montenegro</td><td>629</td><td>560</td><td>0</td><td>0</td></tr><tr><td>Malta</td><td>515</td><td>507</td><td>0</td><td>0</td></tr><tr><td>Northern Africa</td><td>206,421</td><td>307,354</td><td>37</td><td>45</td></tr><tr><td>Near-East</td><td>136,514</td><td>183,909</td><td>24</td><td>27</td></tr><tr><td>Balkan countries</td><td>39,989</td><td>30,471</td><td>7</td><td>4</td></tr><tr><td>Southern Europe</td><td>182,158</td><td>163,582</td><td>32</td><td>24</td></tr><tr><td>Southern and Eastern Shores</td><td>342,935</td><td>491,263</td><td>61</td><td>72</td></tr><tr><td>Northern Shore</td><td>222,147</td><td>194,053</td><td>39</td><td>28</td></tr><tr><td>Mediterranean</td><td>565,083</td><td>685,317</td><td>100</td><td>100</td></tr></tbody></table>

(Source World Population Prospects, 2022)
Although assumptions are difficult to make and subject to discussion, we have nevertheless identified groups of countries whose fertility does not seem, for the time being at least, to reach low fertility levels (Chap. 5). Consequently, the growth dynamics of the regional clusters of Northern Africa and Near East could be more sustained than what all the recent projections predict. Conversely, the projections of decline for the countries of Southern Europe and the Balkans seem less uncertain, as they are part of an inevitable context of ageing and a preference for small families. And if declining countries were to shift their fertility upwards to counter the rate of growth of the elderly, they would have to reach levels of around 3 children per woman (Blanchet, 2001). However, this does not seem to be consistent with the number of desired children reported by families in international comparative surveys.<fnref n="3" />

With regard to migration, Chap. 8 showed the importance of the movements to be anticipated towards ageing Southern Europe. However, regardless of the size of net immigration to these countries over the next 40 years (the evolution of which is the most unpredictable of all the components), this solution would not, a priori make it possible to halt the expected phenomena of decline, because the ageing of the population leads to the observation of too rapid an increase in the number of deaths. As early as the 2000s, a United Nations report (Population Division et al., 2000) modelled an adjustment of imbalances by migration flows. The main conclusions were that controlling ageing through migration would require migration balances twice as high as those experienced by the most attractive countries in the world such as the United States; and some simulations of migration balances needed to maintain dependency ratios in ageing developed countries are even described as “totally unrealistic”<fnref n="4" /> (Blanchet, 2001, 523), because certainly not acceptable to the populations of these same countries, nor realistic.

In conclusion, in the Mediterranean, the average annual growth rates have continued to decline in all countries since the 1950s with the spread of the demographic transition towards the countries on the Southern and Eastern shores. While growth differentials have narrowed, on average much faster rates are still recorded in the Near East and Northern Africa compared to Southern Europe and especially in the Balkan countries. The population dynamics of the vast majority of countries are mainly due to the natural component (excess of births over deaths). If migration dynamics temper the demographic dynamics of sending countries,<fnref n="5" /> it is expected to sustain, but with difficulty, that of the receiving countries with the lowest fertility

<footnote n="3">³ We are thinking in particular of the responses given to surveys such as: The European Values Study (EVS), International Social Survey Program (ISSP), World Values Survey (WVS), Generations and Gender Survey (GGS), Afrobarometer and Anna Lindh Foundation.</footnote>

<footnote n="4">⁴ This text has been translated into English by the authors. The original text in French is as follows: “ totalement irréalistes”.</footnote>

<footnote n="5">⁵ “Anyway, according to CEPAM Medium (SSP2) scenario, migration would not be able to affect significantly the MENA population size and structure: (...) It implies that population changes would be mainly driven by fertility and mortality behaviours under this scenario” (Joint Research Centre [European Commission], 2018, 69).</footnote>
and the highest life expectancies, since most of them are expected to lose inhabitants by 2060.<fnref n="6" />

## References

Adam, D. (2021). How far will global population rise? Researchers can’t agree. *Nature*, **597**, 462–465. https://doi.org/10.1038/d41586-021-02522-6

Blanchet, D. (2001). L'impact des changements démographiques sur la croissance et le marché du travail: Faits, théories et incertitudes. *Revue D'économie Politique*, **111**, 511-564. https://doi.org/10.3917/redp.114.0511

Blöss-Widmer, I. (2022). Make way for numbers: The age race in the Mediterranean. *IEMed Mediterranean yearbook 2022*. European Institute of the Mediterranean (IEMed). https://www.iemed.org/wp-content/uploads/2022/10/Make-Way-Numbers-Age-Race-Mediterranean-Bloss-Widmer-IEMedYearbook2022.pdf

Joint Research Centre (European Commission). (2018). *Demographic and human capital scenarios for the 21st century: 2018 assessment for 201 countries*. Publications Office. https://data.europa.eu/doi/10.2760/41776

Lutz, W., Butz, W. P., & Samir, K. C. (2014). World population and human capital in the twenty-first century. *Oxford University Press*. https://doi.org/10.1093/acprof:oso/9780198703167.001.0001

Population Division, Department of Economic and Social Affairs, and United Nations Secretariat. (2000). *Replacement migration: Is it a solution to declining and ageing populations?* https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/unpd-egm_200010_un_2001_replacementmigration.pdf

Vallin, J., & Caselli, G. (2006). The United Nations’ world population projections. In G. Caselli, J. Vallin, & G. J. Wunsch (Eds.), *Demography: Analysis and synthesis* (Vol. III, pp. 197–234). Elsevier.

Vollset, S. E., Goren, E., Yuan, C.-W., Cao, J., Smith, A. E., Hsiao, T., Bisignano, C. et al. (2020). Fertility, mortality, migration, and population scenarios for 195 countries and territories from 2017 to 2100: A forecasting analysis for the global burden of disease study. *The Lancet* 396. Elsevier: 1285–1306. https://doi.org/10.1016/S0140-6736(20)30677-2

*World population prospects*. (2022). United Nations, Department of Economic and Social Affairs, Population Division. https://population.un.org/wpp/

<footnote n="6">⁶ “If the current demographic trends continue as in the presented scenarios the main driver of change in population size of EU-28 countries would be migration” (Joint Research Centre [European Commission], 2018, 33).</footnote>
**Open Access** This chapter is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

The images or other third party material in this chapter are included in the chapter's Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the chapter's Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

<figure><img src="image_71.png" /></figure>
Chapter 10
Conclusions. An Overview of Population
Dynamics in the Mediterranean

<figure><img src="image_72.png" /></figure>

Check for
updates

**Abstract** This book has made it possible to review the main demographic developments of the last 70 years. Above all, it has made it possible to highlight the rapid global homogenisation of several demographic behaviours in the Mediterranean, to point out certain exceptions and to identify the global challenges that await Mediterranean populations.

**Keywords** Mediterranean · Population studies · International comparison · Demographic convergence

**10.1 Major Demographic Developments Since 1950**

This book has made it possible to review the main demographic developments of the last 70 years. Above all, it has made it possible to highlight the rapid global homogenisation of several demographic behaviours in the Mediterranean, to point out certain exceptions and to identify the global challenges that await Mediterranean populations.

From a geographical point of view, the Mediterranean appears to have extremely heterogeneous populations, since it includes some of the most densely populated regions in the world as well as desert regions. Nevertheless, most of the Mediterranean countries are experiencing a strong coastalisation of its population. In addition, there are several coastal cities. The role of water, the sea and also the rivers in shaping human settlement in the Mediterranean is a characteristic that is present in the entire area studied (the Nile being the most archetypal example). The Mediterranean is undergoing rapid urbanisation, from a predominantly rural population in 1950 to an urban population of 70% by 2020. The urban agglomerations on the Southern and Eastern shores account for most of the Mediterranean's urban population growth between 2000 and 2020. This phenomenon has led to a higher concentration of the population in the area, especially on the coastlines. This human pressure on the natural environment is not without consequences in terms of maritime pollution, the
degradation of the environment and biodiversity, fires, pressures on water resources, etc.

From a demographic point of view, however, the rate of growth has been steadily decreasing for all Mediterranean countries since the late 1970s. However, due to the inertia of the demographic phenomena, the populations of the Mediterranean countries have more than doubled, reaching around 570 million inhabitants in 2020. This increase in Mediterranean populations is mainly driven by the Southern and Eastern shores. Indeed, while the Mediterranean as a whole has gained 110 million inhabitants between 2000 and 2020, the countries on the Northern Shore have only contributed 11 million. This trend explains why today 2 out of 3 Mediterranean people live in a country on the Southern and Eastern shores (compared to 1 out of 3 in 1950), and also why Egypt and Turkey are the most populated Mediterranean countries in 2020, and no longer Italy and France as in 1950.

The slowdown in the rate of population growth in the Mediterranean, which is currently lower than in the past, can be explained by the demographic transition generalising to the whole region. All Mediterranean countries have seen their birth and death rates fall, thus limiting population growth. Nevertheless, we have managed to identify that there are significant disparities behind these overall trends. There is no single demographic transition model in the Mediterranean. On the contrary, there are several types, differing in their pace, course, and post-transitional demographic regime. The transition has been much faster in some countries than in others. Some post-transitional regimes are characterised by declining growth (Bulgaria, Croatia, Italy, etc.), others by low or moderate growth (France, Cyprus, Tunisia, Kosovo, Turkey, etc.), and a few are still experiencing relatively high growth (Egypt, Palestine, Jordan, Algeria, Israel). Thus, the slowdown in the rate of growth is leading some countries to lose population, while others continue to gain population.

If the Mediterranean is increasing its number of inhabitants, it is above all, experiencing a rapid transformation in the composition of its population. In fact, the most striking development noted is that of demographic ageing, with an increase in the number of elderly people in the population and a decrease in that of the young. Currently, the elderly (65 years of age or older) represent 12% of the Mediterranean population, and the young (under 15 years of age) about 24%. In general, the populations of the countries on the Northern shore are older than those on the Southern and Eastern shores: in 2020, people aged 65 or over represented 21% on average for the former, and 6% for the latter. However, the gap between countries is slightly smaller today than it was in 1950. This phenomenon will continue at an even faster pace in the coming decades, with demographic ageing definitively establishing itself as a concern shared by all Mediterranean countries. Indeed, the UN projections (median scenario) will expect that people aged 65 or over represent about 22% of the entire Mediterranean population in 2060, with about 34% for the Northern shore and 17% for the Southern and Eastern shore.

With the demographic transition process, fertility levels have been reduced in all Mediterranean countries. Despite this convergence towards lower levels than those of the pre-transitional regimes, fertility differences still persist in the Mediterranean. Our analyses reveal first of all that some countries have reached a fertility level well
below the population replacement level (2.1 children per woman). With the exception of Cyprus, all of these very low fertility countries are not on the Southern and Eastern shores. Other groups of countries have a fertility level around the replacement level, such as France, Tunisia, Turkey or Lebanon; and finally, other fertility situations are noted as remaining fixed well above this threshold (more than 3 children per woman), such as Jordan, Egypt, Israel and Palestine. In light of the predicted convergence of the demographic transition, our analyses suggest that Mediterranean countries could stabilise at different fertility levels, potentially generating different demographic regimes in the future. For example, two groups can be distinguished in terms of fertility timing: countries where the childbearing age is lower and those for which it is higher. However, this is not a shore-based divide, as there are countries from all shores in both groups. The determinants of these birth timing seem to be very heterogeneous from one country to another, thus fuelling the possibility that fertility in the Mediterranean will not fully converge in the end.

However, family formation and dissolution behaviours have converged in some ways over the last 70 years. In the Mediterranean, there has not only been a decrease in the frequency of marriages and a reduction in the disparities in divertiality, but also an increase in the age at marriage and in permanent celibacy. These contemporary family changes have been interpreted as a profound challenge to the institution of marriage in Western Europe, and as a marriage revolution in Arab-Muslim countries. However, lifelong commitment is still expressed in various forms in Europe and marriage continues to endure and structure family models on the Southern and Eastern shores. Permanent celibacy and postponement of the age of marriage may then be less about questioning the institution of marriage itself than of worsening socio-economic conditions, such as high youth unemployment, greater precariousness and uncertainty about the future, or the cost of housing or marriage being too high. Similarly, not being married does not imply the same social reality. In Arab-Muslim societies, this means waiting longer for social independence and economic autonomy, or being unable to start a family. Thus, similar trends in demographic indicators may conceal very different social situations.

The Mediterranean has also seen a broad convergence of mortality, with a historic increase in life expectancy at birth for all countries. The disparities of the 1950s have narrowed considerably, with countries with the lowest life expectancy at birth catching up rapidly. However, convergence has not been observed for about 30 years. The control of infectious diseases, and later of cardiovascular diseases, has led to a reduction in infant and adult mortality. On the other hand, the unequal capacity of Mediterranean countries to fight against societal diseases, neurodegenerative diseases and cancers, has led to a divergence in life expectancy at age 65. Massive ageing will therefore inevitably lead to a significant increase in the number of deaths in these countries, as survival probabilities at older ages are unlikely to increase rapidly.

Finally, with regard to international migration, the book showed that the Mediterranean constitutes a real migration system, and above all one of the largest migration areas in the world. Migration from the Southern and Eastern shore countries to European countries was intense in the 1960s. However, the various economic crises from the 1970s onwards led to increasingly restrictive entry policies in Europe. Southern
European countries have been gradually becoming host countries. Since the 2000s, there has been a recomposition of the poles of attraction in the Mediterranean, with the emergence of Turkey for example. Finally, the number of refugees and asylum seekers has increased considerably since the “Arab Spring” and the various ensuing conflicts, to the point of talk of a “refugee crisis”. The issue of international migration is, along with that of the urbanisation/littoralisation of the common sea and the ageing of populations, a challenge shared by the entire Mediterranean area.

## 10.2 An Assessment of the Book's Overall Approach

The introduction to this publication sets out a number of approaches, including the implementation of a comparative approach. Now that the project is drawing to a close, what heuristic lessons can we draw from it? First of all, regarding our choice to study Mediterranean populations over a long demographic period (i.e., over the last 70 years), we can commend ourselves, which has proven particularly fruitful. It is indeed by putting recent trends into perspective within long-term developments that has allowed us, for example, to identify the broad movements of convergence that have taken place in various fields. Situating the present in a historical perspective allows for an account of underlying trends rather than short-term fluctuations. Thanks to this approach, it is also possible to affirm that the disparities have been reduced over time, and that the Mediterranean populations are closer and more similar today than in the past. The Mediterranean is therefore well and truly in the process of demographic homogenisation on the whole, despite persistent heterogeneities in certain areas.

This choice of studying it over the long term has also made it possible to show that the demographic history of the Mediterranean countries is not always monotonous, but on the contrary is sometimes punctuated by changes in pace, breaks in trends or even reversals. This historical perspective sometimes makes it possible to put certain recent economic developments into perspective and to interpret them more accurately and also makes it possible to avoid considering demographic developments as being one-way or predetermined. Indeed, recent reversals in trends have again reminded us of this, such as the decline in life expectancy at birth with the COVID-19 pandemic. Some of these may be surprising at first glance, but are less so when hewed from an historical perspective. Increases in fertility in Egypt and Algeria, for example, may appear as notable exceptions to the theory of demographic transition. However, fertility increases have already taken place in the past in the Mediterranean, with baby booms observed in many European countries in the 1950s and 1960s, and in Egypt in the 1980s, putting the current increases or surges in fertility into perspective. The question is to what extent these trend reversals reflect backtracking, a temporary change or even a new behavioural trend.

Our second approach was to implement an overall international comparison, with countries as the level of analysis, rejecting any predefined geographical framework. The analyses in this publication have therefore not sought to reiterate the classic
contrasts,<fnref n="1" /> such as the Northern shore vs. the Southern and Eastern shores, or the Balkans, Southern Europe, North Africa vs. the Near East. On the contrary, we opted for a bottom-up approach, allowing groups from all Mediterranean countries to emerge, regardless of their geographical location.

This choice showed the extent to which the Mediterranean is a complex region that cannot be reduced to a simple demographic opposition between two blocks (Northern Shore/Southern and Eastern shore). Beyond the traditional contrasts, this method made it possible to highlight the internal diversity of each of the blocks in many areas. Surprisingly, some countries are closer to countries on other shores than to their neighbours. For example, Tunisia has a demographic regime closer to France than Algeria or Morocco. Similarly, the demographic regime of France is more similar to that of Tunisia than to those of Italy or Spain. This is also the case for certain Balkan countries (Serbia, Montenegro, etc.) whose life expectancy at birth is similar to that of countries on the Southern and Eastern shores (Turkey, Lebanon).

This option, which consists of taking all the countries without first grouping them together, has made it possible to show once again that the overall contrast between the shores of the Mediterranean is still coherent for a certain number of demographic phenomena. However, even when contrasts between shores are noted, the situations are less often caricatured and there are exceptions for each shore. Indeed, in several chapters, our analyses highlight countries or particular groups of countries that would not have been identified by any other method. This concerns, for example, the particular position of specific Balkan countries (Kosovo, Albania, Macedonia, etc.), which are quite systematically closer to the countries of the Southern and Eastern shores than to the other Balkan countries in terms of several demographic phenomena. This characteristic had already been highlighted for Albania by Attané and Courbage (2004). The same applies to Israel, Cyprus, and sometimes Lebanon, for the Southern and Eastern shores, which stand out as atypical in the region.

In addition, certain demographic phenomena reveal contrasts between countries from different shores. This is the case, for example, for adult mortality, age at child-bearing or age at marriage. It is by refusing to perpetuate existing regional categories that it has been possible to obtain a renewed understanding of the Mediterranean, we have identified trans-Mediterranean formations (grouping together countries from different shores), and regionalisations beyond the Northern shore and the Southern and Eastern shores divide.

This publication is therefore not a juxtaposition of regional monographs, or a bibliographic synthesis of national studies. It is an integrated, bottom-up demographic and geographical approach based on data. This approach has been fruitful in proposing an original synthesis of the major demographic phenomena over the last 70 years, and thereby offering up-to-date insights of demography in the Mediterranean.

The aim of this publication was to provide an overview of the demographic trends over the last 70 years for all populations of the Mediterranean. To this end, we chose to analyse the classic demographic phenomena. On the other hand, some aspects have

<footnote n="1">¹ Throughout the publication, only the graphical representations have used broad regional groupings, for reasons related to practicality and consistency.</footnote>
not been developed or have only been partially developed. These are all avenues to
be developed further with an approach similar to that of this publication. We mention
three of them here, but there are obviously many others.

Firstly, we did not focus enough on educational progress and the status of women.
Both have considerable influence on demographic behaviour, in particular on the
decline in fertility and the nuptiality rate. The Mediterranean area is varied from
the point of view of women's place in society, whether one compares the countries
or the different social and geographical sub-areas specific of each country studied.
The status occupied by women varies between and within societies, just as the place
of residence (urban or rural) or the community to which they belong influences a
couple's plans to have children.

Secondly, it is imperative to obtain an improved understanding of representations
and values in the Mediterranean countries, particularly those associated with the
couple, the family, motherhood and children. We are thinking of, for example, the
ideal number of children,<fnref n="2" /> the importance of family life, the acceptability of giving
birth to a child out-of-wedlock, the importance of work for a woman, the values
transmitted from parents to children, etc. It is rather difficult, despite opinions being
collected via relevant international comparative surveys, to construct a complete
picture of the Mediterranean situation. However, there are some elements that can
provide food for thought. A number of opinion questions are asked to male and
female respondents from different countries. As such, it is possible to pinpoint and
measure the transformation of norms and the conception of marriage and the family
in the Mediterranean and to imagine their future.

Finally, this publication mainly uses countries as the level of analysis, as it was
already rich enough to offer a synthesis of demographic phenomena in the Mediter-
ranean. However, we are aware that the lessons learned at the national level mask
regional inequalities. The analyses carried out at the sub-national level in this publi-
cation, for population density or age structure for example, have shown the extent
to which very contrasting situations can co-exist within the same country, and that
homogeneous geographical groupings can include regions of several countries. There
is now a desire to encourage international comparative studies at a sub-national
level, as has been done for demographic ageing in the Mediterranean (Doignon,
2016, 2020). However, this approach remains painstaking for several reasons. This
is because international databases only cover countries. It would therefore be neces-
sary to obtain data from national statistical offices, international institutions (e.g.
Eurostat) or major international surveys. This raises the question of data access, as
well as data availability and comparability. All these aspects are unequal from one
Mediterranean country to another and vary according to the topic. While it would
therefore be time-consuming to study all the Mediterranean countries at the sub-
national level, it seems to us that the analytical potential of such an approach is very
high. We would thus be highly supportive of any initiative aiming to undertake a
systematic sub-national demographic comparison.

<footnote n="2">² See Ambrosetti et al. (2021) for the case of Egypt.</footnote>
References

Ambrosetti, E., Angeli, A., & Novelli, M. (2021). Childbearing intentions among Egyptian men and women: The role of gender-equitable attitudes and women's empowerment. *Demographic Research* 44, 1229–1270. https://doi.org/10.4054/DemRes.2021.44.51

Attané, I., & Courbage, Y. (2004). *Demography in the Mediterranean region: Situation and projections*. Économica.

Doignon, Y. (2016). *Le vieillissement démographique en Méditerranée: convergences territoriales et spatiales*. Ph.D. in Geography, Aix-Marseille University. https://tel.archives-ouvertes.fr/tel-01471133/

Doignon, Y. (2020). Demographic ageing in the Mediterranean: The end of the spatial dichotomy between the shores? *Spatial Demography*, 8, 85–117. https://doi.org/10.1007/s40980-019-0005-2

**Open Access** This chapter is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

The images or other third party material in this chapter are included in the chapter's Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the chapter's Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
References

Adam, D. (2021). How far will global population rise? Researchers can't agree. *Nature*, 597, 462-465. https://doi.org/10.1038/d41586-021-02522-6

Al Zalak, Z., & Goujon, A. (2017). Exploring the fertility trend in Egypt. *Demographic Research*, 37, 995-1030. https://doi.org/10.4054/DemRes.2017.37.32

Albera, D. (2006). Anthropology of the Mediterranean: Between crisis and renewal. *History and Anthropology*, 17, 109-133. https://doi.org/10.1080/02757200600633272

Alessi, E., & Di Carlo, G. (2018). Pollution plastique en Méditerranée. *Sortons du piège !* WWF. https://www.wwf.fr/sites/default/files/doc-2018-06/180608_rapport_plastiques_medite_rranee.pdf

Ambrosetti, E. (2011). *Égypte, l'exception démographique*. Les cahiers de l'INED 166. Institut National d'Études Démographiques. https://books.openedition.org/ined/1778?lang=en

Ambrosetti, E. (2020). Demographic challenges in the Mediterranean. *IEMed Mediterranean Yearbook 2020*. European Institute of the Mediterranean (IEMed). https://www.iemed.org/wp-content/uploads/2021/01/Demographic-Challenges-in-the-Mediterranean.pdf

Ambrosetti, E., Angeli, A., & Novelli, M. (2021). Childbearing intentions among Egyptian men and women: The role of gender-equitable attitudes and women's empowerment. *Demographic Research*, 44, 1229-1270. https://doi.org/10.4054/DemRes.2021.44.51

Ambrosetti, E., & Strangio, D. (2016). Migration in the Mediterranean across disciplines. In E. Ambrosetti, D. Strangio, & C. Wihtol de Wenden (Eds.), *Migration in the Mediterranean: Socio-economic perspectives* (pp. 3-14). Routledge Studies in the European Economy. Routledge.

Ambrosetti, E., Strangio, D., & Wihtol de Wenden, C., (Eds.). (2016). *Migration in the Mediterranean: Socio-economic perspectives*. Routledge Studies in the European Economy. Routledge.

Anastasiou, E., Doignon, Y., Karkanis, D., Léger, J. F., Parant, A., & Sahraoui, S. E. (2020). *Tendances et perspectives démographiques en Méditerranée*. Les Cahiers du Plan Bleu 21. Plan Bleu. https://planbleu.org/wp-content/uploads/2020/10/PLAN-BLEU-CAHIER-21-Tendances-demographiques-en-Mediterranee.pdf

Attané, I., & Courbage, Y. (2004). *Demography in the Mediterranean region: Situation and projections*. Économica.

Ausubel, J., Kramer, S., Shi, A. F., & Hackett, C. (2022). Measuring age differences among different-sex couples: Across religions and 130 countries, men are older than their female partners. *Population Studies*, 76, 465-476. https://doi.org/10.1080/00324728.2022.2094452

Avdeev, A., Eremenko, T., Festy, P., Gaymu, J., Le Bouteillec, N., & Springer, S. (2011). Populations and demographic trends of European countries, 1980-2010. *Population*, 66, 9-133. https://doi.org/10.3917/popu.1101.0009
Blanchet, D. (2001). L'impact des changements démographiques sur la croissance et le marché du travail: faits, théories et incertitudes. *Revue D'économie Politique, 111*, 511-564. https://doi.org/10.3917/redp.114.0511

Bloom, D., Kuhn, M., & Prettner, K. (2017). Africa's prospects for enjoying a demographic dividend. *Journal of Demographic Economics*, *83*, 63–76. https://doi.org/10.1017/dem.2016.19

Blöss, T. (Ed.). (2018). *Ageing, lifestyles and economic crises: The new people of the Mediterranean*. Routledge Studies in the European Economy. Routledge, Taylor & Francis.

Blöss-Widmer, I. (2019). Pour une connaissance statistique de la Méditerranée. In T. Blöss & I. Blöss-Widmer (Eds.), *Penser le vieillissement en Méditerranée: données, processus et liens sociaux* (pp. 19–24). L'atelier méditerranéen. Karthala; MMSH.

Blöss-Widmer, I. (2022). Make way for numbers: The age race in the Mediterranean. *IEMed Mediterranean Yearbook 2022*. European Institute of the Mediterranean (IEMed). https://www.iemed.org/wp-content/uploads/2022/10/Make-Way-Numbers-Age-Race-Mediterranean-Bloss-Widmer-IEMedYearbook2022.pdf

Bonifazi, C., & Strozza, S. (2019). International migrations in the northern countries of the Mediterranean. Continuity and changes, before and after the crisis. In S. Capasso & E. Ferragina (Eds.), *Mediterranean migration and the labour markets: Policies for growth and social development in the Mediterranean area* (26 p.). Routledge.

Borderon, M. (2023). Migrations, changements environnementaux et climatiques. In Y. Doignon & S. Olliveau (Eds.), *Dynamique du peuplement mondial. Comment la population habite le monde, Encyclopédie Des Sciences. ISTE Editions*.

Bourguet, M.-N., Lepetit, B., Nordman, D., & Sinarellis, M. (Eds.). (1998). *L'invention scientifique de la Méditerranée: Egypte, Morée, Algérie*. Recherches d'histoire et de Sciences Sociales, 77. École des Hautes Études en Sciences Sociales.

Braudel, F. (1949). *La Méditerranée et le monde méditerranéen à l'époque de Philippe II*. Armand Colin.

Bromberger, C., & Durand, J.-Y. (2001). Faut-il jeter la Méditerranée avec l'eau du bain? In A. Blok, D. Albera, & C. Bromberger (Eds.), *L'anthropologie de la Méditerranée* (pp. 733–756). L'atelier méditerranéen. Maisonneuve et Larose, Maison Méditerranéenne des Sciences de l'Homme. https://www.researchgate.net/publication/32233079_Faut-il_jeter_la_Mediterra ne_avec_1%27eau_du_bain

Brunet, R. (1995). Modèles de méditerranées. *L'espace Géographique*, *24*, 200–202. https://doi.org/10.3406/spgeo.1995.3389

Buisson, I. (2016). *Déséquilibre de sexes et conflits: une étude du territoire yougoslave entre 1981 et 2011*. Master's Thesis in Geography, Aix-Marseille University. https://dumas.ccsd.cnrs.fr/DEMOMED/dumas-01383003v1

Carella, M., & Parant, A. (2016). Age-structural transition and demographic windows around the Mediterranean. In R. Pace & R. Ham-Chande (Eds.), *Demographic dividends: Emerging challenges and policy implications* (pp. 83–113). Population Studies. Springer. https://doi.org/10.1007/978-3-319-32709-9

Chesnais, J.-C. (1992). *The demographic transition: Stages, patterns, and economic implications*. Clarendon Press; Oxford University Press.

Clément, C. (2002). Une mer des hommes: les limites du monde méditerranéen. In D. Borne & J. Scheibling (Eds.), *La Méditerranée* (pp. 28–48). Carré géographie 8. Hachette.

Coale, A. J., & Watkins, S. C. (1986). *The decline of fertility in Europe*. Princeton University Press.

Costemalle, V. (2021). Bayesian probabilistic population projections for France. *Economie et Statistique/Economics and Statistics*, *29*–47. https://doi.org/10.24187/ecostat.2020.520d.2031

Coudert, E. (2013). Une approche régionale de la population et de l'urbanisation en Méditerranée, rétrospective et projections à 2025. In J.-P. Carrière (Ed.), *Villes et projets urbains en Méditer- ranée* (pp. 21–31). Perspectives Villes et Territoires. Presses universitaires François-Rabelais.

Courbage, Y. (1997). La démographie en rive sud de la Méditerranée au XXIe siècle: changement de perspectives. *Espace Populations Sociétés*, *1997/1*, 11–26. https://doi.org/10.3406/espos.1997.1786
Courbage, Y. (1999). *New demographic scenarios in the Mediterranean region*. Travaux et documents 142. Institut National d'Etudes Démographiques-Presses Universitaires de France.

Courbage, Y. (2006). Les enjeux démographiques en Palestine après le retrait de Gaza. *Critique Internationale*, **31**, 23–38. https://doi.org/10.3917/crii.031.0023

Courbage, Y. (2008a). Démographie des communautés chrétiennes au Proche-Orient. *Confluences Méditerranée*, **66**, 27–44. https://doi.org/10.3917/come.066.0027

Courbage, Y. (2008b). La guerre des berceaux. *Les collections de l'Histoire*. https://www.lhistoire.fr/%C2%AB-la-guerre-des-berceaux-%C2%BB

Courbage, Y. (2015a). The political dimensions of fertility decrease and family transformation in the Arab context. *DIFI Family Research and Proceedings*, 2015:3. https://doi.org/10.5339/difi.2015.3

Courbage, Y. (2015b). Tunisie: la contre-transition démographique. Interview by Khadija Mohsen-Finan. *Orient XXI*. https://www.youtube.com/watch?v=FBxRclm8wnA

Courbage, Y. (2015c). Egypte, une transition démographique en marche arrière. *Orient XXI*. http://orientxxi.info/magazine/egypte-une-transition-demographique-en-marche-arriere,0956

Courbage, Y., & Todd, E. (2014). *A convergence of civilizations: The transformation of Muslim societies around the world*. Columbia University Press.

D'Addato, A. (2010). Tendances démographiques, développement économique et mobilité des populations en Méditerranée. *Migrations Société*, **6**, 13–30. https://doi.org/10.3917/migra.132.0013

De Haas, H. (2011). Mediterranean migration futures: Patterns, drivers and scenarios. *Global Environmental Change*, **21**, S59–S69. https://doi.org/10.1016/j.gloenvcha.2011.09.003

De Haas, H., Castles, S., & Miller, M. (2020). *The age of migration: International population movements in the modern world* (6th ed.). The Guilford Press.

Delbès, C., Gaymu, J., & Springer, S. (2006). Women grow old alone, but men grow old with a partner. A European Overview. *Population & Societies*, **419**. https://doi.org/10.3917/popsoc.419.0001

Demographic Statistics Database. United Nations Statistics Division. https://unstats.un.org/unsd/demographic-social/products/dyb/index.cshtml

Deprest, F. (2002). Notes on the Geographic Invention of the Mediterranean. *L'espace Géographique*, **31**, 73–92. https://doi.org/10.3917/eg.311.0073

Deslondes, O. (2004). Les populations des Balkans depuis 1990: Aspects géographiques de la crise. *Space Populations Sociétés*, **2004/3**, 487–498. https://doi.org/10.4000/eps.336

Doignon, Y. (2016). *Le vieillissement démographique en Méditerranée: convergences territoriales et spatiales*. Ph.D. in Geography, Aix-Marseille University. https://tel.archives-ouvertes.fr/tel-01471133/

Doignon, Y. (2019). Transitions démographiques et vieillissements en Méditerranée: le Sud rattrapera-t-il le Nord? In T. Blöss & I. Blöss-Widmer (Eds.), *Penser le vieillissement en Méditerranée: données, processus et liens sociaux* (pp. 151–177). L'atelier méditerranéen. Karthala; MMSH.

Doignon, Y. (2020a). Les transitions démographiques des pays méditerranéens depuis 1950. *Géoconfluences*. http://geoconfluences.ens-lyon.fr/doc/etpays/Medit/MeditScient.htm

Doignon, Y. (2020b). Demographic ageing in the Mediterranean: The end of the spatial dichotomy between the shores? *Spatial Demography*, **8**, 85–117. https://doi.org/10.1007/s40980-019-0000-54-2

Doignon, Y. (2023). Dépeuplement et dépopulation dans un monde en croissance. In Y. Doignon & S. Oliveau (Eds.), *Dynamique du peuplement mondial. Comment la population habite le monde. Encyclopédie Des Sciences. ISTE Editions*.

Doignon, Y., Ambrosetti, E., & Miccoli, S. (2021). The spatial diffusion of fertility decline in Egypt (1950–2006). *Genus*, **77**, 23. https://doi.org/10.1186/s41118-021-00131-9

Doignon, Y., Blöss-Widmer, I., & Oliveau, S. (2017). Half a century of ageing in France. *Dynamics and specificities of the Mediterranean coastline*. In T. Blöss (Ed.), *Ageing, lifestyles and economic*
crises: *The new people of the Mediterranean* (pp. 82–100). Routledge Studies in the European Economy. Routledge, Taylor & Francis Group.

Doignon, Y., & Oliveau, S. (2015). Territorial grids in the Mediterranean: Space versus population. *Bollettino dell'Associazione Italiana di Cartografia, 154*, 46–63. https://doi.org/10.13137/2282-472X/11827

Doignon, Y., Oliveau, S., & Blöss-Widmer, I. (2016). L'Europe méridionale depuis 20 ans: Dépeu-plement, dépopulation et renouveau démographique. *Espace Populations Sociétés, 2015/3-2016/1*, 23. https://doi.org/10.4000/eps.6171

Dubresson, A., Moreau, S., Raison, J.-P., & Steck, J.-F. (2011). *L'Afrique subsaharienne: une géographie du changement* (3rd ed.). Armand Colin.

Engelen, T., & Puschmann, P. (2011). How unique is the Western European marriage pattern? A comparison of nuptiality in historical Europe and the contemporary Arab world. *History of the Family, 16*, 387–400. https://doi.org/10.1016/j.hisfam.2011.07.004

Etling, A., Backeberg, L., & Tholen, J. (2020). The political dimension of young people's migration intentions: Evidence from the Arab Mediterranean region. *Journal of Ethnic and Migration Studies, 46*, 1388–1404. https://doi.org/10.1080/1369183X.2018.1485093

Fargues, P. (1986a). Traditions matrimoniales dans les sociétés arabes. *Population et Sociétés, 198*. https://www.ined.fr/fichier/s_rubrique/18983/pop_et_soc_francais_198.fr.pdf

Fargues, P. (1986b). Un siècle de transition démographique en Afrique méditerranéenne 1885-1985. *Population, 41*, 205-232. https://doi.org/10.2307/1533059

Fargues, P. (1989). The decline of Arab fertility. *Population, 44*, 147–175. http://www.jstor.org/stable/2949078

Fargues, P. (1990). Algérie, Maroc, Tunisie: vers la famille restreinte? *Population et Sociétés, 248*. https://www.ined.fr/fichier/s_rubrique/18984/pop_et_soc_francais_248.fr.pdf

Fargues, P. (1995). Les données démographiques de la paix au Proche-Orient. In L. Blin & P. Fargues (Eds.), *L'économie de la paix au Proche-Orient* (pp. 61–90). Maisonneuve et Larose, CEDEJ.

Fargues, P. (2000a). *Générations arabes: l'alchimie du nombre*. Fayard.

Fargues, P. (2000b). La démographie et la Méditerranée ou les faits contre les représentations. In E. Kienle (Ed.), *La reconstruction d'un espace d'échanges: la Méditerranée* (pp. 53–69). CEDEJ—Égypte/Soudan. https://doi.org/10.4000/books.cedej.758

Fargues, P., & Salinari, G. (2011). Flux migratoires et transition démographique. *Evolution et scénarios pour l'avenir*. In C. Jolly & "Mediterranean 2030" Consortium (Eds.), *Demain, la Méditerranée. Scénarios et projection à 2030* (pp. 71–113). Construire La Méditerranée. IPEMED—Institut de prospective économique du monde méditerranéen.

Frenk, J., Bobadilla, J. L., Stern, C., Frejka, T., & Lozano, R. (1991). Elements for a theory of the health transition. *Health Transition Review, 1*, 21–38. http://www.jstor.org/stable/40608615

Frontex. (2015). *Annual risk analysis 2015*. European Agency for the Management of Operational Cooperation at the External Borders of the Member States of the European Union. https://fro.ntex.europa.eu/assets/Publications/Risk_Analysis/Annual_Risk_Analysis_2015.pdf

Gastineau, B. (2012). Transition de la fécondité, développement et droits des femmes en Tunisie. *Les Cahiers d'EMAM, 21*, 75-94. https://doi.org/10.4000/emam.521

Goode, W. J. (1963). *World revolution and family patterns*. Free Press.

Goody, J. (1983). *The development of the family and marriage in Europe*. Past and Present Publications. Cambridge University Press. https://doi.org/10.1017/CBO9780511607752

Goujon, A., & Zalak, Z. A. (2018). Why has fertility been increasing in Egypt? *Population & Societies, 551*. https://doi.org/10.3917/popsoc.551.0001

Guilmoto, C. Z., & Duthé, G. (2013). Masculinization of births in Eastern Europe. *Population & Societies, 506*. https://doi.org/10.3917/popsoc.506.0001

Guilmoto, C. Z., & Oliveau, S. (2007). Sex ratio imbalances among children at micro-level: China and India compared. In *Population Association of America 2007*. http://paa2007.princeton.edu/papers/71096
Hajnal, J. (1965). European marriage patterns in perspective. In D. V. Glass & D. E. C. Eversley (Eds.), *Population in history: Essays in historical demography, Volume 1: General and Great Britain* (pp. 101–143). Edward Arnold; Aldine Publishing.

Herzfeld, M. (1987). *Anthropology through the looking-glass: Critical ethnography in the margins of Europe*. Cambridge University Press.

Horden, P., & Purcell, N. (2000). *The corrupting sea. A study of Mediterranean history*. Blackwell Publishers.

Huebner, S. (2016). A Mediterranean family? A comparative approach to the Ancient World. In S. Huebner & G. Nathan (Eds.), *Mediterranean families in antiquity: Households, extended families, and domestic space* (pp. 3–26). John Wiley & Sons.

Human Life-Table Database (HLD). Max Planck Institute, University of California at Berkeley (USA), French Institute for Demographic Studies (France). http://www.lifetable.de

Human Mortality Database (HMD). Max Planck Institute, University of California at Berkeley (USA), French Institute for Demographic Studies (France). www.mortality.org

Huntington, S. P. (1993). The clash of civilizations? *Foreign Affairs*, 72, 22–49. https://doi.org/10.2307/20045621

Ilbert, R. (2006). Questionner le concept Méditerranée. Presentation presented at the Ateliers méditerranéens, MMSH. https://cinumed.mmsh.univ-aix.fr/collection/item/96810-questionner-le-concept-mediterranee?offset=2

International Migrant Stock 2020. (2020). United Nations, Department of Economic and Social Affairs, Population Division. https://www.un.org/development/desa/pd/content/international-migrant-stock

ITAN. (2015). *Integrated territorial analysis of the neighbourhoods. main report*. European Union. ESPON Programme. https://www.espon.eu/sites/default/files/attachments/02_ITAN-FR-Main_report_FINAL_v15.pdf

Joint Research Centre (European Commission). (2018). *Demographic and human capital scenarios for the 21st century: 2018 assessment for 201 countries*. Publications Office. https://data.europa.eu/doi/10.2760/41776

Jones, G. W. (2006). A demographic perspective on the Muslim world. *Journal of Population Research*, 23, 243–265. https://doi.org/10.1007/BF03031818

Kayser, B. (1996). *Méditerranée. Une géographie de la fracture*. Encyclopédie de La Méditerranée 2. Edisud.

King, R. (2000). Southern Europe in the changing global map of migration. In R. King, G. Lazaridis, & C. Tsardanidis (Eds.), *Eldorado or Fortress? Migration in Southern Europe* (pp. 3–26). Palgrave Macmillan UK. https://doi.org/10.1057/9780333982525_1

Lacoste, Y. (2001). La Méditerranée. *Hérodote*, 103, 3–39. https://doi.org/10.3917/her.103.0003

Kirk, D. (1966). Factors affecting moslem natality. In B. Berelson (Ed.), *Family planning and population programs* (pp.149–154). University of Chicago Press.

Landry, A. (1934). *La révolution démographique: études et essais sur les problèmes de la population*. Sirey.

Laria, S. (2008). L'avenir en Méditerranée se jouera dans les villes. *Annales Des Mines—Responsabilité Et Environnement*, 49, 56–61. https://doi.org/10.3917/re.049.0056

Laslett, P. (1983). Family and household as work group and kin group: Areas of traditional Europe compared. In R. Wall, J. Robin, & P. Laslett (Eds.), *Family forms in historic Europe* (pp. 513–563). Cambridge University Press.

Le Bris, A. (2021). Enfants nés hors mariage au Maghreb: l'influence du genre sur leurs trajectoires. In M. Jacquemin, M. Pilon, D. Bonnet, C. Deprez, & G. Pison (Eds.), *Être fille ou garçon: Regards croisés sur l'enfance et le genre* (pp. 127–149). Questions de Populations. Ined Éditions.

Lerch, M. (2018). Fertility and union formation during crisis and societal consolidation in the Western Balkans. *Population Studies*, 72, 217–234. https://doi.org/10.1080/00324728.2017.1412492
Lesthaeghe, R. (2014). The second demographic transition: A concise overview of its development. *Proceedings of the National Academy of Sciences, 111*, 18112–18115. https://doi.org/10.1073/pnas.1420441111

Lévêque, É. (2017). *L'éducation efface-t-elle les frontières? L'exemple de la fécondité en Méditerranée*. Master's Thesis in Geography, Aix-Marseille University. https://dumas.ccsd.cnrs.fr/dumas-01612919

Lévêque, É., & Oliveau, S. (2019). La transition de la fécondité autour de la Méditerranée: convergence générale et hétérogénéités spatiales, un éclairage par l'éducation. *Espace Populations Sociétés, 2019/2*. https://doi.org/10.4000/eps.9025

Liziard, S. (2013). *Littoralisation de la façade nord-méditerranéenne: analyse spatiale et prospective dans le contexte du changement climatique*. Ph.D. Thesis in Geography. Nice Sophia Antipolis University. https://tel.archives-ouvertes.fr/tel-00927492/document

Locoh, T., & Ouadah-Bedidi, Z. (2014). *Familles et rapports de genre au Maghreb, Evolutions ou révolutions*. Document de travail 213. Institut National d'Etudes Démographiques. https://www.ined.fr/fichier/s_rubrique/22779/document.travail.2014.213.magreb.genre.fr.pdf

Lutz, W., Butz, W. P., & Samir, K.C. (2014). World population and human capital in the twenty-first century. *Oxford University Press*. https://doi.org/10.1093/acprof:oso/9780198703167.001.0001

Martin, I., & Bardak, U. (2011). *Union for the Mediterranean regional employability review. The challenge of youth employment in the Mediterranean*. European Training Foundation.

Matthijs, K., Neels, K., Timmerman, C., & Haers, J. (Ed.). (2016). *Population change in Europe, the Middle-East and North Africa. Beyond the demographic divide*. International Population Studies. Routledge. https://doi.org/10.4324/9781315601496

Meslé, F., & Vallin, J. (2006). The health transition: Trends and prospects. In G. Caselli, J. Vallin, & G. J. Wunsch (Eds.), *Demography: Analysis and synthesis* (Vol. II, pp. 247–260). Elsevier.

Missing Migrants Project. (2023). International Organization for Migration. https://missingmigra-nts.iom.int/

Moriconi-Ebrard, F., & Pascal, R. (2020). Peuplement et urbanisation de la Libye: construction d'une information cartographique. *Géoconfluences*. http://geoconfluences.ens-lyon.fr/informations-scientifiques/dossiers-regionaux/la-mediterranee-une-geographie-paradoxale/articles-scientifiques/demographie-libye

Muñoz-Pérez, F., & Recaño-Valverde, J. (2011). A century of nuptiality in Spain, 1900–2007. *European Journal of Population*, 27, 487–515. https://doi.org/10.1007/s10680-011-9234-1

Notestein, F. W. (1945). Population: The long view. In P. T. Schultz (Ed.), *Food for the world* (pp. 36–57). University of Chicago Press.

Olivier, S., & Doignon, Y. (2014). Ever closer to the water. Recent developments in Mediterranean settlement patterns. *South-East European Journal of Political Science, II*, 22–30. https://halshs.archives-ouvertes.fr/halshs-01070622

Olivier, S., Doignon, Y., & Blöss-Widmer, I. (2023). Population distribution: Follow the Nile. In H. Bayoumi & K. Bennafla (Eds.), *An atlas of contemporary Egypt* (pp. 56–57). CNRS éditions. https://books.openedition.org/editionscnrs/58390

Olivier, S., Larue, Q., Doignon, Y., & Blöss-Widmer, I. (2019). Mapping foreign nationals in Spain: An exploratory approach at local level. *Genus*, 75, 5. https://doi.org/10.1186/s41118-018-0047-5

Omran, A. R. (1971). The epidemiologic transition: A theory of the epidemiology of population change. *The Milbank Memorial Fund Quarterly*, 49, 509–538. https://doi.org/10.1111/j.1468-0009.2005.00398.x

Operational Data Portal Refugee Situations. Mediterranean Situation. (2023). UNHCR (United Nations High Commissioner for Refugees). https://data.unhcr.org/en/situations/mediterranean

Ouadah-Bedidi, Z., Vallin, J., & Bouchoucha, I. (2012). Unexpected developments in Maghrebian fertility. *Population & Societies*, 486. https://doi.org/10.3917/popsoc.486.0001

Panebianco, S. (2022). The EU and migration in the Mediterranean: EU borders’ control by proxy. *Journal of Ethnic and Migration Studies*, 48, 1398–1416. https://doi.org/10.1080/1369183X.2020.1851468
Péguy, C.-P. (1986). L'univers géographique de Fernand Braudel. *Espaces Temps*, **34**, 77-82. https://doi.org/10.3406/espat.1986.3355

Peristiany, J.-G. (1966). Honour and shame: The values of Mediterranean society. University of Chicago Press.

Peristiany, J.-G., (Ed.). (1968). *Contributions to Mediterranean sociology: Mediterranean rural communities and social change*. Mouton&Cie.

Peristiany, J.-G. (Ed.). (1976). *Mediterranean family structures*. Cambridge University Press.

Pfirsch, T. (2011). Une géographie de la famille en Europe du Sud. *Cybergeo: European Journal of Geography*. https://doi.org/10.4000/cybergeo.23669

Pina-Cabral, J. (1989). The Mediterranean as a category of regional comparison: A critical view. *Current Anthropology*, **30**, 399-406. https://www.jstor.org/stable/2743537

Pitt-Rivers, J. (Ed.). (1963). *Mediterranean countrymen. Essays in the social anthropology of the Mediterranean*. Mouton.

Population Division, Departement of Economic and Social Affairs, and United Nations Secretariat. (2000). *Replacement migration: Is it a solution to declining and ageing populations?* https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/unpd-egm_200010_un_2001_replacementmigration.pdf

Pouget, B. (2021). La Méditerranée et les grandes épidémies. Retour sur un demi-siècle de travaux historiques. *Cahiers de la Méditerranée*, **103**, 173-189. https://doi.org/10.4000/cdlm.15133

Puschmann, P., & Matthijs, K. (2016). The demographic transition in the Arab world: The dual role of marriage in family dynamics and population growth. In K. Matthijs, K. Neels, C. Timmerman, J. Haers, & S. Mels (Eds.), *Population change in Europe, the Middle-East and North Africa. Beyond the demographic divide* (pp. 119-165). International Population Studies. Routledge, Taylor & Francis Group. https://doi.org/10.4324/9781315601496

Pyramus de Candolle, A. (1820). *Essai élémentaire de géographie botanique*. Imprimerie de F.G. Levrault.

Rashad, H. (2015). Demographic transition in Arab countries: A new perspective. *Journal of the Australian Population Association*, **17**, 83-101. https://doi.org/10.1007/BF03029449

Rashad, H., Osman, M., & Roudi-Fahimi, F. (2005). Marriage in the Arab world. Population Reference Bureau, 8. https://u.demog.berkeley.edu/~jrw/Biblio/Eprints/PRB/files/MarriageInArabWorld_Eng.pdf

Reba, M., Reitsma, F., & Seto, K.C. (2018). *Historical urban population: 3700 BC-AD 2000. NASA Socioeconomic Data and Applications Center (SEDAC)*. https://doi.org/10.7927/H4ZG6QBX

Reclus, E. (1876). *La Terre et les Hommes: l'Europe méridionale*. Nouvelle Géographie Universelle Tome 1. Hachette.

Roncayolo, M. (2002). Relire la Méditerranée de Fernand Braudel. In D. Borne & J. Scheibling (Eds.), *La Méditerranée* (pp. 216-231). Carré géographie 8. Hachette.

Sacchi, P., & Viazzo, P. P. (2014). Family and household. In P. Horden & S. Kinoshita (Eds.), *A companion to Mediterranean history* (pp. 234-249). Wiley Blackwell Companions to History. Wiley & Sons. https://doi.org/10.1002/9781118519356

Salvini, M. S. (2023). *Le popolazioni del Mediterraneo. Storia, cultura e demografia*. @racne.

Sardon, J.-P. (2001). Demographic change in the Balkans since the end of the 1980s. *Population*, **13**, 49-70. https://www.jstor.org/stable/3030275

Sebti, M., Courbage, Y., Festy, P., &amp; Kurzac-Souali, A.-C. (2009). Maghreb, Morocco, Marrakech: Demographic convergence, socioéconomic diversity. *Population & Societies*, **459**. https://www.cairn-int.info/journal-population-and-societies-2009-8-page-1.htm

Seklani, M. (1960). La fécondité dans les pays arabes: données numériques, attitudes et comportements. *Population*, **15**, 831-856. https://doi.org/10.2307/1526919

Smith, R. (1990). Monogamy, landed property and demographic regimes in pre-industrial Europe: Regional contrasts and temporal stabilities. In J. Landers & V. Reynolds (Eds.), *Fertility and resources* (pp. 164-188). Society for the Study of Human Biology Symposium Series 31. Cambridge University Press.
Sobotka, T., & Beaujouan, É. (2014). Two Is best? The persistence of a two-child family ideal in Europe. *Population and Development Review*, 40, 391–419. https://doi.org/10.1111/j.1728-4457.2014.00691.x

Sorre, M., & Sion, J. (1934). *Géographie Universelle, Tome VII. Méditerranée, péninsules méditerranéennes* (P. V. de la Blache & L. Gallois, Eds.). Armand Colin.

Speziale, S. (2018). Les médecins européens, médiateurs scientifiques et culturels en Afrique méditerranéenne entre le XVIIIe et le XIXe siècle. *Cahiers De La Méditerranée*, 96, 231–248. https://doi.org/10.4000/cdlm.10953

Sterkx, S. (2008). The external dimension of EU asylum and migration policy: Expanding fortress Europe? In J. Orbie (Ed.), *Europe's global role: External policies of the European Union* (pp. 117–138). Routledge.

Tabutin, D., & Schoumaker, B. (2005). The demography of the Arab world and the Middle East from the 1950s to the 2000s. *Population*, 60, 611–724. https://doi.org/10.3917/popu.505.0611

Tabutin, D., Vilquin, E., & Biraben, J.-N. (2002). *L'histoire de la population de l'Afrique du Nord pendant le deuxième millénaire*. Document de Travail 15. Centre de recherche en démographie.

Thornton, A. (2001). The developmental paradigm, reading history sideways, and family change. *Demography*, 38, 449–465. https://doi.org/10.2307/3088311

Tolosana, C. (2001). The ever-changing face of honour. In A. Blok, D. Albera, & C. Bromberger (Eds.), *L'anthropologie de la Méditerranée* (pp. 133–147). L'atelier méditerranéen. Maison-neuve et Larose, Maison Méditerranéenne des Sciences de l'Homme.

Triandafyllidou, A. (2013). *Circular migration between Europe and its neighbourhood: Choice or necessity?* Oxford University Press.

Troisi, J., & Von Kondratowitz, H.-J. (Eds.). (2013). *Ageing in the Mediterranean*. Policy Press.

Vallin, J., & Caselli, G. (2006). The United Nations’ world population projections. In G. Caselli, J. Vallin, & G. J. Wunsch (Eds.), *Demography: Analysis and synthesis* (Vol. III, pp. 197–234). Elsevier.

Vallin, J., & Meslé, F. (2004). Convergences and divergences in mortality. A new approach to health transition. *Demographic Research*, 2, 10–43. https://doi.org/10.4054/DemRes.2004.S2.2

Vallin, J., & Meslé, F. (2014). De la transition épidémiologique à la transition sanitaire: l'improbable convergence générale. In D. Tabutin & B. Masquelier (Eds.), *Ralentissements, résistances et ruptures dans les transitions démographiques* (pp. 257–290). Actes de La Chaire Quetelet (2010). Presses Universitaires de Louvain.

Venier, P., & Oliveau, S. (2023). Populations en mouvement: comment se redessine le peuplement mondial? In Y. Doignon & S. Oliveau (Eds.), *Dynamique du peuplement mondial. Comment la population habite le monde*, Encyclopédie Des Sciences. ISTE Editions.

Verdeil, E., Faour, G., & Velut, S. (2007). Population et peuplement. In Atlas du Liban: Territoires et société (pp. 64–90). Contemporain Co-Éditions. Presses de l'Ifpo, CNRS Liban. https://books.openedition.org/ifpo/402?lang=en

Vollset, S. E., Goren, E., Yuan, C.-W., Cao, J., Smith, A. E., Hsiao, T., Bisignano, C., et al. (2020). Fertility, mortality, migration, and population scenarios for 195 countries and territories from 2017 to 2100: A forecasting analysis for the Global Burden of Disease Study. *The Lancet*, 396, 1285–1306. https://doi.org/10.1016/S0140-6736(20)30677-2

Von Kondratowitz, H. J. (2013). Squaring the circle: Demographic outlook and social development as determinants of ageing in the Mediterranean. In J. Troisi & H.-J. Von Kondratowitz (Eds.), *Ageing in the Mediterranean* (pp. 3–32). Policy Press.

Weeks, J. (2020). *Population: An introduction to concepts and issues* (13th ed.). Cengage.

Wihtol de Wenden, C. (2013). Migrations en Méditerranée, une nouvelle donne. *Confluences Méditerranée*, 87, 19–30. https://doi.org/10.3917/come.087.0019

Wihtol de Wenden, C. (2019). Migration flows in the Euro-Mediterranean region. The challenge of migration and asylum crisis in contemporary Europe and the global compact. In F. Francesca, A. Masi, C. Wihtol de Wenden, & D. Strangio (Eds.), *Migrations. Countries of immigrants, countries of migrants. Canada, Italy* (pp. 21–37). Migrazioni/Migrations. Edizioni Nuova Cultura.
Wilson, C. (2001). On the scale of global demographic convergence 1950–2000. *Population and Development Review*, 27, 155–171. https://doi.org/10.1111/j.1728-4457.2001.00155.x

Wilson, C. (2005). Transitions démographiques en Europe et dans le bassin méditerranéen. In P. S. Cassia & T. Fabre (Eds.), *Les défis et les peurs: entre Europe et Méditerranée* (pp. 21–48). Etudes Méditerranéennes. Actes Sud—Maison Méditerranéenne des Sciences de l’Homme.

Wilson, C. (2011). Understanding global demographic convergence since 1950. *Population and Development Review*, 37, 375–388. https://doi.org/10.1111/j.1728-4457.2011.00415.x

WHO Mortality Database. World Health Organization. https://platform.who.int/mortality

World Marriage Data 2019. (2019). United Nations, Department of Economic and Social Affairs, Population Division. https://population.un.org/MarriageData/Index.html

WorldPop. (2018). WorldPop (School of Geography and Environmental Science, University of Southampton; Department of Geography and Geosciences, University of Louisville; Department de Geographie, Universite de Namur) and Center for International Earth Science Information Network (CIESIN), Columbia University. Global High Resolution Population Denominators Project—Funded by The Bill and Melinda Gates Foundation (OPP1134076). https://www.worldpop.org/

World Population Prospects. (2022). United Nations, Department of Economic and Social Affairs, Population Division. https://population.un.org/wpp/

World Urbanization Prospects. (2018). United Nations, Department of Economic and Social Affairs, Population Division. https://population.un.org/wup/

Zagaglia, B. (2013). Demographic transitions and social changes in the Mediterranean region. *IEMed Mediterranean Yearbook*. European Institute of the Mediterranean (IEMed). https://www.iemed.org/wp-content/uploads/2021/04/Anuari-2013-EN.pdf