Curious Observation of Health Index

I'm a returning player who last played in 2017. I see a lot has changed since then. Something I've noticed while looking around at very large countries ( 200+ million population ) a large number seem to have 200+ health index.

According to documentation 140 is the max welfare index a country can achieve. So in terms of welfare alone, health beyond 140 wouldn't increase welfare. I understand that having more hospitals would decrease deathrates overall. However, it also would increase the % of population over the age of 65 which directly results to more social security payments while having a lower % of population in the workforce.

I'm assuming the reason why a lot of presidents keep a higher health index would be to lessen the degree of population decline in large countries. However from past experience this just leads to stagnation of new workers, as the aging population has a decreased % of population below 24 years old. They also have a lower % of population within the fertile age brackets. This long term causes the problem ( average age of population, population decline, and worker shortages ) to just become even worse over time.

When I played before I've experimented with purposefully keeping a prolonged low health index, around 80 or less. Short term this would cause massive population decline, but once the average age of population is around 34 years or lower and increasing health back up to around 120-130, even in large countries. I would experience a population boom with a much lower cost in health and social security. This would last for months. Multiple game decades. While also having a sufficient supply of new workers to replace retirees. The only downside financially would be a higher cost of education.

Basically I'm just trying to understand the main reasoning for having a higher health index, when both cost of health and social security payments are often the largest expenses a country has, decreasing profitability. Maybe it's more beneficial now that countries seem to be able to grow much larger naturally now than back when I played in the mid 2010s.

I recall this being a popular viewpoint during the time you speak of. Not sure it was ever true. It doesn’t seem to be true now either.

Have you actually looked at the demographics of these countries?

This is definitely not what I see.

I'm observing this more now that you brought it.

I think probably the reason players are doing this, and for sure the reason I'm doing it, is because if you don't your life expectancy is through the floor.

Even for indexes in the low 200s in my countries it's a struggle to keep the life expectancy above 65. But I can see that age distribution is still getting top heavy, despite the cratering life expectancy. Which doesn't make much sense.

The other thing that doesn't make much sense is the number of births is ~2M and the deaths is like 3 - 4M, and yet my population is often reported to be increasing by 200K?

Just a little while back The GM changed the migration index so that it has a much greater effect. I can only assume that growth is coming from migration, and that the health index has an outsize effect on the migration index. But I'm speculating...

My current approach is just to keep the life expectancy and pop growth up, and just observe.

I was looking at migration numbers as well from my countries ( which I only have just started a month ago so the data isn't very useful ). I also checked migration numbers from other large empires on White Giant. It seems for the most part the migration numbers are only between 1500-2000 per game month for both relatively small countries and large ones. As long as welfare index is over 100.

It seems that the expected birth and death numbers are using some other calculations. I assume it's based off of total population size, welfare index and health index. I don't think it takes into account the average age of population, but I may be wrong. I just started playing again so I have to re evaluate how the higher population cap has effected growth.

I'm looking at your main on KB and I indeed have noticed a life expectancy of around 59 years and rising. Yet your population above 65 is steadily increasing, even over 80. While middle ages are sort of increasing but have game months with a decrease as well. Population from 0-21 is also steadily increasing in your country. It seems that the life expectancy is not accurate. I'm not sure how it is calculated.

My country York has a life expectancy of around 73 and rising as well. However it is a new country with population being imported every game month. Yet the health index is much lower. The data on my country isn't useful though since it's changing quickly and isn't stable yet..

Yeah, it's just confusing to me to be honest. It seems that calculations are off for expected births and deaths. I'm not sure why it's so off from the actual population growth.

The forum hasn't changed my name from Kaizen, but I was the original poster.

This is one of the hardest game mechanics to study, because it takes hundreds of years for a full view of any given approach.

There are some things I know to be true:

*The max life expectancy is 100.

*As your population increases you need an ever increasing health index in order to maintain life expectancy, and also population growth. I have just contracted hospitals to my countries. I keep them supplied with just enough hospitals to keep the population increasing. If I stop the supply population growth goes negative pretty quick.

*Increasing the health index eventually increases the number needed to achieve the same change.

I think the number of births and deaths is accurate because they are consistent with my population distribution. I just don't know where the people who increase my population come from, or how they are affecting the age distribution.

So I'm just watching.

hymy1, Evans96,

Life expectancy in Simcountry is not a reliable figure, set a goal for your healthcare index and ignore life expectancy.

Simcountry calculates life expectancy by the equation 100 divided by 'death rate'. This is a terrible way to calculate life expectancy as it will simply show a high life expectancy for countries with young populations and a low life expectancy for countries with old populations. As such it has no relationship to actual life expectancy and should be ignored.

As for where the unexplained population growth is coming from, there are two main sources.

1). To prevent unstable demographics, the game prevents the number of 0-4 year olds from declining, even if natural births aren't able to sustain the population. As such, the actual birth number is usually much higher than the estimate.

2). If there is a shortage of Low, Medium, or High level workers (less than a few hundred thousand unemployed of each type), then the game simply makes additional workers out of thin air and adds them to the population to fill those shortages. This can result in over 200,000 population being added to a country every game month. If you keep unemployment for these groups low, your population growth can be almost unlimited.

This feature was introduced to solve persistent high and medium level worker shortages in countries with large populations, and it largely worked. However, it also created near continuous population growth for any country with low unemployment.