Pay Attention, Healthcare Workers!

Doctors have played a vital role in lowering mortality and increasing human life span and well-being. While representing a humanitarian success, this achievement has also contributed to a rapid increase in human numbers. In 1972, 52 physicians took responsibility for their role in this success and signed a call for action against overpopulation, through education, family planning, and empowerment of women. 48 years later, their call has still not been answered.

By Richard Grossman MD

Family planning could bring more benefits to more people at less cost than any other single technology now available….

– James Grant

Either we reduce the world’s population voluntarily or Nature will do this for us, but brutally.

– Maurice Strong

Two physicians who are concerned about human population just published an article titled “Doctors and overpopulation 48 years later”. It is based on an article that was published almost a half century ago.

The original “Doctors and Overpopulation” was signed by 52 physicians. The first paragraph states: “Many regard overpopulation as the supreme dilemma of our age….” It goes on to say that most people consider overpopulation to only be a problem of developing countries, but that Britain would soon be overpopulated. The population of the USA rose by 121 million, from 210 to 331 million, in those 48 years. Global population has doubled since 1972.

Our medical profession helped cause overpopulation by improving health so people live longer. Decreasing childhood mortality has had a huge effect in increasing population growth, but it is perhaps the most humane action in the history of medicine. The authors of “Doctors and Overpopulation” take some responsibility for the rapid growth caused by this success.

What could those doctors recommend to combat overpopulation? They list 5 actions, all of which are still relevant today: Convince governments of the seriousness of overpopulation; Increase family planning services, Including access to vasectomy; Keep abortion legal and available to all women; Empower women; Include population studies at all levels of education and use mass media to spread information on the subject.

One of the authors of the current article, Dr. John Guillebaud, was also one of the 52 original signers. Guillebaud is a family planning guru and retired professor of reproductive medicine in London. The other author, Jan Gregus, is a gynecologist and philosopher in the Czech Republic. He recently presented a paper at the World Congress of Bioethics on the ethics of small families.

Guillebaud and Gregus discuss 5 roots of overpopulation, starting with the decline in mortality and population momentum (the large number of young people who have yet to have their families). These 2 causes cannot be changed, but the other 3 can be. There are millions of women who want to control their fertility but don’t have access to reliable contraception; access to family planning services can help. Even more women and men are forced by custom and convention to have large families. Social norms in some societies force women to be mothers because that is the only role open to them. Education can help here—especially by non-traditional methods such as telenovelas. The Population Media Center has done an excellent job of using electronic media to educate and empower women and to show the advantages of small family size.

I strongly agree with Guillebaud and Gregus in condemning reproductive coercion. It was unnecessary in India and in China, but coercive programs there and elsewhere have done great harm not only to the affected people but to the movement to slow population growth.

They also talk about the effect of large international conferences, and lament the fact that the huge Cairo conference in 1994 “failed to articulate the threat of unremitting population growth on a finite planet….” Instead, that conference highlighted the importance of reproductive health services. It also promoted education of girls and women and supported “…childbearing needs to become a woman’s personal choice, and not her obligation or a matter of chance….”

Jayathma Wickramanayake, the UN Secretary-General’s Envoy on Youth, speaking at the Nairobi conference. Unfortunately, the problems of population growth weren’t discussed. Photo from UNFPA.

Another conference, held last year in Nairobi on the 25th anniversary of the Cairo conference, followed the global trend of ignoring overpopulation. To quote Guillebaud and Gregus, “Despite… much evidence that unremitting population growth is one of the ‘upstream’ driver[s] of climate change… at the Nairobi population conference the word population was nowhere….”

Yes, there is a taboo against talking about population as a cause of environmental problems. In addition to climate change, the authors list 13 other global crises related to overpopulation—but you seldom see the media making this connection. They call for a “taboo-free talk”. Thanks, Drs. Guillebaud and Gregus; that has been the goal of Population Matters-USA for the past 25 years!

There is good news! Physicians have been slow to recognize the concept of overpopulation, and to acknowledge the connection between medical care and environmental problems. This article, “Doctors and overpopulation 48 years later”, was a step in the correct direction. Earlier this year the equivalent journal in the USA, Contraception, ran a similar editorial: “Family planning, population growth, and the environment.” I only wish that both articles were published where more people could read them.


Please visit for more essays from Richard Grossman about human population (don’t forget the dash in link, to distinguish his website from the British organisation). You can subscribe to receive these monthly essays by email while you are at the blog.

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7 thoughts on “Pay Attention, Healthcare Workers!

  1. Educaton, education, education is the key. Whilst some societies see the role of women purely as breeding factories, education of women and girls enables them to question the unfemitting demands of human breeding cows. When education enables them to see that is not their only role, they will begin to personally be strong enough to take action that turns them into mothers of a few, rather than reproductive factories of many. But it will be a long drawn out process, and needs the urgency factor placed on family planning that is currently placed on climate change.

    1. Thank you, Elaine. I agree that education is important for the reasons that you gave. Although I cannot put my finger on them at the moment, there are studies suggesting that making family planning available is even more important than education of girls and women. In the end, both are important, and I support both.

  2. The medical profession need not go on a solo guilt trip about over population as every drainage engineer and supplier of fresh water has some of the responsibility. As for the teachers who educate girls & women or employers who offer females jobs that lead to prosperity and equality they also have led to the gross reduction in child, infant and neonatal mortality that has caused this issue. Personal memory recalls that prior to the 1970’s their was a slogan that ‘two will do’ banded about in the UK. Is it relevant that the increase in prosperity in the PRC followed the ‘one child policy’? Even though the policy was inflicted with almost religious zealotry and typically Socialist brutality the consequence was improved life quality and the opportunity for progression.

    1. I definitely agree, Dr. Stewart: there are many parts of society that have facilitated the increase in population. I would have liked to have included sanitation and fresh water and refrigeration–but have a word limit to respect.

  3. An even bigger taboo is the link between overpopulation and migration. Unemployment, conflicts and environmental crises have a link with overpopulation, yet no one points it out. Everyone is fleeing “war” and other horrible things, but how did those come about?
    Also, although I support it, telling people in wealthier countries to have even less children than they already do won’t get us very far, as fertility rates are as low as they can probably get in the West. Often, they already have less than they want, and many resent being unable to afford one more child or being told not to have it, only to see their country flooded with migrants often with babies and children of their own in tow. Some fear being outnumbered in their own country – call them racist, fascist, xenophobic, whatever you want but you can’t prevent them from voting in the elections.
    Sorry but THAT is the truth no one wants to speak about. And I say this as someone who is childless/childfree and will probably stay that way.

  4. Grazie, Gaia! There have been at least two wonderful picture essays as a joint project between the New York Times and Pro Publica. Here is the url to one of these excellent reports, which focus on climate change (a symptom of overpopulation) as a cause of migration: I also wrote about it here:
    I agree, that people (especially in the USA) are unwilling to face the connection between overpopulation and migration.
    I disagree about lowering fertility rates in Western countries; I think that we can lower them. The TFR in the USA is 1.7, while it is 1.3 in Italy! The rate of unplanned pregnancies in the USA is almost 50%; if we could lower that, the abortion rate would go down and the TFR might approach that out your country.
    Ciao! Ricardo

  5. That would be Riccardo 🙂
    Yes, Italy has a very low TFR – imagine how frustrating it is to be told everyday by ALL media, political parties + the Vatican that we are suffering from the Empty Cradle Armageddon, that we are not having enough children, that we must be desperate and hopeless to procreate so little, and so on and on, when you actually think this is the best and least painful way to revert to a sustainable population!
    The reason I mention migration however is that, if we want this to work, we need to find (humane) ways to reduce immigration, because otherwise what you get is left-wing parties openly pushing for population increase through more migration at all costs, and right-wingers freaking out and trying to push birthrates up to compete with young, fertile migrants. I think people would accept their population going down if
    1. we didn’t have a growth-obsessed culture
    2. we didn’t have such an unfair and unsustainable pension system (Italy is especially insane, basically older people who are not working make more money than the young that are, and with a very early retirement age given life expectancy, and everyone treats this as a basic human right not up for negotiation)
    3. people didn’t have the impression that, instead of moving towards sustainability, we are just gonna keep up the population through migration from wherever, even if, in such numbers, it brings environmental and social problems
    Unfortunately, even with an extremely low birthrate (which, let us not forget, is not even a choice at these low levels), our population in the last few decades has either gone up or stayed about the same, because of migration. I’ve watched every empty space that could have been reclaimed by nature be either spontaneously or by design filled with migrants. Every time I say this is not sustainable, I am treated like I am Hitler. I have actually lost friends because of this. Madness.

    (Not to mention the fact that providing the outlet of mass migration to richer country creates an incentive for poorer countries to keep up population growth because of remittances)

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