“What a terrible mess we are in!” I hear people say. “The only way overpopulation will be controlled is by the horror of war, famine, or a terrible epidemic.” Do you feel despair about the world’s population? Believe it or not, there is reason to be optimistic.
“The size of the family is shrinking all over the world because women in most countries want fewer children….” reports the Alan Guttmacher Institute. This desire for smaller families is because people have realized their advantages.
Let’s look at the facts. Thirty-five years ago only one in seven women worldwide used contraception. The number of children borne by the average woman (the total fertility rate or TFR) then was 6.1 in developing countries.
The good news is that growth has slowed. The TFR has dropped to 3.0 in developing countries, and worldwide the average is just 2.7. More than half of women in developing countries use contraception now. Many developed countries, especially in Europe, are actually shrinking in population.
Remember that a TFR of about 2.1 leads to a stable population. This is one child to replace each parent, and a fraction more to make up for kids who die in childhood. Unfortunately, a small difference in TFR can make a huge difference in population over a number of years. For instance, if we establish an average TFR of 1.96 now, in 50 years the world’s population will decrease to 5 billion. If the TFR is only slightly higher, at 2.18, the earth will have to support over 20 billion people by the year 2050.
Why are people choosing to have smaller families? The reasons vary from culture to culture. Three essential factors are the availability of contraception, reduction of child mortality and empowerment of women.
More and more people have access to family planning. A third of a century ago in many countries birth control clinics were found only in large cities. Modern contraception was unavailable in most parts of the world. Now, thanks to the media as well as to extensive family planning programs, most people have access to basic information on child spacing.
It is paradoxical that improving child survival can decrease the population growth rate. Historically, the population explosion was caused by decreased mortality. When the child mortality rate is high, parents have more children to assure that some will survive. Studies show that if more than 11% of children die before age five, parents choose to have large families. Not only does lowering child mortality result in a lower TFR and lower growth rateâ€”it is the compassionate thing to do.
The status of women has improved thanks to the work of many. This improvement has been most impressive in developing countries. Overall, school enrollment of girls has more than doubled over the last three decades, as has female literacy. Education and literacy are important in part because they raise women’s aspirations and their ability to find employment outside the home. Education also helps mothers learn about contraception and mothering healthy children.
There are other reasons the population growth rate is slowing. Because they don’t need to have many kids to work the fields, people choose to have fewer children as they shift from rural to urban economies.
Older age at marriage is another important factor in slowing growth. Even though teens reach puberty earlier than in the past, people are starting their families later. Moreover, better-educated and more mature mothers are likely to have healthier and smaller families.
More and more couples are relying on surgical contraception when they have completed their families. Surgical contraception is permanent, so there is little chance for an unplanned pregnancy. One in four couples in developing countries have chosen surgery.
A TFR of 2.1 or less is the goal to stop the runaway increase in our population. Just thirty-five years ago that number averaged 6.1 in the developing world, and it has dropped to 3.0. This means that we are more than half way to the objective! It is unlikely that we will reach that goal soon, however. Even if we did, many millions of people would result from the momentum of the huge number of children growing up and having their own children.
Although we have not solved the problem of population, we have made great strides. There is good reason to be optimistic that excess population growth can be restrained if we make it a top priority and devote sufficient resources to the problem.
Â© Richard Grossman MD, 2006