Applaud Fewer Births

            The US Census Bureau recently reported that the Natural Increase (NI) of our country’s population had dropped below 1 million for the first time in decades. That is both good and bad news.

            The NI is the number of births in a year minus the number of deaths, and does not consider migration. You may already know the number of births has been decreasing gradually for a dozen years. This is good because it is an indication there are fewer unplanned pregnancies. It is also good because it means that the rate of increase of overpopulation is slowing.

            There are many demographic measures. I like the Total Fertility Rate, the number of children a woman has given birth to during her lifetime. It is easy to remember that a country with a TFR of 2.1 will reach a steady population (zero population growth) after 4 or 5 generations, if it isn’t already there. Any TFR greater than 2.1 suggests a country is growing, while less than 2.1 indicates that growth has slowed and eventually the population may even decline. A shortcoming of TFR is that death and migration rates also affect growth, but are ignored by this measure.

            The TFR of our country decreased appreciably in the past decade from 2.1 in 2009 to just 1.7 now. This change might seem small, but over generations it becomes very significant. We are on track to have a gradually shrinking population unless more people immigrate than leave the country. However, it will take decades before that happens, and immigration will probably prevent this from occurring.

            Although it is good the Natural Increase is decreasing, there are several reasons for concern. A graph from the US Census Bureau shows one: the number of deaths has increased over the past decade. Some of this rise in mortality is because there are more older people. Oldsters are more likely to die than youngsters, of course. The sad fact, however, is that the death rate among younger folks is also increasing due to drug overdoses, guns and suicides. We here in La Plata County have seen too many die from these causes. Another cause of the rise in mortality is because people are less healthy. Obesity, fast foods and lack of exercise are also taking their toll.

            Although the TFR seems to have decreased recently, this trend may not last. Women are waiting until they are older to start their families. Whereas women used to have their first baby in their late teens or early twenties, now it is common for first-time mothers to be in their late thirties or even forties. The oldest woman whom I assisted in birth was 52!

            How is this possible? Mrs. Smith (I don’t remember her real name) had been a teacher, then earned her doctorate in education and stayed on at the university as a professor. After retirement she fell in love, married and took advantage of advanced reproductive technology to conceive. All this despite having gone through the menopause! She told me that she didn’t have to worry about genetic testing because the egg had come from a young donor.

            I don’t know how I feel about sophisticated assisted reproduction. I admit that it is wonderful to see a happy, healthy baby resulting from IVF in the arms of her delighted mother. However, there are thousands of children right here in the USA who need loving, adoptive homes. 

            An increase in deaths is not my only concern about the dropping NI. With fewer babies being born our population will age—the average age of people in the USA will increase. Although there are some advantages to an aging populace, the percentage of people in the workforce is likely to diminish. Sometimes I wonder if there will be anyone to take care of me when I’m old and frail.

            Another reason to be concerned about our low TFR and the aging population is that our economic system, capitalism, is based on growth. No biological system (including humans) can grow forever. How will the end of growth play out? We have enjoyed a wonderful era of prosperity that was made possible, in part, by our growing population. Unfortunately, that expansion has been at tremendous cost which we often ignore—climate chaos, water pollution and extinction of species, among other disasters.

            Even though there will be some difficulties as our growth slows, a smaller population in the USA will be better. 

© Richard Grossman MD, 2020


Look Out for the Sahel

Field in Niger, Africa

To Deal with Environmental Problems

“Our common goal is the improvement of the quality of life for all, both now and for succeeding generations…. To deal with the social, economic and environmental problems, we must achieve zero population growth within the lifetime of our children.” 

Joint statement signed by 58 of the World’s Scientific Academies                                (1994, before ICPD)

Last month I wrote about the International Conference on Population and Development that took place in Cairo, Egypt, 25 years ago. That experience inspired me to increase my activism on population and to start writing these essays.

            The primary thrust of ICPD was to turn the global focus away from population and to bend it toward reproductive health. This change was in reaction to the dark side of some past population programs: coercive tactics to get people to accept family planning—especially sterilization. Although the goal was to be more humanitarian, it may backfire.

            After reading my November column on ICPD, a doctor whom I respect highly chided me. Dr. Malcolm Potts wrote “Richard, I was also at the ICPD, which I thought at the time – and continue to think – was a step backwards.”


             I appreciate the many comments I receive on my population essays. They help to inform and inspire me as well as keep me honest. Although I gave a positive slant to ICPD last month, I have to agree with Dr. Potts—that conference seemed to ignore that the world was already overpopulated 25 years ago.

            Another friend who was also there wrote: “I gave a paper on population issues and the unsustainability of current levels of population growth. …the attendance was light and nobody really cared.” Although the rate of growth has decreased in the intervening quarter century, we have gained over 2 billion more people. The climate crisis is evidence that our planet is even more overpopulated

             No place reflects the failure of ICPD more than sub-Saharan Africa, and especially the Sahel. It is a band across the center of Africa that has barely enough precipitation to support life. The land is overgrazed already and people are degrading the environment even more. Despite this, some of the world’s highest population growth rates are in the Sahel. The average woman in Niger (one of the Sahelian countries) will bear 7 children during her lifetime!

            Combine the area’s aridity and fast population growth with climate change and you have a recipe for a potential disaster. Add military conflicts and hundreds of thousands of refugees and things look even worse. Already many countries in the Sahel depend heavily on foreign aid for food, but that is not sustainable.

            Developments in the Sahel reminds me of what happened in a country a bit to the south. People in Rwanda had killed each other shortly before ICPD. Although ethnic and political causes are usually cited as the reasons of this genocide, another theory makes sense to me. James Gasana’s “Remember Rwanda” in World Watch magazine paints a different picture. As a former Rwandan Minister of Agriculture and Environment, Gasana felt hunger due to overuse of resources fueled that violence.

            I am alarmed by an article published November 2019 in the journal Nature, “Avert catastrophe now in Africa’s Sahel”. Already there are thousands of people escaping Africa to Europe. We may see another genocide if crowding and conditions worsen in the Sahel.

4 suggestions to Prevent Catastrophe:

Invest in girls’ education and reconsider marriage laws. We all know that educating girls and women is one of the best ways to slow population growth—plus education is good in itself. What is less well known is that the norm in many places is for girls to be subjected to an arranged marriage when they are teens or younger.

Expand access to family planning. I spent time in Northern Ghana where large families are common. A program to increase access to family planning did little to slow growth. Why? Apparently the people there are loath to discard traditions and benefit from small family size. Organizations such as the Population Media Center could help change old practices.

Increase agricultural production. No till farming, mulching and techniques of water harvesting can increase production markedly.

Act now. The best chance to slow emigration from the Sahel and prevent disaster needs international aid to act quickly. However, the Sahel would be less likely to explode if ICPD had focused more on population 25 years ago.

© Richard Grossman MD, 2019