Everyone is worried about our planet. Whether it is the billionaires trying desperately to exit it, the environmentalists and heads of governments trying to manage expectations or the public health pundits trying to minimise the impact of the COVID epidemic.
In health care we strive to keep people alive and healthy. In prior centuries, we were very good at it. Obstetric advances such as improved childbirth practices and public health initiatives to ensure optimal sanitation and fresh water made an enormous difference.
That it is why it is so difficult for us to discuss strategies that limit and might even cull the human population. Easier to talk about plastics and carbon.
It is no wonder that the late 20th century health goal was to extend life expectancy and promote healthy living. It followed on from several of the greatest population culls known to humankind – the influenza pandemic, two world wars and a host of systematic genocides.
It doesn’t promote discussion that the longest experiment in curbing population growth, China’s one-child policy, ended recently. The outcome of slowing population growth on the ascendancy of China as a world player will be a question only for future eco pundits.
In the meantime, we need to recognize that the passive approach to population density is problematic. Somewhere in the heated and often polarised eco arguments, one of the greatest threats to global survival, unsustainable population growth, gets lost; especially when attention is focussed on non-human populations, for example, extinct species and overdeveloped animals and crops.
We know that wealth and health are not spread evenly. And as populations are forced into sparsely resourced regions, more localized conflicts occur which, in turn, prompt increased migration.
Unfortunately, there is not much clinicians can do to change global migration crises other than to provide humanitarian care. By 2100 the population of Africa is projected to reach 4500 million compared with the 50 million projected population of Europe. It is no wonder that there is mass migration in one direction.
There are some things we can do as clinicians and those interested in the health of our planet. We can educate our patients and voters in our own countries about avoiding overpopulation through thoughtful family planning and get them to help spread the message globally.
This is not just a message of women’s rights.
We need to become ecological health warriors and provide rational and locally relevant advice all around our world about the ill health effects of overpopulation. This is not just a global public health problem; it is the legacy of the current and future generations everywhere to ensure sustainable populations.
Humans are not like birds. We can’t just fly away for the climate “winter”. Even with increased immigration to redirect some populations, unchecked population growth is unsustainable.