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THE GLOBAL POPULATION, 1976
621
Round the World THE GLOBAL POPULATION, 1976
JOHN A. LORAINE Department of Community Medicine, University of Edinburgh was estimated Press accorded the 000 million. The to have reached 4 attainment of this important milestone surprisingly little publicity, In a world preoccupied with intractable pro-
IN
March, 1976, the world population
blems-double-digit inflation, resource depletion, recurrent famines, nuclear proliferation-the population dilemma seemed almost inconsequential. This view is quite unjustified if one looks at future prospects. During 1976, global population will rise by over 70 millionabout the same as current numbers in the world’s most overcrowded country, Bangladesh. United Nations
organisations predict a 55% increase in the global total to 6240 million by A.D. 2000. The Population Reference Bureau in Washington warns that at the current growthrate of 1.8% per annum 5000 million people could be competing for the earth’s dwindling resources by 1989 and that by 2014 the world population could have doubled. The "demographic divide" between rich and poor nations became more pronounced in 1976.2In the developing countries of the Third World birth-rates, death-rates, and infantile mortality-rates generally remained high; so did the rate of population growth. Life expectancy was low; the population contained a high percentage of youth; most people were still rural rather than urban dwellers. In the developed world these trends were reversed. During 1976 fertility in the industrialised countries continued to decline. This happened irrespective of whether the ideological stance of the particular nation state was capitalist or Marxist. There were relatively low birth-rates in Federal Germany and the German Democratic Republic, in Belgium and Bulgaria, in Switzerland and Czechoslovakia, in Sweden and Hungary. In Federal Germany and Luxembourg deaths now exceeded births but immigration maintained population growth above zero. The German Democratic Republic and Portugal were losing population at a rate of 0-3% per annum. Of the countries of western Europe only Ireland and Norway have maintained their fertility during the seventies.44 At mid-1976 the population of the U.S.A. was estimated at 215.3million; this represents about 5% of the global total. The birth-rate was 14.8per 1000, the lowest since records began, even lower than during the economic depression of the thirties. The average family size was just under two children, and gradually the stigmas associated with childless marriages and only children were beginning to disappear. In 1970 the British average family size was 2-5children; by 1976 it had fallen to 1.8. In the twelve months ending June, 1975, the population of England and Wales increased by only 10 000, the lowest figure reported since accurate records began in the 1920s.5 For the twelve months ending June, 1976, deaths in England and Wales exceeded births by 3401.6 The population situation in the third world dominates
the global scene in 1976. 75% of the world’s people live in Africa, Asia, and Latin America; 85% of births are taking place in developing countries. Even more importantly, 90% of the additions to the planet between 1976 and 2000 will occur in the Third World. Asia is preponderant in terms of numbers. By mid-1976 its population was 2 287 million; its annual growth-rate was 2% and numbers could double by the first decade of the 21st century. Some indications of the very high rate of population growth is given by the situation in South Asia-India, Pakistan, Bangladesh, and Sri Lanka. The total population there is currently about 1 300 million, its overall growth-rate is 2.6% and numbers are increasing by 40 000 every day.7 The population giants of the world are India and China; indeed more than one third of the world’s people live in these two countries. The population of India now exceeds 620 million.’ Birth-rates remain high in many areas of the country and death-rates and infantile mortality-rates are tending to fall. By A.D. 2000 if present trends continue, the population of India will be more than 1000 million. Action is now being taken to halt population growth in India. Recently the minimum age for marriage was raised from 15 to 18 for women and from 18 to 21 for men.8 Early in 1976 the director of health and family planning, Dr Karan Singh, told parliament in New Delhi that if the government’s plan of "incentives and disincentives" failed to curb the birthrate, more draconian measures, including compulsory sterilisation after three children, would have to be considered. China is the most populous country. The Population Reference Bureau gives its current population as 837 million.’ The age-structure of the Chinese population is youthful, infantile mortality is low, illegitimacy virtually non-existent. There is virtually no international immigration.9 The Chinese have tackled their overpopulation problem vigorously. They operate one of the most eclectic birth-control programmes in the world making free use of para-medical staff including the celebrated "barefoot doctors". Governmental propaganda favours late marriage for patriotic reasons and the two child norm within marriage. Sex is singularly non-commercialised in China; promiscuity is frowned upon and premarital virginity is said to be a rubric of society. The status of women improved immeasurably under the Mao Tse Tung regime; a frequently heard slogan is "women hold up half the heavens". Female emancipation and the whole ethos of women’s rights are almost certainly exercising a profound anti-natalist effect. Current evidence suggests that the Chinese experiment is having limited success. The current population growth-rate is estimated at 1.7% per annum; this is lower than its Asian neighbours-India, Bangladesh, Indonesia, Pakistan, and the Philippines. In some parts of China there are reports of extraordinarily low birth-rates. For instance in Shanghai, which with well over 10 million people is probably the world’s largest urban agglomeration, birth-rates as low as 8 per 1000 have been claimed. Figures in the same range have been reported from Hunan and Changsha.lO By mid-1976 the population in Africa had risen to 413 million. The annual growth-rate is 2.6% which means that Africans could be twice as numerous by the first decade of the 21st century. The present birth-rate in Africa (46 per 1000) is three times higher than that
622 of
Europe and North America, the death-rate (20 per 1000) twice as high, the infantile mortality-rate (152 per 1000 live births) seven times as high. But death-rates and infantile mortality-rates in Africa are likely to fall steadily as hygiene and medical care improve. This is the main reason why the rate of population growth in that continent is likely to speed up during the final quarter of this century. The population of Latin America, with an estimated growth rate of 2-8% per annum, is increasing more rapidly than any other region. In some countries in the area, notably Argentina, Uraguay, and several Caribbean islands, birth-rates are now tending to fall, but throughout the whole of the region death-rates have been falling for a considerable time and are now in the same range as in the Western world. The imbalance between birth and death rates is especially striking in Latin America; it is one of the main reasons why the area’s population--currently estimated at 326 millioncould double in only 25 years. During 1976 the highest rate of population growth in the world (5-9%) is in Kuwait.’ Other member countries of the OPEC group—Iraq, Qatar, Algeria, and Libyaalso show high rates in excess of 3%. These countries already have a rapid rate of natural increase of population, but an important additional factor has been the high level of immigration of people seeking to benefit from the wealth engendered by soaring oil revenues. Outside the OPEC countries population growth rates in excess of 3% per annum in the midseventies are reported from Kenya, Uganda, Rhodesia, Zambia, Jordan, El Salvador, Mexico, Honduras, Nicaragua, Colombia, and Ecuador. In 1900 the world population was just over 1500 million and only 13.6% of people lived in cities. By 1976, of the world population of 4000 million, 40% were living in towns. This trend would certainly continue, and by 2000, for the first time in human history, urban residents would outnumber those in rural areas. In 1900 there were only 11 cities in the world with over 1 million inhabitants; by 1960 there were 45; by 1976 the total had risen to 200 and most of these were in the third world. Some metropolitan areas in the poor countries are expanding at a phenomenal rate.14 Lagos is reputed to be the fastest growing city in Africa. In 1963 its population was estimated at 1.5million; in 1976 it was 3.33 million; by 1985 it is expected to rise to more than 5 million. In the 1920s Jakarta, then known as Batavia, was the capital of the Dutch East Indies and had a population of some 200 000. Now it has a population of over 5 million. Excessive urbanisation reaches its zenith in Latin America. Brazil is the area’s most populous country. Its cities are growing at over 6% per annum and already five metropolitan areas have over a million inhabitants. In 1950 only 30% of the Brazilian population was urbanised; in 1960 it was 40%; in 1976 it is 58%. Mexico City has become a monster.15 In 1930 it had a population of about 1 million; by 1976 this has increased nine-fold, mainly due to migration from poverty-stricken rural areas. *
*
*
is one of the dominant problems of the final quarter of the 20th century. Its ramifications are enormous; it is causing hardship to millions; it is denying mankind many of his rightful aspirations. To palliate, much less to cure it, the global population crisis
Overpopulation
will demand from us qualities of resourcefulness, ingenuity, and magnanimity not before witnessed in human history. REFERENCES 1. Population Reference Bureau. 1976 May World Population Data Sheet 2. Loraine J. A. New Scientist, 1976. 69, 81. 3. Loraine J. A. Update, 1976, 12, 1047. 4. Population Reference Bureau. World Population Growth and Response; 1965-1975 A Decade of Global Action. 1976. 5. Office of Population Censuses and Surveys OPCS Monitor, December, 1975 6. Office of Population Censuses and Surveys ibid. June, 1975. 7. Population and Food, 1975, National Academy of Sciences, Washington D.C. 8. Family Planning Ass. Newsl. June/July, 1976. 9. Frejka T. People, 1976, 3, 4. 10. Kane, P. Wld Med. 1976, 11, 55. 11. Ward B. The Home of Man. London, 1976. 12. Brown L. R., McGrath, Patricia L., Stokes, B. Worldwatch Paper No 5, Massachusetts, 1976. 13. Loraine J. A. New Statesman, 1976, 91, 708. 14. People, 1976, 3, 12. 15. ibid. p. 9.
Dear
Royal Commissioners
This week we publish another of our items of evidence which might have been submitted to the Royal Commission on the National Health Service. FAIR SHARES IN THE N.H.S.
FROM the beginning the National Health Service was much a rationing system as a general service. No-one concerned with its planning and development from 1946 onward can have imagined that we had the resources, material or professional, to give to everyone any conceivable service which might relieve their condition. We started with wide disparities between areas in the facilities they had, in hospital and community services alike. The greatest progress in equalisation was in the rapid development of district-based specialist services on a regional plan. In general practice the designation of open, closed, and intermediate areas encouraged a more even distribution of general practitioners. The sequel to the Danckwerts award in 1952 helped even more, and also produced a considerable increase in numbers in general practice over the whole country. The work of the Advisory Committee on Consultant Establishments was almost wholly a distributive exercise, as is that of its successor still. But the nature of the deficiencies in hospital buildings and in homes for old people and others were such as to make rapid solution impossible. Indeed, serious capital investment was delayed until the 1960s and the Hospital Building Programme and Health and Welfare Plan produced by Mr Enoch Powell in 1962 and 1963, and later revised by Mr Kenneth Robinson, set the national targets for the first time. The N.H.S. inherited an enormous deficit and, from the first, successive Governments gave it resources toe small to remedy the defects that existed in 1948, much less to overtake the rapid advances in technical capability provided by biomedical science. Other service were given priority. Rudolf Klein’ has recorded that the N.H.S. expenditure increased in real terms by 141 between 1953 and 1973, while public expenditure or. education increased by 274%, on personal social servce· by 506%, and on social-security benefits by 139. BBt such poverty of resources it is not surprising that tce as
1.
Klein,
R. Inflation and Priorities. Centre for Studies
don, 1975.
on
Social Policy. Lon
Round the World THE GLOBAL POPULATION, 1976
JOHN A. LORAINE Department of Community Medicine, University of Edinburgh was estimated Press accorded the 000 million. The to have reached 4 attainment of this important milestone surprisingly little publicity, In a world preoccupied with intractable pro-
IN
March, 1976, the world population
blems-double-digit inflation, resource depletion, recurrent famines, nuclear proliferation-the population dilemma seemed almost inconsequential. This view is quite unjustified if one looks at future prospects. During 1976, global population will rise by over 70 millionabout the same as current numbers in the world’s most overcrowded country, Bangladesh. United Nations
organisations predict a 55% increase in the global total to 6240 million by A.D. 2000. The Population Reference Bureau in Washington warns that at the current growthrate of 1.8% per annum 5000 million people could be competing for the earth’s dwindling resources by 1989 and that by 2014 the world population could have doubled. The "demographic divide" between rich and poor nations became more pronounced in 1976.2In the developing countries of the Third World birth-rates, death-rates, and infantile mortality-rates generally remained high; so did the rate of population growth. Life expectancy was low; the population contained a high percentage of youth; most people were still rural rather than urban dwellers. In the developed world these trends were reversed. During 1976 fertility in the industrialised countries continued to decline. This happened irrespective of whether the ideological stance of the particular nation state was capitalist or Marxist. There were relatively low birth-rates in Federal Germany and the German Democratic Republic, in Belgium and Bulgaria, in Switzerland and Czechoslovakia, in Sweden and Hungary. In Federal Germany and Luxembourg deaths now exceeded births but immigration maintained population growth above zero. The German Democratic Republic and Portugal were losing population at a rate of 0-3% per annum. Of the countries of western Europe only Ireland and Norway have maintained their fertility during the seventies.44 At mid-1976 the population of the U.S.A. was estimated at 215.3million; this represents about 5% of the global total. The birth-rate was 14.8per 1000, the lowest since records began, even lower than during the economic depression of the thirties. The average family size was just under two children, and gradually the stigmas associated with childless marriages and only children were beginning to disappear. In 1970 the British average family size was 2-5children; by 1976 it had fallen to 1.8. In the twelve months ending June, 1975, the population of England and Wales increased by only 10 000, the lowest figure reported since accurate records began in the 1920s.5 For the twelve months ending June, 1976, deaths in England and Wales exceeded births by 3401.6 The population situation in the third world dominates
the global scene in 1976. 75% of the world’s people live in Africa, Asia, and Latin America; 85% of births are taking place in developing countries. Even more importantly, 90% of the additions to the planet between 1976 and 2000 will occur in the Third World. Asia is preponderant in terms of numbers. By mid-1976 its population was 2 287 million; its annual growth-rate was 2% and numbers could double by the first decade of the 21st century. Some indications of the very high rate of population growth is given by the situation in South Asia-India, Pakistan, Bangladesh, and Sri Lanka. The total population there is currently about 1 300 million, its overall growth-rate is 2.6% and numbers are increasing by 40 000 every day.7 The population giants of the world are India and China; indeed more than one third of the world’s people live in these two countries. The population of India now exceeds 620 million.’ Birth-rates remain high in many areas of the country and death-rates and infantile mortality-rates are tending to fall. By A.D. 2000 if present trends continue, the population of India will be more than 1000 million. Action is now being taken to halt population growth in India. Recently the minimum age for marriage was raised from 15 to 18 for women and from 18 to 21 for men.8 Early in 1976 the director of health and family planning, Dr Karan Singh, told parliament in New Delhi that if the government’s plan of "incentives and disincentives" failed to curb the birthrate, more draconian measures, including compulsory sterilisation after three children, would have to be considered. China is the most populous country. The Population Reference Bureau gives its current population as 837 million.’ The age-structure of the Chinese population is youthful, infantile mortality is low, illegitimacy virtually non-existent. There is virtually no international immigration.9 The Chinese have tackled their overpopulation problem vigorously. They operate one of the most eclectic birth-control programmes in the world making free use of para-medical staff including the celebrated "barefoot doctors". Governmental propaganda favours late marriage for patriotic reasons and the two child norm within marriage. Sex is singularly non-commercialised in China; promiscuity is frowned upon and premarital virginity is said to be a rubric of society. The status of women improved immeasurably under the Mao Tse Tung regime; a frequently heard slogan is "women hold up half the heavens". Female emancipation and the whole ethos of women’s rights are almost certainly exercising a profound anti-natalist effect. Current evidence suggests that the Chinese experiment is having limited success. The current population growth-rate is estimated at 1.7% per annum; this is lower than its Asian neighbours-India, Bangladesh, Indonesia, Pakistan, and the Philippines. In some parts of China there are reports of extraordinarily low birth-rates. For instance in Shanghai, which with well over 10 million people is probably the world’s largest urban agglomeration, birth-rates as low as 8 per 1000 have been claimed. Figures in the same range have been reported from Hunan and Changsha.lO By mid-1976 the population in Africa had risen to 413 million. The annual growth-rate is 2.6% which means that Africans could be twice as numerous by the first decade of the 21st century. The present birth-rate in Africa (46 per 1000) is three times higher than that
622 of
Europe and North America, the death-rate (20 per 1000) twice as high, the infantile mortality-rate (152 per 1000 live births) seven times as high. But death-rates and infantile mortality-rates in Africa are likely to fall steadily as hygiene and medical care improve. This is the main reason why the rate of population growth in that continent is likely to speed up during the final quarter of this century. The population of Latin America, with an estimated growth rate of 2-8% per annum, is increasing more rapidly than any other region. In some countries in the area, notably Argentina, Uraguay, and several Caribbean islands, birth-rates are now tending to fall, but throughout the whole of the region death-rates have been falling for a considerable time and are now in the same range as in the Western world. The imbalance between birth and death rates is especially striking in Latin America; it is one of the main reasons why the area’s population--currently estimated at 326 millioncould double in only 25 years. During 1976 the highest rate of population growth in the world (5-9%) is in Kuwait.’ Other member countries of the OPEC group—Iraq, Qatar, Algeria, and Libyaalso show high rates in excess of 3%. These countries already have a rapid rate of natural increase of population, but an important additional factor has been the high level of immigration of people seeking to benefit from the wealth engendered by soaring oil revenues. Outside the OPEC countries population growth rates in excess of 3% per annum in the midseventies are reported from Kenya, Uganda, Rhodesia, Zambia, Jordan, El Salvador, Mexico, Honduras, Nicaragua, Colombia, and Ecuador. In 1900 the world population was just over 1500 million and only 13.6% of people lived in cities. By 1976, of the world population of 4000 million, 40% were living in towns. This trend would certainly continue, and by 2000, for the first time in human history, urban residents would outnumber those in rural areas. In 1900 there were only 11 cities in the world with over 1 million inhabitants; by 1960 there were 45; by 1976 the total had risen to 200 and most of these were in the third world. Some metropolitan areas in the poor countries are expanding at a phenomenal rate.14 Lagos is reputed to be the fastest growing city in Africa. In 1963 its population was estimated at 1.5million; in 1976 it was 3.33 million; by 1985 it is expected to rise to more than 5 million. In the 1920s Jakarta, then known as Batavia, was the capital of the Dutch East Indies and had a population of some 200 000. Now it has a population of over 5 million. Excessive urbanisation reaches its zenith in Latin America. Brazil is the area’s most populous country. Its cities are growing at over 6% per annum and already five metropolitan areas have over a million inhabitants. In 1950 only 30% of the Brazilian population was urbanised; in 1960 it was 40%; in 1976 it is 58%. Mexico City has become a monster.15 In 1930 it had a population of about 1 million; by 1976 this has increased nine-fold, mainly due to migration from poverty-stricken rural areas. *
*
*
is one of the dominant problems of the final quarter of the 20th century. Its ramifications are enormous; it is causing hardship to millions; it is denying mankind many of his rightful aspirations. To palliate, much less to cure it, the global population crisis
Overpopulation
will demand from us qualities of resourcefulness, ingenuity, and magnanimity not before witnessed in human history. REFERENCES 1. Population Reference Bureau. 1976 May World Population Data Sheet 2. Loraine J. A. New Scientist, 1976. 69, 81. 3. Loraine J. A. Update, 1976, 12, 1047. 4. Population Reference Bureau. World Population Growth and Response; 1965-1975 A Decade of Global Action. 1976. 5. Office of Population Censuses and Surveys OPCS Monitor, December, 1975 6. Office of Population Censuses and Surveys ibid. June, 1975. 7. Population and Food, 1975, National Academy of Sciences, Washington D.C. 8. Family Planning Ass. Newsl. June/July, 1976. 9. Frejka T. People, 1976, 3, 4. 10. Kane, P. Wld Med. 1976, 11, 55. 11. Ward B. The Home of Man. London, 1976. 12. Brown L. R., McGrath, Patricia L., Stokes, B. Worldwatch Paper No 5, Massachusetts, 1976. 13. Loraine J. A. New Statesman, 1976, 91, 708. 14. People, 1976, 3, 12. 15. ibid. p. 9.
Dear
Royal Commissioners
This week we publish another of our items of evidence which might have been submitted to the Royal Commission on the National Health Service. FAIR SHARES IN THE N.H.S.
FROM the beginning the National Health Service was much a rationing system as a general service. No-one concerned with its planning and development from 1946 onward can have imagined that we had the resources, material or professional, to give to everyone any conceivable service which might relieve their condition. We started with wide disparities between areas in the facilities they had, in hospital and community services alike. The greatest progress in equalisation was in the rapid development of district-based specialist services on a regional plan. In general practice the designation of open, closed, and intermediate areas encouraged a more even distribution of general practitioners. The sequel to the Danckwerts award in 1952 helped even more, and also produced a considerable increase in numbers in general practice over the whole country. The work of the Advisory Committee on Consultant Establishments was almost wholly a distributive exercise, as is that of its successor still. But the nature of the deficiencies in hospital buildings and in homes for old people and others were such as to make rapid solution impossible. Indeed, serious capital investment was delayed until the 1960s and the Hospital Building Programme and Health and Welfare Plan produced by Mr Enoch Powell in 1962 and 1963, and later revised by Mr Kenneth Robinson, set the national targets for the first time. The N.H.S. inherited an enormous deficit and, from the first, successive Governments gave it resources toe small to remedy the defects that existed in 1948, much less to overtake the rapid advances in technical capability provided by biomedical science. Other service were given priority. Rudolf Klein’ has recorded that the N.H.S. expenditure increased in real terms by 141 between 1953 and 1973, while public expenditure or. education increased by 274%, on personal social servce· by 506%, and on social-security benefits by 139. BBt such poverty of resources it is not surprising that tce as
1.
Klein,
R. Inflation and Priorities. Centre for Studies
don, 1975.
on
Social Policy. Lon