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POPULATION IN RELATION TO DEVELOPMENT, RESOURCES, AND HEALTH MICHAEL D. LEBOWITZ, Ph.D* The question of population growth has become a major international issue in the twentieth century. As Kirk [1], Davis [2], and others have pointed out, it demands intervention in terms of rational commitments and not neo-Malthusian statements of catastrophe. Population growth, socioeconomic development, and health are all interconnected. It is these relationships which are discussed in this paper. Social, economic, and political development, in both industrialized and developing countries, are directly related to population size, distribution, and characteristics. Medicine is of prime importance in influencing population growth, and health is in turn influenced by such growth. Development is also directly related to social and natural resources, living standards, and the quality of life. Historically, population was kept under control through both natural and social means. High death rates, primarily due to infectious diseases, were the predominant natural means. Social means included such factors as age at marriage, enforced sterility, war, and migration. Population growth, when it came, was often tied to some increase in technology or to migration [3, 4, 5]. In the developed countries, the industrial revolution involved population increases, followed by population control. This control was primarily individual incentive, tied in with social means [6, 7]. In the last half-century alone, however, population increase more than doubled in the world, rising from 1 percent to 2.1 percent per year. In developing countries, growth rates of 3 percent per year or more are often present [8]. At 3 percent per year, the population doubles in 23 years. * Section of Pulmonary Diseases, Department of Internal Medicine, University of Arizona Medical Center, Tucson, Arizona 85724. Perspectives in Biology and Medicine · Summer 1973 | 599 In the presently developed countries, the change in death rates was due primarily to changes in living standards and factors such as the sanitation revolution of the last century [9]. In developing countries , on the other hand, the introduction of modern medicine was the primary factor reducing the death rates. However, even in countries where infectious diseases were largely controlled, the rates of death in various age groups have not been reduced to anywhere near the level of the developed countries [8]. Low death rates and high birth rates lead to high growth rates. Since all social systems have checks and balances on population size, it is assumed that some day, in one manner or another, the developing countries will also go through a demographic transition. In developing countries, the resulting population growth has produced major developmental problems. Economic development has been stymied. Economic growth must be far greater than population growth in order for the country to achieve gains in capitalization and industrialization [10]. Economic growth must be in the form of capital savings. This limits short-term increases in living standards. With increasing population growth, the social and educational needs that are already unmet cannot possibly keep up or increase sufficiently . All resources, including health resources, are strained and insufficient with large population growth. The major problem of population control in these countries is that the people will not decrease fertility until they have security in terms of very low death rates, lower disability, less malnutrition, and an increase in per capita wealth or standard of living [2, H]. Behavioral changes will obviously be required to limit population growth and improve health [12]. There are many interactions in the process of development involving utilization of resources. Development includes the construction , operation, improvement, and expansion of usable land, minerals , power, factories, farming, transportation, housing, and education . Development often includes or requires the modification of certain political, social, and cultural institutions [13]. There is no "quick fix" [2, 13]. Some of the basic problems in development in terms of population growth are: (1) loss of social controls leading to a transition stage of population and culture; (2) lack of adequate indigenous scientific technology, training, and confidence; and (3) drain of resources . 600 I Michael D. Lebowitz · Population Growth Brown [13] has stated that, if the standard of living of the Third World increased to the level of the United States, all known resources would be used within 50 years. Even if technology...


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