Improved nutrition vs. public health services as major determinants of world population growth.

Abstract

The growth in population from lowering the death rates in various parts of the world is discussed. Malaria control in Ceylon is not credited with being the major cause of the population increase as it involved only 38% of the people. Also a downward trend in population expansion was noted in Ceylon before the malaria control program with its 26% drop in death rate began. In sub-Sahara Africa 92% of the population live in endemic malaria areas and only 3% were protected by any malaria eradication program as late as 1966. The global effort against malaria did not begin until the late 1950s and there is no widespread use of antibiotics in developing countries so benefits of these drugs is not considered of major importance. Environmental sanitation has reduced infant and other mortality but a safe adequeate water supply is not available to 90% of the population of developing countries. Population growth rates accelerated by a factor of 3 between 1901 and 1950 as compared to 1850-1900. (Public health programs were not extensive before 1850). Improved medical care and better health procedures have not been the only factors in reducing global death rates. The authors point out that the current population explosion began in Europe about 1650 and until recently was generally restricted to whites who were 19% of the world population in 1650 and 27% almost 300 years later. Various diseases such as tuberculosis showed marked declines before any effective treatment was available. In a Guatemalan study between 1959 and 1964 improved nutrition for school children proved as effective as a medical program in reducing death rates but not morbidity. Neither had any effect on birth rates. Improved nutrition in Ireland China Newfoundland and Scandinavia has been associated with population expansion. Communications insect damage to crops storage rodent damage and food distribution influence nutritional benefits. Family planning is not popular in the presence of high infant and child mortality. The technology of contraception does not produce consistent results. Many give up the IUD devices after 18 months. Use of the pill is not popular in poorly motivated populations with fear of side effects high costs and need for daily doses. More food will reduce death rates in the absence of any medical input whatever. Those others than doctors influencing the population crisis are the food scientist the highway engineer the rail developer the irrigation expert the fertilizer manufacturer adn the merchant mariner. (Their influence is great though less obvious.