Global benefits of family planning

By Richard Grossman MD | 27 April 2023

(Credit: Dreamstime)

The following has been extracted from a chapter titled “Family Planning Helps the World”. This chapter is an open access article distributed under the terms and conditions of the (Creative Commons Attribution 3.0 License).

The main thrust of this chapter is the benefits of family planing (FP) to humans, other species and to the environment. I will look at examples in order to make the point that, in addition to helping us, FP helps us to preserve biodiversity and decrease environmental impact.

Most of the world’s environmental problems, including climate disruption and loss of biodiversity, would be improved if there were fewer people on the planet. During the past century we have seen remarkable decreases in the rate of population growth, largely due to the use of voluntary FP. Unfortunately, the importance of FP and its relationship to population growth has been largely overlooked by medical and public health people. Furthermore, some people involved in the social sciences seem to actively deny that the planet is overpopulated. Much of this denial comes from religious beliefs and from the regrettable past history of genocide, forced sterilization and eugenics.

The good news is that almost half of the world’s countries have a total fertility rate (TFR) of less than 2.1, which is the number for replacement fertility. This means that their population will decrease, if the fertility stays below that number, although it may take several decades for that to happen.

How large can the human population be and still be sustainable? I like to use the Ecological Footprint (EF) to compare how we are using Earth’s resources with what is available. In short, the EF breaks down our use of resources to land area—land on which to live, to raise food, to develop resources and to dispose of waste.

Globally, there are about 12.2 billion hectares of bioproductive land and of water. Shared evenly among the current roughly 8 billion people on earth, that would be about 1.5 hectares (3.75 acres) for each person. However, many people use more than that. For instance, the average EF for a person in the USA is about 7 hectares (17.2 acres). The average Ecological Footprint for everyone on Earth is 2.77 hectares—significantly larger than the 1.5 acres that are available. As a consequence, we are using the earth’s resources faster than they can regenerate. Calculations suggest that it would take 1.8 planets Earth to support all the humans at the rate at which we are using resources and generating waste. The excess over what the planet can support sustainably is called “overshoot”.

One way to calculate a sustainable human population is to divide our current population by the overshoot fraction—8 billion divided by 1.75, or about 4.5 billion people. Unfortunately, one of the shortcomings of the EF is that it does not allow any resources for nonhuman species. With a small allowance for all other flora and fauna, we might find that 4 billion humans would be a sustainable population. If we want the planet to be really healthy, the human population should be about 3 billion people.

There are other, perhaps more accurate ways of calculating the size of a sustainable human population. Mostly they end up with estimates in the range of 2 to 3 billion people, as stated above. For a readable review of this subject, I suggest the book “A Planet of 3 Billion” by Christopher Tucker for more information about a sustainable human population.

The bottom line is that our current human population is not sustainable. In fact, our current population, with the average consumption, is about 2 or 3 times what could be maintained indefinitely. Without modern FP, our numbers would have been much, much larger than the current 8 billion!

Let me explain why I focus on population rather than on consumption. In the formula that describes human impact on the environment, I = P × A × T (Impact equals Population times Affluence (or Consumption) times Technology), population is just as important as affluence. However, remember that there are more than 120 million unintended pregnancies every year!. That means that there are many, many women who wish to have control over their fertility—but I know very few people who wish to decrease their affluence. Indeed, globally we live in a sea of advertisements and other media that urge us to buy and consume more, not less.

I do not give the T in the above formula much attention. For instance, I’ve replaced the lightbulbs in our home with compact fluorescent light bulbs, then with LEDs. We have solar panels on our roof that make most of our electricity and also power our plug-in hybrid vehicle. However, my wife’s and my Ecological Footprint is still much larger than 1.5 acres, since these technological modifications only reduce our impact slightly.

To sum up, it would be great to have everyone decrease their footprints down to what is available (1.5 hectares) if we all shared equally. Unfortunately, that is very unlikely. For the average person in the USA it would mean shrinking their footprint by almost 80%, from 7 to 1.5 hectares! Imagine what it would take to have such a small footprint. There are so many things you could not do, and so many things you’d have to do without to have such a small footprint. You would probably have to live in a small house, eat primarily beans and rice or other simple foods with very little meat or none at all. You would have to walk, bike or take public transportation; a car would be impossible. You would have no frills, no TV and probably lots of hard work. It is no wonder that people are not enthusiastic about decreasing their consumption!

On the other hand, millions of people already are trying to control their fertility. Over half a million abortions are performed every year in the USA. It is estimated that there are about 121 million unintended pregnancies globally. The number of women who do not have access to effective contraceptive methods is estimated to be 218 million. Access to voluntary contraception and abortion are certainly the “low hanging fruit” when it comes to decreasing human impact.

There are other, more quantitative ways to appraise the role of FP in lowering our impact. In this part of the discussion, I would like to use climate disruption caused by carbon dioxide (and other greenhouse gasses) as a proxy for all anthropogenic environmental problems. This is because climate disruption is in everyone’s mind—as well it should be. Furthermore, climate disruption has been studied a great deal, and in more quantitative ways, than other environmental problem.

For various reasons, the potential for FP to help solve the evolving disaster of climate disruption has been given much less attention than it deserves. An article written in 2010 claims: “Using an energy–economic growth model that accounts for a range of demographic dynamics, we show that slowing population growth could provide 16–29% of the emissions reductions suggested to be necessary by 2050 to avoid dangerous climate change”. Although it may be too late to achieve such a benefit by the year 2050, there are still large advantages to supporting FP for further in the future. Another study suggests that not only is FP effective, but it may be the least expensive means to slow climate disruption. Another article gives an overview of CO2 emissions in the past and projections using demographics.

However, there are other environmental problems than just climate disruption. Extinction of species, global toxification and other impending tragedies may be as bad as, or even worse, than climate disruption. Working together, all this deterioration of the environment will cause problems that we can only begin to imagine. Do not forget that all of these problems are anthropogenic!

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