Overpopulation as a Public Health Challenge

From: The Journal of the American Medical Association, January 24/31, 2001, Vol 285, No. 4, 411.

To the Editor: Drs Koplan and Fleming¹ proffer a list of 10 public health challenges for the decades ahead. But they do not go far enough in focusing on the greatest threat to human health: environmental degradation on a global scale. A growing human population consuming resources at an unsustainable rate has put humanity's future in jeopardy. Global warming, emerging infections, massive human migrations, and species extinctions all stem from our inability to confront or control our fertility and our appetite.

While no one would argue with the 10 challenges Koplan and Fleming have identified, physicians need to address the uncomfortable reality that global environmental change is a greater threat to human health than any other factor, short of world war. The challenge is to leave future generations a world in which physicians can meaningfully address the important issues identified by Koplan and Fleming.

Roger A. Rosenblatt, MD, MPH
Department of Family Medicine
University of Washington School of Medicine
Seattle

To the Editor: Drs Koplan and Fleming¹ present a list of 10 public health challenges for the next century. I imagine many readers will be tempted to add pet projects of their own. One unmentioned challenge seems to me to be so fundamental and to have such a profound impact on several of the original 10 challenges that I offer it for consideration.

Overpopulation has a great negative effect on eliminating health disparities, cleaning up and protecting the environment, focusing on child development, and reducing the toll of violence. The problem of too many people is not acute in most industrialized countries and its solution is controversial from many political and religious perspectives; however, it behooves the medical, scientific, and public health communities to devise cheaper and more effective methods of birth control than now exist and campaign strongly for their widespread use throughout the world in the coming century.

Norman J. Sissman, MD
Retired
Princeton, NJ

In Reply: While we limited our list of public health challenges to 10, there are comparably worthy additions of which global environmental degradation and overpopulation are excellent examples.

Jeffrey P. Koplan, MD, MPH
David W. Fleming, MD
Centers for Disease Control and Prevention
Atlanta, Ga

From: The Journal of the American Medical Association, January 24/31, 2001, Vol 285, No. 4, 411.