The Contribution of Family Planning to Environmental Preservation
Prepared by:
J. Joseph Speidel, MD, MPH
Adjunct Professor
Department of Obstetrics, Gynecology & Reproductive Sciences
Director for Communication, Development & External Relations
Deborah C. Weiss, MPH
Research and Communications Analyst
Sarah M. Gilbert
Center Assistant
Bixby Center for Reproductive Health Research & Policy
University of California, San Francisco
3333 California Street, Suite 335, Box 0744
San Francisco, CA 94143-0744
(415) 502-3928
(415) 502-8479 fax
July 13, 2006
Table of Contents
I. Summary
II. Population-Environment Interactions: Population Growth, Consumption, and Human Impact
III. Population Growth
III.1. World Population Growth
III.2. U.S. Population Growth
IV. Facing the Challenges of Rapid Population Growth: Politics and Policy
IV.1. Population Policies and Program Goals: Is There an International Consensus?
IV.2. Placing a Priority on Family Planning
V. Family Planning Programs Curb Population Growth: Three Case Studies
V.1. Thailand: Slowing Population Growth through Innovative Methods
V.2. Iran: Improving Family Planning with Political and Religious Support
V.3. Family PACT: A Cost-Effective Program for California’s Low-Income Residents
VI. Remaining Challenges
VI.1. International Challenges
VI.2. Domestic Challenges
VII. Why is Population a Relatively Neglected Aspect of Environmental Preservation Strategies?
VIII. An Action Agenda
VIII.1. Strengthening the Intellectual Base: A Prelude to Action
VIII.2. Activities to Address Population Issues
VIII.3. Steps to Educate and Motivate Relevant Audiences to Action
IX. Conclusion
References
I. Summary
This paper highlights population-environment interactions, summarizes thelocation, magnitude, and sources of population growth, and presentspolicy options for diminishing population pressures worldwide.
Environmental advocates generally understand the importance of population issues, but have often given them a lower priority than deserved for a variety of reasons. These reasons include lack of scientific expertise, thebelief that tackling population issues is too controversial or unlikely to yield success, and a perceived absence of moral standing given the disproportionately high rates of consumption in the U.S. We identifyprevention of unintended pregnancy as a strategy that is non-controversial, yet can have a substantial impact on reducing population growth and the concomitant pressures it places on the environment. To that end, we describe the successful family planning programs of Thailand, Iran, and California to illustrate that such programs are desired, feasible, and cost-effective.
We conclude with an action agenda that addressesremaining challenges to ensure widespread access to and use of family planning in the U.S. and internationally. We encourage environmentalorganizations to educate their membership, policymakers, and the public about global population issues by building and mobilizing a base of grassroots activists to advocate for improved family planning and reproductive healthpolicies and programs and by raising public awareness about the links between population and environment.
Specific actionsat the international level include:
- Improving the policy environment to reduce restrictions on access to family planning information and services,
- Strengthening family planning and related reproductive health services and increasing the resources necessary to support them,
- Supporting safe abortion services, and
- Implementing development programs that help slow population growth.
On the domestic front, environmental support could be directed at:
- Increasing recognition of the negative effects of population growth on the environment,
- Strengthening family planning programs that serve low-income populations,
- Improving access to abortion,
- Ensuring appropriate educational and service programs for adolescents, and
- Seeking acceptable solutions to immigration.
As worldwide awareness of environmental deterioration increases, we believe that the energy and efforts of the environmental community could have a profound impact on improving family planning and reproductive healthpolicies and programs thatbenefit women, men,society, and the environment.
II. Population-Environment Interactions: Population Growth, Consumption, and Human Impact
The world faces an environmental dilemma. Human demands are depleting many of the Earth's natural resources and impairing the capacity of life-supporting ecosystems.1-6 The United Nation’s (UN) medium-variant projection indicates thatbetween 2000 and 2050, the world will somehow have to accommodate three billion additional people,7 as well as support desperately needed advances in living standards for those in poverty, particularly the nearly three billion people living on or belowtwo dollars a day.8
Many experts agree that world population growth poses serious threats to human health, socioeconomic development, and the environment.1 The 1992World Scientists' Warning to Humanity,signed by 1,700 prominent scientists worldwide, cited unchecked population growth as a major barrier to achieving environmental sustainability.9 The following year, a Population Summit involving 58 of the world's scientific academies issued a statementhighlighting the intertwined problems of rapid population growth, wasteful resource consumption, environmental degradation, and poverty.10 Both groups share the view that, without stabilization of population and consumption, good health for many people will remain elusive; developing countries will find it impossible to escape poverty; and environmental degradation will worsen.
The impact of humans on their environment is related to population size, per capita consumption, and the technology used to produce what is consumed. Between 1950 and 2000, the world's population more than doubled, from 2.5 billion to 6.1 billion.7 At the same time, the gross world productexpanded nearlyseven-fold, from approximately $7 trillion to $46 trillion of annual output.11 A further modest two percent annual growth in consumption per capita worldwide would result in a doubling of consumption every 35 years, or an additional four-fold per capita increase by 2075. This increased consumption, on top of a projected 52 percent population increase between 2000 and 2075,12 would require economic production to increase six-fold. To achieve thisincreased economic production without further degradation of important ecosystems presents a daunting challenge.
As we enter the 21st century, the signs of environmental stress are clear. Such damage threatens not only the environment, but our civilization as well.13, 14 As much as half of the Earth’s total biological productivity has been diverted to human use.15 Thus, there are many examples of deleterious interactions between population growth, consumption, and environmental degradation:
- Forests are dwindling: global forest cover has declined by 50 percent since pre-agricultural times.15
- Fisheries are collapsing: with one billion people dependent on fish for protein, 75 percent of global fisheries have been over-fished or fished at their biological limit.15
- Cropland is shrinkingdue to soil erosion and desertification, and crop yields are threatened by rising temperatures and inadequate water supply.14 Rapid population growth threatens agricultural self-sufficiencyin Nigeria, where population is projected to increase from 111 million in the late 20th centuryto 258 million in 2050, resulting in a decline in grainland per capita from 0.15 to 0.07 hectares. Over the same period, population in Pakistan is expected to grow from 146 million to 295 million with a corresponding decrease in grainland from 0.08 to 0.04 hectares per person.16, 17
- Water tables are falling as 15 countries containing half of the world’s people, a total of 3.26 billion, are overpumping aquifers.14 Depletion of aquifers threatens India with a 25 percent decline in grain production, at a time when more than half of the country's children are malnourished and the population is projected to increase by some 500 million over the next 50 years.18, 19
- The reality and effects of global warming are emerging with increasing clarity. They include a doubling of the Earth’s land area affected by drought from 15 percent in 1970 to 30 percent in 2002, reduced snow pack to feed irrigation and rivers in summer months, slowing of ocean circulation, more destructive storms, melting ice, and rising sea levels.14
The recent Millennium Ecosystem Assessment, which was conducted by more than 1,300 experts in 95 countries, examined the effects of ecosystem change on human health and well-being.5 It found that humans have changed ecosystems more rapidly and extensively over the past 50 years than during any other period, primarily to meet increasing demands for food, fresh water, timber, fiber, and fuel. For instance, more land was converted to cropland in the 30 years after 1950 than in the 150 years between 1700 and 1850.
The assessment estimated that 60 percent of the ecosystem services examined are being degraded or used unsustainably.5 These include fresh water, capture fisheries, air and water purification, climate regulation, natural hazards, and pests. If such degradation remains unchecked, the potential consequences include the emergence of new diseases, changes in water quality, shifts in regional climate, the collapse of fisheries, and a decline in living standards. These harmful outcomes disproportionately affect the poor and are contributing to increasing economic and social disparities across populations. The assessment concluded that without significant changes in policy and practice, further substantial ecosystem degradation is likely to occur over the next 50 years, undermining efforts to eradicate poverty and hunger, improve health, and protect the environment. As Lester Brown has pointed out:
If croplands are eroding and harvests shrinking, if water tables are falling and wells are going dry, if rangelands are turning to desert and livestock are dying, if fisheries are collapsing, if forests are shrinking, and if rising temperatures are scorching crops, a poverty eradication program—no matter how carefully crafted and well implemented—will not succeed.14
III. Population Growth
III.1. World Population Growth
The Numbers
Although fertility rates have declined over the past half century, annual population growth has not. In 1950, the world’s population was 2.5 billion, the total fertility rate (TFR)[*]was 5.3, and annual population growth was 48 million.7 Since then, the TFR has decreased to 2.7, but a continued decline in death rates, accompanied by risingannual population growth to 76 million, have led to a 160 percent increase in world populationto6.5 billion in 2005 (see Figure 1).7 It took only 12 years, from 1987 to 1999, for world population to grow from five billion to six billion.20 This is the shortest time ever to add one billion people—equivalent to the population of India or the combined population of Europe and North America—to the world’s population.7
Figure 1: Estimated World Population Growth: 1750 to 205021
Source: McDevitt TM. World Population Profile: 1998. Washington, DC:
US Census Bureau; 1999.Available:
The UN’s medium-variant projection suggests a further decline in the world’s TFR to 2.1 by 2050, though population will increase to 9.1 billion.7 Developing countries currently account for 95 percent of world population growth.22
Despite projected declines in fertility, the annual number of births worldwide is expected to remain at more than 130 million for at least the next 15 years.21 Previously high-fertility rates have left many poor countries with large numbers of women of reproductive age; worldwide this sub-population isprojected to increasefrom 1.6 to 2.1 billion between 2005 and 2050.7 Of particular concern is the large number of women just entering their reproductive years: in 2005, there were nearly 590 million young women aged 10 to 19 years.7 As these women have children, the absolute number of people will increase, even as fertility rates decline, a phenomenon known as population momentum. For example, though China’s TFR has fallen below the replacement level of 2.1, the large number of couples of reproductive age has kept the country’s population growing by about eight million annually.17
High-fertility still persists in much of the world. In 2005, the TFR for the 3.9 billion people living in less developed countries outside of China was estimated at 3.5,with an annual population growth rate of 1.8 percent.17 At thisrate, the populationof these countries would double in just 39 years.
A small number of countries are responsible for much of the world’s population growth. The UN projects that nine countries will account for half of the world’s population increase between 2005 and 2050: India, Pakistan, Nigeria, the Democratic Republic of Congo, Bangladesh, Uganda, the U.S., Ethiopia, and China (in order of their size of contribution to population growth).22 In four of these countries—the Democratic Republic of Congo, Ethiopia, Nigeria, and Uganda—the TFR is far from replacement level, ranging from 5.3 in Nigeria to 7.1 in Uganda.7
The Sources of World Population Growth
Demographer John Bongaarts of the Population Council hasdisaggregated the sources of population growth into three categories: (1) high desired family size (individuals or couples desiring more than two children); (2) unwanted fertility (largely caused by those who wish to delay or stop childbearing but do not use birth control); and (3) population momentum.23 Most of the projected population increase in developing countrieswill result from population momentum (49 percent),followed by unwanted fertility (33 percent), and high desired family size (18 percent).
Reducing unintended pregnancy is the source of population growth most amenable to program and policy intervention. More than 200 million women in developing countries wish to limit or space their childbearing but are unable to do so; of these,64 million rely on traditional, less effective methods of contraception, and 137 million are using no method because they lack access or face other barriers to adequate family planning information and services.24 These barriers include cultural values that support high fertility, opposition of family members, and fears about health risks or side effects of contraception.25 Thequality of available family planning services can also directly affect the extent to which contraceptive methods are used correctly and consistently. In general, high quality services must be affordable, geographically accessible, and include the full range of contraception options, along with appropriate information and follow-up.
Further evidence of unmet needfor family planning services can be seen from the high proportion of pregnancies that are unplanned each year: out of 210 million annual pregnancies worldwide, 80 million (38 percent) are unplanned, and 46 million (22 percent) end in abortion.26 In the developing world,66 million out of 182 million pregnancies (36 percent) are unplanned each year, and 36 million (20 percent) end in abortion.26
III.2. U.S. Population Growth
The Numbers
In contrast to the slow or negative population growth occurring in other developed countries, the U.S.population is increasing rapidly. Between the census years of 1990 and 2000, almost 33 million people were added to the U.S. population—the largest 10-year increase in the country’s history.27 The U.S. is currently the world’s third-largest country and is projected to grow from 294 million in 2004 to nearly 350 million in 2025, and to420 million by 2050.17 While Russia and Japan currently join the U.S. as the only developed nations among the 10 most populous in the world, both will cease to be on the list by 2050, while the U.S. will remain.17
The Sources of U.S. Population Growth
The predominant causes of U.S. population growth are natural increase (births exceeding deaths) and immigration. Natural increase accounts for 60 percent of growth, with 4.1 million births and 2.4 million deaths in 2003, andimmigration accounts for the remaining 40 percent.28, 29
Unintended pregnancy is a major contributing factor to the relatively high birth rate in the U.S. Of the 6.4 million pregnancies in the U.S. in 2001—the most recent year for which data is available—almost half(3.1million) were unintended (as were82 percent of the 811,000 annual teen pregnancies),resulting in 1.3 million abortions and 1.4 million unintended births.30 About one-third of all birthswere unintended at the time of conception,30 either because the mother did not want any more children or because she was not ready for a pregnancy at that time. Without these 1.4 million unintended births, the natural increase of the U.S. population would be about 400,000 per year, less than one-quarter of what it is today.
Immigration is also of great importance to U.S. population growth. Between 2000 and 2004, 4.3 million immigrants, including an estimated two million illegal immigrants, arrived in the U.S.31 Migration expert Jeffrey Passel estimates there are 11.5 to 12million undocumented immigrants in the U.S., with more than one-half from Mexico and nearly one-quarter from other Latin American countries.32 A study by the investment firm Bear Stearns has concluded that there may be as many as 20 million illegal immigrants in the U.S.33
There is also an important relationship between immigration and natural increase. While fertility among U.S.-born women has reached replacement level, that of foreign-born women continues to fuel population growth: nearly one-quarter of babies born in 2002 had a foreign-born mother, an increase from 15 percent in 1990 and six percent in 1970.34 It is estimated that new immigrants, both legal and illegal, along with births to immigrants add about 2.3 million people to the U.S. population each year.34
High birth rates among immigrants, together with high levels of immigration are major contributors to rapid population growth in the U.S. and therefore are unsustainable in the long-term.
IV. Facing the Challenges of Rapid Population Growth: Politics and Policy
Addressing population size and growth rates—important causal factors relating to environmental degradation—is often neglected in the search for policies and programs to protect the environment. In addition, attention to population issues has been motivated by a variety of concerns that have resulted in varying population policies since their first emergence in the last half of the 20th century. The policy implications of these various rationales may differ in emphasis, but are seldom in conflict.
IV.1. Population Policies and Program Goals: Is There an International Consensus?
Between 1974 and 1994, the UNsponsored decennial population conferences at which government representatives and population experts exchanged knowledge and forged agreement on international population policies and action programs. The most recent of these, the International Conference on Population and Development (ICPD), was held in Cairo in 1994. Participants made a collective commitment to improve women's status and to make family planning and an array of reproductive health services universally available in developing countries by the year 2015.35
The ICPD set a broad agenda for population work.36 In addition to the provision of basic family planning services, itemphasized poverty eradication, women’s empowerment, gender equity, human rights, environmental protection, male responsibility in sexual behavior and family welfare,adolescent reproductive health, and safe abortion.35 The ICPD set a 2005 funding target of $18.5 billion for family planning, basic reproductive health care, and HIV/AIDS. However, when inflation is taken into account and increased needs for reproductive health and a worsening HIV/AIDS epidemic are considered, the estimated level of funds needed rises to an annual total of $45 billion.37 Unfortunately, the current annual outlays of an estimated $18.5 billion by donors, developing country governments, and consumers is only about one-third of the total investment needed.38