Unhealthier by degrees
BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d6893 (Published 26 October 2011) Cite this as: BMJ 2011;343:d6893
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Michael James is alarmed at the failure to discuss overpopulation, at
the recent BMA Climate change conference. Rightly so, but no one who has
tried to introduce the subject in the course of similar meetings will be
too surprised. One's efforts are met with tired half smiles, at best.
Despite a widespread preference for (by comparison) the ephemeral
trivia that fill these pages, a few doctors have done their best to
stimulate interest, notably George Morris, who started a 'Doctors and
Overpopulation Group' forty years ago.
The more recent, tireless efforts of Maurice King are insufficiently
appreciated. His difficulties in exposing the likely 'demographic
entrapment' of people in Africa have been such that any interested reader
will be inclined to join the ranks of conspiracy theorists.(1)
The evidence that women who are empowered, by education, by micro-finance, or by cultural change, will then have more control over their
destinies and family size, is correctly emphasised by Richard Bartley.
Whether that process will happen fast enough to limit population growth in
the time left to us is debatable.
Female empowerment is essential for its own sake, but it will not
happen as quickly as it should unless we are more honest in our use of
words.
What is needed is a recognition that it is male behaviour (greed,
violence, anger, lust) that forces women into submissive roles.
We hide this simple truth by pretending that the need for female
empowerment is the problem.
We men are the problem, world wide.
Competing interests: Member of 'Population Matters'
In reference to 'solutions' to the current slide towards an all too
avoidable ecological precipice, Henry Nichols allows himself to talk to
his audience as a politician would. 'Perhaps in years to come, it will no
longer be possible to fly with the freedom we now have'.
Surely the imperative is to act now not 'in years to come'. The
single biggest cut we can all make to our carbon footprint is not to fly
and that means sacrificing something i.e. a piece of our discretionary
spending.
If we do not act as though we are all responsible, as the article
states, it will be our children who pay the price. We will have sold their
tomorrows by our profligacy today.
Dr Stuart Galey
Competing interests: No competing interests
The current impending so called 'population crisis' is down to a
global system that rewards the rich, punishes the poor, whilst tolerating
a narrow middle class to keep the status quo through their votes.
The poor produce low CO2 emissions and make little use of global
resources. The rich on the other hand emit colossal amounts of CO2 and
squander disproportionate resources to feed their lifestyles.
As George Monbiot states on his blog: "Where are the movements
protesting about the stinking rich destroying our living systems? It's
time we had the guts to name the problem. It's not the poor; it's the
rich" (1).
As long as the greedy in our society squander earth's recourses we
need to find other ways of compensating for the consequences of this
inequitable mess.
Technological advances and intelligent inter-governmental initiatives
raise the prospect of increases in current global resources (but not
without some drawbacks). However for me, the key lies in the education and
emancipation of women all over the world.
Empowering women though better education, equal rights and
challenging cultural practices that limit women's freedom is being shown
to work in a number of countries (2).
Judith Bruce, a policy analyst at the Population Council
(www.popcouncil.org) states that "education of women has a tremendous
return in all the things that change family size and improve the
distribution of resources. A woman who educates her children sets in
process reduced fertility" - fewer, better-cared-for children" (3).
In a chaotic world dominated by men, it seems one solution is to let
women decide our futures.
1. http://www.monbiot.com/2009/09/29/the-population-myth/
2. http://www.childinfo.org/education.html
3. http://www.csmonitor.com/World/Global-Issues/2011/1031/
As-world-welcomes-7-billionth-baby-UN-says-empowering-women
-is-key-to-stability
Competing interests: No religious allegiance.
Dear Sir
Last week I criticised the journal for demonstrating a lack of
awareness and insight into the totality of the problem when reporting on
the climate change meeting, which had been hosted by the BMJ. However,
this week you have published a more detailed account of the proceedings of
the meeting, which simply increased one's horror at the ineptitude of the
"minds" that we have tackling it. The meeting appeared to simply provide
an outlet for various enthusiasts to espouse their own particular areas of
obsession, many of which are really quite extreme, ranging from the anti-technologists who wish that all private cars are banned, to the vegetarian
lobby who think that the world will be saved by everybody becoming
vegetarians.
Ludicrous though these suggestions are, it is right that all
avenues should be explored and we should not miss any opportunities to
address our harmful excesses. However, amazingly none of the delegates
appeared to appreciate the significance of, or thought to even discuss the
single most important issue causing our problem - over-population, or at
least if they did the journal did not think it important enough to report
it. One might have hoped that this was at least as innocent as oversight,
but seemingly this is not the case. It appears to be the consequence of a
conscious act of denial; Hugh Montgomery has been attributed as stating
that "we humans are understandably fond of reproduction and there are few
things that motivate us as much as our children", a statement which
appeared to provoke no controversy what so ever. This is not only
unbelievably blinkered selfishness, it is really quite unacceptable. The
world population is partial to many things, generally resource consuming
and emission producing, but being "fond" of things does not make them
acceptable. It may be understandable that people want children, but it is
an issue that has to be addressed.
At last I would have to share Fiona
Godlee's view that there is no hope for the future, if the authorities
charged with driving our response to the problem are so lacking in vision
and purpose. What is even more amazing is that in the same issue of the
journal you announced that China has managed to control its population
growth to the extent that it is about to cease to be the most populous
nation in the world; its amazing what can be achieved by people with a
sense of purpose.
Competing interests: No competing interests
Re:Re:Unhealthier by lack of awareness
I absolutely agree with Stuart Galey's point that we need to act NOW,
e.g. by radically restricting flying, if we are to stand any chance of
addressing the current worsening climate crisis. It is a pity that Michael
James seeks to dismiss the 'vegetarian lobby' as ludicrous, since reducing
meat consumption will be crucially important for increasing food security
and reducing CO2 emissions. It also seems clear to me that the route of
the problem is in excessive consumption and emissions in the 'developed
world', and one of the greatest difficulties the world faces is in
pursuing a more sustainable path of development in the poorer majority
world, when globalisation and advertising have such seductive power.
I would like to pick up on Hugh Montgomery's injunction to
'communicate it ( the seriousness of climate change as a threat to health)
to our patients'. This is a great challenge. By hanging my cycle helmet
in my consulting room, and doing house calls by bike, I hope to
communicate a message about fitness and not needing a car. But to go
beyond this and talk specifically about climate change in a consultation
is not something I have done, although I would welcome the incentive and
official sanction of QOF points, which would be a far better use of the
whole wretched system than the latest pointless waste of time of peer-
reviewing and analysing the out-of -hours behaviour of our patient
outliers!
Perhaps the BMJ or Climate and Health Council could produce a poster
linking climate change and health, which could be distributed with the
BMJ, and displayed, potentially, to the entire UK population.
Then some good conversations with patients might follow, and they might
follow the example of those of us who are prepared to set one.
Competing interests: No competing interests