Human numbers, environment, sustainability, and health

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Abstract
The complex relationships between economic development, population size, environmental conditions, and health have long stimulated discussion Usually, however, health has not been regarded as the primary outcome of interest. For example, a prominent paper published in 1967, entitled “Health, population and economic development,” examined various inter-relationships between these three variables—with the exception of how population growth or economic development affected health.1 Similarly, the much quoted report of the World Commission on Environment and Development of 1987 paid little attention to how environmental and economic changes affect population health.2 There is need for a more critical assessment of the ecological conditions under which health gains might be both generalised to the whole human population and sustained into the future. #### Summary points The rapid increase in population which began about two centuries ago has slowed since the 1960s, and stabilisation at around 10-11 billion is now expected The disruption of natural systems on a global scale now seems a more serious potential harm from excessive numbers than does the occurrence of local difficulties in subsistence The prospect of further intensification of ecologically disruptive economic activity means that paths to sustainability will require a shared radical “greening” of productive technologies and consumption habits The main practical need, in the short term, is for indicators of ecological and social sustainability There will be substantial scope for improving population health at any level of national income, by developing social and human, rather than material, resources We have familiarity with the scientific literature on population biology, the history of human ecology, and global environmental change and its potential health consequences. We consulted mainstream authoritative texts on these topics. The extensive literature on climate change was accessed through publications of the Intergovernmental Panel on Climate Change. Demographic, economic, and other characteristics for national populations are taken from …