PAGE EIGHT

THE MICHIGAN DAILY

SUNDAY, 21 FEBRUARY 1965

PAGE IGHT HE MIHIGA DAIL S4TTn.............. OR

F.7 V l f i![i i H 4 ,l' Lliiitl V L} i i .C O V J

Rate of Births and Deaths

births per 100 pop.
(1958-62)

deaths per 1000 pop.
(1958-62)

Underdeveloped Areas
Asia exc. Japan
and China) 21

44

Africa
Latin
America

23

46

13

41

{

Developed Areas

U.S.
Canada
Europe
U.S.S.R.
Japan
Oceania

24
19
10
24
17
24

0

RAPID POPULATION GROWTH has led to overcrowded living conditions such as these which exist
in Taichung, a city on Taiwan (Formosa). A survey conducted in Taichung with the assistance of
the University's Population Studies Center indicated that the people there want to limit their birth
rate, but lack effective methods for doing so.

(Data from the United Nations Demographic Yearbcok, as
reported in Chemical and Engineering News, Dec. 14, 1964.)

HEALTH CENTERS WHERE WOMEN can obtain contraceptives were set up in many parts of Tai-
chung (Formosa) where the University participated in a population studies project. These centers
were established as part of a program to reduce the birth rate in this area, one of the most densely
populated in the world. (Taichung photographs courtesy of Mrs. Ronald Freedman.)

University Tackles

Urgent Population Problems


Public Aid
For Control
Is Necessary
Need To Change
Restrictive Policies,
Eliminate Apathy
"If the world's population keeps
increasing at the presesnt rate, by
the year 7000 A.D. the mass of hu-
man flesh on this planet will be
expanding at the speed of light."
Dr. J. Robert Willson, chair-
man of the gynecology and ob-
stetrics department of the Medi-
cal School, often says this to em-
phasize the importance - and
seriousness - of the population
explosion.
The rapid population increase
is occurring in the West as well
as the underdeveloped countries.
Threatening to outgrow the food
supply, deplete natural resources,
and increase human suffering
everywhere, population growth is
a problem of increasingly wide-
spread concern.
Public Concern
"Thenature of the population
problem has changed from an
individual matter to one of pub-
lc concern," Dr. Myron Wegman,
dean of the public health school
says.
"However, facilities for hand-
ling the problem are often in-
adequate he adds, explaining that
often more trained personnel and
administrators to provide family
planning education are needed.
Willson mentions difficulties in
the medical aspect of the prob-
lem. "Birth control methods are
by no means perfected. No one
best method exists, and some
people have difficulty using any
of them."
Local Reaction
Technical and administrative
problems are not the only ones
encountered in trying to establish
family planning programs in this
country or abroad. Apathy, even
opposition are often found.
Crucial questions in undertaking
such programs are how much in-
itial opposition exists is expected,
whether attitudes are changing
and what can be done to facilitat
adoption of responsible attitudes
toward the population problem.
"Lower class women have diffi-
culty getting birth control infor-
mation," Willson says, "because
they do not have personal phys-
icians who will take the time to
talk with them. Doctors do not
establish the same kind of doctor-
patient relationship with welfare
cases that they do with their mid-
die class patients."
"Few hospitals have specific
policies on giving birth control in-
formation to the women in ma-
ternity wards," Dr. Johan W.
Eliot, professor of maternal and
child health in the public health
school, says.
Detroit Area
A study of hospitals in the De-
troit area last year revealed that
most hospitals leave the decision
on whether to give such informa-
tion up to the individual doctor.
A few hospitals have a definite
policy either for or against giving
birth control information to ma-
ternity patients.
"Doctors differ widely in their
attitudes toward giving birth con-
trol information," Eliot says.
"Doctors should be made more

U' Experts
Reiort on

tilizedi ovum from becoming at-

accurate forecast must take into

Prof. Ronald Freedman (far left) is director of the University's Population Studies Center, which is doing research on sociological
aspects of the population problem. Dr. Myron. Wegman (second from left) is dean of the public health school, which conducts train-
ing programs for professional workers in family education. Dr. J. Robert Willson (second from right) is chairman of the gynecology
and obstetrics department in the Medical School. Dr. Johan W. Eliot (far right) is professor of maternal and child health in the

public health school.
titude the Catholic Church will
take on the matter," said Eliot.
"We may even find the Catholic
Church leading us out of the wil-
derness."
His belief seems to be support-
ed by the fact that a number of
Catholic clergy and laymen have
announced support for public
birth control programs. Detroit
mayor Jerome Cavanaugh, a
Catholic, publicly supported the
establishment of free public fam-
ily planning clinics in that city,
for example.
Catholic Stand
"One change in the Catholic
Church's policy is that it no
longer opposes public or govern-
ment support of family planning
programs in this country or
abroad, although the birth con-
trol methods taught in these pro-
grams may not be in accord with

cide whether or not to give con-
tracertive information to unmar-
ried women. Some of the women
at whom the public family plan-
ning clinics are aimed are not
married.
Eliot says that the health and
welfare of these women and their
children, many of whom are un-
wanted and cannot be properly
cared for, is at stake.
Major Aims
"Individual relief and the cre-
ation of conditions for building
better families are the major aims
of these public health programs,"
Eliot says.
Attitudes against giving con-
traceptives to unmarried women
may be changing. An Illinois sen-
ator has been quoted in the "Wall
Street Journal" as saying that he
approved of such a program be-
cause hearings had convinced him

"There is a great difference in
the kinds of information and
treatment available to middle
class and lower class women,"
Eliot says. "Not only is contra-
ceptive information more avail-
able to middle class women, but
it is easier for them to get abor-
tions."
Largest Factor
"According to the Kinsey re-
port, the one largest factor mak-
ing a difference in the illegiti-
mate birth rate between middle
and lower class women is the
greater prevalence of abortions
among the middle class," Eliot
says.
He also says that it is easier
for middle class women to have
legal abortions. A study done in
New York City hospitals indicates
that different sets of standards
for private and public patients
exists, he said.
Dr. Ralph Ten Have, a re-
search associate in the maternal
and child health division of the
public health school believes that
a number of existing laws and
attitudes should be changed. He
says:
.-Abortions should be made
easier to obtain legally in certain
circumstances. This, along with
more effective family planning
education, would prevent deaths
that occur as a result of abortions
performed by amateurs.
-Voluntary strilization should
be more widely practiced as a
method of preventing unwanted
births.
-Information about birth con-
trol should be madeamore avail-
able to teen-agers, along with a
sound sex education that would
reduce the need for sexual ex-
perimentation. People are marry-
ing younger, but the incidence of
maternal a n d infant deaths
among teen-agers is higher than
among adult women. Moreover,
50 per cent of teen-age brides are
pregnant.
Middle Class Origin
"Many aspects of the popula-
tion problem are not really un-
derstood," Ten Have says. "Over-
population in this country is
mainly a result of too many ba-
bies being born in middle class
families."
"The average expected family
size in the United States is now
3.2 children. It should be no
more than 2.5 children. The wel-
fare cases that are widely cited as
contributing to overpopulation
are such a small part of our popu-
lation that a change in the birth
rate of this group would have lit-
fit. affec~t nin nnulation growth.

"In fact, the population in the
United States is causing much
faster depletion of natural re-
sources than the more rapidly
growing population in the under-
developed countries," Ten Have
says.
The underdeveloped countries,
too, seem to be on the verge of
severe problems. They may soon
experience problems in even
maintaining their populations at
a subsistence level, Prof. Raymond
Ewell of the State University of
New York reports in "Chemical
and Engineering News."
He predicts that there will be
serious famines in many parts of
the underdeveloped world by 1970
unless food production is some-
how increased in these areas.
Ewell claims that extensive use of
fertilizer is the only practical way
of averting this short-run food
crises.

Re search
Fanily Planningj
Methods Important
"Birth limitation will be achiev-
ed by the use of several contra-
ceptive methods. There is no 'best'
one," Di. J. Robert Willson, chair-
man of the gynecology and ob-
stetrics department in the Medi-
cal School, believes.
The kinds of contraceptives that
can be used depends on a num-
ber of factors. These include in-
divioual preferences, age, cost,
and education of the user. Cer-
tain methods are preferable for
those with little education or low
motivation.
Injections
Research at the University and
elsewhere is being done to devel-
op injections that would prevent
conception for a specific period
of time, such as six months or
a year.
Given to a. woman, the pro-
posed method would immunize her
against spermatozoa. Given to a
man, the injection would pre-
vent the production of sperma-
tozoa. Some experts estimate that
this method will be in use in five
years.
Another method which has come
into wide use only recently is
plastic intra-uterine inserts. These
come in several shapes and when
inserted into a woman's uterus by
a doctor are an extremely effec-
tive contraceptive.
Willson said that the way they
work is not really known. One
theory is that they produce con-
tractions which prevent the fer-

tached to the uterine wall. account not only the size of the
Willson noted that intra-uter- population, but also what percent-
ie devices have several features age of the population will want
that make them especially desir- to go to college.
able for use among lower class Prof. David Goldberg, an asso-
people in this country and in un- ciate director of the Population
derdeveloped countries. They re- Studies Center, conducted a study
quire no thought by the user once of Michigan's college enrollment
they are in place, are inexpen- potential in which he found that
sive, and require no storage space the population increased by three
-sometimes a problem in crowd- times from 1900 to 1960 while
ed living conditions. the college enrollment increased
Oral Contraceptives 20 times during the same period.
Oral contraceptives, pills con- Underdeveloped countries have
taining hormones that prevent also been studied to determine
ovulation when taken during part their special problems and needs.
of a woman's menstrual cycle, are An experiment designed to study
another very effective contracep- the effectiveness of ways of
tiv- method. Relatively high cost spreading information about fam-
makes it unlikely that they will'ily planning was conducted in
be widely used in many underde- Taiwan (Formosa).

MORE PEOPLE, LESS FOOD
".. .This is the greatest and most nearly in-
soluble problems in the history of the world.

| And it is almost here
The world is on the thresh-
hold of the biggest famine in his-
tory. Not the world we live in, but
the underdeveloped world, the
three poor continents of Asia, Af-
rica and Latin America.
The populations of these con-
tinents are growing rapidly, and
the production of food in these
continents is lagging the popula-
tion growth. This is the problem
in a nutshell. This is the greatest
and most nearly insoluble problem
in the history of the world. And
it is almost here.
If present trends continue, it
seems likely that famine will reach
serious proportions in India, Pak-
istan, and Communist China in
the early 1970's. Indonesia, Iran,
Turkey, Egypt, Brazil, and several
other countries will, follow with-
in a few years. Most of the other
,ountries of Asia, Africa, and Latin
America -will fall in this cate-
gory by 1980. Such a famine will
be of massive proportions affect-
ing hundreds of millions, possi-
bly even billions of persons. If
this happens, as appears probably,
it will be the most colossal ca-
tastrophe in history. It would be
a completely new situation in thf
world's history-not enough foor
for the billions of human beings
inhabiting the surface of this
globe. This would be the Mal-

I'
.t
*

veloped countries.
Medical research is not the only
kind of work on population prob-
lems that is being done at the
University. Two, units, the Popu-
lation Studies Center, established
in 1961, and the public health
school are both doing a great deal
of work in this area.
Work at the Population StudiesI
Center includes research by so-
ciologists on such subjects a5~ at-
titudes toward family planning in
this country and abroad, urban
growth. migration, and projections
of population growth.
Underdeveloped Countries
Center staff members act as
consultants, particularly for un-
derdeveloped countries. Prof. Amos
Hawley, an associate director of
the Center, is presently in Thai-
land as an advisor on population
problems. He is conducting a study
on the dissemination of birth con-.
trol information. ,
Training graduate students is
also an important part of the
Center's work. Foreign students
from many countries come to
study in the Center's program.
The public health school is al-
so conducting studies on various
aspects of the ponulation orob-
lem, such as provision of effec-
tive family planning services an('
the teaching of fertility regulation
in medical schools.
Clinics
Clinics are being provided by
the school in several parts of the
Detroit area for helping women
who want assistance in family
planning.
Training students (many of
whom are from foreign countries)
on population studies is an im-
portant part of University public
health activities.
In America, knowledge of ef-
fective birth control methods is
available, studies at the Popula-
tion Studies Center have found. A
planned family is not necessarily
a small family, however, one re-
port says, pointing out that fac-
tors other than knowledge of con-
traceptive methods will determin,
population trends in this country.
A small increase in the 'average
family size among the middle class
can create a large change in the
size of the population in a few
years. Another factor affecting
population size in this country
is that people are living longer
More generations are alive at the
same time.
Two factors related to family'
size in this country are the reli-
gion and the educational level of
the parents. Catholics have larger
families than Protestants. Fam-
ily size also decreases the the
educational level of the parents
increases, research has found.
In a country where securing an
adequate food supply for the pop-
ulation is usually not a problem,
a "baby boom" such as this coun-

Motivation
One finding in the study was
that the people did not need to
be motivated to limit the size of
their families. The project, there-
fore, involved helping them find
effective contraceptive methods so
they could have the number of
children they really wanted.
Publicity
Another factor that was being
studied was the amount of pub-
licity needed to communicate in-
formation about a birth control
program to virtually the entire
population.
Generating a "critical mass"
which will carry the word to oth-
ers is especially important in un-
derdeveloped countries which do
not have the resources to contact
each family individually.
The results of the program in
"planned fertility" on Taiwan
were considered promising by the
researchers, although conditions
on Taiwan are more favorable for
such a project than in some other
underdeveloped countries. Similar
projects may be undertaken in
other countries.
Public health work on' popula-
tion problems being done at the
University has included a study
of therteaching of fertility regu-
lations in medical schools. One
finding of the study is noted by
Eliotas quite relevant to popula-
tion problems.
This is the perpetuation of the
"poverty cycle" in which poor
families or unwed mothers have
had- to depend on publicly sup-
ported medical care and have
almost no contraceptive services
available to them.
Medical Teaching
While nearly all medical schools
teach students about family plan-
ning methods, the study found,
few teach that such methods
should be made available to un-
married persons.
Giving these people information
about contraception is "probably
a necessary step for limiting the
number of children born to such
persons," Eliot said.
A bright side of the picture is
that agencies and groups which
are trying to meet the problems
of the population explosion have
greatly increased their activity
in the last few years, Eliot says.
"Things are changing so fast
that what is true today may not
be true tomorrow," he says.
Voluntary Agencies
The groups working on the
problem include voluntary agen.
,ies like Planned Parenthood, pro-
fessional medical and public
health organizations, state and
federal government assistance
teaching programs in medical and
public health schools for profes-
sional people in these fields.
"Excess fertility," Eliot says,
"has led to a problem that must
he met by r rhans aniintvrdi.

k

private groups in most countries
in the world today, but it is mov-
ing slowly in Asia, Africa, and
Latin America and seems unlike-
ly to cause any marked decrease
in the birth rate before the
1980's. But ultimately, birth con-
trol is the only answer.
Increasing agricultural produc-
tion is, however, the only real
possibility of averting world fam-
ine in the 1970's and 1980's. It is
technically possible to double or
even triple agricultural production
in all of Asia, Africa, and Latin
America through the use of mor(
fertilizers, more irrigation, better
seed varieties, more pesticides, and
other improved agricultural prac.
tices.
Of the various technical factors,
increased use of fertilizer offers
the best possibility for a quick
increase in agricultural produc-
tion. Field trials in many coun-
tries have established that mod-
erate applications of fertilizer wil'
give large increases in yields even
if other technical inputs such a-
seed varieties and water supply
are left unchanged.
The oceans offer a possibility
of increased food production, but
capital costs are high and the
realistic potentials are generally
overestimated.
The developed countries will

BECAUSE OF HIGH birth rates, children such as these, born
in a village on Taiwan, face a life of poverty. (Picture courtesy
of Prof. Norma Diamond.)

the teachings of the church,"
Eliot says.
Other imaginary obstacles have
also been created, Eliot feels. For
example, it has been claimed that
oral contraceptives, an effective
birth control method, cannot be
used by illiterate women in un-
derdeveloped countries because of
the need to use a calendar and
count.
He described studies done in
sections of Kentucky and Mexico
where many of the women were

that it' was the lesser of two evils
-the alternative being the addi-
tion of the children of these wo-
men to public welfare rolls.
The major concern of public
health workers is for the health
of the indigent groups.
Another reason, also mentioned
for lowering lower class birth
rates, is to decrease the number
of people who must be supported
at public expense.
A Minority
Further, a small minority of the