Nutrition, population and health: Theoretical and practical issues

This paper outlines the biological, social, economic, and cultural links between population and health. The role of nutrition in mediating some population/health interactions is explained. Particular attention is directed to the effects of: (1) nutrition on the health of children; (2) fertility patterns on health; (3) nutrition on fertility; and (4) health on fertility. Nutritional status at birth and early childhood nutrition are both strongly correlated with mortality risk during childhood. High parity and closely spaced births present health risks for mothers and their children. Maternal nutritional status is probably not very important in determining fertility rates, but patterns of breast-feeding may be. Fertility may also be strongly influenced by the health status of children and the willingness of couples to avail themselves of existing contraceptive services.

Because of the close relationships among health, nutrition, and population variables, sensible policy must address the three concerns simultaneously. There is no moral or intellectual justification for attempts to slow progress in health as a way of dealing with population pressures. Technology development and transfer must proceed with caution, balancing hazards with potential benefits. The medical and nutritional choices made in industrialized countries may be unfortunate and should not be adopted indiscriminately by developing nations. Particular attention should be directed to the central role of women in most cultures when dealing with health, nutrition, and reproductive concerns. Planning for the future must also address foreseeable shifts in the age composition of a population. Finally, a sensible program development may include a limited number of efficacious and efficient health services, as well as the provision of family planning services.