[Population growth, health and development].

The rate of infant mortality has declined in the whole world; yet there are regions with grave disparities with the rate exceeding 15% of live births in some areas. In less developed countries maternal deaths related to pregnancy and birth amount to 500/100000 compared to about 15/100000 in developed countries. According to the US Population Crisis Commission there is a direct and unequivocal relationship between population growth and the rate of human suffering with a coefficient of correlation of 0.83. Countries with extreme suffering can be encountered in Africa and Asia where the average rate of population growth is 2.5-3.0% and the population doubles every 20 years. Minimum suffering occurs in the Northern Hemisphere Australia New Zealand and Singapore where the annual rate of growth is about 0.5% and it takes a century for the population to double. The phenomenon of population aging in these countries is caused by increased longevity. It exerts a major impact on health services a problem which is often solved by building more nursing homes whose quality of care is not always up to standard. There are also significant regional differences in life expectancy: in Japan it is 79 years vs. 38 years in Niger and Sierra Leone 66 years in Brazil and 75 years in Portugal. By the year 2030 in market economy countries life expectancy will reach 81 years vs. only 64 years in sub-Saharan Africa. Infant mortality is 5/1000 live births in Japan with a per capita income of $25.000 vs. 161/1000 in Cali Columbia with an annual income of $280. By the year 2025 about 75% of the worlds population will be living in cities and only 25% will be living in rural areas. By the year 2000 there will be 20 cities with more than 10 million inhabitants. In the developing countries the youthful population composition puts pressure on health services education and available employment while in developed countries the aging population requires more specific health services.