Future of health humanities

By Arvind M. Dhople, Ph.D., Professor Emeritus, Florida Tech

Estimating the future is fraught with uncertainty.  Time makes fools of all prophets.  But the broad contours of humanity’s destination can be sketched, at least tentatively.  Right now, the United Nations (UN) indicates 8 billion people will populate the planet in November 2023.  And by 2050, that figure will have risen to 9.7 billion people.  In the league table of nations, India will pass China as the most populous country in early 2024.  These numbers reflect the otherwise hidden finding that the growth rate of the world’s human family fell below 1% for the first time since 1950.

                The UN draws several important conclusions relevant to health from its analysis.  First, although global life expectancy continues to increase, large inequalities exist.  In 2019, life expectancy in the least developed countries of the world was about 7 years below the global average of 72.8 years.  What the UN describes as a “male disadvantage” in life expectancy is also a pervasive findings, range from 7 years in Latin America to almost 3 years in Australia and New Zealand.  Second, the number of older people living in societies is increasing – in absolute numbers and as a proportion of the whole.  The percentage of people aged 65 years and older is expected to increase to 16% in 2050 from 10% in 2023.  The health implication is clear and urgent.  Not only is universal health coverage the most important adaptation to meet the challenge of aging societies, but social care will be essential to protect the autonomy and dignity of older people.  Third, Covid-19 has had multiple effects on human populations, from severe restrictions in migration to fluctuations in numbers of pregnancies and birth.  The pandemic caused a dip in global life expectancy in 2021 (from 72.8 years in 2019 to 70.0 years), although a rebound can be expected in future years. 

                A further critical health-related consequence of population flux is the demographic dividend, a phase of fast economic growth that follows changes in a country’s population age structure – a smaller dependent young population than that of working age.  Countries across sub-Saharan Africa will experience sharp increases in working age population in the coming years, together with some nations in Asia and Latin America.  If this opportunity can be combined with stable political institutions, peaceful civil societies, and investments in health and education, the resultant boost to economic growth will create fiscal space for further investments in the health sector.  No such benevolent dividend exists for countries in Europe and North America.

                From a planetary health perspective, the relation between population and the climate crisis is only cursorily considered.  The geography of humanity and the migratory shifts that will influence place during future decades will influence urban, food, and health systems in transformative ways.  These forces shaping human movements across the globe are inevitable and must be embraced and managed, not dismissed or resisted. 

                What are the practical implications of the latest UN population figures?  The UN argues that “policies aimed at reducing fertility would have little immediate impact on the pace of global growth”.  Investing in the rights of women, from access to modern contraception to the education of girls, will yield important advantages not only for women and girls, but also for whole societies.  The UN should be on the front line of activism for women and girls.  In a world in which the chill winds of conservatism are rolling back decades of progress for gender equality, the voice of an independent UN that represents the interests of people, not politicians, has never been more important.

                So, finally, one can argue on the etymological transition from the phrase “medical humanities” to “health humanities” and the universal benefits this small change can have on future physicians and patients.