According to the United Nations (UN), the Earth's population reached 8 billion individuals in November 2022. There are now more than 30 cities worldwide that have populations of 10 million people or more, and the population of India surpassed that of China in April 2023.1,2 Historically, populations experience ups and downs. Should we view the current growth favorably or with trepidation? In thinking about the Earth's population, we should consider inequities that exist within and between populations related to access to nutrition, clean water, education, healthcare, housing, safety, and freedom, among others. Natural disasters, conflict and war, human displacement, climate change, diseases, and poverty all impact people's capacity to survive, thrive, and lead healthy lives.

Population is often linked to fertility rates within a country-whether the number of births is voluntary or imposed. The formulated "replacement level" fertility rate, not for an increase or a decline in population, is 2.1 births per female. Yet the common factor around the globe when addressing fertility should center around the reproductive rights and autonomy of women and girls.3 This is the overarching theme in the UN State of the World Population 2023 report, 8 Billion Lives, Infinite Possibilities: The Case for Rights and Choices. The report states: "All human beings have the right to make choices about when (or whether) to have children, how many children to have and with whom to have them. Their right to bodily autonomy means just that: free and informed choice, unhindered by requirements to live in service to any broader demographic, economic, social, political, environmental or security claims."

Health equity

However, to deflect the dialogue from the reproductive rights and autonomy of women and girls over their own bodies, government officials, scientists, demographers, and even the media often place a different focus on population numbers, sometimes evoking uncertainty and fright. Of course, medical advancements along with improvements in agriculture, sanitation, nutrition, education, and public health are some contributors to growing populations. Many countries have implemented strategies and policies to help them move toward successfully meeting many of the UN's Sustainable Development Goals (SDGs). Legitimate concerns encompass resource allocation, workforce capacity, aging, and healthcare. One SDG to ensure healthy lives and promote well-being for all reads, "Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all."4 How can we accomplish this goal for more than 8 billion people?

Nursing advocacy

The World Health Organization, in declaring 2020 the International Year of the Nurse and Midwife, stated, "No global health agenda can be realized without concerted and sustained efforts to maximize the contributions of the nursing workforce and their roles within interprofessional health teams."5 Keeping 8 billion people healthy without considering the healthcare workforce, particularly nursing, is not possible. Approximately 27 million nurses and midwives globally are omnipresent, educated, trained, caring, and ready to provide needed healthcare services to individuals, families, communities, and nations. Consider grounding discussions about population around women and girls' reproductive freedom and autonomy as well as the empowerment of nurses, including the removal of education and practice barriers for them.

Jamesetta A. Newland, PhD, FNP-BC, FAANP, DPNAP, FAAN

Editor-in-Chief mailto:[email protected]

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