Birth Control Clinics in Crowded Puerto Rico
When the United States took possession of Puerto Rico at the turn of this century, the island had fewer than a million inhabitants; by 1950, with scant natural resources and a per capita income half that of Mississippi, its population had increased to more than two and a quarter million, despite heavy emigration. Only about half the land is arable, and the present number of people per square mile is roughly fifteen times that of the United States.
The increase in population has been brought about by spectacular declines in mortality, largely as a result of effective public health work. At the turn of the century, births were occurring annually at the rate of 40 per thousand, and deaths at the rate of about 25 per thousand, creating a relatively modest rate of increase. By mid-century the birth rate was still around 40 -- twice that of the United States -- but the death rate had dropped to 10 roughly that of the continental United States. At this rate of increase, assuming no migration, the island would have approximately nine million inhabitants in another fifty years.
Aware that the island's program of development and industrialization was being undermined by a too rapidly expanding population, the government of Puerto Rico set up, in 1939, a network of 160 birth control clinics. Part of the extensive facilities of insular public health, these clinics are staffed by regular members of public health units, provided with contraceptives,