Intended for healthcare professionals

Views & Reviews Book Review

Growth without greed

BMJ 2011; 342 doi: (Published 29 June 2011) Cite this as: BMJ 2011;342:d3998
  1. Richard Smith, director, UnitedHealth Chronic Disease Initiative, London

Is there a healthier kind of economic growth? Richard Smith was inspired by a book that gives a recipe for a more sustainable economy

Politicians, particularly those in Europe and the United States, are desperate for economic growth, but it’s the wrong kind of growth. The kind of growth that we’ve known recently, driven by debt and consumption, will destroy us. That’s the argument of Boston economist Juliet B Schor, who describes a different form of sustainable growth that will be kinder for us, our health, and the planet. She calls it plenitude.

Schor’s book is easily understood by non-economists and contains data, evidence, and stories that illustrate a new world. The book reads like a first draft of how we all might live lives that are not austere but environmentally sustainable and fulfilling. There’s more thinking and work to be done, particularly about what plenitude might mean for the billions living in poverty in low and middle income countries. And typically Schor is stronger on analysing the problem than describing the detail of the solution.

Economists identify two forms of growth: intensive and extensive. Intensive growth is using resources more efficiently; extensive growth is replacing public and household production with the market sector. Extensive growth is not real growth, argues Schor. Rather, it’s replacing one economy with another, and depends on using the natural world, like fossil fuels, which have been described as, “a one time gift that underwrote a one time binge of growth.”

Population increase plus the emergence of a global middle class has led to a “truly gargantuan scale of consumption.” The US has led the way. In 2007, 70% of the US economy was personal consumption, up from 61.5% in 1961. The average US resident spends $32 144 (£20 000, €22 600) a year, when half the world’s population lives on under $1000. There has been an orgy of consumption, which Schor illustrates with data that the average US resident in 1991 bought 34 garments (excluding hosiery and underwear) but 67 in 2001: this is a new piece of clothing every 5.4 days. The same has happened with furniture, toys, mobile phones, computers, and much else. In 2001 the US used 132 000 lb (60 000 kg) of oil, sand, grain, iron ore, coal, and wood per person; 362 lb per person a day. It’s not sustainable.

People as old as me have heard something like this before. I listened to Paul R Ehrlich, the Stanford ecologist, argue in the 1970s that the population bomb was about to go off and that we wouldn’t be able to feed the world. The Limits to Growth, published in 1972, selling 30 million copies, argued that by 2015 income would decline, food production would become inadequate, and pollution would begin to overwhelm the planet. In 2011 this looks familiar, but at the time many economists argued that the book was badly wrong, and seemed to win the day. “But,” asks Schor, “did economists win the battle over the model and lose the war over whether we are actually facing limits . . . Most economists have practised their craft as if nature did not exist.”

This situation is, however, beginning to change, and the 2006 Stern Review on the Economics of Climate Change by the UK economist Nicholas Stern was a “game changer.” The Stern Review argued that ignoring climate change would be much more costly than responding to it. The conventional wisdom is that climate change can be solved with innovative technology and market incentives such as a carbon tax. Schor is sceptical, partly because of the rebound effect whereby more efficient use of energy causes people to buy more—for example, aviation fuel efficiency has increased by 40% since 1975 but overall consumption has increased by 150%. “Either,” argues Schor, “we need to grow less or we need to grow differently.”

“True wealth,” she writes, “can be achieved by mobilizing and transforming the economies of time, creativity, community, and consumption.” Americans have put more time into market activity, mainly employment, and used the money they make to buy goods and services. Better, argues Schor, to free time from market activity and use the hours released to develop new skills and activities—like growing and preparing food, making things like clothes, learning (particularly about techniques for environmental sustainability), developing relationships, and contributing to the community. This may sound like the ethos of the characters in the 1970s BBC television series The Good Life, but, with advanced technology, so called self provisioning can be liberating and economically substantial rather than a craft movement.

Reallocation of time is the first principle of plenitude, and self provisioning the second. The third principle is so called true materialism, recognising the true value of what we consume: we must be more, not less, materialist. The final principle of plenitude is to, “restore investment in one another and our communities.”

Plenitude is, argues Schor, emerging, with many people working less, growing more food themselves, installing solar panels and more efficient stoves, teaching and learning about skills for living sustainable lives, recycling, and buying less and making more. I think of some good friends of mine, a doctor and a nurse, who have done all of these things, changing their lives more dramatically than most of us will manage.

Some aspects of plenitude are reminiscent of David Cameron’s “big society,” something that it is fashionable to scorn, and I don’t think that the book fully explains how plenitude would mean that growth would continue. Presumably there would not be growth in the gross domestic product as currently measured, but we would feel richer rather than poorer. Plenitude boils down to “work and spend less; create and connect more,” which strikes me as an excellent formula; good for the planet and for us.


Cite this as: BMJ 2011;343:d3998


  • Plenitude: The New Economics of True Wealth

  • Juliet B Schor

  • Penguin Press; 258 pages

  • ISBN: 9781594202544

  • Rating: **

  • Competing interests: None declared.

  • Provenance and peer review: Commissioned; not externally peer reviewed.

View Abstract

Log in

Log in through your institution


* For online subscription