It's only fair to share…

EuropeA new WHO report on health in Europe shows life expectancy to be increasing. In addition, between now and 2020 there is projected to be a reduction in premature death of 1.5% each year. This you would think is good news.

Sadly good news is not popular in public health. It is a threat to funding. So rather than celebrate the reality of increased life expectancy (which are based on simple math’s and are extremely hard to fudge), they warned about dangers.

“Europeans drink and smoke more than anyone else. We are world champions- and it’s not a good record,” said Claudia Stein, WHO Europe’s head of information, evidence research and innovation.

According to Reuters, health officials warned that Europe has the world’s highest rates of drinking and smoking, and more than half its people are too fat, putting them at high risk of heart disease, cancer and other deadly illnesses”.

Yet as we saw above, premature deaths have been predicted to fall. Hence the report continues “…the number of people whose lives are cut short by cardiovascular diseases, cancer, diabetes and chronic respiratory diseases is steadily declining”.


This illustrates the difference between “hard” outcomes and proxy outcomes. Death numbers are a hard outcome. People have been born on a certain day and die on a certain day. This is recorded. I won’t pretend it is impossible to fudge but it is (in Western countries at least) nigh on impossible to fudge on a big scale.

Proxy outcomes are figures like smoking, drinking and obesity rates. They are used to project diseases, which may occur. We know that smoking, excessive alcohol consumption and being significantly overweight all increase the risk of illness and death. We do not know whether and in whom that risk becomes actual disease.

However, as I have noted many times, the body mass index (BMI) cut off of 25 for overweight is too low hence far more people are classed as being “at risk” than really are. Alcohol consumption worldwide is in a gradual decline whilst the “dangerous drinking” levels have been relentlessly lowered. Once more this has the effect of putting more people in the “at risk” category than really should be there.

So we have this conundrum where the reality in Europe is increasing life expectancy with a projection for this to continue. This is attributed to declining rates of illnesses. Yet the same report claims that the same illness will increase because of the “alarming” rates of certain behaviours.

It is even possible that a clever statistician could conclude that these alarming rates of smoking drinking and obesity actually were linked to increasing life expectancy.

And no hand wringing public health report could resist trotting out the old line about how the next generation won’t live as long as ours. Conveniently ignoring their own figures on life expectancy and the worldwide 150 years trend of increasing life span, which shows no sign of slowing.

Meanwhile standard public health lobby claim that those in low SES groups consume the most fast food has also been exposed as false. Figures from the CDC in America showed that the children and teenagers from the poorest families consumed the smallest amount of their total calories from fast food. To be fair the differences across income groups was not big.

This makes sense; eating out is not cheap and if dollars are tight you are less likely to do so.

Regular readers will know my views on nanny state nagging, which has also been shown to be ineffective at best and counter productive.

The key problem here is that the narrative of those in public health is based on a particular moral view of the world. When facts contradict it, they find a way to spin them. After all it is much easier to argue for taxpayer funding when you can convince governments there is a crisis.

So who does not want good news on health? Clearly the WHO.


Dr Joe Kosterich M.B.B.S is an author, speaker, media presenter and health industry consultant, who wants you to be healthy and get the most out of life. Dr Joe also gives practical, motivational health talks for the general public and organisations where he is known as “An independent doctor who talks about health”.

His latest book “60 minutes to Better Health” is available on Amazon.