Donating à la carte

Donating à la carte

Decisions are hard. Especially when the outcomes are important, the options are numerous, and relevant information is hard to find.

For many everyday decisions (where to eat, what clothes to wear, what to do tonight), I have a pretty good idea of what I can do, what I’d like to achieve, and how likely I am to do so. And despite most of these decisions being largely inconsequential I still consider them in great detail. I assume others are somewhat similar to me, delicately wasting their processing power on life’s minutiae.

Yet, of all the choices we make, one of the most impactful seems among the least rationally considered: donations.

We can donate to almost anything, anyone, at any time. But do we consider the options available before giving? And if so, how are we to weigh up the pain of a malnourished child to the impact of a polluted river; the needs of our local lifesaving club to the suffering of 100 battery hens; climate change to the housing needs of a woman escaping domestic violence?

We’re so overwhelmed by the immense number of possibilities that we often yield to impulse, emotion and social pressures. But these decisions deserve our most careful consideration. We have the power to change the status quo. And to ignore this is to choose to do nothing.

Thanks to the interwebs it’s now as easy to support locally as it is to support (almost) anywhere else in the world. So, we can cast as wide or as narrow a net as we like when looking to get behind a cause.


Modelling donations – a menu of causes

The model below presents the main options available for donations. Its aim is to help us make more conscious decisions, and explicitly remind us of what we’re ignoring.


Using the model – 2 paths to better donations

The model can be used in two ways:
1. Proactively – help guide your thinking when deciding on a cause, and
2. Re-actively –  recognise when a charity focuses on a particular group at the expense of others.


Method 1 is great for clarifying your personal values and systematically prioritising the areas you’d like to support.

Hypothetical example 1: the proactive method
I could start by acknowledging that I care more for people than animals and the environment. Then, I explicitly recognise a desire to help the local LGBTIQ community. Lastly, wanting to have an immediate impact, I support a charity which focuses on providing every-day services. This gives me the following combination:

Using the model as such can help articulate what I’m after, and find a charity which provides the desired service. If all charities were classified using this framework, then I could easily find an organisation to suit my needs.


Method 2 helps remind us of all the things we could be supporting before choosing a particular charity. When donating to a cause, we are implicitly choosing it above all others. The mapping exercise, i.e. explicitly acknowledging what we are focusing on, may highlight an excluded cause which, when considered, we find more worthy.

Hypothetical example 2: Check yo’self

If I’m a long-time supporter of an organisation sheltering dogs, it’s easy to continue doing so by focusing on the wonderful work the organisation does, and feeling great that I could help. However, by mapping their work to the model, I am forced to recognise there are many other animal species in need which I am implicitly ignoring. In fact, others’ need may be greater (either through the amount of cruelty experienced, or the sheer number being subjected to it); for example battery hens or caged pigs. With this realisation I can re-examine my values and act accordingly. If post-introspective I recognise I care more about the suffering of battery hens, then I can go back to Method 1 and better align my donations to reflect my values.


The Four Dimensions of Donations

The model has 4 main dimensions (with the key one broken down into subcategories)

1. The who (including ‘which subcategory’)
This helps differentiates between people, animals or the environment. Each of these key categories is broken down into further subcategories. For example, people can be dissected by religion, or sexuality, or age; animals by species; and the environment by ecosystem (rivers vs rain-forests vs oceans vs desserts, etc.).

2. The where (place)
This helps dictate the place and spread of the donating net. Are you interested in all specimens in the world equally, or do you have a particular attachment or concern over a region over all others?

3. The what (aspect)
Within each category there are different aspects which can be improved or supported. For people, helping improve health or education are pretty central, but there is also work done to support the arts, local sports clubs, churches or world peace. Animals and the Environment also have specific aspects which can be targeted, and these are presented in the model.

4. The how (support)
The how differentiates the different types of work which can help your cause. Should we act now, educate, try to change the decision makers, or continue researching to find better solutions? For example, if you want to help the world deal with climate change, would you prefer to support an organisation providing immediate direct work (e.g. decreasing emissions now) or should more funding be provided towards research in the hope that we discover a more efficient solution in the near future?

By combining the four dimensions, you can have a much better understanding of how you would like to help.


The why

The model does not cover how we do or should decide which box to focus on. That will form another post, hopefully in the near future. But the aim for now was to raise awareness to the breadth of work available, with the hope that before making quick impulsive decisions, we consider what we can do, and hopefully do more with what we give.


To be improved…

It goes without saying that this model is probably missing a whole bunch of stuff. So please let me know what’s missing so I can update it as we discuss.

1st: Indigeneity and migrant status – from our UN correspondent! (How did I miss them?)
2nd: Biodiversity – Thanks Ms Sabrewing
3rd: Circumstance – From a recent dinner discussion, mentioning “Legacy”


The following documents were used in the development of this model:

Charity Navigator:
Government organisations
UK –
Australia –


How bad is bad – rating cancers

How bad is bad – rating cancers

Around 125,000 Australians will be diagnosed with cancer sometime this year. That’s just over 5 new cases per 1,000 Australians. Chances are, someone I know knows some one being diagnosed this year, and they’ll tell me about it. Cancer is never good news. But they’re also not all the same. While some are hard to beat, others have very decent survival rates.

So how bad is my mate’s mate’s cancer?

(This post focuses purely on the likelihood of death as a measure of ‘badness’.)


Some are deadlier than others

One method of comparing a condition’s “deadliness” is the mortality-to-incidence ratio (MIR). The MIR denotes the number of people who die of a particular cancer in a given year, to the number of people diagnosed with the same cancer in the same year. The ratio ranges from 0 to 1, and the lower the value the longer one is expected to survive.  A MIR of 0 means no one dies of that particular cancer.

The 10 most common cancers in 2012, in terms of incidence, accounted for 71% of new cases. These cancers, listed below, have MIRs ranging from 0.13 to 0.90. That’s to say, some common cancers are 8 times as deadly as other common cancers.

Cancers aint cancers 1


In short, lung and pancreatic cancers have a much worse outlook than prostate, breast or melanomas.


Visualising MIR’s results

The MIR has a huge impact on how many people die from a particular cancer, compared to how many are diagnosed with it. For example, even though prostate cancer impacts 8 times as many people as pancreatic cancer (20,637 vs 2,383), both claimed roughly the same number of lives in 2012 (3,173 vs 2,437). The graph below shows the incidence and mortality of Australia’s 21 most common cancers.

Cancers aint cancers 2


How bad is bad: not as bad as it used to be

Huge improvements in survival rates are being made across most cancers. Over the past 30 years, 8 of the top 10 cancers saw large drops in mortality ratios. The two most common cancers, prostate and breast, are now less than half as deadly as they were in the early 1980s. Unfortunately, progress has been less effective for bladder cancer, which has in fact gone backwards, by 39%.

Cancers aint cancers 3

* 1982 MIRs are age-adjusted based on the 2012 population, to make the figures more comparable.

** Care must be taken when comparing colon and rectal cancers  over time, as it is likely that the figures are disturbed by coding changes, thus may not reflect real changes in survival rates


Neither me nor my mate’s mate get a say on which cancer they have, but it does help to know that treatments and support are improving every year.





All data used sourced from the AIHW’s Australian Cancer Incidence and Mortality (ACIM) books.


Is a breast worth 15 lungs

Is a breast worth 15 lungs

Lung cancer is by far the biggest killing cancer in Australia. In 2014 it claimed the life of over 8,200 people. That’s almost as many as the next three cancers combined (prostate 3 102 + breast 2 844 + pancreas 2 547 = 8 493).


In popstats format, that’s one Australian death every hour.

Fortunately, much like pop, lung cancer’s mortality rate peaked in the early 80s, and has been declining steadily since.


Women catching up on the wrong race

This decrease, however, has been entirely gender lopsided.

While the anti-smoking initiatives have helped halve the mortality rate of men’s lung cancer since 1981, women’s has increased by 60% in the same period.



The increase in women dying of lung cancer has been so drastic that it has overtaken breast cancer as the biggest killer of women among all cancers. Back in the 1970s, breast cancer killed 4 times as many women as lung cancer.



Yet, lung cancer seems to be largely ignored (relatively speaking).

Research conducted by Cancer Australia, shows that even though lung cancer kills about 3 times as many as breast cancer, it receives less than a fifth of the research funding. Similar comparisons can be made with prostate and other cancers.  The graph below from their 2016 Cancer Research Review[1] provides a great representation of the inequality of research funding distribution currently in the field.



Lungs don’t sell

The communities’ disdain for lung cancer is also clear in the organizations we support. The Australian Charity and Not-for-profit Commission’s register includes 18 organisations mentioning “Breast cancer” by name, and another 15 mentioning “prostate cancer”.  Yet not one combined the words “lung” and “cancer” in their name[2].

This is not to say that there aren’t any organisations working in the area, but rather suggests that highlighting their cause is not considered a draw card.


Who’s to blame

Many suggest the community ignores lung cancer sufferers because a many of them are somewhat responsible for their condition. After all, smoking is linked with about 80%-90% of lung cancer sufferers[3]. But since when have we been so spiteful?

We help countless who have had a hand in their demise.

When the injured arrive at Emergency, triage forms don’t cover culpability.

We help those who drove too fast for the unexpected just as much as careful drivers who became their victims.

We help young men who go clubbing in Sydney, even if they threw the first punch.

People take all sorts of risks. Yet help is at hand when things don’t work out the way they hoped.

If James Dean does it


Not to mention that around 4 out of 5 sufferers took up smoking before the Vietnam War[4]; smoking warnings were not even a thing[5], and ads were the epitome of cool.


Not to mention the other 15%

That’s all without even thinking of the roughly 1,500 sufferers who never touched a smoke!


Heal the world

This, by the way, is a global phenomena. Lung cancer killed 1.6 million people worldwide in 2014 [7], yet similar under funding occurs across the major economies (or at least the ones I could find on a quick google search). So, any impact local research has in Australia could potentially help millions across the world.


So, why not?

Why not indeed.

In this age of cost-benefit analysis, we sometimes forget to put it into practice where it matters most. Lung cancer might be decreasing, but it sure isn’t going away. Smoking rates may have decreased, but they still haunt half as many as they did in the 80s[6]. At this rate, lunch cancer will still be the biggest killer for generations to come.

It’s time to stop victim blaming smokers, and put some money where are lungs are.




The author is a reformed smoker… the worst kind.


Feature pic by hey_paul:

Human Lung Embroidery Wall Decor




[2] Based on their 2014 data.


[4] Based on their age – over 65s in 2013.  And research showing 90% of smokers pick up the habit before the age of 20 (United States Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality. National Survey on Drug Use and Health, 2014. ICPSR36361-v1. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2016-03-22.





The death of dying

The death of dying

Life is getting longer.

Life expectancy in Australia grew from 50 years in the late 1800s, to 70 in the 1960s, to 82 or so today. And we’re nowhere near finished.  But while many are aware of this, not many appreciate the magnitude of this achievement, nor its continuous impacts.

Perhaps there’s a lack of newspaper headline moments claiming “1,000 people did not die yesterday”.  Or perhaps it’s because people think lives are merely being elongated when we’re at our worst, forcing us into a dependent cycle of medical attention from which the doctors gain more than the patients.

Yet, neither of these is entirely true.

Making headlines every day

While 154,000 Australians died in 2014 (latest data available), the figure would have been closer to 176,000 (22,000 more deaths) had the mortality rate not improved in the last 10 years. (And 10 years is hardly a long time. In today’s currency, it’s barely 5 Prime Minsters ago.)  Improvements since 2004 are saving an extra 2,200 people each year, on average.  To put it in perspective, around 230 people are murdered in Australia each year. So mortality improvements, which rarely rate a mention, are saving 10 times the number murdered more every year than the last!

Seeing as murders are front page material, mortality improvements should have their own weekend section.


Saving lives at all stages

Unlike popular opinion, extending life expectancy is not about delaying death while holding people to ransom, feeding them mashed cauliflower through transparent tubes.  Death rates for teenagers and kids under 5 year-olds have both decreased by a third.  Basically, we’ve saved 1 in 3 of the teenagers (and babies) who would have died had the improvements not occurred.

Had we saved a third of the price of electricity Josh Frydenberg would have declared it a national holiday.

All ages decreasing


These decreases were not a once off, nor were they specific to one group.  Improvements across the younger years have been pretty steady over the past decade.

constant decreast young


Improvements in mortality rates translate into less people dying than would have under the previous rates.

Deacreading death is people


As expected, the majority the decrease in deaths occurs at the latter stages of life.  Though surprisingly, the only cohort with an increasing mortality rate are those over 95 years of age.  And yet, the improvements are so large that even though the younger cohorts make up smaller percentages, they are still newsworthy. Without the improvements of the last 10 years, 2014 would have seen the death of around:

  • 376 more kids under 5
  • 124 more teenagers
  • 426 more people in their 20s
  • around 3000 more working aged folk (15-65 year-olds)

Instead, our attention is focused on gruesome anecdotes of villains and victims.  A hero cowardly king-hit, a young family destroyed by a murder-suicide, three teenagers overdosing on ice behind the local servo, or a joy ride gone awfully wrong.  Without balancing these out with the constant excitement of decreasing mortality and longer lives, we fall into a pessimistic spiral of despair.  We fail to recognise the huge progress made and foster a sense of nostalgia for times which were in fact significantly worse.

Shit’s never been this good. We’re just too busy reading the headlines to realise it.



Death figures sourced from : ABS Deaths Publication, 2014

Converted to rates using ERP by age

What India doesn’t have fills the world

What India doesn’t have fills the world

There are more people living without safe drinking water at home in India than the entire population of Europe… about 100 million more.

There are some fundamental things a home needs: clean drinking water, hygienic toilet, bathing facilities, a kitchen and electricity.  And while we’re aware that not everyone has all these things, it’s easy to underestimate the magnitude of the issue.

India has the second largest population in the world, estimated at 1,210,854,977 through the 2011 Census.  The percentage of this population without the fundamental facilities is enough to paint substantial sections of the rest of the world.

For example:

  • There are as many people living without an inside toilet in India as the entire population of Europe;
  • More live without electricity than the population of the USA and Canada combined;
  • More lack a kitchen inside the house than the population of Latin America;
  • More lack bathing facilities than the rest of Southern and West Asia; and
  • 4 times more people cook with cowdung than all of Australia… 

Beyond the fundamentals, another 215 million lived without a radio, TV, phones, computers, vehicles or even a bicycle.


Picture taken in Jaipur, India.

Smoking the poor

Smoking the poor

Australia’s 2016-17 budget announcement included “four annual 12.5 per cent increases in tobacco excise and excise equivalent customs duties”, claiming it will raise “$4.7bn over the next four years”.¹

This is unlikely to face much opposition. After all, taxing smoking aims to discourage the leading cause of preventable deaths in Australia².

But it’s interesting to see who will be most impacted by this, as smoking is a poor person’s game.

Based on 2009-10 household expenditure data³, increasing the cost of smoking will have a much larger impact on the poorest sectors of the community than anyone else.  More specifically, it will impact households receiving unemployment, disability, and carers payments – those already under the most amount of financial strain.

Smoking poor

Back in 2010, the poorest 20% of households were already spending four times as much of their weekly expenditure as the richest 20%.  Households whose main source of income was unemployment benefits spent three and half times the national average on tobacco, in relation to their total income.  Those whose main income was disability and carer payments spent three times the national average.

This is likely to be much more accentuated today as the 25% annual increase in tobacco excise since 2010 has almost doubled the price of cigarettes since that data was produced[4].

So how will this picture look in 4 years’ time, after 8 years of tobacco increases, when a packet of winnie blues cost $50?

Smoking is addictive. I suspect it’s easier to sell a house than quit smoking. Yet, when governments change legislation, making previous decisions less financially desirable, there’s usually talk of ‘grandfathering’ policies. That is to say that if we ever change capital gains policies we’ll ensure those who got in on the action prior to the changes don’t lose out.  Should similar considerations be made with smokers? Or is this more like the drug dealer who gives away the first few hits until you’re hooked, and then jacks up the prices, marginalising the destitute to a life of crime, imprisonment and social isolation?

I suspect it’s not all bad. Many will quit, thus improving their lives, and those of their loved ones. But for those unable to let go of nicotine’s vice, I suspect health issues will be only part of their worries.







Death Tree

Death Tree

Not quite as cool as the Death Star, this Death Tree breaks down the 153,580 deaths which occurred in Australia in 2014, by cause:

Interpreting the Tree
Size of the box shows relative number of deaths, compared to all other deaths.
The colour represents the sex divide.
The bluer boxes represent diseases which kill more men than women. The yellow boxes kill more women than men. The legend on the top right provides a guide as to the sex representation.

Navigating the Death Tree
Left clicking drills down into finer level causes (e.g.: Cancer breaks down into Lung cancer, colon cancer, breast cancer, etc.).
Right clicking drills back up.

All causes are classified using the International Classification of Diseases (ICD).

The Death Tree provides a bigger, more user-friendly representation.

In the meantime, here is a smaller embedded version:

Everyday people, everyday deaths

Everyday people, everyday deaths

You may not have read it in the newspapers this morning, nor on social media, but 421 Australians died yesterday. And the day before. And most likely today too. Roughly speaking of course, averaging out the 153,580 who died over the course of 2014¹. (Coincidentally, 153,000 is roughly how many people die worldwide per day².)

The media may focus on the half a person murdered per day, or the 3.8 people tragically killed on the roads, but to use a common idiom, the majority of people who died in 2014 (55%) ‘had a good innings’. (A good innings, in my eyes, equates to living past 80.) But this has not long been the case. Until 2005 less than half of Australians who died each year reached 80. In fact, the percentage of people who died before reaching 80 was 44% in 2000, 34% in 1990, and 29% in 1980³.

The graph below shows the percentage of deaths by age group, since 1910.Age of death 1910-2013

The gains achieved over the past 115 years are huge. Much of the improvement, in particular in the first half of the century, was a result of decreased infant (under 1) and child (1 to 4 years) mortality. Infant deaths decreased from 81 deaths per 1,000 live births in 1910 to 25 per 1,000 in 1950, to just 3 in 2014 [4].

The improvements over the last 50 years, however, have also been driven by decreased rates of death in older Australians. This, in no small part, is a result of the improved ways in which we deal with heart disease. Heart disease is “the largest single cause of death in Australia” [5], but if current trends continue it won’t be for long. While heart disease (ICD-10 I20–I25) accounted for 30% of all deaths in 1970, by 2014 this had decreased to 13%.

Over the past 18 years heart attacks (which account for about half of all heart disease deaths) have dropped from 13% of all deaths to 6%. Dementia on the other hand, has increased from 1% to 5%. The changes have been so pronounced that dementia now kills more women than heart attacks do.

Heart attcks vs dementia

Since 1997, the number of heart disease deaths has reduced by an average of 505 people per year. That’s twice the average number of murder victims per year (which itself is decreasing).

Society is not getting more violent, or more dangerous. But improvements in the way we treat health conditions have dramatically improved and extended our lives.

If the amount of attention on scientific and medical improvements, as well as sensationalised but unlikely scenarios, more accurately reflected reality, perhaps we would have a very different perception of our state of affairs.

Shit’s getting better. Way better.


To better understand what people die of these days, the Death Tree Map linked here shows all Deaths in Australia in 2014 by cause. Clicking each category drills into finer categories in greater detail (i.e. Cancer breaks down into Lung cancer, colon cancer, breast cancer, etc.). Right clicking drills up.
The colour represents the sex divide. The bluer boxes represent diseases which kill men more than women. The yellow boxes kill more women than men. The legend on the top right guides the sex representation.
(below is a smaller representation of the Death Tree Map)




The roads know no date

The roads know no date

By the time the Christmas Holiday Road Toll counter begins, the worst is all but over. For many, unfortunately, the reminders of the roads’ dangers come too late.

Every year the Australian media and Police and Roads Departments produce an hour by hour, day by day counter of the road fatalities occurring during the festive season. News bulletins focus on yet another untimely death, and end of year best wishes are accompanied by a “stay safe on the roads” message.

It has almost become a new Hallmark theme, alongside “It’s a boy”, “Get Well soon”, and “I might not want to personally join such an outdated and discriminative institution, but I respect your right to do so, even if many aren’t yet afforded that right”¹.

Whilst road fatalities are a serious issue deserving of media attention, the Christmas period is not news worthy. In fact, the focus might incorrectly imply that the rest of the year is less dangerous, and therefore less deserving of our vigilance.

Road Toll Graph

Based on figures from 1989-2014 from the Bureau of Infrastructure, Transport and Regional Economics’ (BITRE), the Xmas Toll period (which this year runs from the 23rd December to the 3rd January) has a lower road fatality average than the rest of the year².

The graph above compares each day in December through to mid-January to the average death rate for the entire year. These figures are based on data in the 1989-2014 period, for which the average is 4.7 road fatalities per day.  The red areas denote a day where there are more deaths on the road than average, and grey areas denote smaller number of casualties.

Other than a small spike on Boxing and New Year’s Day, the rest of the Xmas Road Toll Period is remarkably below average.

Unlike the Festive period, the weeks just prior to it do seem more dangerous than average. On average, 110 people will die on the roads in the first 3 weeks of December every year. This is more than in any other 3 week continuous period during the year.

Newspapers are not entirely unaware of the numbers. In fact they usually publish an article or two every year showing how misleading these tolls are (example ³). Yet they continue to misguide the community and create panic by perpetuating the myth.

The question is how we focus our educational and advertising campaigns to have the greatest impact.  I doubt Christmas is the answer. It rarely is.


[1] This comment is source-less, and potentially misleading.



Re-calibrating medical sex

Re-calibrating medical sex

Thirty years ago TVs were filled with MacGyver, dancefloors swayed to Cindy Lauper, the US threw its weight all over Latin America, and 8 out of 9 visits to Australian Doctors were seen by guys.

Australians made 68.1 million visits to General Practitioners in 1984-85, and 60.6 million of those services were provided by male doctors[1].

Since then the GP sexual landscape has been changing at a steady pace.

University data show increasing number of women graduating, doing so in larger number than men since about 1987[2], and these graduates have had a visible impact on the professional make-up.

Whilst we haven’t scaled the heights of Cindy nor MacGyver, and the US is still largely using its army to secure market-share around the globe, our medical gender balance has drastically improved.

By 2013-14 women provided 33% of all GP services. That’s triple the 11% provided in 1984-85.

Like many other professions, women work part-time at higher rates than men. Women GP work the equivalent of half a full-time role on average, while male doctors work two-thirds of a full-time role. This means that even though only 33% of GP services are provided by women, they make up 43% of all working GPs. This is almost double the 22 % they made up in 1984-85.

Count of GPs by Sex

This means that of the 15,742 more GPs Australia has now in comparison to the mid-80s, 10,228 of them (or 65%) are women!

Unfortunately the Health Department figures are not provided by gender and age. However, based on the rapid change in gender balance, the increasing rates of female graduates, and the growing number of doctors nearing retirement age, I suspect the overall balance will continue to calibrate in the coming decade.

Is this enough? Hells no. But it might provide more role-models, and perhaps even help the gender pay-gap which has stubbornly continued despite improvements across various socio-economic areas.



Paging Doogie Howser, stat!

Paging Doogie Howser, stat!

Australia’s population is slowly ageing, not only individually, but as a group.  However, some groups are ageing faster than others, and our GPs (Medical practitioners) appear to be on a downhill race to retirement.

Back in the mid to late 80s, 2 out of every 3 GPs in Australia were under 45 years of age (64%).  In 2014, the same age group contributed just over 1 out of every 3 GPs (or 37%).

Meanwhile, those over 65, for whom retirement bells toll loudly, now account for 13.4% of all GPs. This is almost double the 6.9% they made up thirty years ago.

After 30 years in decline however, it seems GPs have solved the ageing dilemma.  Since around 2010 there are signs that the younger cohort is increasing faster than those who’ve come before.

Let’s hope these same GPs can solve all our ageing issues, because this getting older business is not for me.