WS MoreOrLess: Measuring World Health

Summary

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Podcast Summary: WS MoreOrLess – Measuring World Health

Podcast: More or Less (BBC Radio 4)
Episode: WS MoreOrLess: Measuring World Health
Date: March 14, 2015
Host: Hannah Moore
Guests: Wesley Stevenson, Professor David Gordon, Professor Franco Cappuccio, Professor Jim Horn

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Episode Overview

This episode examines the accuracy and meaning behind recent claims that babies born into the poorest areas of the UK have "worse prospects for a long and healthy life" than those born in Rwanda. The hosts dissect the numbers, explore global health inequalities, and clarify what “healthy life expectancy” really measures. The second half of the episode revisits the topic of sleep, discussing how much is needed throughout life and addressing common listener questions.

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Key Discussion Points and Insights

1. Questioning the "Babies in Rwanda Healthier Than the UK Poor" Claim

• [00:36] The episode opens with a claim highlighted by Professor David Gordon and sourced from The Telegraph:

  “Babies born in the poorest parts of the UK today have worse prospects for a long and healthy life than those born in Rwanda.”
  – Professor David Gordon (00:36)

• Comparative Life Expectancy:

  • Babies in England’s poorest 10%: Life expectancy of 76 years.
  • Babies in Rwanda: Life expectancy of 65 years.
  • Life expectancy is higher in England, even among the poorest.

  “Life expectancy is better in England, even the most deprived parts, than it is in Rwanda as a whole.”
  – Wesley Stevenson (01:23)

• Healthy Life Expectancy (HALE):

  • Poorest 10% in England: 52 out of 76 years in good health.
  • Top 10% in England: 71 years in good health.
  • Rwanda: 55 years in good health (according to Telegraph/WHO).

  “It's pretty startling that there's a 19 year gap between the highest and lowest health expectancy.”
  – Hannah Moore (01:51)

2. Problems with the Data Comparison

• Different Data Sources and Methods:

  • UK data: Office for National Statistics (ONS).
  • Rwanda: World Health Organization (WHO).
  • Measurement inconsistencies between countries—data quality in Rwanda (and similar countries) is poorer due to less comprehensive records.
  • WHO relies on “life tables" and population assumptions in countries lacking complete data.

  “The Telegraph has used its figures — it's lumped together two different data sets… and those two organizations have different ways of measuring what healthy life expectancy actually means.”
  – Wesley Stevenson (02:41)

  “In poor countries like Rwanda, unfortunately, they don't have such comprehensive information... you can get somewhat different results.”
  – Professor David Gordon (03:10)

• Self-Reporting Biases:

  • Self-identification as having a disability or limiting illness is higher in richer countries, partly because of greater awareness and more help available.

  “The main difference in the number of people who consider they have a limiting disease or disability is between richer and poorer countries... The more help that's available for people, the more people are willing to define themselves as disabled.”
  – Professor David Gordon (04:37)

3. Real Inequality in UK Health Outcomes

• Even if the figures aren't directly comparable, profound health inequality exists within the UK.

  “There's great inequality in the UK in terms of health and wealth, and unfortunately, it's growing. And in the worst parts of the UK, people die younger than they do in the richer parts of poor developing countries.”
  – Professor David Gordon (05:33)

4. Global Healthy Life Expectancy Figures

• Sierra Leone: 39 years in good health (lowest worldwide)

• Nigeria: 46 years

• United States: 70 years

• Singapore: 76 years (highest worldwide)

  “Top of the pile are the people of Singapore. They have the best prospects in the world, living, on average, 76 years in good health.”
  – Wesley Stevenson (06:01)

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5. Understanding Sleep: How Much Do We Need?

• Listener Question: Do sleep recommendations apply to all ages?

  • “It seems implausible to me that newborns and elderly people should have the same amount of sleep as a young adult.”
    – Listener email (07:01)

• Expert Answers:

  • Babies and Young Children:

    • Sleep up to 16 hours daily; two-thirds of infant time spent sleeping.
    • Sleep cycles not aligned with day/night immediately.

    “Babies and young children tend to sleep longer. Their brains and bodies are developing at a rapid rate...”
    – Wesley Stevenson (07:23)

  • Teenagers:

    • Notably, teenagers tend to sleep later and wake later due to delayed phase clocks.
    • Some UK schools now start later to accommodate this pattern.

    “It's not that they need more sleep... it's that they have a delayed phase clock.”
    – Hannah Moore (07:43)

  • Adults and Older People:

    • Older adults may get by with around 6 hours per night, often taking naps.
    • The traditional siesta pattern — sleeping twice per 24 hours — can be beneficial.

    “Humans are designed to snooze not once but twice every 24 hours in warm countries... And older people often need less sleep.”
    – Wesley Stevenson (08:09)

  • Sleep Quality Matters:

    • Quality more important than absolute quantity; undisturbed sleep is best, regardless of totals.

    “Having just a few hours, comfortable, undisturbed sleep is probably better than eight hours of disturbed sleep.”
    – Hannah Moore (08:33)

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Notable Quotes & Memorable Moments

• “It's pretty startling that there's a 19-year gap between the highest and lowest health expectancy.” – Hannah Moore (01:51)
• “The more help that's available for people, the more people are willing to define themselves as disabled.” – Professor David Gordon (04:37)
• “In the worst parts of the UK, people die younger than they do in the richer parts of poor developing countries.” – Professor David Gordon (05:33)
• “Top of the pile are the people of Singapore…” – Wesley Stevenson (06:01)
• “Having just a few hours, comfortable, undisturbed sleep is probably better than eight hours of disturbed sleep.” – Hannah Moore (08:33)

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Timestamps for Important Segments

• 00:36 – 02:23: Exploring the claim comparing babies’ health prospects in UK and Rwanda and digging into the data.
• 02:41 – 04:37: Differences in data quality and self-reporting between rich and poor countries.
• 05:33 – 06:01: Global ranking of healthy life expectancy.
• 07:01 – 08:33: Sleep needs across age groups; science of napping and sleep quality.

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Conclusion

This episode of More or Less deftly unpacks the complexities and pitfalls of international health statistics, especially when used in media headlines, while highlighting genuine health inequalities in the UK. The sleep segment provides practical, research-based advice for listeners of all ages. Throughout, the tone is approachable and factual, with clear explanations demystifying sometimes misleading statistics.

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Transcript

[Hannah Moore]

This is the short edition of More or Less, first broadcast on the BBC World Service.

[BBC Announcer]

Thank you for downloading from the BBC. For details of our complete range of podcasts and our terms of use, go to bbcworldservice.com podcasts.

[Hannah Moore]

Hello, and welcome to More or Less on the BBC World Service. I'm Hannah Moore on. On this week's programme, we'll be returning to the subject of sleep. But first, a claim from UK newspaper the Telegraph caught my eye recently.

[Professor David Gordon]

Babies born in the poorest parts of the UK today have worse prospects for a long and healthy life than those born in Rwanda.

[Hannah Moore]

Is that true? Wesley Stevenson's here to help me explain.

[Wesley Stevenson]

Right, well, this claim seems surprising considering the two countries comparative wealth. The UK is one of the world's richest countries, the sixth richest according to data from the World bank, while Rwanda in Central Africa is one of the poorest.

[Hannah Moore]

The Telegraph article compares figures for England, not the whole of the uk, as the headline suggests from the Office for National Statistics with World Health Organization figures for Rwanda. These show that a baby born into the most deprived 10% of England can expect to live to 76. A baby born in Rwanda will on Average live to 65.

[Wesley Stevenson]

So, as you can tell, life expectancy is better in England, even the most deprived parts, than it is in Rwanda as a whole. But the headline's a little bit more subtle than that. What it says is that babies born in the poorest parts of the UK today have worse prospects for a long and healthy life than those born in Rwanda. So it's not talking about how long people live, but how long people live in good health.

[Hannah Moore]

The ONS says people in the bottom 10% of England will spend on average 52 of their 76 years in good health. But a baby born into the top 10% could expect to live for 71 years in good health. It's pretty startling that there's a 19 year gap between the highest and lowest health expectancy.

[Wesley Stevenson]

Yeah, it's astonishing really, isn't it? And the Telegraph goes on to tell us a baby born in Rwanda today can expect to live 55 years in good health. And remember, it's 52 years, 50 for the most deprived in England.

[Hannah Moore]

There are, of course, areas of real deprivation in the UK where deaths from poverty related illnesses such as stroke and coronary heart disease are high. But can it be true that living in one of those areas in a developed country with universal health care will kill you faster on average than living in Rwanda?

[Wesley Stevenson]

Well, as you may have guessed, there's a problem with how the Telegraph has used its figures, it's lumped together two different data sets. The figures for England from the Office for National Statistics and and World Health Organization figures for Rwanda. And those two organizations have different ways of measuring what healthy life expectancy actually means.

[Hannah Moore]

Professor David Gordon is director of the Townsend Centre for International Poverty Research at Bristol University in the uk.

[Professor David Gordon]

The healthy life expectancy is how long people will live before they're likely to become disabled or have a chronic disease. And of course, the way this is measured will vary from country to country. In the uk, we know how many people are born, how many people die, when they die, and more or less what they died of. In poor countries like Rwanda, unfortunately, they don't have such comprehensive information, so there's no developing country which has a comprehensive register of the causes of child death. For example, many children become sick and die and they're never recorded on any official documents. And therefore, in order to measure healthy life expectancy in a country like Rwanda, where all the necessary data aren't available, a number of assumptions have to be made and what's called life tables are applied. And of course, depending on the assumptions you make, you can get somewhat different results.

[Hannah Moore]

And it's not just about recording when people were born and when they died, is it? There's a survey data as well.

[Professor David Gordon]

It's also getting an estimate from the population of how many people are sick and disabled, and that uses a series of three questions in the European Union, which have been harmonized across all 28 European countries.

[Hannah Moore]

Of course, there will be different cultural standards, I suppose, of measuring one's own health.

[Professor David Gordon]

The main difference in the number of people who consider they have a limiting disease or disability is between richer and poorer countries. What we find is in the richer countries, there are more people who regard themselves as disabled than there are in the poorer countries. This, in part is because the population of the richer countries tends to be older, but it's also because people tend not to define themselves as disabled or having a limiting illness unless they feel they can get some help for it. The more help that's available for people, the more people are willing to define themselves as disabled.

[Hannah Moore]

So what happens if you compare the World Health Organisation data for the UK with Rwandas? Remember, average healthy life expectancy in Rwanda is 55 years, and for the UK today it's 71. But despite the dodgy data, Professor Gordon reckons the Telegraph still makes a valid point about inequality.

[Professor David Gordon]

There's great inequality in the UK in terms of health and wealth, and unfortunately, it's growing. And in the worst parts of the uk, people die younger than they do in the richer parts of poor developing countries.

[Wesley Stevenson]

And how does healthy life expectancy compare around the world? Well, Sierra Leone has the lowest. According to the World Health Organization, babies born there only live 39 years in good health on average.

[Hannah Moore]

In Nigeria, it's 46 and in the US 70.

[Wesley Stevenson]

But top of the pile are the people of Singapore. They have the best prospects in the world, living, on average, 76 years in good health.

[Hannah Moore]

Now, after all that number crunching, it's time to think about having a rest.

[Wesley Stevenson]

Yeah, sounds a marvellous idea. We recently looked into whether having too much sleep could damage your health. I can't imagine there's ever a time

[Professor David Gordon]

when you can't have too much sleep,

[Wesley Stevenson]

but what we found was that sleeping for less than six hours or more than eight, is associated with health problems like cardiovascular disease and the chance of dying earlier.

[Hannah Moore]

There's a lot of debate among scientists about what's causing the health problems, though. Is it the sleep or lack of it, or is it underlying health issues?

[Wesley Stevenson]

The story got you asking more questions and several of you emailed [e-mail] among you, Thiago Bottello, who do the sleep

[BBC Announcer]

studies mentioned apply across all of the age spectrum? It seems implausible to me that newborns and elderly people should have the same amount of sleep as a young adult.

[Hannah Moore]

We went back to two of our sleep experts in the uk, Professor Franco Cappuccio from the University of Warwick and Professor Jim Horn of Loughborough University Sleep Centre.

[Wesley Stevenson]

Babies and young children tend to sleep longer. Their brains and bodies are developing at a rapid rate, but they don't always sleep when their parents would like them to. They tend to sleep during the day and wake at night, as they haven't adapted their sleep wake cycle to light and darkness. Infants spend around two thirds of their time asleep, up to 16 hours.

[Hannah Moore]

The average amount of sleep a child needs gradually decreases through childhood and then the teenager is born. Teenagers always seem to be in bed, but it's not that they need more sleep than the average adult, it's that they have a delayed phase clock, which means they naturally tend to wake up later in the morning and go to bed later. Some schools in the UK have cottoned onto this and they're now starting and ending the day later.

[Wesley Stevenson]

Now, if you like your sleep like I do, you won't be surprised to hear humans are designed to snooze not once but twice every 24 hours in warm countries. This pattern is still common, and research suggests the siesta is good for you. And older people often need less sleep. They tend to sleep for around six hours a night, but they can catch up with naps during the day, unlike the weary office worker.

[Hannah Moore]

And the quality of sleep is really important. Having just a few hours, comfortable, undisturbed sleep is probably better than eight hours of disturbed sleep. So we don't need to get hung up on the idea that we should all be getting a specific amount of sleep. It varies according to age and personal need. Thank you to our sleep experts and to you for listening. Keep your questions and comments coming in to more or lessbc.co.uk our website is BBC.com moreorless.

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