Feature Christmas 2012: Thoughts for Today

Using speed of ageing and “microlives” to communicate the effects of lifetime habits and environment

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e8223 (Published 17 December 2012) Cite this as: BMJ 2012;345:e8223
  1. David Spiegelhalter, professor of biostatistics and Winton professor for the public understanding of risk
  1. 1Statistical Laboratory, University of Cambridge, Cambridge CB3 0WB, UK
  1. d.spiegelhalter@statslab.cam.ac.uk
  • Accepted 15 November 2012

Public communication of chronic lifestyle risks is generally opaque and potentially misleading. David Spiegelhalter suggests using the concept of ageing faster or slower, by expressing the daily effect of lifestyle factors as changes in “microlives” (half hours of life expectancy)

We are bombarded by advice about the benefit and harms of our behaviours, but how do we decide what is important? I suggest a simple way of communicating the impact of a lifestyle or environmental risk factor, based on the associated daily pro rata effect on expected length of life. A daily loss or gain of 30 minutes can be termed a microlife, because 1 000 000 half hours (57 years) roughly corresponds to a lifetime of adult exposure. From recent epidemiological studies of long term habits the loss of a microlife can be associated, for example, with smoking two cigarettes, taking two extra alcoholic drinks, eating a portion of red meat, being 5 kg overweight, or watching two hours of television a day. Gains are associated with taking a statin daily (1 microlife), taking just one alcoholic drink a day (1 microlife), 20 minutes of moderate exercise daily (2 microlives), and a diet including fresh fruit and vegetables daily (4 microlives). Demographic associations can also be expressed in these units—for example, being female rather than male (4 microlives a day), being Swedish rather than Russian (21 a day for men) and living in 2010 rather than 1910 (15 a day). This form of communication allows a general, non-academic audience to make rough but fair comparisons between the sizes of chronic risks, and is based on a metaphor of “speed of ageing,” which has been effective in encouraging cessation of smoking.

Communication about chronic risks

Quantities such as hazard ratios, standardised mortality ratios, and population attributable fractions arise naturally from standard epidemiological study designs. For example, …

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