What doesn’t kill you makes you…colder

Recently, it has become fashionable to douse yourself in freezing cold ice water. Since the Ice Bucket Challenge has gone viral these past few weeks, I’ve wondered about the economic efficiency of the phenomenon.  The marketing method has been highly successful; the ALS Association has raised over $15 million, obliterating the $1.8 million from the same period last year.

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People are pretty excited to participate in a big cultural movement, especially if it’s as easy as shooting a 30 second video.  Partaking in a cultural movement where not participating means not donating or raising awareness for charity pushes even more people to do it.  It’s also easy (and important) for PR conscious celebrities (and also celebrities who care) to get in on the action.

But according to Slate, the ice bucket challenge originally had nothing to do with ALS, and started with people donating to any charity while filming themselves doing something dumb.  And while the ALS Association has done a good job steering the phenomenon towards something they care about, the arbitrariness of the charity brings up a couple questions: Is the allocation of charitable donations efficient? And should you donate to ALS among all the causes available?

The first question is hard to know for sure. Last year, Americans gave $335 billion to charity. with about $32 billion going to health related charities.  It seems silly to believe $15 million from a viral video will have too large of an impact on total giving, even to health charities. Even if the ice bucket challenge continues to get bigger, it’s hard to see ALS raising more than say $50 million from this, and even that number is unlikely.  And with that relatively small drop in the fundraising bucket, it also seems silly to believe ALS is stealing funding from other charities, although that’s exactly what William MacAskill writes for Quartz.  MacAskill cites research showing people are less likely to give to other charities once they give to one.  But only time will tell once we can see the total charitable giving from this entire half of the year.

But I have a second question besides MacAskill’s concern for ALS stealing other charities’ spotlight: if I’m doing the ice bucket challenge, is ALS research the best cause to give to? The short answer: not really. ALS is pretty terrible disease, but after doing some research on general mortality in the US, it’s clear there are far more deadly problems. The CDC has an easy to read chart for the top ten causes of death by age group. Reading from the full report (page 4), the top 15 causes of death in the United States are:

  1. Heart Disease
  2. Malignant Neoplasms (tumors)
  3. Chronic Lower Respiratory Diseases
  4. Cerebrovascular disease (strokes)
  5. Accidents
  6. Alzheimer’s
  7. Diabetes (both types, although Type II is 90% of all cases)
  8. Influenza/pneumonia
  9. Nephritis and nephrois (kidney inflammation)
  10. Suicide
  11. Septicemia (inflammation from infection)
  12. Liver diseases
  13. Hypertension and hypertensive renal disease
  14. Parkinson’s
  15. Pneumonitis (lung inflammation)

But it’s also important to know exactly when these causes of death strike; Alzheimer’s killed about 85,000 people in 2011, but almost all of them were over the age of 65.  ALS, by contrast, can hit anyone at any age.  We want to weight diseases that kill younger people slightly higher and see how ALS does.  If we consider the unit of a life-year, where 1 life-year is lost when someone dies a year before the life expectancy age of 78.7, we can try and figure out which diseases and problems rob Americans of the most years of potential life.  Using only the top ten causes of death to get a rough estimate, I came up with these findings for 2011:



This pie chart is simply to illustrate these causes relative to each other. A large fraction of life-years lost has been left out entirely because there are too many causes of death. It is also worth noting that the table above is also under representing the total loss from each of these causes of death.  Since only the top 10 causes of death were used for each age group, the data is incomplete. It nevertheless serves to loosely calculate how deadly these problems are. Generally speaking, it is clear that even with weighting young deaths more, the two main causes of death, heart disease and cancer, are by far most responsible for the loss in human life-years.  Of course, cancers themselves are quite diverse of a subcategory, but even the 10 most common cancers kill tens of thousands.  ALS by contrast loses about  (78.7 – (median US age=36.8) * (5600 diagnosed a year)) 235,000 life-years per year maximum.

However, it is unlikely that any of these causes of death will be cured soon, and it really should be emphasized that it’s clearly better to donate some money to ALS than nothing at all to any charity. The ice bucket challenge has unequivocally done a good thing by trying to get more people involved in giving back. My point is only to say that if you feel compelled to give to a different health charity to address any of the problems listed above, whether it be a cancer foundation, suicide prevention, or making cars safer, you will most likely be helping more people.  But you will still be very, very cold.