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Vol. LXII, No. 7
April 2, 2010
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Rosling Advises ‘Mind the Gap,’ Touts Fact-Based World View


Statistics is filled with numbers and percentages, facts and figures and more charts than you can shake a stick at. It offers the scientific field a wealth of information and can be invaluable in planning new research goals and charting new methodologies.

Unfortunately, for the majority of both scientists and the general population, reviewing statistical information is often about as interesting as watching someone do their taxes.

Reading report after report or flipping through pie charts and graphs and instantly grasping what it all means is akin to reading a book of recipes and knowing which dish will be delicious. Or, to borrow the analogy NIH director Dr. Francis Collins used in his recent introduction of Dr. Hans Rosling to a Masur Auditorium audience, such skill is like looking at a Chopin score and remarking, “Oh, that’s beautiful music.

Rosling, a scholar-in-residence as part of the Fogarty International Center’s 40th anniversary, is fascinated by statistics.
Dr. Hans Rosling, a scholar-in-residence as part of the Fogarty International Center’s 40th anniversary, is fascinated by statistics.

“Most people looking at the notes have no sense of what’s there and need to actually hear it,” Collins said. Rosling, he continued, is “taking those notes on the page and turning them into music that we can all appreciate and learn from.”

Rosling, a professor of international health at Sweden’s Karolinska Institute and a scholar-in-residence as part of the Fogarty International Center’s 40th anniversary, is fascinated by statistics. But he too knows they can be a little dry. He’s intrigued by global health statistics that show just how different Western beliefs about the “developing” world are in comparison with the reality of modern facts.

As with many scientists who blaze a trail for others, Rosling’s interpretation of statistics as it relates to global health is a result of a combination of training, experience and being in the right place to make sense of everything. After studying statistics, medicine and public health, he worked as a physician in Mozambique. It was there that he discovered a new paralytic condition brought about by insufficient processing of the cassava root, a staple of the local food supply. He went on to study the relationship of economic development, agriculture, poverty and health at great length, and statistics led him to discover truths about the world’s health that are far different than what many believe.

Rosling said that when he first taught public health, the conventional wisdom was that poverty causes disease. Later, he came to understand differently.
Rosling said that when he first taught public health, the conventional wisdom was that poverty causes disease. Later, he came to understand differently.

He likes to tell a story about how he used a simple test at the beginning of each semester to illustrate why a course on global health was needed at Karolinska. He asked his graduate students to name which countries had higher rates of infant mortality: Sri Lanka or Turkey, Poland or South Korea, Malaysia or Russia, Pakistan or Vietnam, and Thailand or South Africa? Almost invariably, the students were wrong. The test not only proved the students had misconceptions, but also indicated that there is a lagging understanding of health in the world today.

“Only pre-conceived ideas can produce this result,” Rosling said of his students’ answers.

He proceeded to develop statistical software with his son and daughter-in-law and formed a foundation called Gapminder, after the oft-heard “mind the gap” message that plays in London’s subway system. The gap here, Rosling explained, is the distance between an outdated worldview and a new one based on facts. The goal is to close that gap.

The software, called Trendalyzer, converts dry facts into an active graph that can be set in motion to reflect change over the course of years, highlighting how some countries have surged ahead in terms of health, wealth or a variety of other social factors. Google has since adopted the software as a way to present statistics in an appreciable way.

Rosling put one such graph into motion, showing the tremendous progress that has unfolded in the world over the course of more than 50 years in terms of family size and length of life. Each bubble on the graph corresponded to a country; the color of the bubble reflected its continent and the size depicted its population.

“What is your worldview? Do you know what has happened?” he asked the audience before setting the graph in motion starting at year 1950.

Starting the graph, he called the action like an announcer at Churchill Downs: “Vaccinations being applied in Asia…That is the great leap forward by Mao Zedong which caused the famine…now China is getting it into order with family planning and the family size is decreasing, and India is trying to follow there and see the miracle of Bangladesh! Bangladesh is coming there and they are going, and—oh! The Arab countries, they go for family planning and this is the late HIV epidemic that brings down some African countries, but the others meet up there,” he finished, his pointer aimed at a large cluster of culturally diverse countries with fairly small families and longer life expectancies. Somebody gave a whistle of surprise. In 30 seconds, Rosling had traversed a half-century of data and displayed the reality of today’s life-expectancy figures. They weren’t what many had imagined.

“We have a completely new world,” he said. “Global health is full of ignorance, full of myths.”

The truth of today’s world, he said, can no longer be described in terms of “us” and “them,” meaning developed countries and developing countries.

“We’re using the wrong taxonomy. We can’t have two groups of people to represent the whole world,” he said. “It was a diverging world, and now it is a converging world.”

Whereas old data showed that countries first got rich and then got healthy, current data show the trend has shifted. Countries can get healthy first and then accumulate wealth.

Rosling said that when he first taught public health, the conventional wisdom was that poverty causes disease. Later, he came to understand differently.

“I now say disease causes poverty, because the most common reason for someone being deprived today is that [a family member] needed a cesarean section, or fractured a leg, or needed hernia surgery or something like that and you are back in poverty,” he said.

And while many countries seem poised to grow their GDP and advance their world standing, Rosling said this does not apply to countries that still face systemic poverty, war and disease.

“The difference between the worst off and the best off is bigger than ever,” he said. NIHRecord Icon

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