[July 18 2019 addendum: This assumes that coffee has a causal- rather than merely correlational- influence on longevity. See comment section for more details.]
The T-shirt in the featured image was probably designed as a joke, but I take it very seriously.
Indeed, I think there is a strong case to be made that subsidizing coffee could be seen as an Effective Altruist priority. You see, you can save a life with coffee for as little as $50k. This makes coffee an intervention that is on par with some of the top charities in the world, and it is an outlier when it comes to the cost-benefit ratio of medical interventions. Consider how, e.g. this article on QALY states that:
“The UK’s recommendations, for example, are about £20,000 to £30,000 ($30,000 to $45,000) for each additional year of good health, once it has been adjusted to take into account the quality of life. So a drug that achieved 0.5 on the QALY measure would only merit £10,000-15,000 ($15,000 to $22,500).”
Assuming a QALY-adjusted average life-span of about 60 years per person, coffee is about 30 to 50 times more cost-effective than the types of medical interventions the UK is willing to subsidize to extend people’s lives. And that’s not even considering what people themselves are willing to pay to extend their own lives, which is, of course, a lot more than what a government would.
Relative to GiveWell‘s top charities this is still not the best intervention out there (with some of the ultra-effective charities saving a life for about 2,000 dollars). I would nonetheless point out that the ultra-effective charities out there are all effective because they address populations where very basic human needs are not typically met. In Malaria-ridden, war-torn areas, a little can go a long way. But what’s different about coffee is that it is as effective everywhere in the world. Sure, you can save a life with $50k in many African countries. But can you do so in Sweden?! With coffee you can!
…
Anyhow, how did I arrive at these numbers? Well consider that you can get about 380 doses of coffee for as little as 10 dollars.*
So this means you can have a cup of coffee for as little as 2.63 cents(!). In turn, we know from a lot of research that each cup of coffee up to 4 cups a day prevents about 1/2 micromorts (interestingly, it is just as cost-effective to encourage people who don’t drink coffee to drink 1 cup as it would be to encourage people who drink 3 to go ahead and drink 4).
Given those numbers, we have that the cost of a full life-span worth of micromorts is about $52,631.58.
Why are we not funding this?!
*With: Example 48 oz brand. (we could do even better buying in bulk – I reached out to a delivery company to get a quota and will update when I know more).
Can you please link some research with that micromort figure?
Hi!
Apologies for not linking to research on the original post. I wrote it on a whim, and I’m planning on revising and expanding it (especially to include a caveat about the valence-arousal correlation in people being negative about 30% of the time [Kuppens 2007], and thus decaf or decaf + l-theanine being a better option to get people like that starting to drink coffee daily).
The first time I saw a microlife figure associated with coffee was in “Using speed of ageing and “microlives” to communicate the effects of lifetime habits and environment” by David Spiegelhalter (see: https://understandinguncertainty.org/files/2012bmj-microlives.pdf).
It lists 2-3 cups of coffee a day as 1 mocrolife, with a “year of life gained” of 1 and a hazard ratio of 0.90.
For the microlife gain to be about 2 per day (based on the same table) we would need about 0.81 hazard ratio. That’s where I made the connection that coffee in higher doses might give you up to 2 microlives or so at most. Looking through large-scale studies (with hundreds of thousands of participants), I’ve seen hazard ratios for coffee that go as low as:
0.84 and for 4-5 cups a day: https://www.empr.com/home/news/coffee-drinking-found-to-lower-risk-of-all-cause-mortality/
0.88 (males) and 0.84 (females) for 2-3 cups a day: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3439152/
0.84 for 6-7 cups a day: https://www.mdmag.com/medical-news/drinking-1-to-8-cups-of-coffee-lowers-allcause-mortality
So the figure I mentioned originally in the article is probably a bit inflated. At minimum, I do think the evidence indicates that 4 cups of coffee gives you at least 1 microlife or so, but possibly more (up to 1.5, or 2 being optimistic).
Even if it is only one microlife maximum, though, we would just need to roughly double the cost-per-life stated in the article (to about $100k), which would still be 10 times or more cost-effective than subsidized medical interventions.
Ps. I should also admit I’m somewhat confounding micromorts and microlives, which in some cases can be used interchangeably but in others they can’t (especially as one talks about people who are very old or very young). But I think for back-of-the-envelope calculations it’s not a bad error to make.
Thanks for responding!
All these studies seem to be correlational though. So it’s also plausible that healthy people are somehow more likely to drink coffee or that people who drink coffee are also more likely to do something that keeps them healthy (e.g. exercise). There seem to be nothing I’ve seen so far to support the claim that coffee itself is the cause of health benefits. So maybe if you artificially increase coffee consumption, the true cause of good heatlh outcomes will be lacking in the consumption surplus cohort.
There seem to be some studies with causal designs but there are probably fewer of them and they don’t seem to support “correlation = causation” hypothesis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213346/
Thanks for sharing that possibility. I did consider, in my mind, the possibility that this was not a causal effect, but I dismissed that possibility given the sheer size of the studies and the number of confounders that have been controlled for (such as eating fruits and vegetables, exercising, income, etc.).
At the same time, we do have the case of alcohol having a similar pattern where a large number of studies show that drinking a little bit (1 unit per day) has life-extending benefits relative to being a teetotaler. But then this massive study based on data from the Global Burden of Disease report and funded by the Gates Foundation comes out, which specifically tests for all of the causally-plausible mechanisms of action of alcohol and finds that alcohol is bad for you at even small doses. (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31310-2/fulltext)
So the argument goes that being a teetotaler is perhaps a weak signal that one is not really able to tolerate alcohol and in turn that’s a signal that one is not as healthy as others who can drink an alcohol unit without any trouble.
(As an aside – I wonder if re-analyzing the data from the studies I mentioned with probabilistic graphical models could already tell us more about the causal effects of coffee… though maybe we still need more possible confounders and larger datasets for that.)
Perhaps coffee works the same way. If so, then yes, encouraging people to drink more coffee should definitely not be an EA cause area, haha.
Coffee saves lives? Cool! I love coffee anyway. lol 😉