Part 2a: Can one person make a difference? What the evidence says.

If you focused on making a contribution to the world, how much good could you actually do? In the last article, we showed that getting good at something that helps others is the key to a fulfilling career, but what can you really do to help others?

Sometimes it feels like individuals can’t do much, but that’s wrong. In the past, some people’s careers have had a really, really huge impact. For instance, Bill Gates has prevented the deaths of millions of children, making him better than Batman. We’ll cover some even higher impact examples you probably haven’t heard of.

The huge spread in impact between careers means that if there’s anything you can do to raise the chances of your career being among the high impact ones, then it will do a lot of good. In fact, we’ve discovered an easy way for any college graduate to make a big difference with little sacrifice.

Watch this video or read the full article (10 minutes).

The bottom line

Any college grad in the developed world can make a major difference to the lives of hundreds of people. They can do this by donating 10% of their income to the world’s poorest people. We call this the easy baseline.

Some careers have more impact than others

How much good does a doctor do?

When people think of careers that make a difference, they tend to imagine jobs like teaching, social work and medicine. It’s true that these jobs have a substantial impact, but it’s actually less than you might think.

We made estimates of the impact you’d have by becoming a practicing doctor. We found that on average in the course of their career, a doctor in the UK will enable their patients to live an extra 120 years of healthy life, either by extending their lifespan or by improving their quality of health. There’s a huge amount of uncertainty in this figure, but it’s unlikely to be more than ten times higher.3

Using a standard conversion rate of 30 extra years of healthy life to one “life saved”, that’s equivalent to 4 lives saved. There’s no doubting that this is a significant impact, however it’s less impact than many people expect doctors to have. There are three main reasons for this.

  1. It’s widely accepted by researchers that medicine has only increased average life expectancy by a few years. Most of the increase in life expectancy that’s occurred in the last 100 years is instead due to better nutrition, better sanitation, higher wealth, and other factors besides medicine.

  2. Doctors are only one part of the medical system, which also relies on nurses, hospital staff, and all the buildings and equipment. The impact of medical interventions is shared between all of these elements.

  3. There are already many doctors in the developed world, so the most important and impactful procedures are going to get done whether or not you become a doctor. Additional doctors therefore only enable us to carry out procedures that deliver smaller and less certain health benefits.

You can see this in the chart below, which compares different countries. On the side is the level of ill health in the population, measured in “DALYs” per 100,000 people, where one DALY is a year of life lost due to ill health. On the bottom is the number of doctors per 100,000 people.

DALYs compared to doctors
WHO data from 2004 (or latest available year). DALYs per 100 000 versus doctors per 100 000. Line is the best fitting hyperbola determined by non-linear least square regression. Full explanation in this draft paper.

You can see that the curve goes nearly flat once you have more than 150 doctors per 100,000 people. After this point (which is met by almost all developed countries), additional doctors only have a small impact.

So if you become a doctor, your career will probably have more impact than an ordinary job, but it will still not be a huge impact.

Who has had more impact? Examples from medical research

Despite this, some doctors have much more positive impact than the average. We’ll stick with the metric of lives saved to make some more comparisons (although of course saving lives is not all that matters).

In 1968, while working in a refugee camp on the border of Bangladesh and Burma, Dr David Nalin made a breakthrough in the treatment of patients suffering from diarrhea. He realized that if patients were given water mixed with the right concentration of salt and sugar, they could be rehydrated at the same rate as they lost water. This prevents death from dehydration much more cheaply than with the existing treatment, an intravenous drip.

Dr Nalin helped to invent oral rehydration therapy
Dr Nalin helped to save millions of lives with a simple innovation: giving diarrhea patients water mixed with salt and sugar.

Since then, this astonishingly simple treatment has been used all over the world. The annual rate of child deaths due to diarrhea has fallen from 5 million to 1.3 million. Researchers estimate that in total about 50 million lives, mostly children’s, have been saved due to the therapy.1

This treatment would still have been discovered eventually even if Dr Nalin was never involved. However, even if we suppose that he sped up roll out of the treatment by only six months, the impact of Dr Nalin’s work would be to save about 500,000 lives.

This means that his impact was some 100,000 times greater than that of an ordinary doctor:

Lives saved by Dr. Nalin

But Dr Nalin is far from the most extreme example. Even just within medical research, there have been more impactful discoveries. Karl Landsteiner’s discovery of blood groups likely saved tens of millions of lives.2

Lives saved by Dr Landsteiner

Thinking more broadly, Roger Bacon and Galileo pioneered the scientific method, without which none of these discoveries would have been possible (along with the industrial revolution and much more). You could make a good case for their work having a far greater impact still.

The unknown Soviet Lieutenant Colonel who saved your life

Stanislav Petrov probably saved your life

Or consider the story of Stanislav Petrov. He was on duty in a Soviet missile base in 1983, when early warning systems apparently detected an incoming missile strike from the United States. The clear protocol was to order a return strike, but Petrov reasoned that the number of missiles was too small, so he didn’t push the button.

If a strike had been ordered, hundreds of millions would have died, and it may have triggered all out nuclear war, leading to billions of deaths and, in the worst case, the end of civilization. Perhaps we could quantify his impact as saving one billion lives, and that’s probably an underestimate because a nuclear war would have devastated scientific, artistic, economic and all other forms of progress.

Lives saved by Petrov

What does this mean for your career?

Some careers have huge positive effects, and some vastly more than others.

Some component of this is due to luck – these people were in the right place at the right time. But if there’s anything you can do to increase the chances of your career being among the high impact ones, it would really be worth doing. And we’re going to show that you can do plenty. This means anyone can have a significant impact with their career.

These examples also show that the most high-impact paths might not be the most obvious ones, or traditional ‘do-gooder’ paths. Being a doctor turned out worse than it first looks. And being an officer in the Soviet military doesn’t sound like a good thing to do with your life, but Petrov probably did more good than our most celebrated leaders, who are commemorated on stamps and with statues.

So how much impact can you have if you try? First, we’ll give a conservative estimate: it turns out that any college graduate in the developed world can have a very substantial social impact – perhaps even more than you could by becoming a doctor. Then in the next two parts we’ll explore ways to do even more good.

But first, let’s clarify what we mean by “making a difference”. We’ve been talking about lives saved so far, but that’s not all that matters.

What do we mean by social impact?

When we talk about your “positive impact”, “the good you do” or the “difference you make”, we mean your social impact. We define it as:

The number of people whose lives you improve, and how much you improve them.

This means that there are two ways you can have more social impact: helping more people, or helping the same number of people to a greater extent (pictured below).

Social impact - how to change the world - help people more, or help more people

There are a few points to make about this definition before we go on.

  1. Although we talked in the previous section about saving lives, social impact is not confined to this: improvements to quality of life can be just as significant. That could involve making people happier, helping them reach their potential, or making their lives more meaningful.

  2. We are usually uncertain about the social impact of different actions will have, but that’s okay, because you can use probabilities to make the comparison. For instance, a 90% chance of helping 100 people is roughly equivalent to a 100% chance of helping 90 people.

  3. Your social impact includes all of the people your actions help, both immediately and over the coming decades and beyond. As a result, it may be better to seek an indirect impact. For example, if you improve the quality of government decision-making, that could have a huge social impact in the long run even if it doesn’t help people right now. We’ll come back to this in the next article.

(Read more about the definition of social impact.)

How anyone can make a big difference

We’ve discovered that any college graduate in the developed world can have a significant social impact with little personal sacrifice. How?

One way is what we call the easy baseline:

  1. Take whatever job you find most personally fulfilling.
  2. Give 10% of your income to the world’s poorest people.

Today, you can give to the world’s poorest people through GiveDirectly, a charity that provides one-off cash transfers to the poorest people in East Africa via mobile phone.

This isn’t necessarily the best you can do. In fact we’ll show that you can have far more impact by choosing the right job and donating to even more effective charities. But it’s an option open to almost anyone that already does a lot of good.

How much good will this do?

As we saw in part one, money goes further the less you have. We saw that in the US a doubling of income is associated with about half a point gain in life satisfaction, on a scale of one to ten.

Other surveys have found similar results across the world. This study covered over 160 countries, and here’s a sample of the results:

Stevenson, Betsey, and Justin Wolfers. Subjective well-being and income: Is there any evidence of satiation? No. w18992. National Bureau of Economic Research, 2013 Archived link

The poor in Kenya have an average individual income of about $200 per year.4 The average US college graduate has an annual individual income of about $68,000.5 This means your money will go about 340 times as far if given to the Kenyan rather than spent on yourself.7

If someone earning that average level of income were to donate 10%, it would be enough to double the annual income of 34 people living in extreme poverty each year, likely having a major positive impact on hundreds of people over your career.

In human terms: Grace, 48, is a typical recipient. She’s a widow who lives with four children:

Screen Shot 2015-12-16 at 1.36.04 AM

I would like to use part of the money to build a new house since my house is in a very bad condition. Secondly, I would wish to pay fees for my son to go to a technical institute….

My proudest achievement is that I have managed to educate my son in secondary school.

My biggest hardship in life is [that I] lack a proper source of income.

My current goals are to build and own a pit latrine and dig a borehole since getting water is a very big problem.

GiveDirectly has done a randomized controlled trial of their program, which found significant reductions in hunger, stress and other bad outcomes for years after the transfers are made. Most of the money is invested in assets, such as metal roofs and water equipment. GiveDirectly’s trial adds to an already substantial literature on cash-transfers, showing significant benefits.

How much sacrifice will this involve?

In this path, you get to do whatever job you find most personally fulfilling, which is much easier than switching jobs.

Moreover, you will only give up 10% of your income. Normally when we think of doing good with our careers, we think of paths like becoming a teacher or charity worker, which can easily involve earning 50% less than you would in the private sector.

Finally, as we saw in the last article, extra income over $40,000 doesn’t have that much effect on your happiness, while giving to charity probably makes you happier.

To take just one example from the literature, it was found that in 122 of 136 countries, if you answered “yes” to the question “did you donate to charity last month?”, your life satisfaction was higher by an amount associated with a doubling of income.4 So we think there’s a good chance that giving 10% makes you happier overall.

(Not persuaded? Read much more on whether giving 10% will make you happier.)

Higher impact than being a doctor

If you think there are charities that are more effective than GiveDirectly, then this path becomes even better. The charity evaluator GiveWell estimates that donations to Against Malaria Foundation save a life for about $3,000, as well as many other benefits in terms of quality of life and income. This means that your donations could save more than two lives every year. This is such a good opportunity that even the most prominent aid skeptics agree we should do it.

Two lives per year over an entire career would probably be more impact on health than you’d have by becoming a practicing doctor, which we earlier estimated at around saving four lives over an entire career. For this reason, many of the doctors we’ve advised, like Abbie below, have decided to focus on having an impact through research, public health, or donating, rather than directly through treating patients.

“My thoughts on how best to help people have changed dramatically.”

Read Abbie's story

Abbie portrait photo

Perhaps you think it’s more effective to work on systemic change, research or other “high risk” opportunities than directly funding health (as we do). That’s great, because it means there are even more effective charities you could fund, which means giving 10% will achieve even more.

In fact, if everyone in the richest 10% of the world’s population gave 10% to whichever problems they think are most pressing, that would be $3.5 trillion per year.8 Just 4% of that would be enough to raise everyone in the world above the $1.25/day poverty line by simply giving them cash. We could then provide universal education, increase scientific research spending 50%, fund a new renaissance in the arts…and still have more left over.

How is this possible?

It’s astonishing that we can do so much good with so little sacrifice. Why is this possible?

It’s because we live in a very unintuitive world. Consider the graph of world income:

World income distribution
Source: Doing Good Better, by Will MacAskill, 2015

If you’re reading this, you’re probably somewhere in that big spike on the right of the graph (and perhaps even way off the chart), while almost everyone else in the world is in the flat bit at the bottom that you can hardly even see.

If you earn $53,000 per year and don’t have kids, then globally speaking, you are the 1%. Find out exactly how rich you are by using this quick calculator.

There’s no reason to be embarrassed by this fact, but it does mean that it’s important to consider how you can use your good fortune to help those without your advantages. In a more equal world, we could all just focus on helping those around us, and making our own lives go well. But it turns out we have an enormous opportunity to help other people with little cost to ourselves – and it would be a terrible shame to waste that.

Take action right now

All of us at 80,000 Hours were so persuaded by these arguments that we pledged to give at least 10% of our lifetime income to effective charities. We mostly took this pledge while college students, and we did it through an organization called Giving What We Can. (Our co-founder, Will, actually went a bit further and pledged to give all his income above $35,000 to charity.)

Giving What We Can enables you to take a public pledge to give 10% of your income to the charities you believe are most effective. They also provide research-backed recommendations on where to give.

Taking the pledge is straightforward and likely to be the most significant thing you can do right now to do more good with your life.

Pledge now

It’s not legally binding, you can choose where the money goes, and if you’re a student, it only commits you to give 1% for the time being. You’ll be joining over 2,500 people who’ve collectively pledged over a billion dollars.

And if you’re not quite ready yet, Giving What We Can allows you to choose how much you want to pledge for one year, to see how it goes before making any long term commitment. Try out giving.

What if you don’t want to give money?

You can have just as much impact by publicizing how to take action on the most pressing problems. To take a simple example, if you can persuade one other person to give 10%, then you’ll have had just as much or even more impact than if you had done it yourself.

Similarly, you could tell people about any of the other high impact paths we’ll discuss in the coming articles. What matters is the difference you make, not whether you contribute directly or through inspiring others. This means you can still have a big impact even if you don’t have money to give.

How can you have the greatest impact?

How can you beat the easy baseline? In the next two articles we’ll cover how to give yourself the best chances of having a major social impact. That could mean contributing through research, campaigning, non-profits or entrepreneurship, as well as donations.

The first step is to focus on the most pressing problems. We’ve mentioned one here – extreme global poverty – but there are many others, some of which we think are even more pressing. We’ll explain how to compare these problems in terms of urgency, and give you a list of recommendations.

Part 2b: What are the world’s most pressing problems?

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Notes and references

  1. Source: Science Heroes. Archived link, retrieved 4-March-2016.
    Since the adoption of this inexpensive and easily applied intervention, the worldwide mortality rate for children with acute infectious diarrhea has plummeted from 5 million to about 1.3 million deaths per year. Over fifty million lives have been saved in the past 40 years by the implementation of ORT.
  2. Source: Science Heroes. Archived link, retrieved 4-March-2016.
    Superman of Science Makes Landmark Discovery - Over 1 Billion Lives Saved So Far! Every source quoted an amazing number of transfusions and potential lives saved in countries and regions worldwide. High impact years began around 1955 and calculations are loosely based on 1 life saved per 2.7 units of blood transfused. In the USA alone an estimated 4.5 million lives are saved each year. From these data I determined that 1.5% of the population was saved annually by blood transfusions and I applied this percentage on population data from 1950-2008 for North America, Europe, Australia, New Zealand, and parts of Asia and Africa. This rate may inflate the effectiveness of transfusions in the early decades but excludes the developing world entirely.

    We assumed a constant number of lives saved per year, and a speed up of 1%.
    1bn * 1% lives is 10m.
  3. In our career review, we provide an optimistic all considered estimate of 4 DALYs averted per year. Over a 35 year career, that’s 120 DALYs averted.

    A standard conversion rate is 30 DALYs = 1 life saved. Source: World Bank, p. 402, retrieved 31-March-2016
  4. Mean daily per capita consumption among eligible households = $0.65.
  5. Source: Carnevale, Anthony P., Stephen J. Rose, and Ban Cheah. "The college payoff: Education, occupations, lifetime earnings." (2011).
    "the mean (average) earnings of those with a Bachelor’s degree is $500,000 higher than the median ($2.7 million)"

    They are using a 40 year career to calculate these:
    Overall, the median lifetime earnings for all workers are $1.7 million, which is just under $42,000 per year ($20 per hour). Over a 40-year career, those who didn’t earn a high school diploma or GED are expected to bring in less than $1 million, which translates into slightly more than $24,000 a year ($11.70 per hour).

    So 2.7 million / 40 = $67,500
  6. Aknin, Lara, Christopher P. Barrington-Leigh, Elizabeth W. Dunn, John F. Helliwell, Robert Biswas-Diener, Imelda Kemeza, Paul Nyende, Claire Ashton-James, Michael I. Norton (2010). “Prosocial Spending and Well-Being: Cross-Cultural Evidence for a Psychological Universal.” Harvard Business School Working Paper 11-038.
  7. If the relationship between income and wellbeing is logarithmic, then doubling someone's income increases their wellbeing by a constant amount. That means if someone has an income of $68,000 and another has an income of $200, you'd need to increase the first person's income by $68,000 to increase their wellbeing as much as you would if you increased the second person's income by $200. $68000/$200 = 340. We explain why we think the relationship is logarithmic (or perhaps even weaker) in our evidence review on income and happiness.
  8. This is based on estimates suggesting that the top 10% of income earners account for a bit over 50% of global income (PPP) from Global Income Inequality by the Numbers: in History and Now by Branko Milanovic. While these figures are from 2008 we expect they remain fairly accurate today.