Factfulness: Ten Reasons We're Wrong About the World – and Why Things Are Better Than You Think

The Size Instinct
You tend to get things out of proportion. I do not mean to sound rude. Getting
things out of proportion, or misjudging the size of things, is something that
we humans do naturally. It is instinctive to look at a lonely number and
misjudge its importance. It is also instinctive—like in the hospital in Nacala
—to misjudge the importance of a single instance or an identifiable victim.
These two tendencies are the two key aspects of the size instinct.
The media is this instinct’s friend. It is pretty much a journalist’s
professional duty to make any given event, fact, or number sound more
important than it is. And journalists know that it feels almost inhuman to look
away from an individual in pain.
The two aspects of the size instinct, together with the negativity instinct,
make us systematically underestimate the progress that has been made in the
world. In the test questions about global proportions, people consistently say
about 20 percent of people are having their basic needs met. The correct
answer in most cases is close to 80 percent or even 90 percent. Proportion of
children vaccinated: 88 percent. Proportion of people with electricity:
85 percent. Proportion of girls in primary school: 90 percent. The use of
numbers that sound enormous, together with constant images of individual
suffering presented by the charities and the media, distort people’s view of the
world and they systematically underestimate all these proportions and all this
progress.
At the same time, we systematically overestimate other proportions. The
proportion of immigrants in our countries. The proportion of people opposed

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to homesexuality. In each of these cases, at least in the United States and
Europe, our interpretations are more dramatic than the reality.
The size instinct directs our limited attention and resources toward those
individual instances or identifiable victims, those concrete things right in front
of our eyes. Today there are robust data sets for making the kinds of
comparisons I made in Nacala on a global scale, and they show the same
thing: It is not doctors and hospital beds that save children’s lives in countries
on Levels 1 and 2. Beds and doctors are easy to count and politicians love to
inaugurate buildings. But almost all the increased child survival is achieved
through preventive measures outside hospitals by local nurses, midwives, and
well-educated parents. Especially mothers: the data shows that half the
increase in child survival in the world happens because the mothers can read
and write. More children now survive because they don’t get ill in the first
place. Trained midwives assist their mothers during pregnancy and delivery.
Nurses immunize them. They have enough food, their parents keep them
warm and clean, people around them wash their hands, and their mothers can
read the instructions on that jar of pills. So if you are investing money to
improve health on Level 1 or 2, you should put it into primary schools, nurse
education, and vaccinations. Big impressive-looking hospitals can wait.