Latest / Research Insights, a Society of Actuaries Podcast / Long Term Drivers of Future Mortality - Episode 3 - Lifestyle

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Long Term Drivers of Future Mortality - Episode 3 - Lifestyle · Research Insights, a Society of Actuaries Podcast

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  Unknown: Music,
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  Ronora Stryker: Hi listeners, and welcome to the Research
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  Insights Podcast. I'm Ronora Stryker, a Senior Practice
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  Research Actuary here at the Society of Actuaries Research
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  Institute. And welcome back to our special podcast series
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  focusing on the paper Long Term Drivers of Future Mortality that
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  was part of our 2023 Living to 100 Symposium. The paper is
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  authored by Yair Babad, Professor Emeritus at the
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  University of Illinois Chicago, and Al Klein, Principal and
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  Consulting Actuary at Milliman. Today we're exploring Chapter
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  Three on Lifestyle. I'm joined by two members of our Mortality
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  and Longevity Strategic Research Program Steering Committee. Our
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  first member is Al Klein, one of the authors of our paper.
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  Welcome Al!
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  Al Klein: Thanks Ronora, and welcome everyone from near and
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  far.
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  Ronora Stryker: We also have Eric Pickett, actuary and Chief
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  Content Officer of Club, Vita, Hi, Eric!
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  Eric Pickett: Hello, Hello. It's great to be here!
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  Ronora Stryker: Okay Listeners. As a quick reminder, if you want
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  to download the paper, just go to soa.org and click on the
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  research institute tab, look for research by topic, and click on
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  Mortality and Longevity. This will take you to the M & L
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  landing page, where you will find the link to the paper and
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  this podcast in the upper right hand corner. And with that, I'll
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  pass you over to Al and Eric, take it away. Al!
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  Al Klein: Thanks Ronora, as you mentioned today, we're diving
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  into Chapter Three, where we examine how lifestyle choices
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  impact mortality and longevity. Lifestyle choices are some of
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  the more significant drivers of future mortality. Actuaries need
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  to consider how evolving lifestyle trends, both positive
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  and negative, will shape mortality and population
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  forecasts and projection models, whether for life insurance,
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  annuities or pension plans. Lifestyle choices also affect
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  demographers and public health official's future estimates.
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  Eric Pickett: Exactly and lifestyle factors such as
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  physical activity, diet, smoking, alcohol consumption and
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  stress management all play significant roles in determining
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  health outcomes, longevity and quality of life. Understanding
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  trends in these behaviors at the population level and for
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  different socioeconomic groups is crucial when building long
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  term mortality and population projections. And unlike many of
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  the other drivers featured in this paper, these are ones over
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  which individuals actually have some control. So there's a
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  really wide range of influences on how these trends may develop
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  into the future. Are behaviors improving? Are new risk factors
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  emerging? Are attitudes towards different behaviors changing?
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  Are there any changes to public health interventions on the
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  horizon? How will such changes affect different groups of
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  people? These are the key questions that actuaries need to
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  consider.
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  Al Klein: That's a lot to consider, but you're right,
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  Eric, even small shifts in behavior over time can have
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  significant implications for mortality rates of individuals
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  and society as a whole. Let's start by discussing one of the
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  most influential factors, exercise. Why don't you start
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  with this one?
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  Eric Pickett: Yeah, thanks Al! So regular physical activity is
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  known to improve many health outcomes, including reducing the
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  risk of cardiovascular disease, diabetes, obesity and even
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  mental health issues like depression. And the amount of
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  data we have to study on this driver has recently increased
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  with the use of pedometers and other activity tracking through
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  mobile health apps.
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  Right now, physical inactivity is a growing concern. The US
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  Physical Activity Guidelines for adults recommends at least two
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  and a half hours of moderate aerobic activity per week, but
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  the latest figures from the CDC in 2020 show that less than half
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  the US adult population achieves this recommendation with some
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  big differences between different geographical and socio
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  economic groups across the US. Conversely, there's also a push
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  towards more health conscious living with wearable technology,
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  corporate wellness programs and fitness tracking becoming more
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  popular, although this has slowed some with COVID. That
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  said, while there's the potential to mitigate some of
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  the sedentary behavioral trends, there's also the potential to
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  increase the differential between groups as unemployment
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  increases.
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  Yeah, a really interesting set of interactions there, I think,
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  and it certainly will be a challenge to predict their
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  overall effects on the future mortality rates, some of the key
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  questions for actuaries to consider then are, how have
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  inactivity levels changed over recent decades, and how are they
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  likely to change in the future? Are we becoming more or less
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  sedentary, and how does this differ between socio economic
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  groups or geographical groups? Also, how long does it actually
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  take for inactivity levels to filter through into mortality
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  and morbidity statistics. For example, when does a change in
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  behavior for a 40 year old now show up in the data? Is it right
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  away, or is there a lag until they reach their 60s or their
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  70s?
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  Al Klein: Understanding how different sub populations engage
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  with physical activity is key when modeling future mortality
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  rates, factors such as urban planning, access to recreational
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  spaces and the integration of exercise into daily life can all
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  impact long term trends in mortality and the overall
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  population, which in turn, can affect public policy and
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  community service budgeting. And before we leave this topic, it
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  is my hope that as you research things like exercise for
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  projecting future mortality, you also consider it personally. Now
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  let's turn to the next topic, diet. Dietary trends are another
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  major lifestyle factor impacting mortality, and understanding
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  this impact is made more challenging as there does not
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  seem to be a wide consensus on a recommended healthy diet. That
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  said, if you see me in person at any of the SOA or other
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  meetings, I'd be happy to discuss this topic further,
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  maybe over a healthy lunch!
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  Eric Pickett: I might take you up on that Al, I think I need
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  all the help I can get! Nevertheless, by various
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  measures, dietary habits seem to have been getting worse over the
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  years, and this is correlated with the increase in overweight
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  and obesity rates. A key question for actuaries is
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  whether we will see a reversal in unhealthy dietary trends.
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  While some populations are shifting towards more plant
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  based and whole food diets, the widespread availability of high
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  calorie low nutrition processed foods remains a concern.
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  Additionally, food insecurity and nutritional inequality could
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  exacerbate health and mortality disparities. We are also eagerly
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  awaiting more information on the long term effects and take up
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  rates of the recent appetite suppressing obesity medications,
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  which is still a relative unknown.
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  Al Klein: Forecasting dietary trends is challenging, but
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  actuaries must monitor the levels of obesity in the
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  population at large as well as the insurance population.
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  Obesity typically leads to conditions like diabetes,
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  cardiovascular disease and metabolic disorders, each of
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  which are significant drivers of mortality.
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  Eric Pickett: Okay, next, let's turn our attention to one of the
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  big ones, and that's not a pun. After talking about obesity, I
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  now want to discuss smoking. Smoking remains one of the
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  leading causes of preventable deaths worldwide and is one of
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  the major behavioral drivers of differences in mortality rates.
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  Al Klein: That's right, Eric, although smoking rates in the US
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  have decreased significantly over the last 60 years. The
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  latest figures estimate around 11.6% of the US population
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  smokes down from about 40% or over 40% in the 1960s and this
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  large reduction in smoking rates is at least partially
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  responsible for the mortality improvements we have seen in the
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  US over the recent decades.
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  Eric Pickett: So when considering changes to future
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  mortality rates, we'll need to think about where the further
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  reduction in smoking rates will be possible over the coming
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  years. Remember, someone who doesn't smoke can't give up
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  smoking.
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  Al Klein: That should be pretty easy to remember, Eric.
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  Something else to consider is the difference in smoking rates
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  among different groups in society. There are more smokers
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  among men than women, and lower socioeconomic groups are more
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  likely to smoke than higher socioeconomic groups, so there
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  may be even more room for mortality improvements among
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  these populations, assuming they reduce their rate of smoking.
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  Eric Pickett: Yeah, that's a really good point. Al, we've
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  recently seen higher mortality improvements among higher socio
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  economic groups in the US, but from a smoking perspective,
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  maybe there is more potential for future gains among lower
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  socio economic groups. Also, actuaries must consider the
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  prevalence and potential impact of movements from tobacco
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  cigarettes to electronic smoking.
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  Al Klein: Again, to monitor these developments, we'll need
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  to monitor emerging data on tobacco related mortality and
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  consider e cigarettes, but also public health efforts and
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  changes in generational attitudes towards smoking. Now
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  moving on to our next topic, alcohol and drug use. Present
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  another lifestyle factor that will affect future mortality,
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  morbidity and overall quality of life, while moderate alcohol use
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  may not significantly impact mortality, and according to some
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  studies, may even have a slightly positive effect on
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  mortality. Heavy drinking and substance abuse are problems
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  that contribute to premature deaths.
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  Eric Pickett: As far as alcohol and recreational drugs are
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  concerned, we again need to consider if there are any major
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  changes to consumption that might develop over time, apart
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  from the gradual relaxation of marijuana laws, it doesn't seem
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  that major regulatory changes are on the horizon. However,
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  there may be some generational changes in attitudes towards
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  consumption. It seems that larger numbers of Gen Z may be
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  turning towards sobriety, with a number of surveys showing
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  abstinence from marijuana and alcohol reported in in higher
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  numbers in younger generation.
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  Al Klein: That is an interesting development. Another thing to
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  keep an eye on is the impact on the recent COVID 19 pandemic.
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  There was an increase in alcohol related deaths during the first
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  few years of the pandemic, and the data is not yet in to show
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  whether this effect has dissipated. And before we move
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  on, we can't forget to mention the widely reported opioid
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  crisis seen in the US over recent years that has
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  significantly increased mortality in certain
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  demographics, especially the working age, age bracket, the
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  addictive nature of opioids makes this difficult to stop.
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  Actuaries need to assess whether policies aimed at reducing
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  addiction and overdose deaths, or even the availability of
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  opioids will be effective in reversing this trend.
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  Eric Pickett: Okay, so the final area for us to talk about today,
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  then, is stress. Stress is often overlooked when we talk about
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  mortality, but chronic stress can have an impact on health
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  outcomes, contributing to higher levels of inflammation and
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  increasing the risk of heart disease, stroke and cognitive
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  decline. Actuaries should consider the long term impact of
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  stress related diseases and the role of mental health support in
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  reducing these risks.
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  Al Klein: That's right, and I don't think the mental health
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  issue is considered often enough. Another important thing
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  for actuaries to consider here is the increase in stress levels
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  through the COVID 19 pandemic. The American Psychological
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  Association has warned that the nation is facing a mental health
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  crisis that could yield serious health and social consequences
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  for years to come, so this will be something to monitor in the
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  future.
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  Eric Pickett: Thanks Al, so listeners, we've now touched on
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  the key areas of the chapter, and we hope that gives you a
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  good overview of lifestyle considerations for future
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  mortality before we both head off to the gym. Al, would you
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  like to run through a summary of how you and Yair saw the likely
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  impact for the general population.
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  Al Klein: Yes of course, as a reminder at the end of each
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  chapter, Yair and I included a table where we highlight the
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  outlook for the impact on future mortality expectations of the
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  different areas covered in the chapter, the key drivers
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  included in the table for this chapter were diet and obesity,
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  physical activity, smoking, addiction and stress. Of these
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  drivers, we projected modest impacts in the short term, but
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  we thought diet and obesity, as well as stress, were likely to
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  have larger negative impacts on long term future mortality
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  rates. Please remember that you need to adjust these
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  expectations so they are relevant to the specific
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  population for which you are predicting future mortality
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  assumptions.
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  Eric Pickett: Thanks. Al. So to summarize the key takeaways from
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  today, then lifestyle factors play significant roles in
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  shaping health outcomes and longevity, and they are one of
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  the key determinants of differences in both current and
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  future mortality rates between socio economic groups and
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  geographical groups across the US. Reductions in smoking rates
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  have made large contributions to mortality improvements over
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  recent decades, but there is now a question around whether it is
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  possible for these rates to reduce even further. We've seen
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  increases to overweight and obesity levels in the US in
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  recent years, likely driven by the changes in physical activity
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  and diets. But how will this develop into the future, and
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  what impact will new weight management drugs have? And a few
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  other emerging questions that I will be keeping a close, close
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  eye on are, will changing attitudes to things like alcohol
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  consumption and exercise among younger generations, resulting
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  greater mortality improvements in the future. And what long
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  term impact has the COVID 19 pandemic had on lifestyle
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  behaviors?
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  Al Klein: Eric thanks for that summary. The only thing I will
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  add is that while what to monitor makes a lot of sense,
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  how to monitor it and predict the outcomes remains a
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  challenge. That said, this is certainly an interesting and
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  ever evolving field. That's it for now Listeners. Please join
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  us for our next podcast where we'll be tackling the topic of
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  inequality. Back to you, Ronora to close out this podcast.
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  Ronora Stryker: Thanks Al and Eric. I really appreciate your
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  time and sharing your thoughts and expertise about lifestyle
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  and how it might impact future mortality. Okay, listeners,
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  that's all we have time for today. Join us at the end of
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  next month for our next episode, which is focused on chapter
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  four, Inequality and its impact on longevity. We'd love to hear
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  your feedback on this podcast series and thoughts on topics
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  for future research. Just email us at Research-ML@soa.org.
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  Thank you listeners for joining us on our chapter by chapter
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  journey through The Long-Term Drivers of Future Mortality
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  podcast series. We always appreciate your support and
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  engagement. For the Mortality and Longevity Strategic Research
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  Program Steering Committee and the Research Insights Podcast,
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  I'm Ronora Stryker for the Society of Actuaries Research
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  Institute.
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  Rose Northon: This was a podcast of the Society of Actuaries. The
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• 15:32
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