Future gains in health and longevity will depend on the success of public health policy, and in particular the earlier diagnosis of disease, a report suggests.
Life expectancy has steadily improved internationally for well over a century, but in recent years the rate of mortality improvement has slowed in a number of advanced countries.
The latest sigma report from the Swiss Re Institute warns that for governments and private financial institutions that are exposed to longevity risks, shifts in the underlying mortality trend are crucial as this risk cannot easily be diversified or perfectly hedged.
Cause-of-death statistics indicate that some of the recent slowdown in mortality improvement might reflect the lack of additional progress in treating major illnesses such as cardiovascular diseases. Worsening trends in circulatory-related disease have been a key influence on the slowdown.
The report suggests lifestyle choices regarding diet and physical exercise, rather than smoking/alcohol consumption, are the most obvious explanations.
It said that by defining a sub-group, perhaps in terms of diet or blood pressure, policies can be directed towards closing the gap in mortality experience between the general population and that of the target group.
Research on an anonymised patient database from the UK indicates that if current mortality among a target healthy group with no diagnosis of 30 major diseases were to be targeted across the wider population (and this was realised over 20 years), the rate of mortality improvement would broadly return to that observed over the past four decades.
The sigma study emphasises that the future of healthcare has to be focused on identifying early signs and symptoms of disease, and attempting to prevent disease progression and overall poor health.
“Digital health tools like telemedicine and wearables can play an important role in driving future mortality improvement. These technologies not only improve access to care, but also encourage healthcare markets to compete for lower, more affordable options,” it said.
Paul Murray, chief pricing officer, life & health products centre at Swiss Re, warned that we may be entering a new period where we see no improvements to life expectancy.
“Decision makers in insurance will need to be alert to how the uncertainty plays out in the coming years in regards to pricing, reserving decisions and policy,” he added.
Swiss Re said overly conservative pricing to cover the range of future mortality outcomes will make products such as annuities and life insurance unnecessarily expensive.