People in advanced economies are living longer, healthier lives today, thanks to medical innovations to combat cardiovascular disease and campaigns to end smoking that have spared millions from tobacco-related disease since the 1970’s.
However, rapid gains in mortality improvement that characterized the 20th century have levelled off in the past decade, a new report by the Swiss Re Institute showed.
Identifying trends that will kick off the next wave of mortality gains is critical for insurers, as even moderate rate changes can impact life and health insurance portfolios, according to Paul Murray (pictured), CEO, life and health at Swiss Re.
“In our business, we take risks for 30 or 40 years,” he told Insurance Business. “Part of our job is not just to look at what's immediately here and now, but also to think about what may develop in 20 to 30 years’ time.”
Advancements in the diagnosis and treatment of cardiovascular diseases contributed to the last large wave of improvement in life expectancy, Swiss Re Institute said.
“General living standards, good governance, clean water, refrigeration – all these things have been environmental factors that have been positive contributors over time,” Murray said. “There’s always a will to invest and explore the frontiers of science and medicine to prolong life.”
However, longevity gains started to plateau around 2010. Lifestyle factors like poor diet and sedentary behaviors have led to a rise in obesity and diabetes rates. Dementia and respiratory illnesses have also caused higher mortality in ageing populations.
“The main contributing factor to that was that cardiovascular-related improvement started to slow down, probably because we've done about as much as we can to understand and improve cardiovascular health,” Murray said.
Additionally, cancer rose to become one of leading causes of death in advanced economies, though the medical industry quickly responded with better screening and treatments to improve disease outcomes.
The global average life expectancy sat at 73.4 years in 2019, according to data by the World Health Organization. In the US, average life expectancy is 77.28 years. In the UK, it’s 80.9 years. Japan holds one of the highest rates at 84.62 years.
Murray highlighted several key trends in the medical and healthcare industry that could contribute to the next wave of longevity improvement:
Cancer causes around 10 million deaths worldwide every year. The Swiss Re Institute report named cancer mortality as an area of tremendous opportunity for advancement.
The global medical community is likely to produce better, more personalized treatments, screening, and diagnostics to drive improvements in cancer mortality for the next 25 years, it said.
For Murray, cancer innovations are the big hope for the future of life expectancy.
“We’re not great at understanding and dealing with [cancer] just yet, and part of the reason is that we catch it too late. Because the early stages of cancer are not so observable, we don't understand the process as well as we might want to,” Murray said.
“There are techniques emerging now that enable you to detect cancerous matter in the blood, for example, and more techniques coming that can help inform us about what's going on. But there's a long road of discovery ahead of us here to try and then turn that into material impact.”
One medical innovation that grew to prominence during the COVID-19 pandemic is mRNA vaccines. Though we’ve only started scratching the surface of these therapies, technology has a massive scope for future development, according to Murray.
“Immunotherapy also on my list, as it was a bit further developed in mRNA. There's still a lot of hope in that space,” the CEO added.
With a growing ageing population, the number of individuals living with Alzheimer’s disease and dementia is only set to increase in the years ahead. Swiss Re Institute pointed to a clear gap in the market for therapies to address both disease progression and symptomatic relief.
“The science around Alzheimer’s has been about mitigating the impact rather than stopping or slowing it down. With our knowledge evolving, I can conceive that Alzheimer’s developments will be positive contributors to life expectancy in the future,” Murray said.
Finally, making transformational lifestyle changes in individuals will be key to improving mortality rates in the future. This is where the insurance industry can drive a significant amount of change.
“There is huge potential for life and health insurers and reinsurers to extend their remit to guiding clients toward proper nutrition and sleep, adequate exercise and mental health and wellbeing. Modifiable behaviors help create a better experience for clients, our industry and for society,” Murray said.
But he also acknowledged systemic issues influencing lifestyle choices, including access to healthcare and quality food and other socioeconomic factors. In these cases, long-term policy may be needed to address gaps.
“Twenty years ago, we used to look to the US as the forefront of lifestyle development, owning their health and making good decisions about their diet. It's not the case now,” Murray said.
“So, how do we turn that around? Economic development and getting control of inflation will help governments make better long-term policy that will help towards that.”
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