When it comes to risk selection, insurers typically assess whether an applicant has a clinically diagnosed mental illness like schizophrenia or bipolar disorder. But insurers usually do not assess a potential customer’s mental wellbeing and the broader, more holistic ways it affects health and longevity. How do stress and happiness factor into a person’s health?
People who experience chronic and traumatic stress, anger and hostility are found to be more likely to develop high blood pressure, high cholesterol levels and weight-related issues. These conditions increase a person’s risk for cardiovascular disease or type 2 diabetes.
Positive mental wellbeing, however, was shown to be linked to lower blood pressure, reduced risk of heart disease, healthier weight, better blood sugar levels and longer life.
Evidence suggests that several techniques – including meditation and cognitive therapy – can help people develop skills needed to make positive, healthful changes. Mindfulness, for example, has been associated with improved glucose levels and a lower body mass index. Improved mental health can, in fact, lead to improved physical health.
While physical activity is vital to a person’s health, studies show that lifestyles, especially in developed nations, are becoming increasingly sedentary. An estimated 1.4 billion people lack any substantial physical exercise in their daily routines. Worldwide obesity has nearly tripled since 1975.
Increased physical activity reduces health risks such as cardiovascular disease and cancer. One study found a 21% reduction in heart attacks and stroke for those engaging in moderate to vigorous activity three to four times per week, compared to those who do not participate in regular exercise.
Since increased physical activity has a clear impact on health and mortality, Swiss Re has been exploring ways to leverage wearable fitness technology. Facilitating fitness-related consumer engagement programmes and using new data in risk assessments holds a wealth of potential for insurance-driven improvements.
Environmental risks to health are typically defined as all the external physical, chemical, biological and work-related components that affect a person’s health. In a broader sense, these include factors such as pollution, light, radiation, noise, land use patterns, work environment and climate change. Their impact on health is significant: in 2019, environmental risk factors, including air pollution, heat and cold waves, water pollution and occupational risk globally accounted for an estimated 11.3 million deaths – about 20% of all deaths that year.
Prevalent, systemic risk factors like second-hand tobacco smoke, air pollution and sunlight exposure are especially important for the insurance industry. Second-hand smoking (SHS), for example, is becoming a serious health hazard. Approximately 2.3% of worldwide mortality (or 1.3 million deaths each year) is attributed to SHS, and these numbers are rising. This growing burden has been a major motivation for smoke-free laws in workplaces and indoor public places, as well as some outdoor public spaces.
Swiss Re’s research team found that too little or poor quality sleep can increase a person’s chance of developing a cardiovascular condition. Key factors increasing the risk for cardiovascular issues – high blood pressure, poor cholesterol, being overweight or having diabetes – are significantly associated with sleep duration.
Sleeping less or experiencing disturbed sleep puts a person at a greater risk for developing these health conditions. Those who sleep on average less than seven hours each night are more likely to have high blood pressure, for example. The impact is more severe the less sleep a person gets.
Furthermore, these conditions are not mutually exclusive and their effects on each other can exacerbate complications. For example, while poor quality sleep can increase the chance of having a cardiovascular condition, a high BMI can negatively affect sleep quality.
Thus, to get a complete picture of health, assessing a person’s sleep habits is vital. This data is relatively easy to track and report.
Poor nutrition is a key risk factor for numerous chronic diseases, most notably obesity, heart disease, type 2 diabetes, and as many as 13 types of cancer. Swiss Re’s research shows how better nutrition can lead to better health outcomes and increased societal resilience against disease.
As researchers continue to learn about what kinds of dietary patterns help the brain and body thrive, there is also new evidence that certain foods can aggravate health issues. For instance, certain foods promote inflammation – and many major diseases, including cancer, heart disease, diabetes, arthritis and Alzheimer’s, have been linked to chronic inflammation. Processed meats, artificial sweeteners, vegetable oils and high-fructose corn syrup are found to increase inflammation. Meanwhile, broccoli, salmon and blueberries are found to help the body fight inflammation and increase nutrient absorption.
Insurance’s consideration of substance use is mainly focused on alcohol and tobacco use. But even for these two factors, risk assessment remains a common and often challenging underwriting dilemma, except in scenarios of extreme consumption. More nuanced underwriting insight is highly valuable to the quantification of alcohol and tobacco risk.
Swiss Re’s research into the impact of alcohol and tobacco use can provide vital insights for insurers. Data continues to shed light on how these substances impact health. For example, alcohol risk is dose dependent. Pattern of use is also important. Binge use is associated not only with increased accidental death risk but also cardiovascular issues. In fact, alcohol contributes to 3.8% of all global deaths (males 6.3%, females 1.1%). Causes include unintentional injuries (27%), cardiovascular diseases (22%), cancer (20%), intentional injuries (11%) and cirrhosis (15%).
Since the impact of substance use varies with a person’s consumption pattern, good underwriting with an overall assessment of risk is particularly important during evaluation. Swiss Re’s experts continue to look for knowledge that can improve this assessment.
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