Category: Mortality

The amazing power of “machine eyes”

Mary Pat Campbell

Link: https://erictopol.substack.com/p/the-amazing-power-of-machine-eyes

Graphic:

Excerpt:

Today’s report on AI of retinal vessel images to help predict the risk of heart attack and stroke, from over 65,000 UK Biobank participants, reinforces a growing body of evidence that deep neural networks can be trained to “interpret” medical images far beyond what was anticipated. Add that finding to last week’s multinational study of deep learning of retinal photos to detect Alzheimer’s disease with good accuracy. In this post I am going to briefly review what has already been gleaned from 2 classic medical images—the retina and the electrocardiogram (ECG)—as representative for the exciting capability of machine vision to “see” well beyond human limits. Obviously, machines aren’t really seeing or interpreting and don’t have eyes in the human sense, but they sure can be trained from hundreds of thousand (or millions) of images to come up with outputs that are extraordinary. I hope when you’ve read this you’ll agree this is a particularly striking advance, which has not yet been actualized in medical practice, but has enormous potential.

Author(s): Eric Topol

Publication Date: 4 Oct 2022

Publication Site: Eric Topol’s substack, Ground Truths

Texas Maternal Death Data to Be Published Post-Midterms

Mary Pat Campbell

Link: https://www.governing.com/now/texas-maternal-death-data-to-be-published-post-midterms

Excerpt:

Texas health officials have missed a key window to complete the state’s first major updated count of pregnancy related deaths in nearly a decade, saying the findings will now be released next summer, most likely after the Legislature’s biennial session.

The delay, disclosed earlier this month by the Department of State Health Services, means lawmakers won’t likely be able to use the analysis, covering deaths from 2019, until the 2025 legislative cycle. The most recent state-level data available is nine years old.

In a hearing this month with the state’s Maternal Mortality and Morbidity Review Committee, DSHS commissioner Dr. John Hellerstedt said the agency wanted to better align its methodology with that of other states, and that there hadn’t been enough staff and money to finish the review for a scheduled Sept. 1 release.

….

Ortique said the state has already identified 149 potential maternal deaths in 2019, of which 118 have been analyzed by the committee to see if they were pregnancy-related. Six newly identified deaths may be added to that group, she said. The numbers cover deaths during the pregnancy through one year after giving birth.

The state has published a maternal death report every other year since 2014, often based on preliminary data updated later. For example, the maternal death report in 2018 identified 29 deaths in 2012 that were not included in the previous report. The committee also released updating findings from its most recent report, studying deaths from 2013, at the Sept. 2 meeting.

Out of 175 potential maternal deaths in 2013, 70 have since been determined to be pregnancy-related.

Author(s): Julian Gill and Jeremy Blackman, San Antonio Express-News

Publication Date: 14 Sept 2022

Publication Site: Governing

Death Is Anything but a Dying Business as Private Equity Cashes In

Mary Pat Campbell

Link: https://khn.org/news/article/funeral-homes-private-equity-death-care/

Excerpt:

Private equity firms are investing in health care from cradle to grave, and in that latter category quite literally. A small but growing percentage of the funeral home industry — and the broader death care market — is being gobbled up by private equity-backed firms attracted by high profit margins, predictable income, and the eventual deaths of tens of millions of baby boomers.

The funeral home industry is in many ways a prime target for private equity, which looks for markets that are highly fragmented and could benefit from consolidation. By cobbling together chains of funeral homes, these firms can leverage economies of scale in purchasing, improve marketing strategies, and share administrative functions.

According to industry officials, about 19,000 funeral homes make up the $23 billion industry in the U.S., at least 80% of which remain privately owned and operated — mostly mom and pop businesses, with a few regional chains thrown in. The remaining 20%, or about 3,800 homes, are owned by funeral home chains, and private equity-backed firms own about 1,000 of those.

….

Robertson said the funeral home industry is different from other sectors that private equity firms might consider investing in, describing it as a calling comparable to working in hospice care. Foundation Partners is fortunate their backers understand the service part of the industry, as well as the financials, he said. “Private equity firms aren’t necessarily known for having deep compassion for people. They’re more known for their financial returns,” he said. “To get both is really important.”

Foundation Partners owns Tulip Cremation, an online service that allows people to order a cremation with just a few clicks — and without having to set foot in a funeral home. Tulip currently operates in nine states where Foundation Partners has funeral homes. The company expects the service to eventually operate nationally.

Author(s): Markian Hawryluk

Publication Date: 22 Sept 2022

Publication Site: Kaiser Health News

S&P Global’s Proposed Capital Model Changes and its Implication to U.S. Life Insurance Companies

Mary Pat Campbell

Link: https://www.soa.org/sections/financial-reporting/financial-reporting-newsletter/2022/september/fr-2022-09-sun/

Graphic:

Excerpt:

Life technical risks measure the possible losses from deviations from the best estimate assumptions relating to life expectancy, policyholder behavior, and expenses. The life technical risks are captured through mortality, longevity, morbidity, and other risks. The methodology for calculating the capital adequacy for these four risk categories remains unchanged under the proposed method, apart from the recalibration of capital charges or the consolidation of defining categories within each risk. Comparing to the current GAAP based model, charges have materially increased across all categories partly due to higher confidence intervals, with notable exceptions of longevity risk, with reduced charges across all stress levels (changes applicable to U.S. life insurers are illustrated in Tables A2 to A5 in the Appendix linked at the end of this article). Please note that S&P’s current capital model under U.S. statutory basis does not have an explicit longevity risk charge. However, this article focuses on comparison to current GAAP capital model[1] that is closer to the new capital methodology framework.

For mortality risk, lower rates are charged for smaller exposures (net amount at risk (NAR) $5 billion or less) with the consolidation of size categories, but higher rates are charged for NAR between $5 billion and $250 billion, with an average increase of 49 percent for businesses under $400 billion NAR. A new pandemic risk charge (Table A3 in the Appendix linked at the end of this article) will further increase mortality related risk charges to be 109 percent higher than original mortality charges under confidence level for company rating of AA, and 93 percent higher for confidence level for company rating of A, respectively, on average (Figure 1). The disability risk charge rates increased moderately for most products, across all eight product types such that the increase of disability premium risk charges is 6 percent under confidence level for AA, and 2 percent for A, respectively. In addition, the proposed model introduced a new charge on disability claims reserve, ranging from 13.7 percent of total disability claims reserves for AAA, to 9.6 percent for BBB. However, the proposed model provides lower capital charge rates in longevity risk and lapse risk.

Author(s): Yiru (Eve) Sun, John Choi, and Seong-Weon Park

Publication Date: September 2022

Publication Site: Financial Reporting newsletter of the SOA

5 Worst States for Working-Age Deaths in August

Mary Pat Campbell

Link: https://www.thinkadvisor.com/2022/09/27/5-worst-states-for-working-age-deaths-in-august/

Graphic:

Excerpt:

The number of deaths of working-age Americans was lower in August than in August 2021, but it was still much higher than it was in August 2019, before the COVID-19 pandemic began.

Death figures for the period from July 31 through Aug. 27 are just starting to firm up. But very early figures show that at least 53,655 U.S. residents ages 25 through 64 died from COVID-19 and all other causes during that four-week period.

The number of deaths was down sharply from 77,847 in August 2021, but it was still up 6.1% from the total of 50,590 for August 2019.

Author(s): Allison Bell

Publication Date: 27 Sept 2022

Publication Site: Think Advisor

COVID-19: Audit Cites ‘Distortion, Suppression Of Facts’ In Nursing Home Reporting Under Cuomo

Mary Pat Campbell

Link: https://dailyvoice.com/new-york/northsalem/news/covid-19-audit-cites-distortion-suppression-of-facts-in-nursing-home-reporting-under-cuomo/828102/

Excerpt:

The state Health Department intentionally “misled the public” regarding the number of COVID-19 deaths in nursing homes under former New York Gov. Andrew Cuomo’s administration, according to a scathing audit from the Comptroller Thomas P. DiNapoli.

When the COVID-19 pandemic swept through New York, the Department of Health was not prepared to respond to the infectious disease outbreaks in nursing homes, according to the audit, which helped lead to the inaccurate virus-related death count in facilities.

Auditors found that health officials undercounted the death toll in nursing homes by at least 4,100 residents and at times more than 50 percent, despite claims from the former governor, who said the state was doing well in protecting seniors.

Author(s): Zak Failla

Publication Date: 17 March 2022

Publication Site: New York Daily Voice

John Hancock to Pilot 50-Cancer Detection Test

Mary Pat Campbell

Link: https://www.thinkadvisor.com/2022/09/20/john-hancock-to-pilot-50-cancer-detection-test/

Excerpt:

John Hancock wants to find out what happens when life insurance insureds get a blood test that might reveal early signs of about 50 different types of cancer.

The Boston-based Manulife subsidiary is working with Munich Re and other reinsurers to offer a pilot program that will pay either 50% or 100% of the cost of Grail’s Galleri cancer screening test for insureds in the John Hancock Vitality wellness program.

John Hancock will not get individual test results for the insureds who use the pilot program, nor will the program results affect the participants’ coverage, premiums or Vitality points.

Author(s): Allison Bell

Publication Date: 20 Sept 2022

Publication Site: Think Advisor

Covid Still Kills, but the Demographics of Its Victims Are Shifting

Mary Pat Campbell

Link: https://khn.org/news/article/covid-still-kills-but-the-demographics-of-its-victims-are-shifting/

Graphic:

Excerpt:

Californians age 75 and older made up 53% of covid deaths through July in 2022, up from 46% in 2020 and 2021. Only about 6% of the state’s residents are 75 and older. And white Californians 75 and older outnumber Latinos in that age group about 3 to 1.

In the initial vaccination rollout, California prioritized seniors, first responders, and other essential workers, and for several months in 2021 older residents were much more likely to be vaccinated than younger Californians.

“Now, the vaccination rates have caught up pretty much with everybody except for kids, people under 18,” Brewer said. “You’re seeing it go back to what we saw before, which is that age remains the most important risk factor for death.”

Author(s): Phillip Reese

Publication Date: SEPTEMBER 21, 2022

Publication Site: KFF

Will Survivors of the First Year of the COVID-19 Pandemic Have Lower Mortality?

Mary Pat Campbell

Link: https://crr.bc.edu/working-papers/will-survivors-of-the-first-year-of-the-covid-19-pandemic-have-lower-mortality/

Report: https://crr.bc.edu/wp-content/uploads/2022/08/wp_2022-10.pdf

Graphic:

Abstract:

The mortality burden of the COVID-19 pandemic was particularly heavy among older adults, racial and ethnic minorities, and those with underlying health conditions.  These groups are known to have higher mortality rates than others even in the absence of COVID.  Using data from the 2019 American Community Survey, the 2018 Health and Retirement Study, and the 2020 National Vital Statistics System, this paper estimates how much lower the overall mortality rate will be for those who lived through the acute phase of the early pandemic after accounting for this selection effect of those who died from COVID.  Such selection may have implications for life insurance and annuity premiums, as well as assessments of the financial standing of Social Security – if the selection is large enough to substantially alter projected survivor mortality.

The paper found that:

  • 10-year mortality rates, absent direct COVID deaths and long COVID, will likely be lower in 2021 than anticipated in 2019.
  • However, these differences are small, ranging from a decline of 0.4 percentage points for people in their 60s to 1 percentage point for those in their 90s.
  • The small difference is in spite of the fact that COVID mortality was, indeed, very selective, with mortality declines exceeding half the maximum possible declines, holding total COVID deaths constant, for every age group.

 
The policy implications of the findings are:

  • That declines in mortality due to COVID selection likely will not impact overall population mortality substantially enough to affect Social Security cost projections.
  • Any impact of selection effects on Social Security costs will likely be swamped by ongoing mortality increases directly attributable to acute and long COVID.

Author(s): Gal Wettstein, Nilufer Gok, Anqi Chen, Alicia H. Munnell

Publication Date: August 2022

Publication Site: Center for Retirement Research at Boston College

Social and Other Determinants of Life Insurance Demand

Mary Pat Campbell

Link: https://www.soa.org/resources/research-reports/2022/determinants-life-insurance/

Report: https://www.soa.org/4a50aa/globalassets/assets/files/resources/research-report/2022/determinants-life-insurance.pdf

Graphic:

Excerpt:

The authors examine 19 factors to determine which were most closely linked to permanent and term life insurance premiums sold in the United States in 2020. With spatial regression analysis using multi-scale geographically weighted regression (MGWR) approach, the authors find the following 5 covariates to be the most statistically significant for and positively correlated with permanent insurance sold: household income, percentage of the population that is African American, education, health insurance, and Gini index (a statistical measure of wealth inequality). For term insurance sold, the 5 most significant covariates are household income, education, Gini index, percentage of households with no vehicles, and health insurance. Their relationships with term insurance sold are positive except for the percentage of households with no vehicles.

Author(s):

Wilmer Martinez
Kyran Cupido
Petar Jevtic
Jianxi Su

Publication Date: August 2022

Publication Site: SOA

Can the CDC Repair Its Reputation?

Mary Pat Campbell

Link: https://knowledge.wharton.upenn.edu/article/can-the-cdc-repair-its-reputation/

Graphic:

Excerpt:

The Centers for Disease Control and Prevention must learn from the mistakes it made during the height of the COVID-19 pandemic if it wants to win back public trust, according to Wharton health care management professor Ingrid Nembhard.

She thinks CDC Director Rochelle Walensky is on the right path to do just that. Walensky, who was appointed by President Joe Biden in 2021, has announced a major overhaul to modernize the agency and get the public messaging right.

….

Nembhard is particularly hopeful about Walensky’s focus on changing the culture at the CDC. The infrastructure to conduct the science and disseminate the information is vital, but so is the culture. Reports have surfaced that paint the agency as clunky with a risk-averse culture.

“If you have all of the structures but nobody is speaking up, where are you?” Nembhard said. “You don’t have all the information that you need, and I think that’s been one of the realities that we’ve seen them having to deal with. You really do need to have your systems in place to be flexible, to be able to manage under ever-changing circumstances.”

Author(s): Angie Basiouny

Publication Date: 13 Sept 2022

Publication Site: Knowledge @ Wharton

2020-2021 Excess Deaths in the U.S. General Population by Age and Sex

Mary Pat Campbell

Link: https://www.soa.org/resources/research-reports/2022/excess-death-us/

Full report: https://www.soa.org/4a55a7/globalassets/assets/files/resources/research-report/2022/excess-death-us.pdf

Graphic:

Excerpt:

The data used for this analysis was provided by the CDC as of August 17, 2022 and includes incurred deaths
by week, beginning on December 29, 2019 and going through July 2, 2022. For 2020, the CDC defines Week
1 as ranging from December 29, 2019 through January 4, 2020 and Week 52 as ranging from December 19,
2020 through December 26, 2020, so when reporting on 2020 results, this convention is used. The year
2021 begins on December 27, 2020 and runs through January 2, 2022. For the purposes of this analysis, the
start of the COVID-19 active period is March 22, 2020.
Due to the delay in reporting, the actual deaths have been completed based on factors that vary by age
and sex. These are shown below along with the expectations that are based on the five-year trend after
adjusting for seasonality.

These data are as of August 17, 2022 and exclude deaths that occurred after July 2, 2022. Figure 1 shows
that, for most months, the total A/E ratio is much greater than 100%, while the A/E ratio excluding COVID19 deaths is also greater than 100% by a few percent.

Author(s): Rick Leavitt, ASA, MAAA

Publication Date: August 2022

Publication Site: Society of Actuaries Research Institute