Iowa Actuaries Education Day: U.S. Mortality Trends Short-Term and Long-Term -- The Summary
A quick transcript from Otter, graphs, and presentation PDF for download
Howdy! I gave a talk for the Iowa Actuaries Club yesterday, on U.S. general population mortality trends, short-term (2019-2024) and long-term (1900-2024).
The presentation ran for an hour, and I have a very raw transcript of that. I hope to do shorter videos of sections of the much larger presentation (which is 90+ slides — I edited down that presentation to fit within an hour) as I did a few years ago.
Let me focus on the summary and I will pull a few graphs as well.
Overview of the Presentation
Mary Pat Campbell presented on U.S. mortality trends post-pandemic, highlighting data from the CDC and Social Security Administration. She noted that while overall mortality rates have stabilized since 2019, specific age groups and causes of death show significant variations. Heart disease and cancer mortality rates have fluctuated, with some improvements and setbacks. Notably, drug overdoses and motor vehicle accidents increased by 35% from 2019 to 2021. Stroke and chronic lower respiratory disease deaths also surged. Campbell emphasized the importance of considering long-term trends and potential interactions with COVID-19 in mortality projections.
The above is the overview provided by Otter, which is the transcription service I use.
Though it did pull out the high-level stat on drug ODs and motor vehicle accident deaths, I explicitly did not focus on those in the talk. BOO, Otter, BOO!
That said, those are important causes of death that have had a huge impact among younger adults, and I did mention it at key points in my talk, so maybe Otter was smarter than I am. So, maybe, yay Otter.
Here is a key graph from the presentation:
I will take a little time on this graph, because a version of this graph is one I use over and over.
I keep comparing recent mortality experience against 2019, as that was the last “normal” year before the pandemic. But also because 2019 was a boring death year: no major natural catastrophes in the U.S., no bad seasonal flu, nothing weird (as far as we knew) going on.
Some people like to define the metric I’m graphing as “excess mortality”, but I’m seriously just saying it’s the change. There’s no “natural” level of mortality, so there’s no great way to define “excess mortality”.
I emphasized 2023 in the above graph because that is the last year I have finalized data for. The data for 2024 are provisional, and there are reasons not to fully trust that data yet.
I’ve de-emphasized the data for 2020-2022 (pandemic years), because as an actuary, I need to think about where the risk may be going.
Not where it used to be.
The concerning ages are these: the younger adults, around ages 25-44, which have demonstrated heightened mortality compared to 2019. Also over age 85.
Yes, quite a bit of that is due to drug overdoses and motor vehicle accident deaths for the younger adults. But there are natural causes of death that are heightened among those ages.
For older ages, there are other causes.
Summary Outline of the Talk
Here is what Otter gave as the talk outline. I will salt a few of the graphs within.
Overview of Mortality Trends
Mary Pat Campbell starts with a high-level view of mortality trends, comparing 2024 provisional statistics to 2019.
She explains the crude death rate and age-adjusted death rate, noting the impact of aging baby boomers and the pandemic.
Discussion on the seasonality of mortality, with a focus on the impact of flu and pneumonia deaths.
Comparison of 2023 and 2024 mortality rates to 2019, highlighting the ongoing impact of the pandemic.
Age-Specific Mortality Rates
Mary Pat Campbell presents mortality rates by age group, noting the highest rates among infants and the lowest among children.
Discussion on the impact of the pandemic on different age groups, with a particular focus on younger adults.
Explanation of the use of logarithmic scales to present mortality rates.
Analysis of the causes of death, including natural causes, external causes, and the impact of the pandemic.
Causes of Death: Natural vs. External
Mary Pat Campbell discusses the major categories of causes of death: natural (physiological) and external (suicide, homicide, accidents).
Explanation of the data quality issues with external causes of death, including the undercount of deaths and the impact of censoring.
Analysis of the impact of the pandemic on external causes of death, with a focus on drug overdoses and motor vehicle accidents.
Discussion on the long-term trends in external causes of death, including the impact of falls among seniors.
Impact of COVID-19 on Mortality
Mary Pat Campbell provides a short-term view of COVID-19's impact on mortality, comparing 2020 to 2021 and 2023.
Explanation of the pull-forward effect, where older, more vulnerable individuals died in 2020, reducing deaths in 2021.
Discussion on the impact of vaccination rates on mortality, with older individuals being vaccinated first.
Analysis of the long-term trends in mortality, including the impact of other respiratory diseases like flu and RSV.
Long-Term Mortality Trends
Mary Pat Campbell presents a long-term view of mortality trends, comparing data from 1900 to 2018.
Discussion on the impact of smoking on heart disease and cancer rates, with a focus on the history of smoking in the US.
Analysis of the trends in heart disease and cancer, noting the stalling out of improvements in recent years.
Explanation of the impact of lifestyle factors, including diet and obesity, on mortality trends.
Specific Causes of Death: Heart Disease and Cancer
Mary Pat Campbell provides a detailed analysis of heart disease and cancer mortality trends.
Discussion on the impact of the pandemic on heart disease mortality, with a focus on ischemic heart disease among younger adults.
Analysis of cancer trends, including the impact of early-onset cancers and the role of lung cancer in driving overall trends.
Explanation of the impact of treatment and screening on cancer mortality, with a focus on the disruptions caused by the pandemic.
Selected Causes of Death: Stroke and Diabetes
Mary Pat Campbell presents selected causes of death, including stroke and diabetes, and their impact during the pandemic.
Analysis of the increase in stroke deaths, particularly among younger adults and older seniors.
Discussion on the impact of chronic lower respiratory disease and flu and pneumonia, with a focus on the substitution effect of COVID-19.
Analysis of the increase in diabetes deaths, particularly among younger adults, and the potential impact of COVID-19.
Life Expectancy and Public Health Improvements
Mary Pat Campbell presents data from the Social Security Administration on life expectancy trends from 1900 to 2021.
Discussion on the impact of public health improvements, including clean water and vaccines, on life expectancy.
Analysis of the stalling out of life expectancy improvements in recent years, with a focus on obesity and lifestyle factors.
Explanation of the impact of the pandemic on life expectancy, with a focus on the short-term and long-term effects.
Insurance Collaboration and Future Considerations
Mary Pat Campbell introduces the Insurance Collaboration to Save Lives initiative, focusing on the impact of non-COVID increased mortality.
Discussion on the potential for actuaries to be more proactive in addressing mortality and morbidity risks.
Analysis of the impact of accidental morbidity and mortality on workers' compensation and other insurance sectors.
Encouragement for actuaries to consider stress scenarios and potential risks in their modeling and projections.
Conclusion and Q&A
Mary Pat Campbell concludes her presentation, emphasizing the importance of considering all possible cause-effect interactions in mortality projections.
Discussion on the impact of the pandemic on group life insurance and the need for conservative modeling assumptions.
Q&A session with the audience, addressing questions about the assumptions and stress scenarios in mortality modeling.
Mary Pat Campbell provides contact information for further inquiries and resources, including her substack and the Insurance Collaboration to Save Lives initiative.
