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By Dr. Michael Fulks, MD

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Bad news for actuaries: according to the latest from the US Journal of the American Medical Association, mortality rates for people aged 25–64 have risen steadily for the past decade, with corresponding reduction in overall life expectancy. What is causing this alarming change?


Non-Hispanic whites still lead the increase, but almost all ethnic groups are impacted. This increase is largely limited to the US, and impacts men slightly more than women with no signs of lessening. In terms of location, mortality for this age band has increased the most in Maine and New Hampshire and Ohio through West Virginia (20% increase), while the West coast has done better but no area has escaped (5% overall).


Data on cause, age, sex, ethnicity and state, show drugs (think opioids), alcohol and suicide are leading causes of the increase. For the older half of the surveyed group, diabetes and hypertension are also contributing causes. To date no single cause has been identified but increasing socio-economic stress and the obesity epidemic are likely factors aggravated by the more recent availability of high-potency, potentially lethal, narcotics.


Self-selection and underwriting may protect the life insurance industry somewhat; but by how much, and for how long, are open questions. Protection is available against some of the risk by expanded opioid and alcohol testing and by diabetes screening and possibly by non-medical risk scoring. The former two are available directly from CRL, and are active areas of research and publication, while the latter can be transmitted through CRL.

Contact CRL at today to learn more about Smart Score and how to utilize it in your insurer and underwriting efforts in 2020.


Woolf, Steven, Schoomaker, Heidi. Life expectancy and mortality rates in the United States, 1959–2017. JAMA. 2019;332:1996–2016.

About the Author

Michael Fulks, MD, Consulting Medical Director, is board-certified in internal and insurance medicine. After leaving practice, he served as a medical director, creating or editing several underwriting manuals and preferred programs. For the past 8 years, Dr. Fulks has consulted for CRL, participating in its mortality research on individual tests and all laboratory test results, BP and build in combination. He is also involved in the development and implementation of automated screening tools for non-laboratory data.

Tags: Drug Test, Life Insurance, Mortality, Underwriting