Macro Trends in Health and Employment

1
Macro Trends in Health and Employment

• Susan Ring Chief Executive Officer

2
Improving The Health of the Nation

• Cancer static at around 200/100,000 (ageing
  population)
• Infections negligible

Source Office of National Statistics (UK)
3
Improving The Health of the Nation

• Health Status in 2001 gt 80 of people in 45-59
  60-74 yr age groups report good/fairly good
  health

Source Office of National Statistics (UK)
4
Self-Reported Activity Restriction by Sex
Percentage Reporting Restrictions
Year
Source Office of National Statistics
5
Increased Common Health Complaints
Three year incidence () of symptoms in general
practice
Source Kroenke Mangelsdorff 1989
6
Claims Trends
Source Unum
7
Incapacity Benefit Growth 1979-2001
Source Department for Work and Pensions (UK)
8
Incapacity Benefit Recipients by Diagnosis Group
November 2003
February 2001
Source Department for Work and Pensions (UK)
9
The Bio-Psychosocial Model
SOCIAL Workplace and wider societal issues
PSYCHO- Individual psychological factors
An individual-centred model that takes account of
the person, their health problem, and their
environment.
BIO- The medical condition
10
The Population is Ageing
Source Office of National Statistics (UK)
11
The Population is Ageing
Source Office of National Statistics (UK)
12
The Age Tsunami
The baby boom years 1946 - 1964
Source US Census Bureau. Approximate data shown.
13
Predominance of Older Workers
Percent Growth in U.S. Workforce by Age 2000-2020
Source US Census Bureau International Database
14
Retirement Expectations
50 of a Sample of Boomers Indicated Retiring
Past Age 65 or not at all.
At what age do you plan to retire?
Source The New Employee/Employer Equation, the
Concours Group and Age Wave, 2004
15
Is Ageing Always Unproductive?
Traditional View
Productive Ageing View
Source Retire Retirement, Rekindle Careers,
Retain Talent, Dychtwald, Erickson, and
Morrison, 2005
16
U.S. Labor Force Growth Will Continue to Decline
Percentage Change (5-Year Moving Average)
Source GAO analysis of data from Office of the
Chief Actuary, Social Security Administration.
Approximate data shown.
17
A Growing Shortage of U.S. Workers
Expected Labour Force and Labour Force Demand
Palpable by the End of this Decade
Source Employment Policy Foundation analysis and
projections of Census/BLS and BEA Data.
Approximate data shown.
18
Healthcare Costs by Age and Risk
Source Musich, McDonald, Hirschland, Edington,
Disease Managements Health Outcomes 2002
10(4) 251-258 University of Michigan Health
Management Research Center. Used with permission.
19
Ageing Impact on Long Term Disability Incidence
Median Age (Increasing 5 Months per year)
Source Unum Disability Database
20
Obesity in the USA
Percentage of Adults Who Report Being Obese by
State
21
Mortality Obesity
Mortality Ratio with Increasing Weight Relative
to Average Weight
Source National Health Nutrition Examination
Surveys (UK)
22
Alcohol
23
Alcohol

• Injuries
• Alcoholism
• Liver disease
• Brain damage
• Heart disease
• Depression

24
Increasing Deaths From Alcohol-Related Illnesses
Source Office of National Statistics (UK)
25
Industry Issues and Implications
Increase in overall physical health but current
increase in prevalence of common health problems

• Different approach to medical underwriting
• Relevance of the current Critical Illness product
• Healthcare requirements shift to mental health/
  common health complaints
• Increased need for service solutions and advice
• Departure from traditional family-orientated
  benefits
• Increase in flex, voluntary and supplemental
  benefits
• Different approach to disability claims
  management
• Incapacity definitions
• Product designs
• Early intervention return to work strategies
• Fresh look at Long-Term Care

26
A Final Warning!
If we do not allow the productivity of the new
older workforce, we will have

• Roaming bands of bored, annoyed, grumpy,
  unemployed and sexually active elders
• Leading to public displays of
• Affection
• Social upheaval
• Overall mayhem
• It wont be pretty!

27

• Susan Ring

28
Improving The Health of the Nation

• Cancer static at around 200/100,000 (ageing
  population)
• Infections negligible

Source Office of National Statistics (UK)
29
Improving The Health of the Nation

• Health Status in 2001 gt 80of people in 45-59
  60-74 yr age groups report good/fairly good
  health

Source Office of National Statistics (UK)
30
Self-Reported Activity Restriction by Sex
Percentage Reporting Restrictions
Year
Source Office of National Statistics
31
Increased Common Health Complaints
Three year incidence () of symptoms in general
practice (Total and with organic cause). Source
Kroenke Mangelsdorff 1989
32
Claims Trends
Source Unum
33
IB Growth 1979-2001
Source Department for Work and Pensions (UK)
34
IB Recipients by Diagnosis Group
February 2001
Source Department for Work and Pensions (UK)
35
IB Recipients by Diagnosis Group
November 2003
Source Department for Work and Pensions (UK)
36
The Bio-Psychosocial Model
SOCIAL Workplace and wider societal issues
PSYCHO- Individual psychological factors
An individual-centred model that takes account of
the person, their health problem, and their
environment.
BIO- The medical condition
37
The Population is Ageing
Source Office of National Statistics (UK)
38
The Population is Ageing
Source Office of National Statistics (UK)
39
The Age Tsunami
The baby boom years 1946 - 1964
Source US Census Bureau. Approximate data shown.
40
Continuing for Our Working Lives
Percent Growth in U.S. Workforce by Age 2000-2020
Source US Census Bureau International Database
41
Retirement Expectations
50 of a Sample of Boomers Indicated Retiring
Past Age 65 or not at all.
At what age do you plan to retire?
Source The New Employee/Employer Equation, the
Concours Group and Age Wave, 2004
42
Is Ageing Always Unproductive?
Traditional View
Productive Ageing View
Source Retire Retirement, Rekindle Careers,
Retain Talent , Dychtwald, Erickson, and
Morrison, 2005
43
U.S. Labor Force Growth Will Continue to Decline
Percentage Change (5-Year Moving Average)
Note Percentage change is calculated as a
centered 5-year moving average of projections
based on the intermediate assumptions of the 2005
Trustees Reports
Source GAO analysis of data from Office of the
Chief Actuary, Social Security Administration.
Approximate data shown.
44
A Growing Shortage of U.S. Workers
Expected Labour Force and Labour Force Demand
Palpable by the End of this Decade
Source Employment Policy Foundation analysis and
projections of Census/BLS and BEA Data.
Approximate data shown.
45
A Growing Shortage of U.S. Workers
Expected Labour Force and Labour Force Demand
Palpable by the End of this Decade
Source Employment Policy Foundation analysis and
projections of Census/BLS and BEA Data.
Approximate data shown.
46
Healthcare Costs by Age and Risk
Source Musich, McDonald, Hirschland, Edington,
Disease Managements Health Outcomes 2002
10(4) 251-258 University of Michigan Health
Management Research Center. Used with permission.
47
Healthcare Costs by Age and Risk and Ageing
Impact on LTD Incidence
Source Unum Disability Database and Musich,
McDonald, Hirschland, Edington, Disease
Managements Health Outcomes 2002 10(4)
251-258 University of Michigan Health Management
Research Center. Used with permission.
48
Ageing Impact on LTD Incidence
Source Unum Disability Database
49
Obesity in the USA
Percentage of Adults Who Report Being Obese, by
State
Source ????
50
Mortality Obesity
Mortality Ratio with Increasing Weight Relative
to Average Weight
Source National Health Nutrition Examination
Surveys (UK)
51
Alcohol
Source ????.
52
Alcohol

• Injuries
• Alcoholism
• Liver disease
• Brain damage
• Heart disease
• Depression

53
Increasing Deaths From Alcohol-Related Illnesses
Source Office of National Statistics (UK)
54
Industry Issues and Implications
Increase in overall physical health but current
increase in prevalence of common health problems

• Different approach to medical underwriting
• Relevance of the current CI product
• Healthcare requirements shift to mental health
  common health complaints
• Increased need for service solutions and advice
• Departure from traditional family-oriented
  benefits
• Increase in fees, voluntary and supplemental
  benefits
• Different approach to disability claims
  management
• Incapacity definitions
• Product designs
• Early intervention return to work strategies
• Fresh look at LTC

55
A Final Warning!
If we do not know the productivity of the new
older workforce, we will have

• Roaming bands of bored, annoyed, grumpy,
  unemployed and sexually active elders
• Leading to public displays of
• Affection
• Social upheaval
• Overall mayhem
• It wont be pretty!