Mortality and Morbidity Liaison Committee--ISCS body mass index study

Area of Science:

• Actuarial science
• Public health
• Epidemiology

Background:

• Limited data exists on insured mortality for elevated Body Mass Index (BMI).
• Underwriting practices have evolved, impacting the classification of individuals by build.
• Understanding mortality risk associated with BMI in insured populations is crucial for actuarial assessments.

Purpose of the Study:

• To analyze the association between Body Mass Index (BMI) and mortality within an insured population.
• To specifically examine BMI's impact in isolation from other health risk factors.
• To provide updated mortality experience data for individuals with abnormal build.

Main Methods:

• Utilized the Impairment Study Capture System (ISCS) data from 241,966 policies (1989-2003).
• Calculated actual Body Mass Index (BMI) for insured individuals with abnormal build codes.
• Computed Standardized Mortality Ratios (SMR) using the 2001 Valuation Basic Table (VBT) as the expected basis.

Main Results:

• Standardized mortality ratios (SMR) increased with rising BMI, particularly at extreme ranges (<18.5 and >=40.0).
• Nonsmoker policies with elevated BMI as the sole impairment showed significantly higher SMRs.
• The presence of other impairments altered SMR patterns in moderate to severe obesity ranges.

Conclusions:

• Excess mortality is evident at both underweight and severely obese BMI ranges, especially when BMI is the primary impairment.
• The study provides a reference for the mortality experience of insured individuals with elevated BMI compared to standard policies.
• The observed mortality experience may be influenced by the construction of the standard Valuation Basic Table (VBT).