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Mortality Risk of Low BMI in Life Insurance Applicants
Steven J Rigatti1, Robert Stout1
1Author Affiliations: Rigatti - Founder, Rigatti Risk Analytics, LLC, Consultant Medical Director, Clinical Reference Laboratories, Lenexa KS. Stout - Chief Scientific Officer/Laboratory Director, Clinical Reference Laboratories, Lenexa KS.
Journal of Insurance Medicine (New York, N.Y.)
|May 27, 2024
Summary
Low body mass index (BMI) increases mortality risk in healthy life insurance applicants over age 50. This risk varies by age and sex, with no increased mortality detected in individuals under 40.
Area of Science:
- Epidemiology
- Biostatistics
- Public Health
Background:
- Low body mass index (BMI) is linked to increased mortality.
- Previous research indicates a higher mortality risk for individuals with low BMI compared to those with normal BMI.
Purpose of the Study:
- To quantify the mortality risk associated with low body mass index (BMI) in life insurance applicants.
- To assess the impact of low BMI on mortality among individuals deemed otherwise healthy based on laboratory profiles.
Main Methods:
- Analysis of over 4.7 million life insurance applicants' BMI data from 1995-2021.
- Utilized Cox proportional hazards models, treating BMI as both continuous and categorical variables.
- Vital status was determined using the Social Security Death Master File, controlling for age and sex, and excluding individuals with abnormal lab results.
Main Results:
- Low BMI showed a strong association with increased mortality in both sexes aged 50 and above.
- Specific low BMI categories (below 1st-10th percentiles) were significantly linked to elevated mortality in men and women aged 40-80.
- No elevated mortality risk was observed for individuals under 40 with low BMI.
Conclusions:
- Low body mass index (BMI) is associated with increased mortality in healthy life insurance applicants.
- The association between low BMI and mortality is age-dependent.
- Risk stratification for low BMI in life insurance underwriting requires consideration of age and sex.
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