decline. The combined effect created an
elderly care shortage that led to the increase in mortality soon after.
In addition, many retirement accounts were adversely affected during
the recession. In this climate, informal
care should play a larger part than usual
in retirement, compounding its impact
during economic recovery.
Economic recovery can also cause
mortality increase for the working population. [ 7, 8] Economic expansions are
associated with reduction in sleep and
increase in alcohol consumption, overtime, and work stress. 8 These factors
have adverse impacts on health, especially for those with chronic diseases.
Less-experienced new hires may also
have higher likelihood of injuries.
Post-recession mortality is often ob-
served after major economic recessions.
The 2015 mortality increase is such
an example after the most severe sys-
temic economic recession since World
War II. There are multiple reasons for
this mortality increase. Some, such as
flu, are random in nature. Drug poison-
ing is concerning but remains relatively
small. Others, including obesity, smok-
ing cessation, and dementia are unlikely
to vary greatly from year to year. These
headwinds only partially explain the dis-
ruptive mortality increase in 2015.
If history can be a guide, however, this
effect will be short-lived. Post-recession
mortality following the Great Depression
lasted two to four years. We will likely see
mortality return to its downward trend
soon. When we as actuaries set mor-
tality-related assumptions, we should
of course consider the clear increase in
2015, but it alone does not mean a rever-
sal of overall mortality improvement.
We should also identify the
headwinds against future mortality im-
provement. Decreasing benefits from
smoking cessation, increasing obesity,
and many other factors will weigh down
improvement. After the Great Recession,
the decline in government social care
spending continues to impact mortal-
ity improvement. In fact, the worsening
mortality in middle-aged white Ameri-
cans showed alarming signs for certain
On the other hand, medical advances
continue to reveal new and promising
fronts. Segments of the population are
improving their lifestyle behaviors with
increased awareness on health, all fa-
cilitated by quickly evolving electronic
devices. In a few years, the 2015 mortality
increase will likely be seen as a blip on the
mortality trend. We will likely discuss less
whether mortality will keep improving in
the foreseeable future and more about the
magnitude of the improvement.
LI LIU, MAAA, FSA, PHD, is a director
and actuary at Prudential Financial.
XIAOXUE LIU is a senior associate at
AUSTIN KROMPASKY, MAAA,
ASA, is a senior actuarial associate at
[ 1] “Final Flu Vaccine Effectiveness Data
Published”; Public Health England;
Sept. 11, 2015.
[ 2] “Recorded Dementia Diagnoses”; U.K.
Health and Social Care Information
[ 3] The State of Obesity—Better Policies for
a Healthier America. Retrieved on Feb.
7, 2017, from stateofobesity.org.
[ 4] “Statistics on obesity, physical activity
and diet: England, 2015”; Lifestyles
Statistics Team, U.K. Health and Social
Care Information Centre; 2015.
[ 5] “Rising morbidity and mortality in
midlife among white non-Hispanic
Americans in the 21st century”;
Proceedings of the National Academy of
Sciences of the United States of America;
[ 6] “The Economic Depression and Public
Health Memorandum Prepared by the
Health Section” League of Nations;
Quarterly Bulletin of the Health
[ 7] “Increasing mortality during the
expansions of the U.S. economy,
1900-1996”; International Journal of
[ 8] “Life and death during the Great
Depression” Proceedings of the National
Academy of Sciences of the United States
of America; 2009.
[ 9] “Episodes of Systemic and Borderline
Financial Crises”; World Bank; 2003.
[ 10] “National Health Expenditures 2015
Highlights”; Centers for Medicare &
Medicaid Services; 2016.
[ 11] Valuing Carers 2011: Calculating the
value of carers’ support; Centre for
International Research on Care, Labour
& Equalities; 2011.
[ 12] “The 1918 Influenza Epidemic’s Effects
on Sex Differentials in Mortality in the
United States”; Population and
Development Review; 2000.
FIGURE 4. U.K . national informal adult care output and older
Informal Adult Care Output
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014