Around 50 invited guests from a range of disciplines attended the Mortality Experts Scoping Meeting on 3 March 2008 at Staple Inn. The meeting was chaired by Professor Tom Kirkwood, Director of the Institute for Ageing and Health at the University of Newcastle, who delivered the 2001 Reith Lecture, The end of age. The range of backgrounds represented by the delegates, including life companies, actuarial consultancies, research councils, charities, regulators and universities, was testimony to the avid interest the topic arouses. The objective of the meeting was to explore how gaps in current research into mortality, identified in the report ‘Scoping mortality research’ prepared by Dr Catriona Macdonald under the supervision of the Mortality Development Scoping Project Steering Group, might be identified and filled. The Project Steering Group recognises that collaboration between the actuarial profession and other disciplines will be beneficial in gaining new insights into mortality trends. 

In presenting the report Dr Macdonald acknowledged that the report did not claim to be exhaustive. The methodology of asking experts in a range of disciplines to identify what they believed were the five most important pieces of research into mortality developments at the present time ensured that the research studied would be significant and of high quality but at the same time carried the risk that the review would not be comprehensive. 

A number of key themes emerged from the literature reviewed:

• The roles which medicine has played in the decline of all-cause mortality  
• The role of lifestyle and environment  
• Factors influencing the decline of specific causes of death  
• Aspects of age-specific mortality from childhood to the oldest old  
• The extent to which the increase in life expectancy has influenced the proportion of the lifespan spent in good health  
• The ‘cohort effect’ experienced by those born between 1925 and 1945 who experience greater improvements in all-cause mortality than those cohorts born before or after.  
• Actuarial views on the future of life expectancy  

These themes in turn gave rise to a number of questions: 

• What role does medicine play in mortality decline and what role will it play in the future?  
• What causes ageing?  
• Is ageing a separate condition from disease?  
• Is ageing an underlying cause of death?  
• Is there a maximum limit to human longevity or will longevity continue to increase in the future?  

Feedback on the report identified a number of areas that should also be explored in seeking to better understand mortality developments, including diet, physical activity, alcohol consumption, dementia, lung disease, cancer, the availability of social networks and social support, and the developmental origins of health and disease. 

Feedback from breakout discussions identified the availability and quality of data as significant issues for research. Participants considered the possibility of sharing data between agencies, including whether the NHS would be prepared to share data with actuaries and whether medical researchers would be interested in analysing CMI data. It was noted that some biomedical research is not as useful as it might be because important information such as age, gender, etc, is often omitted. Cause-specific data may be suspect as practice in completing death certificates may vary between doctors. An important challenge is to estimate the impact of Government initiatives on behaviour change, for example in relation to healthy eating and smoking. The impact of such changes in behaviour, if any, on mortality experience is likely to take many years to emerge. It was pointed out that it took around 40 years for the physiological impact of smoking to be forecast with accuracy. 

Whilst there was a consensus that a cause-specific mortality model spanning all causes of mortality could be an excellent long-term objective, the attendees accepted that at this stage this is a distant goal, suggesting a need for a methodology which breaks down the project into component parts.

Recognising the practical nature of the meeting, the group then heard from a panel of users and potential funders of research, who answered questions on ‘Who needs mortality research?’ and ‘How can such research be funded?’

All participants agreed that the event had been worthwhile and had sufficient momentum to move forward. Proposed outcomes include an enhanced version of the Scoping Project report to include insights from the meeting and a high-profile multi-disciplinary conference in 2009. 

Presentations to the meeting together with Catriona Macdonald’s report can be accessed on the Profession’s website. 

For further information about the Group, contact Nicky Wilkinson: Tel: 01865 268 238; email: nicky.wilkinson@actuaries.org.uk.

Sally Grover
Knowledge Services Manager