Summary
Obesity is regarded by insurance companies as a substantial risk for both life and disability policies. This risk increases proportionally with the degree of obesity. Mortality statistics for life insurance were the earliest indicator that the cost of obesity to the individual was a decreased life span and increased illness, particularly that affecting the cardiovascular and musculoskeletal systems.
The prevalence of coronary heart disease rises with increases in the body mass index in both men and women. Cigarette smoking greatly augments these risks in both sexes. Hypertension and diabetes are very common in obese persons and add further to the risks of vascular disease. Abdominal obesity (when the abdominal girth measured round the umbilicus exceeds the maximum measurement round the hips) is correlated with the risk of cardiac disease and stroke, independently of bodyweight. Insurance companies consider abdominal obesity as unfavourable and rate it accordingly.
Obesity (even that of moderate degree) greatly increases the chances of disability due to cardiovascular disease or musculoskeletal illness. In one study of 51 522 adult Finns, 25% of disability pensions in women were found to result directly from obesity.
Obesity causes increased health expenditure, decreased life span and productivity, and premature retirement. Insurance companies are compelled to build these risks into their policies. However, because the excess mortality occurs late in mild to moderate obesity, some companies may minimise this risk for life policies that mature early.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Andres R, Elahi D, Tobin JD, Muller DC, Brant L. Impact of age on weight goals. Annals of Internal Medicine 103: 1030–1033, 1985
Blood Pressure Study 1979. New York: Society of Actuaries/Association of Life Insurance Medical Directors of America, 1980
Brackenridge RDC, Baird IMcL. Build. In Brackenridge & Elder (Eds) Medical selection of life risks, 3rd ed., pp. 212–216, Stockton Press, New York and MacMillan Publishers, Basingstoke, 1992
Build and Blood Pressure Study 1959. Society of Actuaries, Chicago, 1959
Build Study 1979. Society of Actuaries/Association of Life Insurance Medical Directors of America, New York, 1980
Dawber TR. The Framingham study. The epidemiology of arteriosclerotic disease. Harvard University Press, Cambridge, MA, 1980
Diet and Health. National Academy of Sciences Press, Washington DC: National Academy of Sciences Press, 1991
Dietary and Nutritional Survey of British Adults by the Office for Population Census and Surveys. HMSO, London, 1980
Doll R, Hill AB. Mortality in relation to smoking: ten years observation of British doctors. Concluded. British Medical Journal 1: 1460, 1964
Fitzgerald AP, Jarrett RJ. Body weight and coronary heart disease mortality: an analysis in relation to age and smoking habit. International Journal of Obesity 16: 119–123, 1992
Health of the Nation. HMSO, London, 1992
Kannel WB, McGee DL. Diabetes and cardiovascular disease. The Framingham study. Journal of the American Medical Association 241: 2035–2038, 1979
Kjelsberg MO. Mortality after 10.5 years for hypertensive participants in the Multiple Risk Factor Intervention Trial. Circulation 82: 1616–1628, 1990
Kemsley WFF, Billewicz WZ, Thomson AM. A new weight for height standard based on British anthropometric data. British Journal of Preventive and Social Medicine 16: 189–195, 1962
Larsson B. Regional obesity as a health hazard in men: prospective studies. Acta Medica Scandinavica (Suppl. 723): 45–52, 1988
Lew EA. Relative mortality of insured lives. Transactions of the Association of Life Insurance Medical Directors of America 64: 123, 1980
Lew EA, Garfinkel L. Variation in mortality by weight among 750,000 men and women. Journal of Chronic Diseases 32: 563–576, 1987
Manson JAE, Colditz GA, Stampfer MJ, et al. A prospective study of obesity and risk of coronary heart disease in women. New England Journal of Medicine 322: 882–889, 1990
McKeigue PM, Shah B, Marmot MG. Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet 337: 382–386, 1991
Metropolitan Life Insurance Company Statistical Bulletin, New York, Jan–June 2–9, 1983
National Institutes of Health Consensus Development Panel. Health implications of obesity, National Institutes of Health Development Conference Statement. Annals of Internal Medicine 103: 1073–1077, 1985
Rissanen A, Heliovaara M, Knekt P, et al. Risk of disability and mortality due to overweight in a Finnish population. British Medical Journal 301: 835–837, 1990
Specialised Mortality Investigation. Actuarial Society of America, 1903
Stewart AL, Brook RH. Effects of being overweight. American Journal of Public Health 7: 171–178, 1983
United States Department of Health, Education and Welfare. Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service, 1979
Vanltallie TB, Lew EA. Overweight and underweight. In Lew EA & Gajewski J (Eds) Medical risks: trends in mortality by age and time elapsed, Praeger Press, New York, 1990
Vogt MT, et al. Prevalence and correlates of lower extremity arterial disease in elderly women. American Journal of Epidemiology 137: 559–568, 1993
Wadden TA, Stunkard AJ. Social and psychological consequences of obesity. Annals of Internal Medicine 103: 1062–1067, 1985
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Baird, I.M. Obesity and Insurance Risk. Pharmacoeconomics 5 (Suppl 1), 62–65 (1994). https://doi.org/10.2165/00019053-199400051-00013
Published:
Issue Date:
DOI: https://doi.org/10.2165/00019053-199400051-00013