June 26, 1991

Medical Risks: Trends in Mortality by Age and Time Elapsed

Author Affiliations

UNUM Life Insurance Co Portland, Me

UNUM Life Insurance Co Portland, Me


vols 1 & 2, edited by Edward A. Lew and Jerzy Gajewski (reference volumes sponsored by the Association of Life Insurance Medical Directors of America and The Society of Actuaries), various pagination, $195, ISBN 0-275-93786-0, New York, NY, Praeger, 1990.

JAMA. 1991;265(24):3316-3317. doi:10.1001/jama.1991.03460240114043

Many physicians think of "medical risks" in terms of the risk of accident or the risk of an untoward clinical outcome, or perhaps the lung cancer risk of a heavy smoker. Insurance physicians and actuaries use the term more broadly, as an idiom for medical impairments, conditions or risk factors with morbidity or premature mortality implications. This extensive two-volume document focuses on the latter concept.

Similarly, while practicing physicians talk about survival rates, this document homes in on mortality ratios (100 × number of deaths in interval/number of expected deaths) and excess death rates per 1000 per year (1000 × the difference between observed and expected number of deaths per person-years of exposure).

Why the difference? A 95% five-year survival rate for a group of 30-year-olds treated for a particular type of cancer sounds pretty good to clinicians (especially given