Mortality Trends in Transition? - Global Insights and Lessons from COVID-19 and Past Pandemics

What happens to mortality after a pandemic? This presentation dives into the data and tries to answer the question: Are we returning to pre-pandemic trends, or has COVID-19 changed the trajectory of mortality permanently? By not only tracking headline trends but also dissecting the underlying causes behind improvements, we aim to provide a nuanced understanding of what truly drives changes in mortality across countries and populations.

Before focusing on the COVID-19 pandemic, we analyze four decades of mortality improvements across major economies, using the survival probability 35p30—a measure that, unlike life expectancy, focuses specifically on the typical insured ages 30 to 65. This approach allows for a targeted comparison of trends in France, Germany, Switzerland, the UK, the USA, Japan, and others, highlighting both remarkable progress and persistent gaps.

For selected countries, a deeper analysis by cause of death reveals how the drivers of mortality improvement have shifted over time. In developed countries, the reduction in cardiovascular mortality was the main driver of improvement for decades, but its contribution has recently declined, giving way to cancer as the leading contributor. This underscores the potential for both further gains and the risk of stagnation or reversal of future trends.

Turning to the COVID-19 pandemic, we place its impact in historical context by comparing it to previous global outbreaks, such as the Spanish, Asian, and Hong Kong Flu. Historical analysis demonstrates that while pandemics can cause sharp but temporary increases in mortality, populations have typically returned to pre-pandemic trends within a few years. However, the COVID-19 pandemic’s impact on insured ages appears more persistent in some countries, notably the UK, where excess mortality remains elevated even after the acute phase. We are studying the drivers of this excess and also examine the indirect effects of the pandemic, from healthcare system strain and delayed treatments to rising alcohol-related deaths and behavioral changes, which may have long-term consequences for population health.

The presentation further discusses the differences between the general population and insured portfolios. Individual underwriting and group insurance characteristics tend to filter out higher-risk individuals, meaning insured portfolios may fare differently from the general population.