Editorial comment: On long term care and the top 10 causes of death

September 15, 2009 at 08:00 PM
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A quick glance at the new cause-of-death figures out from the National Center for Health Statistics, Hyattsville, Md., should be a heads-up for long term care insurance practitioners.

First, the top 10 causes of death are about the same for people of all ages as for older people ages 65 and up. (See the table below for the comparison.)

Significantly, many of those causes are ones that often trigger long term care–and the need for LTC funding. Episodes of serious heart disease, cancer and diabetes come to mind.

Also worth noting is that the first four leading causes of death are identical in the All ages group and the Age 65+ group. These are diseases of the heart, malignant neoplasms (tumors), cerebrovascular diseases and chronic lower respiratory diseases.

By comparison, the top four causes of death among younger adults, ages 25 to 44, are different in significant areas–accidents rank number one, and suicide number four. (Malignant neoplasms and diseases of the heart are numbers two and three.) Suicide was not even on the older age list.

Some younger consumers might take those top four causes of death for Ages 25 to 44 as a reason not to buy LTC insurance or even think about LTC.

After all, they may reason, at least two of the top four–accidents and suicide–are often within the individual's control and, as such, are not a serious risk for the safety-minded among them. They may also point out that that many accidents and all suicides are not likely to cause a LTC event, "so, what's the problem?"

However, if these same younger adults are shown the causes of death at the older ages, they might change their tune. They may come to understand–with the advisor's help–that all top four causes of death at the older ages could be preceded by a LTC event.

A final point worth noting: From fifth place on, the older age list shows very common causes of death for elders–Alzheimer's, diabetes, influenza and pneumonia, and so on. This is not surprising.

But the ninth cause of death among older people–accidents–may be startling to some observers. After all, as the vital statistics research shows, this is the number one cause of death for younger adults who live a much more active lifestyle. How could accidents even rank in ninth place as a cause of death for older folks who are much less active?

The answer may rest with the cause of the accident.

Common knowledge attributes death by accident among younger adults to active lifestyles–theyi drive more, travel more, do more than older people.

In addition, this age group is more inclined to have accidents due to high-risk activity, adventure and/or carelessness. Most people do not think the same of older folk (although outliers do exist!).

Still, older people do have accidents, lots of them. Ask any LTC expert. The LTC lore overflows with stories about elders falling and going to hospital and then to LTC facility due to the resulting bone fractures, hip replacements and worse. And yes, death does follow sometimes. The precipitating causes are fairly mundane–decreasing vision, perhaps, or dizziness, or slips-and-falls in the home or neighborhood–but accidents are a "clear and present danger" for LTC as well as death.

Prospective LTC insurance buyers probably already know about the link between accidents and LTC and, if they don't, they should be told. But they should also be told the rest–i.e., when a good LTC program is in place, many times that helps diminish the number/severity of such accidents among older people, thereby prolonging life and increasing chances for wellbeing.

Many times, that good LTC program will include, or be buttressed by, a strong LTC policy or other insurance solution.

In LTC circles, much is made of the risk of morbidity, and of the importance of planning to protect against the consequences of that risk. But the risk of mortality is linked to that exposure. Discussing the morbidity-mortality connection may help consumers see that the LTC risk is real and worth addressing while people are still in good health.

[ To weigh in, click write to the editor or blog your comments below. ]

–Linda Koco, Managing Editor, Products and Managing Editor, e-Publications

National Underwriter Life & Health

Top 10 causes of death

All ages

Ages 24 to 44

Age 65 and up

1

Diseases of the heart

Accidents (unintentional injuries)

Diseases of the heart

2

Malignant neoplasms

Malignant neoplasms

Malignant neoplasms

3

Cerebrovascular diseases

Diseases of the heart

Cerebrovascular diseases

4

Chronic lower respiratory diseases

Intentional self-harm (suicide)

Chronic lower respiratory diseases

5

Accidents (unintentional injuries)

Assault (homicide)

Alzheimer's disease

6

Alzheimer's disease

Human immunodeficiency virus (HIV)

Diabetes mellitus

7

Diabetes mellitus

Chronic liver disease and cirrhosis

Influenza and pneumonia

8

Influenza and pneumonia

Cerebrovascular diseases

Nephritis, nephritic syndromes and nephrosis

9

Nephritis, nephritic syndromes and nephrosis

Diabetes mellitus

Accidents (unintentional injuries)

10

Septicemia

Septicemia

Septicemia

Source: Data is taken with permission from "Deaths: Preliminary Data for 2007″, an online article in the National Vital Statistics Reports, Volume 58, Number 1, August 19, 2009. The authors are Jiaquan Xu, M.D.; Kenneth D. Kochanek, M.A.; and Betzaida Tejada-Vera, B.S., all from the Division of Vital Statistics, National Center for Health Statistics, Hyattsville, Md. The article can be seen here View the article here

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