Cohort Mortality Risk or Adverse Selection in the UK Annuity Market?

2013 ◽  
Author(s):  
E. S. Cannon ◽  
Ian Tonks
Keyword(s):  
Adverse Selection ◽  
Mortality Risk ◽  
Annuity Market ◽  
The Uk

scholarly journals 699 Sleep Health Traits and COVID-19: Mortality Risk from the UK Biobank

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A273-A273
Author(s):  
Xi Zheng ◽  
Ma Cherrysse Ulsa ◽  
Peng Li ◽  
Lei Gao ◽  
Kun Hu
Keyword(s):  
Risk Factors ◽  
Sleep Apnea ◽  
Sleep Duration ◽  
Sex Education ◽  
Mortality Risk ◽  
Self Report ◽  
Severe Illness ◽  
Uk Biobank ◽  
Sleep Health ◽  
The Uk

Abstract Introduction While there is emerging evidence for acute sleep disruption in the aftermath of coronavirus disease 2019 (COVID-19), it is unknown whether sleep traits contribute to mortality risk. In this study, we tested whether earlier-life sleep duration, chronotype, insomnia, napping or sleep apnea were associated with increased 30-day COVID-19 mortality. Methods We included 34,711 participants from the UK Biobank, who presented for COVID-19 testing between March and October 2020 (mean age at diagnosis: 69.4±8.3; range 50.2–84.6). Self-reported sleep duration (less than 6h/6-9h/more than 9h), chronotype (“morning”/”intermediate”/”evening”), daytime dozing (often/rarely), insomnia (often/rarely), napping (often/rarely) and presence of sleep apnea (ICD-10 or self-report) were obtained between 2006 and 2010. Multivariate logistic regression models were used to adjust for age, sex, education, socioeconomic status, and relevant risk factors (BMI, hypertension, diabetes, respiratory diseases, smoking, and alcohol). Results The mean time between sleep measures and COVID-19 testing was 11.6±0.9 years. Overall, 5,066 (14.6%) were positive. In those who were positive, 355 (7.0%) died within 30 days (median = 8) after diagnosis. Long sleepers (>9h vs. 6-9h) [20/103 (19.4%) vs. 300/4,573 (6.6%); OR 2.09, 95% 1.19–3.64, p=0.009), often daytime dozers (OR 1.68, 95% 1.04–2.72, p=0.03), and nappers (OR 1.52, 95% 1.04–2.23, p=0.03) were at greater odds of mortality. Prior diagnosis of sleep apnea also saw a two-fold increased odds (OR 2.07, 95% CI: 1.25–3.44 p=0.005). No associations were seen for short sleepers, chronotype or insomnia with COVID-19 mortality. Conclusion Data across all current waves of infection show that prior sleep traits/disturbances, in particular long sleep duration, daytime dozing, napping and sleep apnea, are associated with increased 30-day mortality after COVID-19, independent of health-related risk factors. While sleep health traits may reflect unmeasured poor health, further work is warranted to examine the exact underlying mechanisms, and to test whether sleep health optimization offers resilience to severe illness from COVID-19. Support (if any) NIH [T32GM007592 and R03AG067985 to L.G. RF1AG059867, RF1AG064312, to K.H.], the BrightFocus Foundation A2020886S to P.L. and the Foundation of Anesthesia Education and Research MRTG-02-15-2020 to L.G.

scholarly journals COVID-19: the relationship between perceptions of risk and behaviours during lockdown

2020 ◽  
Author(s):  
Richard Douglas Brown ◽  
Lynne Coventry ◽  
Gillian V Pepper
Keyword(s):  
Mortality Risk ◽  
Perceived Risk ◽  
Risk Perceptions ◽  
Health Behaviours ◽  
Unintended Consequences ◽  
Perceptions Of Risk ◽  
Extrinsic Mortality ◽  
Nationally Representative ◽  
The Uk ◽  
Threat To Life

Background Understanding COVID-19 risk perceptions and their impact on behaviour can improve the effectiveness of public health strategies in the future. Prior evidence suggests that, when people perceive uncontrollable risks to their health, they are less likely to make efforts to protect their health in those ways which they can control (e.g. through diet, exercise, and limiting alcohol intake). It is therefore important to understand the extent to which the threat of COVID-19 is perceived to be an uncontrollable risk, and to assess whether this perceived risk is associated with differences in health behaviour. MethodsWe surveyed a nationally representative sample of 496 participants, shortly after the peak of the pandemic in the UK. We collected data to assess people’s perceptions of COVID-19-related risk, and how these perceptions were associated with behaviours. We examined self-reported adherence to behaviours recommended by the UK Government and National Health Service to prevent the spread of the virus, as well as more general health behaviours. We predicted that increased perceived extrinsic mortality risk (the portion of a person’s mortality risk which they perceive to be uncontrollable) would disincentivise healthy behaviour. ResultsPerceived threat to life was found to be the most consistent predictor of reported adherence to measures designed to prevent the spread of infection. Perceived extrinsic mortality risk was found to have increased due to the pandemic, and was also associated with lower reported adherence to Government advice on diet and physical activity, as well as smoking. ConclusionsOur findings suggest that promoting a message that highlights threat to life may be effective in raising levels of adherence to measures of infection control, but may also have unintended consequences, leading to a reduction in health-promoting behaviours. We suggest that messages that highlight threat to life should be accompanied by statements of efficacy, and that messages evoking feelings of concern for others may also be effective in promoting compliance with anti-infection measures.

scholarly journals Association of Antioxidants Use with All-Cause and Cause-Specific Mortality: A Prospective Study of the UK Biobank

Antioxidants ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 1287
Author(s):  
Inken Behrendt ◽  
Gerrit Eichner ◽  
Mathias Fasshauer
Keyword(s):  
Respiratory Disease ◽  
Mortality Risk ◽  
Cancer Mortality ◽  
Primary Objective ◽  
Inverse Association ◽  
Uk Biobank ◽  
Cancer Subtypes ◽  
Specific Mortality ◽  
The Uk ◽  
The Impact

Prospective studies and randomized controlled trials elucidating the impact of antioxidants supplementation on mortality risk are inconclusive. The present analysis determined association between regular antioxidants use and all-cause (primary objective), as well as cause-specific, mortality in 345,626 participants of the UK Biobank cohort using Cox proportional hazard models. All models were adjusted for confounders and multiple testing. Antioxidants users were defined as participants who indicated to regularly use at least one of the following: multivitamins, vitamin C, vitamin E, selenium, and zinc. Median age of antioxidants users (n = 101,159) and non-users (n = 244,467) at baseline was 57 years. During 3.9 million person-years and a median follow-up of 11.5 years, 19,491 deaths occurred. Antioxidants use was not significantly associated with all-cause, cancer, and non-cancer mortality including several cancer and non-cancer subtypes. Interestingly, mortality risk from respiratory disease was significantly 21% lower among antioxidants users as compared to non-users (hazard ratio: 0.79; 95% confidence interval: 0.67, 0.92). In conclusion, the present study findings do not support recommendations for antioxidants supplementation to prevent all-cause, cancer, or non-cancer mortality on a population level. The significant inverse association between antioxidants use and respiratory disease mortality needs further study.

scholarly journals Health impacts and environmental footprints of diets that meet the Eatwell Guide recommendations: analyses of multiple UK studies

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e037554
Author(s):  
Pauline Scheelbeek ◽  
Rosemary Green ◽  
Keren Papier ◽  
Anika Knuppel ◽  
Carmelia Alae-Carew ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Water Footprint ◽  
Vegetable Consumption ◽  
Total Mortality ◽  
Environmental Benefits ◽  
Health Impacts ◽  
Secondary Outcome ◽  
Processed Meat ◽  
Environmental Footprints ◽  
The Uk

ObjectivesTo assess the health impacts and environmental consequences of adherence to national dietary recommendations (the Eatwell Guide (EWG)) in the UK.Design and settingA secondary analysis of multiple observational studies in the UK.ParticipantsAdults from the European Prospective Investigation into Cancer - Oxford(EPIC-Oxford), UK Biobank and Million Women Study, and adults and children aged 5 and over from the National Diet and Nutrition Survey (NDNS).Primary and secondary outcome measures risk of total mortality from Cox proportional hazards regression models, total greenhouse gas emissions (GHGe) and blue water footprint (WF) associated with ‘very low’ (0–2 recommendations), ‘low’ (3–4 recommendations) or ‘intermediate-to-high’ (5–9 recommendations) adherence to EWG recommendations.ResultsLess than 0.1% of the NDNS sample adhere to all nine EWG recommendations and 30.6% adhere to at least five recommendations. Compared with ‘very low’ adherence to EWG recommendations, ‘intermediate-to-high adherence’ was associated with a reduced risk of mortality (risk ratio (RR): 0.93; 99% CI: 0.90 to 0.97) and −1.6 kg CO2eq/day (95% CI: −1.5 to −1.8), or 30% lower dietary GHGe. Dietary WFs were similar across EWG adherence groups. Of the individual Eatwell guidelines, adherence to the recommendation on fruit and vegetable consumption was associated with the largest reduction in total mortality risk: an RR of 0.90 (99% CI: 0.88 to 0.93). Increased adherence to the recommendation on red and processed meat consumption was associated with the largest decrease in environmental footprints (−1.48 kg CO2eq/day, 95% CI: −1.79 to 1.18 for GHGe and −22.5 L/day, 95% CI: −22.7 to 22.3 for blue WF).ConclusionsThe health and environmental benefits of greater adherence to EWG recommendations support increased government efforts to encourage improved diets in the UK that are essential for the health of people and the planet in the Anthropocene.

scholarly journals Religious affiliation and the risk of COVID 19 related mortality; a retrospective analysis of variation in pre and post lockdown risk by religious group in England and Wales

2020 ◽  
Author(s):  
Charlotte Hannah Gaughan ◽  
Daniel Ayoubkhani ◽  
Vahe Nafilyan ◽  
Peter Goldblatt ◽  
Chris White ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Cox Regression ◽  
Religious Affiliation ◽  
Religious Groups ◽  
England And Wales ◽  
Risk Of Death ◽  
Before And After ◽  
The Difference ◽  
Behavioural Factors ◽  
The Uk

AbstractBackgroundCOVID 19 mortality risk is associated with demographic and behavioural factors; furthermore religious gatherings have been linked with the spread of COVID. We sought to understand the variation in the risk of COVID 19 related death across religious groups in the UK both before and after lockdown.MethodsWe conducted a retrospective cohort study of usual residents in England and Wales enumerated at the 2011 Census (n = 48,422,583), for risk of death involving COVID-19 using linked death certificates. Cox regression models were estimated to compare risks between religious groups. Time dependent religion coefficients were added to the model allowing hazard ratios (HRs) pre and post lockdown period to be estimated separately.ResultsCompared to Christians all religious groups had an elevated risk of death involving COVID-19; the largest age adjusted HRs were for Muslim and Jewish males at 2.5 (95% confidence interval 2.3-2.7) and 2.1 (1.9-2.5), respectively. The corresponding HRs for Muslim and Jewish females were 1.9 (1.7-2.1) and 1.5 (1.7-2.1). The difference in risk between groups contracted after lockdown. Those who affiliated with no religion had the lowest risk of COVID 19 related death before and after lockdown.ConclusionThe majority of the variation in COVID 19 mortality risk was explained by controlling for socio demographic and geographic determinants; however, Jews remained at a higher risk of death compared to all other groups. Lockdown measures were associated with reduced differences in COVID 19 mortality rates between religious groups, further research is required to understand the causal mechanisms.

scholarly journals EP.FRI.552 Evaluating short term and long term outcome for patients undergoing emergency laparotomy in comparison to NELA mortality risk calculator

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Nourelhuda Darwish ◽  
Elsammoual Mohammed ◽  
Ibrahim Warrag ◽  
AdeelAbbas Dhahri ◽  
Bogdan Ivanov
Keyword(s):  
Mortality Risk ◽  
Emergency Laparotomy ◽  
Risk Calculator ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Risk Of Death ◽  
Increased Risk ◽  
The Uk

Abstract Aim NELA is a project that was introduced in the UK since 2013, aiming to improve quality of care for patients undergoing emergency laparotomy.  NELA mortality risk calculator”was launched in 2017, which estimates the risk of death within 30 days of emergency laparotomy.  Our aim is to determine the short-term (30-day) and long-term (12 months) outcome in patients undergoing emergency laparotomy surgery and compare this with the estimated scores that were documented in the NELA website. Methods This is retrospective study involving patients who underwent emergency laparotomy surgery in the year of 2019. The primary outcome is to determine short-term (30-day) mortality. Results A total of 135 patients were included. The overall 30-day mortality was 8.8% (12/135). 55.77% (78/135) had NELA mortality score of < 5%. Only 1 out of these (1.28%) died within 30 days. (4/78,5.12%) died in 6 to 12 months period of this group. 9 patients (11.53%) had NELA score > 30%, of which 6 (66.66%) died within 30 days and 1 died within 6 months. 26.96% (48/135) had NELA scores 55 to 30%, 5 of them (10.41%) died within 30 days while 7 (14.58%) died within 6-12 months.  Patients with NELA scores more than 5% who survived the operation had higher chance of 30-day complications (25.58%, 11/43), when compared to those with scores less than 5% (11.68%, 9/77). Conclusion NELA mortality score has high accuracy especially if it was >30%. In addition, high NELA scores are associated with increased risk of post operative complications.

scholarly journals Adverse Selection Spirals

2006 ◽  
Vol 36 (2) ◽  
pp. 589-628
Author(s):  
Piet De Jong ◽  
Shauna Ferris
Keyword(s):  
Family History ◽  
Adverse Selection ◽  
Risk Classification ◽  
Insurance Market ◽  
Severe Problem ◽  
Risk Levels ◽  
Correlated Information ◽  
The Uk ◽  
Informational Advantage

This article discusses risk classification and develops and discusses a framework for estimating the effects of restrictions on risk classification. It is shown that expected losses due to adverse selection depend only on means, variances and covariances of insurance factors and rates of uptake of insurance. Percentage loadings required to avoid losses are displayed. Correlated information, such as family history, is also incorporated and it is seen how such information limits losses and decreases required loadings. Although the evidence suggests that adverse selection is not, at present, a severe problem for insurers, this might change if the authorities impose restrictions on risk classification and/or customers gain an informational advantage (such as better knowledge of their own risk levels). Application is made to unisex annuity pricing in the UK insurance market.

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