Analysis of All-Cause Mortality Population of Insurance Applicants

Main Article Content

Muhammad Ghafoor Ali


Background: The risk of all-cause mortality is assessed in the study from factors consisting of BMI, medical history, socioeconomic status etc where factors are available in the life insurance organization data and submitted at the time of registration and subsequently in the death claim papers which gives detail about the state of health and cause of death.

Methods: A retrograde study has been carried out of 300 deceased life insured (2005-2014) from the data of a life insurance organization in Pakistan about all-cause mortality from the available factors in death claim files. The research instruments were consisting of death claim register, proposal forms, medical reports and death claim papers.

Results: The results indicate maximum deaths found due to Cardiovascular causes (43.34%) followed by Cancer (9.00%) while minimum found in, Endocrine disorders(0.33%)followed by Respiration(0.67%). However significant causes of death occurred due to Accident, Liver, CNS, Multisystem involvement, Natural disaster and Un- natural. The correlation co-efficient found as ‘0.07’ for all-cause mortality indicating positive relationship between BMI and Life Expectancy.

Conclusion: Medical history plays an important but not a compulsory role in mortality. Since BMI (WHO) showed higher mortality with normal BMI whereas BMI (Asia) showed it at-risk value therefore WHO should make separate criteria of standard of BMI as being different for different ethnicities. In Insurance organization NT-proBNP and BMI of ethnic area be used to asses life expectancy in applicants. Necessary measures should be opted for implementation of “The Sendai Framework for Disaster Risk Reduction 2015-2030”.

Policyholder, deceased, insurance, BMI, Proposal Form, Medical Report, claim form.

Article Details

How to Cite
Ali, M. G. (2020). Analysis of All-Cause Mortality Population of Insurance Applicants. Asian Journal of Medicine and Health, 18(9), 128-138.
Original Research Article


Akhtar Sherin. Obesity: How to prevent Pakistani people from getting heavier? Khyber Med Univ J. 2013;5(2):59-60.

Katherine M. Flegal, Brian K. Kit, Heather Orpana, Barry I. Graubard. Association of all-cause mortality with overweight and obesity using standard body mass index categories a systematic review and meta- analysis.JAMA. 2013;309(1).

Christian Nordqvist. BMI: Is the body mass index formula flawed? Medical News Today. Published; 2013.

John Danesh. Body-mass index and all-cause mortality: individual participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 2016;388:776–86.

WHO. Global status report on noncommunicable diseases 2014". World Health Organisation; 2018.

Vaughn W. Barry, Meghan Baruth, Michael W. Beets, Larry Durstine J, Jihong Liu, Steven N. Blair. Fitness vs. Fatness on All-Cause Mortality. Progress in Cardiovascular Diseases Elsevier. 2014; 56:382–390.

Raj Padwal, William D. Leslie, Lisa M. Lix, Sumit R. Majumdar. Relationship among body fat percentage, body mass index, and all-cause mortality. Ann Intern Med. 2016; 164:532-541.

Clark M, Kaufman V, Fulks M, Dolan VF, Stout RL. NT-proBNP as a predictor of all-cause mortality in a population of insurance applicants. Journal of Insurance Medicine. 2014;44(1):7-16.

Ziad Obermeyer, Brent Cohn, Michael Wilson, Anupam B Jena, David M Cutler. Early death after discharge from emergency departments: Analysis of national US insurance claims data. The British Medical Journal. BMJ 2017;356: 239.

Shoaib Afzal, Anne Tybjærg-Hansen, Gorm B. Jensen, Børge G. Nordestgaard. Change in body mass index associated with lowest mortality in Denmark, 1976-2013. JAMA. 2016;315(18):1989-1996.

Tuen-Ching Chan, Jameska hay Luk, Leung-Wing Chu, Felix Hon Vai Chan. Association between body mass index and cause-specific mortality as well as hospitalization in frail Chinese older adults. Geriatrics and Gerontology International. 2014;15:72–79.

Ghulam Hussain, Mirza Ahmad Raza Baig, Abdul Ghaffar, Sara Zaheer, Hafiz Muhammad Azam Raheel, etal. Effect of body mass index on early outcomes of coronary artery bypass grafting. J Pak Med Assoc. 2017;67(4):595-599.

Abdulla Shehab, Bayan Al-Dabbagh, Khalid Al Habib, Alawi Alsheikh-Ali, Wael Almahmeed, et al. The obesity paradox in patients with acute coronary syndrome: Results from the gulf RACE-2 study. Angiology; 2014.

Abdulbari Bener, Erol Yildirim, Tu¨ rker €Ozkan, Timo Lajunen. Driver sleepiness, fatigue, careless behavior and risk of motor vehicle crash and injury: Population based case and control study. Journal of Traffic and Transportation Engineering-english; 2017;4(5):496-502.

Nobuyuki Miyatake, Naoko Tanaka, Noriko Sakano, Hiroshi Kinoshita. Relationship between Road traffic accidents and drinking habits in all 47 prefectures of Japan. Journal of Transportation Technologies. 2013;3:190-193.

Jin-hu Fan Jian-bing Wang, Shao-ming Wang, Christian C. Abnet, You-lin Qiao,Philip R. Taylor4. Body mass index and risk of gastric cancer: A 30- year follow-up study in the Linxian general population trial cohort. Cancer Sci. 2017;1667–1672.

Sarah E. Jackson, Malgorzata Heinrich, Rebecca J. Beeken, Jane Wardle. Weight loss and mortality in overweight and obese cancer survivors: A systematic review. PLOS ONE. 2017;12(1).

Soumya Chatterjee. nutritional implications of gi-related scleroderma practical gastroenterology; 2016.

Yi-Hao Yen, Kuo-Chin Chang, Ming-Chao Tsai, Po-Lin Tseng,Ming-Tsung Lin, Cheng-Kun Wu, Jung-Ting Lin, Tsung-Hui Hu*, Jing-Houng Wang, Chien-Hung Chen. Elevated body mass index is a risk factor associated with possible liver cirrhosis across different etiologies of chronic liver disease. Journal of the Formosan Medical Association. 2018;117:268-275.

Weiping Sun, Yining Huang, Ying Xian, Sainan Zhu, Zhirong Jia, Ran Liu, Fan Li, Jade W. Wei, Ji-Guang Wang, Ming Liu,. Association of body mass index with mortality and functional outcome after acute ischemic stroke. Scientific Reports. 2017;7:2507.

Oac. Obesity and stroke fact sheet. Obesity Action Coalition; 2017.
Available: Sheet.pdf

Rahimlu M, Shab-Bidar S, Djafarian K. Body mass index and all-cause mortality in chronic kidney disease: A dose-response meta-analysis of observational studies. J Ren Nutr. 2017;27(4):225-232.

Hamidreza Heidari, Farideh Golbanaei, Aliakbar Shamisipour, Abbas Rahimi Forushan, Abbasali Gaeini. Evaluation of heat stress among farmers using environmental and biological monitoring: A study in north of Iran. International Journal of Occupational Hygiene-IJOH 2015;7. 1-9.

Hsin-Hao Lai, Yun-Ju Lai, Yung-Feng Yen. Association of body mass index with timing of death during tuberculosis treatment. PLoS ONE. 2017;12(1).

Dr.Ananya Manadal. obesity and respiratory disorders. News Medical Life Sciences; 2018.
Available: disorders.aspx

Fei Gao, Zhi Jian Wang, Hua Shen, Shi Wei Yang, Bin Nie, Yu Jie Zhou. Impact of obesity on mortality in patients with diabetes: Meta-analysis of 20 studies including 250,016 patients. J Diabetes Investig. 2018;9:44–54.

Gerald Keil, Elizabeth Cummings, Joa˜o Pedro de Magalha˜es. Being cool: How body temperature influences ageing and longevity. Biogerontology. 2015;16: 383–397.

Lesley Gray. Social determinants of health, disaster vulnerability, severe and morbid obesity in adults: Triple jeopardy. International Journal of Environmental Research and Public Health. 2017;14(12): 1452.

Kimberley J, Omond, Neil EI. Langlois, Roger W. Byard. Obesity, body mass index, and homicide. Journal of Forensic Sciences. 2016;930-933.

Kenneth W. Michael Wills. What Does it Mean When the Cause of Death Is Undetermined? Legal Beagle; 2018.