Much of those gains reflect what public health professionals call the “epidemiological transition,” a profound change not just in terms of when we die, but of what. Thanks to advances in public health and medicine, the 20th century saw chronic diseases overtake infectious diseases, a gradual trend that remained almost clad in iron — that is, until March 2020, when infectious disease reasserted itself.
Over time, as COVID-19 becomes endemic, we will eventually turn the spotlight back to the diseases that most concerned public health officials prior to 2020, including heart disease, cancer, and diabetes. When that happens, one of the most important questions yet to be addressed in the pandemic is whether the public’s relationship with chronic disease will be the same as before, or if our experience passing through COVID-19’s gauntlet will have changed how we think about even noninfectious disease.
That open question may turn out to be an opportunity to improve how we live as we age — not just for individuals, but for organizations that serve them. World-leading financial services firms headquartered in Boston and elsewhere — life insurers, in particular — may find themselves in a prime position to influence this issue for the better.
The shift from infectious to chronic diseases that had been occurring for the decades prior to COVID-19 had contributed to a growing gap between life expectancy and “healthy life expectancy”: the number of years a person is likely to live in good health. According to new research from RAND and John Hancock’s Vitality Program, the number of years that someone can expect to live in poor health in the United States has jumped 14 percent since 1990. In theory, we could have reversed this trend with greater attention paid to Healthy behaviors and baseline indicators of health, but we also know that such changes are difficult to put into practice.
The pandemic, however, may be making people more cognizant of their baseline health. In addition to important factors like age and vaccine status, one of the most consistent factors affecting outcomes and recovery from COVID-19 is an individual’s level of health prior to infection. The acute danger posed by COVID-19, as compared with the slow-boil nature of chronic disease, appears to be spurring some Americans to rethink longstanding health behaviors. In one major survey of US consumers, for instance, almost 70 percent of respondents claimed that one thing they would “do differently as a result of COVID-19” would be to exercise more and stay more active.
Fortunately, it is possible to make the distant, future benefits of healthy choices feel more immediate — without the threat of COVID-19. There is a natural alignment between consumers’ interests in health and longevity and the goals of financial industries, which benefit the longer their customers stay with them. This is especially true of the life insurance industry. Historically, life insurers’ relationship with their customers’ lives was purely transactional: collecting premiums, evaluating risk, paying claims. But the time is right for life insurers to do more: Develop meaningful and personal relationships with customers by shifting the focus to both the length of life and how we live it.
John Hancock’s Vitality Program is one example of how financial companies can engage more fully with their customers’ lives, and their well-being. It is a technology-enabled program that covers a broad spectrum of activities including exercise, nutrition, sleep, preventive screenings, and mindfulness. It is designed to reward customers — wherever they are on their health journey — for the small, everyday things they do to stay healthy or improve their health.
This shared-value approach can make a difference and is expanding around the globe with such solutions now offered in over 20 countries. John Hancock Vitality Plus policyholders take nearly twice as many steps as the average American. And nearly half of members report body mass index reductions since joining the program, with 40 percent having reduced their “Vitality Age,” a statistical indication of overall health relative to chronological age.
Although life insurance is perhaps the clearest example of a financial services industry whose interests align with consumer longevity, it is far from the only one. Life insurance has always been more about dying than living, and finance has always been about what money can do to make life better. Financial companies — especially those in Boston’s increasingly longevity-aware business community — should dare to think big and join the effort to build a better old age.
Brooks Tingle is president and CEO of John Hancock Insurance.