With fitness levels among adolescents plunging, doctors are warning of a teen health timebomb. So how will this impact future ratings for life and health cover? Kirstie Redford investigates
Teenagers are known for their unhealthy habits. Usually this is the time that young people begin experimenting with alcohol and other drugs and opt for fast food rather than balanced meals. As teenagers become sexually active, teenage years can also be fraught with the dangers of sexually transmitted infections (STIs) and unplanned pregnancies.
Bad risk pool
Health problems such as these may be nothing new and be widely accepted as part and parcel of growing up. However, according to a landmark report by the British Medical Association (BMA) last year, today's teenagers are taking these conditions to the extreme. The truth is the next generation of young adults - and the life and health policyholders of tomorrow - could be shaping into a bad risk pool for insurers.
Let's look at the facts. According to the BMA's report, the number of overweight children has doubled in the last 20 years; with one in five 13 to 16-year-olds now classed as obese. A quarter of 15 to 16 year-olds in the UK are regular smokers. Alcohol consumption, in particular binge drinking, among teenagers is now at one of the highest levels in Europe. One fifth of 15 to 16 year-olds are taking drugs. And with 60% of 16 to 24-year-olds admitting they do not use a condom, STIs are soaring.
This doesn't paint a healthy picture for the future. Although teenagers may have the mindset that they will live forever, their life span could be shorter than they think. So how are insurers preparing to absorb the risk?
The potential health risks of the next generation are not a subject reinsurer Swiss Re is taking lightly. In fact it has recently undertaken extensive research into adolescent obesity, which will be published this month. Although the study focuses on the US, it is believed similar trends will hit the UK in time.
Ronald Klein, head of global pricing at Swiss Re, says the industry has a tough challenge on its hands.
"Some of the main problems with obesity in developed countries start with childhood. Kids are sitting at home, playing video games and eating prepared foods because their parents are working. They are basically eating more than they are expending. We're hoping we can pull back this trend, but because it is a lifestyle choice, it's going to take a major effort. The Government is also up against fast food giants such as McDonalds and Coca Cola, which could mean some big law suits," he says.
One of the most shocking findings from this US research is the fact that adults may still carry health risks from being obese as children even if they lose the weight later in life. Although, as Klein points out, it would be difficult to prove whether or not you were obese as a child, this could potentially be considered by underwriters as important evidence when rating adult applicants in the future.
"The longer you remain obese as children, the more likely you are to be obese as adults and the less likely you are to grow out of it. If you are obese as a child, and you lose weight, you still carry the associated risks of obesity into adulthood," says Klein.
Although Swiss Re says rising obesity levels are not affecting pricing at the moment because overall mortality is seeing a downward trend, a new report published by UnumProvident paints a different picture.
Its research, again conducted in the US, shows that over the last decade, there has been a 10-fold increase in the incidence of disability claims attributed to obesity - an epidemic that is costing US employers over $12bn a year.
Shock findings
Chief medical officer at UnumProvident, Dr Michael O'Donnell, believes it won't be long before obesity has a knock-on effect on UK premiums. "With rising levels of childhood obesity and predictions that a quarter of women and a fifth of men could be obese by 2005, Britain could see a considerable increase in the number of claims due to obesity-related illness. This could result in a significant increase in premiums on both individual and group income protection policies," he says.
However, not all in the market share the same view. Chief underwriter at Norwich Union, Tony Jupp, believes adolescents today are just as fit as teenagers were 50 years ago. Although he doesn't deny we are seeing an unhealthy change in the way teenagers are living, he says advances in medicine are balancing the problem out.
"If you look back over the generations, there has always been angst over how teenagers are going to turn out," he says, "but the mods, rockers and hippies of yesterday have turned out to be respectable members of society. If obesity goes up, there is potential growth for diabetes and other conditions caused by being overweight. But just because a young person is overweight today doesn't mean they will be in 10 years' time."
Sea change
Jupp argues that despite each generation of adults being concerned with how teenagers run their lives, very seldom has it led to a sea change in insurers' attitudes.
"Insurance is based on a long-term view, but it would give us all an awful headache if we tried to factor in that we are statistically 2lbs heavier than last year," he says. "Although obesity is more prevalent now than in the past, nine out of 10 times, doctors will be able to reverse the abuses we are putting on ourselves."
When it comes to other bodily abuses, insurers are concerned with the growing drug culture among adolescents. However they are also aware of the risk of alienating future policyholders if they take a heavy hand.
"We don't want to give teenagers today the impression that insurers will look down on them. We need to encourage a healthy lifestyle. There is certainly a threshold people reach which means they are considered 'sub-standard' by underwriters, whether it is being overweight or taking non-prescription pills and potions. But we certainly don't want to tar all young people with the same brush," explains Jupp.
However, there is a strong argument that a rise in binge drinking - especially among young women - will cause future health problems. According to reinsurer RGA Re, there was a 17% increase in binge drinking among women between 1998 and 2001. Young women drink more than three times the amount consumed by those over 65 and a total of 27% of women aged 16-24 regularly drink twice the recommended daily level in one session.
Another growing problem among adolescents in the UK is the rise of STIs. It is not just young people who are vulnerable to catching STIs, but the steep increase in infections such as chlamydia among young women has prompted recent publicity campaigns by the Government to hammer home the frightening facts. Education is of course paramount to the control of infections, but there will always remain a stigma and social embarrassment for young people talking openly about their own sexual health, making the role of medical professionals that bit harder.
Responsibility
A somewhat damning report on the lack of responsibility among young people to protect themselves against STIs was published in the British Medical Journal in February this year. Focusing on the notorious tourist resort of Ibiza, the report claims one in four young men and one in seven young women have more than one sexual partner during their stay. Over 40% of those surveyed said they did not always use a condom. The proportion of visitors having unprotected sex was also found to have increased since a similar survey was conducted three years previously.
Although these findings may seem unrelated to health insurance, they do illustrate the growing problem medics are facing with curbing the rise in infections. Despite educational campaigns, it is still proving an uphill struggle to get young people to act more responsibly and safeguard their sexual health. The infections they are exposed to during their adolescence could result in untold complications when they are older, from fertility problems to an underwriter's worst nightmare, HIV.
According to the latest figures from the Health Protection Agency, new cases of HIV have surged by 20% in the UK in just one year. Although it has in the past mistakenly been associated as an epidemic among gay men, there has been a 27% increase in heterosexual diagnoses over the last year. And worst news for underwriters, these figures are likely to increase in the future.
Dr Barry Evans, HIV expert at the Health Protection Agency, says: "The rising trend in new diagnoses is liable to only get worse before it gets better. Increases in unsafe sex are undoubtedly the main driving force behind this epidemic."
With rising levels of obesity, alcohol binging, recreational drug use and STIs, it looks like the health insurance industry has a difficult battle on its hands to cap the growing health risks in the UK. It appears tomorrow's policyholders could be paying a high price for gambling with their health today.
COVER notes
• Rising levels of obesity are already increasing protection claims in the US, suggesting UK premiums could be impacted in the future.
• Despite downward trends in mortality, adolescent health risks are increasing due to binge drinking, drug taking and a rise in STIs.
