2021 CCA Enrolled Actuaries Conference 1

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Session 2-A-1

Longevity 2021: What to Assume for the Future in the Wake of COVID-19?

Steve Goss, ASA, MAAA, Chief Actuary, US Social Security Administration

2021 CCA Enrolled Actuaries Conference | May 5, 2021
2021 CCA Enrolled Actuaries Conference 2

Our Agenda - questions to address:

1. What are recent US mortality patterns (pre-COVID), and what has driven that?

2. Is our recent slowdown in mortality improvement reflected in other developed 

nations?

3. Is mortality improvement cyclical? 

3a. Are there longer-term implications from COVID-19?

4. How do the experts project future improvement?

5. What are the implications of geography and lifestyle on mortality?

6. What are the key sources of mortality improvement and trends?
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1.What are recent US mortality patterns 1 (pre-COVID)?
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Recent U.S. Experience: All Ages

Reductions falling short of expectations since 2009

4

700

750

800

850

900

950

1,000

1,050

1,100

1990 1995 2000 2005 2010 2015 2020

Age-Sex-Adjusted Death Rates (per 100,000)

Total, All Ages

2018TR 2019TR 2020TR Actual

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Experience Falls Short: Over and Under 65 

Even with improvement over 65 since 2015

200

250

300

350

400

1990 1995 2000 2005 2010 2015 2020

Age-Sex-Adjusted Death Rates (per 100,000)

Ages Under 65

2018TR 2019TR 2020TR Actual

4,000

4,200

4,400

4,600

4,800

5,000

5,200

5,400

5,600

5,800

6,000

1990 1995 2000 2005 2010 2015 2020

Age-Sex-Adjusted Death Rates (per 100,000)

Ages 65 and Older

2018TR 2019TR 2020TR Actual

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Age-Adjusted Death Rates (courtesy Robert Anderson, NCHS)

Strong Declines 1999-2009 for Heart and Stroke; Little Since 2009

Rate per 100,000 standard population

NOTE: Data prior to 1933 contain death-registration States only. Data for 2015 is provisional.

Heart disease

Cancer

Stroke

Unintentional injuries

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Is our recent slowdown in mortality 

improvement reflected in other 2developed nations?
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Canada—Slowdown in Mortality Improvements

January 2020 Living to 100 Symposium: Assia Billig, Chief Actuary, CPP 

Source: OAS Mortality Fact Sheet – to be published in January 2020

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

3.5%

4.0%

2003 -

2008

2008 -

2013

2013 -

2018

65-69

2003 -

2008

2008 -

2013

2013 -

2018

70-74

2003 -

2008

2008 -

2013

2013 -

2018

75-79

2003 -

2008

2008 -

2013

2013 -

2018

80-84

2003 -

2008

2008 -

2013

2013 -

2018

85-89

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United Kingdom—Deceleration Since 2011

January 2020 Living to 100 Symposium:

Adrian Gallop, UK Government Actuary’s Department

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Age-Standardized Mortality Rates for Top Five Leading 

Causes of Death, 2001 to 2017, England & Wales

Note—we are looking at this carefully for the U.S.

0

50

100

150

200

250

300

350

400

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Dementia and Alzheimers (F01, F03, G30) Ischaemic heart disease (I20-I25)

Cerebrovascular disease (I60-I89) Chronic lower respiratory disease (J40-J44)

Lung cancer (C33, C34)

Courtesy Adrian Gallop, UK Government Actuary’s Department

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Is mortality 3improvement cyclical?
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Mortality Decline Varies Over Time: On a Period Basis

Conditions: Antibiotics/economy 1936-54; Medicare/Medicaid 1968-82

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Cohort Considerations?

• Post-World War 2 births—special conditions:

• Antibiotics when young; statins, etc. later

• What does change up to age x say above age x?

• If cohort is fundamentally healthier at x: 

Then expect lower mortality over age x

• If medical interventions have just reduced deaths through 

age x:

Then cohort mortality over age x could be worse, with 

increased numbers of impaired survivors

• What does one cohort imply for the next cohort?

Further changes depend on conditions, not trend

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Are there longer-term 3a implications from COVID-19?
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Pandemic Effects in the Near Term:

Only every 100 years? 

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COVID-19 Longer-Term Implications 

• Raise death rates 16% in 2020, similar in 2021?

• Second coronavirus in 20 years

• Expect periodically in a now mobile world population?

• Reduced life expectancy for affected cohorts

• But hopefully transient, not affecting future cohorts

• Thus, possibly no implication for “trend rate” in mortality 

• But, if deaths are raised by 16% in 2 of every 20 

years:

• Average LEVEL of mortality will be 1.6% above “trend”

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How do the experts 4project future improvement?
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How Do Experts Project?

• Extrapolating past trends of:

• Age setback?

• Life expectancy at birth or other ages?

• Improvement by cohort?

• Mortality rate by age and sex?

• Mortality rate by age, sex, and cause?

• Use a statistical extrapolation?

• Consider factors affecting mortality change?

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Can Life Expectancy Rise Linearly?

• Requires accelerating rate of 

decline in mortality rates if 

retain age gradient

• LE most affected by lowest 

ages—only so much gain 

possible

• Is there an omega? “Squaring” 

the survival curve: see later slide 

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Extrapolation by Cohort

•As stated earlier:

• What does change up to age x say above age x?

• What does one cohort imply for the next cohort?

•Period effects from known conditions 

appear to be stronger—at least in the 

U.S.

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Extrapolation by Just Age and Sex

• Lee and Carter

• Assume future conditions replicate past

• Assume age gradient never changes

• No deceleration in mortality decline

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Projections by Age, Sex, and Cause

• Scientific approach reflecting biology

• Developed in consultation with medical experts

• Johns Hopkins survey of medical researchers and 

clinicians came to very similar medium- term 

expectations—independently

• Allows change in age gradient

• Results in deceleration in mortality decline

22

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Variation by Age is Substantial

Age gradient in past reduction is clear

23

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Is There an Omega?

It appears we are rectangularizing the survival curve

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Death Rates Will Continue to Decline: 

But How Fast and for Whom?

• Must understand past and future conditions

• Persistent historical “age gradient”

• Avoid simple extrapolation of past periods

• Cannot ignore changing conditions

• “Limits” on longevity due to physiology

• Latter half of 20th century was extraordinary

• So deceleration seems likely

• Cause-specific rates allow basis for assumptions

• Results: in the 1982 Trustees Report, we projected 

LE65 for 2013 to be 19.0; actual was 19.1

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What are the implications of geography 5and lifestyle on mortality?
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Geography/Lifestyle

• Geography can be important due to mobility within and across 

countries, and different economic climate and customs

• Immigration can distort data

• But for a specific employer or employment group, level of 

mortality may differ, even if trend rate does not

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Mortality By Career-Average Earnings 

Level: Actuarial Study #124

Age group 65-69 relative mortality ratios—not diverging?

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Coverage and Data Source Matter: 

LE65 increases less for SSA/Medicare Population than HMD!

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Experience Data Must be Consistent with Plan Coverage: 

Trustees Data have consistent deaths and exposure, and exclude 

undocumented (non-covered) population

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What are the key sources of mortality 6improvement and trends?
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Mortality Decline by Cause of Death: 

Rate of change from 1979 to 2017

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How Will Conditions/Trends Change?

• Cardiovascular and smoking—much left?

• How about: Vaping? Climate effects?

•Obesity—sedentary lifestyle

• Health spending—must decelerate

• Advances help only if they apply to all

• Changing causes

• Dementia as seen recently in England

• Despair (Case and Deaton)

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Trends in Obesity: US 1971-2006

Sam Preston 2010—must consider cumulative effects

Increasing duration of obesity for aged in future

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Health Spending Cannot Continue to 

Rise at Historical Rates—Effects on Mortality?

Note Trustees’ deceleration

-1%

0%

1%

2%

3%

4%

5%

 1970-1980 1980-2010 2010-2040 2040-2070 2070-2085

Annual Percent Change in Medicare Cost per Beneficiary 

Relative to GDP per Worker: 2015 TR

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Opioids? Affected Age 15-64 Mortality Decline 

Since 1999, but Not the Deceleration Since 2009

-1.5%

-1.0%

-0.5%

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

Under Age 15 Ages 15 - 49 Ages 50 - 64 Ages 65 - 84 Ages 85 and Over Total

Male Comparison of Mortality Improvement Including and Excluding Deaths from Opioids

1999 to 2009

Including

Opioids

2009 to 2017

Including

Opioids

1999 to 2009

Excluding

Opioids

2009 to 2017

Excluding

Opioids

SG
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37

For More Information from SSA

http://www.ssa.gov/oact/

 Documentation of Trustees Report data & assumptions

https://www.ssa.gov/oact/TR/2020/2020_LongRange_Demographic_Assumptions.pdf

 Historical and projected mortality rates

https://www.ssa.gov/oact/HistEst/DeathHome.html

 Annual Trustees Reports 

https://www.ssa.gov/oact/TR/index.html

 Actuarial Notes and Studies

https://www.ssa.gov/oact/pubs.html

37
Projecting Mortality 

Followup Discussion

Steve Goss, Chief Actuary

US Social Security Administration

2021 Enrolled Actuaries Conference Followup

Session 2-A-1

June 2, 2021
Mortality Decline Varies Over Time: On a Period Basis

Conditions: Antibiotics/economy 1936-54; Medicare/Medicaid 1968-82

2
Recent U.S. Experience: All Ages

Reductions falling short of expectations since 2009

3

700

750

800

850

900

950

1,000

1,050

1,100

1990 1995 2000 2005 2010 2015 2020

Age-Sex-Adjusted Death Rates (per 100,000)

Total, All Ages

2018TR 2019TR 2020TR Actual

Mortality Decline by Cause of Death: 

Rate of change from 1979 to 2017

5
Mortality By Career-Average Earnings 

Level: Actuarial Study #124

Age group 65-69 relative mortality ratios—not diverging?

6
Pandemic Effects in the Near Term:

Continuing effects—this year and beyond 

CDC fluview updated as of May 28, 2021

7
Pandemic Effects in the Near Term:

BY AGE GROUP CDC fluview updated as of May 28, 2021

8

0.6

0.7

0.8

0.9

1

1.1

1.2

1.3

1.4

1.5

1.6

2020.012020.042020.072020.102020.132020.162020.192020.222020.252020.282020.312020.342020.372020.402020.432020.462020.492020.522021.022021.052021.082021.112021.142021.17

Total Weekly Deaths: Ratio to 52/104 wks 

prior

<18 18-64 65+

0

1

2

3

4

5

6

7

8

2020.012020.042020.072020.102020.132020.162020.192020.222020.252020.282020.312020.342020.372020.402020.432020.462020.492020.522021.022021.052021.082021.112021.142021.17

PIC Deaths last 4 weeks: Ratio to 52/104 wks 

prior

<18 18-64 65+
9

For More Information...

http://www.ssa.gov/oact/

 Documentation of Trustees Report data & assumptions

https://www.ssa.gov/oact/TR/2020/2020_LongRange_Demographic_Assumptions.pdf

 Historical and projected mortality rates

https://www.ssa.gov/oact/HistEst/DeathHome.html

 Annual Trustees Reports 

https://www.ssa.gov/oact/TR/index.html

 Actuarial Notes and Studies

https://www.ssa.gov/oact/pubs.html

9