Last time in this space, we discussed how physical or emotional stress affects the human heart. This time, we will focus on why maintaining a favorable balance between a commitment to our jobs and the need to prioritize our lives outside of the workplace is both a life-affirming and possible life-saving necessity.

Let’s start by looking back to the early 1990’s, when researchers in Japan started to study and report on a phenomenon where it appeared ostensibly healthy, middle-aged, mostly men, started to die suddenly. The term coined for the cause of death in this group was “karoshi”, meaning death from overwork. The common thread running through these cases was a history of chronically long work weeks, logging in at 60 hours and often more. The cause of death was disturbing in its’ repetition, most often heart disease, stroke or suicide (1).

More recently, and perhaps due to the pandemic and a growing body of knowledge increasingly difficult to ignore, there is renewed interest in the burden and toll of an unhealthy work life. Continue reading “Work-Life Balance: Tipping the Mortality Scale” →

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Work-Life Balance: Tipping the Mortality Scale

The Irish playwright, Oscar Wilde, observed that the heart was made to be broken. Indeed, the experience of being alive is almost certain to contain at least one heartbreak, perhaps even adding to the richness of our humanity or sowing the seed of a future happiness. The medical community has long questioned whether heartbreak or its’ frequent companion, severe or chronic physical or emotional stress, can damage the human heart, the muscle responsible for each life sustaining breath. Let’s take a look at possible answers to those questions. Continue reading “What becomes of the broken-hearted? Stress and the Human Heart” →

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What becomes of the broken-hearted? Stress and the Human Heart

Prostate cancer continues to be a scourge on the Canadian health landscape as the most commonly diagnosed and third leading cause of cancer-related death among men (1). It currently accounts for about 20% of all new cancers in men and approximately 4,500 deaths annually (2). Underwriters increasingly are presented with prostate cancer in the medical history and we will see even more cases as our population continues to age.

But the landscape also points to a good news horizon. Thanks to improved screening and treatment, prostate cancer mortality continues to fall, dropping from its’ high of 45.1 deaths per 100,000 men in 1995 to 22.7 per 100,000 in 2021 (1). One of the more remarkable advances in the screening and diagnosis of this malignancy is the use of imaging studies, such as the prostate MRI. From the earliest images 40 years ago using magnetic resonance imaging technology, the current prostate MRI uses state-of-the-art image modalities such as dynamic contrast-enhanced (DCE) and spectroscopic views to get a better look in order to detect clinically significant prostate cancer (3). The impact on detection, accuracy and diagnosis is a major contributor to improved prostate cancer mortality. Prostate MRIs are also increasingly utilized to monitor for prostate cancer recurrence after treatment, no doubt also contributing to improved mortality. Continue reading “Looking Good: Prostate Cancer’s Sharper Image” →

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Looking Good: Prostate Cancer’s Sharper Image

Nearly 10 per cent of Canadians ages 12 and older have a mood disorder (1). One definition of mood disorder is a general emotional state or mood that interferes with one’s ability to function. Major depression disorder (MDD), anxiety and bipolar disorder (BP) are the commonly thought of mood disorders. However, are you aware that seasonal affective disorder, a form of depression, is also a mood disorder? Continue reading “Shining a Light on Seasonal Affective Disorder (SAD) and Underwriting” →

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Shining a Light on Seasonal Affective Disorder (SAD)

A look back in time helps demystify insurance underwriting

Life insurance underwriting has been around a long time. Since the first life insurance policy issued in 16^th century England, the practices supporting fair and competitive life insurance risk selection have evolved often apace with emerging technologies, but the principles that undergird underwriting remain remarkably unchanged.

Living benefits, via disability and critical illness insurance, are considered relative newcomers to the marketplace. Still, the earliest forms of these coverages have been available for a long time. The second American president, John Adams, signed the Act for the Relief of Sick and Disabled Seamen in 1798 (1). The law required seafarers to put aside twenty cents per month from their wages in order to fund medical care for other sailors who fell sick or became disabled. This group of seamen were so vital to trade and commerce, that the law created a provision for the building of hospitals for sick seamen. This is perhaps one of the earliest examples of what we now consider accident and sickness and disability insurance.

Critical illness is the youngest member of the life and living benefits insurance family. It was the brainchild of South African Dr. Marius Barnard who launched the first version in 1983 under the ominously titled Dread Disease Insurance. The premise was groundbreakingly simple: get diagnosed with a covered illness, survive 30 days and collect the claim payment. Critical illness made its way to our shores a few years later and remains a powerful protection tool that continues to benefit Canadian insurance buyers, often in ways that have been described as life changing and life saving. Continue reading “Life vs. Living Benefits Underwriting: Consider the Differences” →

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Life vs. Living Benefits: Consider the Differences

“Loneliness is the ultimate poverty” (1). So said the everyday philosopher Pauline Philips, better known to millions as “Dear Abby”, the legendary advice columnist. The theme of loneliness runs deep in our past and present society, inspiring music, literature, film and a long list of commercial endeavours to alleviate what another great legend, Bob Dylan, described as “endless emptiness” (2). It’s all a little grim. In more clinical terms, it can be described as a subjective feeling related to the lack of social relations or simply a sense of disconnectedness or isolation (3).

So, why discuss loneliness in an underwriting setting and why now? Well, the simple answer is that when it comes to medical reporting, loneliness as a component of psychiatric disorders has long been a red flag for concern. That same report would typically also reveal a history of depression, insomnia, disturbed appetite and other markers of reduced well-being. In more extreme cases, there can be the misuse of alcohol, marked stress and drug use. Physicians have long recognized that loneliness can predispose the sufferer to a broad range of illness, including cardiovascular and immune system diseases (4). In older populations, isolation can accelerate cognitive decline, interfering with day-to-day functioning and the quality of life (5). In younger people, social stress and isolation are cited as precipitating factors for suicide, which accounts for 24% of all deaths among 15-24 year-olds living in Canada (6). In fact, every day we lose ten Canadians to suicide (7). Continue reading “Loneliness – How Risky Can It Get?” →

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Loneliness – Hope on the Horizon

Since its completion in 2003, the Human Genome Project has garnered a great deal of attention for genetic testing. All of this focus has resulted in the identification and mapping of the three-billion pairs of human gene structure, known as the genome. Today, geneticists can perform many different types of analyses that have never been seen before, including deep sequencing, RNA sequencing and epigenomics, the overall study of the complete set of epigenetic modifications on the genetic material of a cell – all of these allow scientists to study the expression of genetic patterns from person-to-person and more.

Genetic therapy is a developing area of our unprecedented understanding of the human genome. Imagine being able to add a normal, healthy gene where a person has inherited a defective gene variant? In some cases, this may improve outcomes from a disease and in the best cases, cure or prevent it altogether. Continue reading “Gene Therapy – The Fix Is (Almost) In” →

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Gene Therapy – The Fix Is (Almost) In

Most agree that money can buy the necessities and a little more money can add a few extra comforts to our day-to-day lives. In fact, it is often debated whether a greater fortune brings longer life, but few medical studies have taken a serious look at this question.

Continue reading “Money and Mortality” →

Sometimes, medical tests done for underwriting purposes point to a potential health or mortality concern, even when the client has received a clean bill of health from their attending physician. This can result in the client being offered a ‘rated’ life insurance policy or being categorically declined coverage altogether even though the client reports, “But my doctor says I’m fine!” Continue reading “But My Doctor Says I’m Fine” →