The claim that walking 10,000 steps each day makes a significant difference to one’s health didn’t actually come from medical research — the general consensus is that it started as a marketing campaign in Japan in the 1960s.
In 1965, after the Tokyo Olympics, there was a big fitness boom in Japan. Yamasa Clock and Instrument Company created one of the first pedometers and branded it the “Manpo-kei”, which means “10,000 steps meter” in Japanese. The number 10,000 may have been chosen partly because it’s a nice round, memorable number but at the time, there wasn’t strong scientific evidence that 10,000 was a magic threshold. It was more of a catchy slogan to promote walking and health awareness.
It turns out that the magic number is actually 7,000. That is according to Daily steps and health outcomes in adults: a systematic review and dose-response meta-analysis, an article published in The Lancet Public Health in August.
The authors analysed data from over 160,000 adults and found that walking approximately 7,000 steps per day is associated with reductions in the risk of several serious health outcomes, including all-cause mortality (47% reduction), cardiovascular disease (25% reduction), cancer (6% reduction), type 2 diabetes (14% reduction), dementia (38% reduction), depression (22% reduction), and falls (28% reduction).
Current mortality tables do not factor in the number of steps walked each day by an individual – after all, the ability to collect this data is only fairly new, with the advent of smartphones and associated GPS tracking technology.
But if everyone in an insurance cohort – a defined benefit pension cohort from a pension risk transfer deal, a book of life annuity business, or even a standard whole of life insurance cohort – walked 7,000 steps a day, the mortality table would, most likely, look very different than it does now.
But how can pensions and insurers actually collect and use this data? And what is the reality for insurers and pensions that want to collect data – on enough people?
“Activity level data, including steps, can be gathered from a number of sources, including smartphones, wearable watches, patches, health related apps, etc. This data is able to be captured on any individual that grants access to their data,” said Mary Bahna-Nolan, Senior Director, Insurance Consulting & Technology at WTW.
“For insurance applications where there is an application process, an insurer can request access to such information which often includes both current and historical data but for a pension scheme or business that covers a group cohort, it becomes more challenging to obtain the data on a sufficient number of individuals – at least, today.”
There are people – likely plenty of them – that do monitor their daily number of steps; smartphones now come with built-in apps which provide this information at no charge. As with any new or emerging technology, there are teething issues, but patterns will emerge eventually.
“Different devices and how an individual uses them, wears them, etc. can provide different measurable data. Over the course of time, however, consistency in patterns of activity will likely be the similar to use in certain scoring models and measures. In addition, the technology for capturing and monitoring activity and inactivity levels continues to improve and thus, so should the reliability of the data itself. In addition, the models, as they obtain more data points, will become better calibrated to a particular population,” said Bahna-Nolan.
Whether or when insurance and pension cohorts get to a place where most of their cohorts are doing their 7,000 steps is up for debate; after all, an article from The Lancet Global Health just a year ago, based on physical activity reported by adults (aged ≥18 years) in population-based surveys, suggests that insufficient physical activity increased in people aged 60 years and older in all regions and both sexes.
So, is there realistically anything for pensions and insurers to be worried about in terms of their mortality models underestimating the extent to which people are walking 7,000 steps per day – and therefore, their mortality profile?
“Behavioural change is slow and often linked to educational background. Insurers already use a wide range of proxy variables such as income, education and postal code, to gauge likely good or bad health behaviours and willingness to change. As such the study will not cause immediate concern for those pricing individual annuities or group annuity policies,” said Steven Baxter, Chief Data Scientist at Club Vita.
“That said, we are aware of several insurers who are actively assessing the practicalities of using step count data to improve their approach to understanding the mortality or longevity risk of policyholders and form part of underwriting. These organisations will no doubt be reading this study with interest.”
Indeed, a recent study by WTW found that wearable-driven mortality modelling does improve underwriting accuracy and while there are many challenges for pensions or insurers to get accurate step count data – and enough of it – for inclusion in a model, you have to start somewhere.
“For any insurance use, it is important that insurers and pensions perform feasibility studies to understand the data and how to best calibrate it to their target population; indeed, we only recommend incorporating such data into key decision making after careful study and analysis of the implications on specific use cases,” said Bahna-Nolan.
“But this is an area that will continue to emerge over time, but we can’t understand the implications and opportunities if we don’t start collecting the information and measuring the outcomes.”