Patients diagnosed with a terminal illness often ask, “How long do I have?” Whether you receive a life threatening diagnosis or not, as you grow older, you will probably make plans based on how long you expect to live. Life expectancy, the average number of additional years a person at a given age can expect to live, is an estimate that reflects population health and mortality. Based on sex, date of birth, and sometimes, race, life expectancy is used to build a mortality table, also called a life table or actuarial table, that shows “the general probability of a person's death before their next birthday, based on their current age”. Life tables, however, do not take into account a wide number of factors such as current health, lifestyle, and family history.
Based on provisional data for the year 2020, the U.S. Centers for Disease Control and Prevention (CDC) reports that life expectancy in the U.S. fell by 1.5 years in 2020, the biggest one-year drop since World War II. Although much of this decline is attributed to COVID-19, other factors, including death from drug overdose, homicide, and neglect and/or lack of access to treatment for chronic medical conditions such as heart disease and diabetes, also decreased life expectancy. The question that needs to be addressed in our post-pandemic time is: Can life expectancy be accurately estimated by limiting criteria to sex, date of birth, and race? One alternative to an estimate based on such limited data is a “rated age”. Often obtained from an underwriter of structured settlement annuities issued by a life insurance company, a “rated age” evaluates how medical and family history, lifestyle, and current health, in addition to sex, age, and race, may impact life expectancy.
In addition to their role in the construction of insurance policies, life tables are used by states in injury and death actions to calculate recoverable damages. For example, North Carolina law includes a life table that “ . . . shall be received in all courts and by all persons having power to determine litigation, as evidence, with other evidence as to the health, constitution and habits of the person . . . .” (NCGS §8-46. Mortality tables as evidence.) Until these generally accepted tables are updated to take into account the impact of COVID-19, it is likely that the admissibility of these data as evidence will be challenged in the courtroom. The CDC releases national-level life tables annually, and in March 2011, “the first set of annual complete period life tables for each of the 50 states and the District of Columbia (D.C.) for the year 2018” were published. (Arias et al., 2021) “Death certificate information may later be revised, and additional death certificates may be received until approximately 6 months after the end of the year.” This would suggest that life tables reflecting the impact of the COVID-19 pandemic on life expectancy will likely be unavailable for at least a couple of years.