emerging risks in workers compensation shades of things to come? workers compensation educational...
TRANSCRIPT
Emerging Risks inWorkers Compensation
Shades of Things to Come?
Workers Compensation Educational ConferenceOrlando, FL
August 19, 2008
Robert P. Hartwig, Ph.D., CPCU, PresidentInsurance Information Institute 110 William Street New York, NY 10038
Tel: (212) 346-5520 Fax: (212) 732-1916 [email protected] www.iii.org
Presentation Outline
1. The Obesity Epidemic
2. The Aging Workforce
3. Resurgent Claims Severity
Inflation as a Driving Force
4. War Veterans and Return-to-Work Issues
5. Non-English Speaking Workers
Q&A
#1Emerging (Mega) Trend
The Obesity Epidemic
Definitions:• Obesity
Having a very high amount of body fat in relation to lean body mass
Body Mass Index of 30 or higher
• Body Mass Index (BMI) A measure of an adult’s weight in relation to his or her
height,Specifically, the adult’s weight in kilograms divided by the
square of his or her height in meters
What Do We Mean by “Obesity”and How Do We Measure It?
Source: Centers for Disease Control and Prevention.
BMIs for VariousHeights and Weights
100
150
200
250
300
350
58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76
BMI=25 BMI=30 BMI=35 BMI=40
Height (inches)
Weight (lbs)
1998
Obesity Trends* Among U.S. AdultsBRFSS, 1990, 1998, 2006
(*BMI 30, or about 30 lbs. overweight for 5’4” person)
2006
1990
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
In Every State (except Colorado), Over 20% of the Adult Population is Obese
Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System www.cdc.gov/Features/dsObesity
BMI Categories• Underweight: BMI <18.5• Healthy Weight: BMI=18.5-24.9• Overweight: BMI=25.0-29.9• Obese
Class I BMI=30.0-34.9Class II BMI=35.0-39.9Class III BMI>40.0
For Analysis Purposes,We Create BMI Categories
The Most Obese Workers File Twice as ManyWC Claims as Healthy-Weight Workers
40.9760.17
75.21
14.19
183.63
117.61
5.53 5.807.05
10.80
8.81
11.65
0
20
40
60
80
100
120
140
160
180
200
BMI <18.5(Underweight)
18.5-24.9(HealthyWeight)
25-29.9(Overweight)
30-34.9 (ObeseClass I)
35-39.9 (ObeseClass II)
40+ (ObeseClass III)
Los
t W
ork
day
s p
er 1
00 F
TE
s
0
2
4
6
8
10
12
14
Cla
ims
per
100
FT
Es
Lost Workdays Claims
Source: Ostbye, T., et al, “Obesity and Workers Compensation,” Archives of Internal Medicine, April 23, 2007.
The most obese have 13 times more lost workdays
than healthy weight workers!
WC Medical Claims Costs are 6.8x Higher for the Most Obese Workers
$7,1
09
$13,
338
$19,
661
$3,9
24
$5,3
96 $13,
569
$34,
293
$7,5
03
$51,
091
$23,
373
$23,
633
$59,
178
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
BMI <18.5(Underweight)
18.5-24.9(Healthy Weight)
25-29.9(Overweight)
30-34.9 (ObeseClass I)
35-39.9 (ObeseClass II)
40+ (ObeseClass II)
Medical Claims Costs Indemnity Claims Costs
Source: Ostbye, T., et al, “Obesity and Workers Compensation,” Archives of Internal Medicine, April 23, 2007.
Indemnity costs are 11 times higher for the most obese workers than for healthy-
weight workers.
Some people with high BMI also have other characteristics that contribute to disability and/or death. They Smoke and/or regularly drink alcohol heavily
Are older and/or male
Have chronic diseases (e.g., diabetes, heart disease)
Have other conditions/circumstances (e.g., no health
insurance, don’t exercise) that are related to poor health
Failure to adjust for these “confounding factors” likely results in overstating the effect of obesity.
It’s Not All Because of Obesity: “Confounding Factors”
Source: Flegal, Graubard, Williamson, and Gail, “Excess Deaths Associated with Underweight, Overweight, and Obesity,” JAMA Vol. 293, No. 15 (April 20, 2005) pp. 1861-1867.
Relative* Death Risk for “Never-Smokers” by BMI and Age Category
1.25
0.660.77
2.97
1.000.81
2.30
1.50
1.00 0.901.13 1.12
1.00
1.251.21
0.0
0.5
1.0
1.5
2.0
2.5
3.0
BMI <18.5(Underweight)
18.5-24.9 (HealthyWeight)
25-29.9 (Overweight) 30-34.9 (Obese ClassI)
35+
25-59 60-69 >70
Source: Flegal, Graubard, Williamson, and Gail, “Excess Deaths Associated with Underweight, Overweight,and Obesity,” JAMA Vol. 293, No. 15 (April 20, 2005) pp. 1861-1867.
For never-smokers, the relative death risk appears to be highest for ages 60-69 whose BMI is
either under 18.5 or over 34.9. The pattern including smokers is
similar.
*Compared to people with BMI of 18.5-24.9.
Relative Risk
#2Emerging (Mega)Trend
The Aging Workforce
Source: US Bureau of Labor Statistics, 2004.
40.5
39.0
35.8
34.335.2
36.6
38.0
39.440.6 40.7
30
32
34
36
38
40
42
1962 1970 1975 1980 1985 1990 1995 2000 2005 2008Year
U.S. Workforce is Aging: Significant Implications for Workers Comp
Median Age of U.S. Worker
The median age of US workers as the Baby Boomer begin to retire is about 41 years. Immigration will hold this
number down and may even lower the figure.
Older and less healthy workforce
Sources: US Bureau of Labor Statistics, and Toossi, “Labor Force Projections to 2014: retiring boomers,” Monthly Labor Review, November 2005, pp. 25-44.
57.5
%
57.4
%
57.8
%
57.9
%
58.8
%
58.9
%
59.3
%
59.8
%
59.8
%
60.0
%
59.9
%
59.8
%
59.6
%
59.5
%
59.2
%
59.3
%
59.4
%
76.4
%
75.8
%
75.8
%
75.4
%
75.1
%
75.0
%
74.9
%
75.0
%
74.9
%
74.7
%
74.8
%
74.4
%
74.1
%
73.5
%
73.3
%
73.3
%
73.5
%
57%
60%
63%
66%
69%
72%
75%
78%
1990 1992 1994 1996 1998 2000 2002 2004 2006
% of women in the labor force% of men in the labor force
Year
Changes in Labor Force Participation by Gender, 1990-2006
Projected change from 2004-2014: -1.5% for
men, +0.5% for women
Male/Female Labor Force Participation Rates*, Ages 55-64, 1998-2008
51.0
%
51.2
%
51.5
% 53.1
%
54.5
% 56.5
%
56.0
%
56.6
%
57.9
%
57.9
%
58.5
%
68.3
%
68.5
%
69.0
%
68.2
%
67.1
%
67.9
%
68.2
%
69.6
%
69.9
%
69.5
%
70.1
%
50%
55%
60%
65%
70%
75%
1998.2 1999.2 2000.2 2001.2 2002.2 2003.2 2004.2 2005.2 2006.2 2007.2 2008.2
MaleFemale
Source: US Bureau of Labor Statistics, US Department of Labor; Rates shown are end of 2nd quarter each year.
During the last decade, about 68-69% of men ages 55-64 were in the labor force. But over that span the percent of labor-force participation by women
ages 55-64 rose from 51% to 58.5%.
Participation Rate
*not seasonally adjusted
In January 2008, 18 percent of workers said that, in the past year, they’d changed their expected retirement start.14.2% postponed retirement, 3.8% accelerated it.
These percentages can change quickly: in 2003 the percent changing their planned retirement age in the prior year was 32%.
Some Workers Are Planning to Start Retirement at a Later Age
Source: EBRI Issue Brief No. 316, (April 2008), p. 15
Fatal Work Injury RatesClimb Sharply With Age
5.04.2
3.73.32.72.8
0.9
11.2
0
2
4
6
8
10
12
16-17 18-19 20-24 25-34 35-44 45-54 55-64 65+
Source: US Bureau of Labor Statistics, US Department of Labor; Insurance Information Institute.
The fatality rate for workers 65 and older is triple that of workers age 35-44. The workplace of the future will have to be completely redesigned to accommodate
the surge in older workers.
Fatal Work Injuries per 100,000 Workers (2006)
US Population:2007 vs. 2025 Projection*
14,269
10,721
8,440
7,361
5,523
5,334
21,128
19,647
16,041
12,268
7,557
8,011
0 4,000 8,000 12,000 16,000 20,000 24,000
60 to 64
65 to 69
70 to 74
75 to 79
80 to 84
85 and over
2007 2025
Source: National Projections Program, Population Division, U.S. Census Bureau
*Using the Census Bureau’s Middle (i.e., most probable) projections
Population in each age group (in thousands)
There will be nearly as many
85+ people in 2025 as there are 70-74
today
At What Once Was Retirement Age, More People Are Working
25.2
%
25.2
%
26.3
%
26.5
%
26.2
%
27.9
%
27.2
%
27.4
%
27.9
%
27.3
% 27.8
%
27.6
%
26.8
% 27.6
%
29.3
%
29.5
%
27.9
% 28.5
%
28.7
%
30.8
%
29.3
% 30.1
%
29.1
%
30.3
%
30.1
%
27.0
%
22.9
%
23.0
%
22.8
%
23.0
%
22.3
%
22.5
%
22.1
%
23.5
% 24.4
%
24.4
%
24.3
% 24.9
%
24.4
%
24.4
%
24.8
%
20.0%
22.0%
24.0%
26.0%
28.0%
30.0%
32.0%
Source: US Bureau of Labor Statistics, US Department of Labor; Insurance Information Institute.
The labor force participation rate for workers 65-69 has grown considerably since 1998. It might grow even faster in the future as seniors find they can’t fully retire on their meager retirement savings.
Labor Force participation rate
People born
1929-1933
People born 1939-1943
Quarterly Labor Force Participation Rate, Ages 70-74, 1998-2008
14.2
%
13.8
%
14.2
%
14.0
%
14.0
%
14.4
%
14.4
% 14.9
%
14.9
% 15.4
%
15.6
%
15.3
%
16.4
% 17.0
%
15.8
%
16.2
% 16.7
%
16.9
%
17.2
%
17.0
%
16.7
%
16.8
%
18.0
%
17.5
%
17.3
%
14.6
%
13.1
%13.6
%
12.4
%12.9
%
12.4
%
12.2
%
12.5
% 13.1
%
13.3
%
13.5
%
13.6
%
13.8
% 14.4
%
13.7
% 14.2
%
10%
12%
14%
16%
18%
20%
Source: US Bureau of Labor Statistics, US Department of Labor; Insurance Information Institute.
The labor force participation rate for workers 70-74 has also grown considerably—by about 50%—since 1998. It too might grow even faster in the future as seniors find they can’t fully retire on their meager
retirement savings.
Labor Force participation rate
People born
1924-1928
People born 1934-1938
Quarterly Labor Force Participation Rate, Ages 75 and Over, 1998-2008
5.4%
5.1%
5.1% 5.2%
5.0%
5.5%
5.9%
5.8% 5.9% 6.0% 6.1%
6.5%
6.1%
6.6%
6.3%
6.7%
6.4% 6.
6%
6.0%
6.5%
6.5%
7.1%
7.0%
6.9%
6.9%
5.8%
5.4%
5.1%
4.8%5.
0%
4.6%
4.6%
4.5%
5.2% 5.
4%
5.3%
5.2% 5.3%
5.2%
5.2%
5.1%
2%
3%
4%
5%
6%
7%
8%
Source: US Bureau of Labor Statistics, US Department of Labor; Insurance Information Institute.
The labor force participation rate for workers 75 and over has grown slowly in absolute terms—
but relatively by about 50%—since 1998.Labor Force participation rate
People born 1923 and
earlier
People born 1933 and
earlier
The percent working full time grew from 44% in 1995 to 56% in 2007
Workers 65+ by Work Schedule,1977-2007
Why Elderly Stop Working, byAge Group: 2002
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
55-59 60-64 65-69 70-74 75-79 80+
Poor Health More Time With Family
Wanted To Do Other Things Didn't Like Work
Source: Growing Older in America, US Department of Health and Human Services, p 47.
Percent whostop working
Age 80+ workers not retiring due to poor health!
Older Workers Have More Lost Time from Work Due to Injury or Illness
1211
10
8
6
44
0
2
4
6
8
10
12
14
16-19 20-24 25-34 35-44 45-54 55-64 65+
Source: US Bureau of Labor Statistics, US Department of Labor
There will be more lost time as the
workforce ages in the future.
Median Days Away From Work (2005)
Age 65+ workers median lost time is 50% greater than workers age 35-44
Distribution of Non-Fatal Work Injury Days AwayFrom Work, by Length of Period and Age group,
Ages 45 and over, 2005
38.8
%
11.6
%
20.5
%
30.2
%
32.5
%
15.3
%
17.7
%
34.5
%
28.4
%
19.1
%
12.3
%
40.3
%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
1-5 days 6-10 days 11-30 days 31+ days
Ages 45-54Age 55-64Age 65 and over
Source: US Bureau of Labor Statistics, US Department of Labor, Table 8 from 2005 Survey of Nonfatal Occupational Injuries and Illnesses Requiring Days Away from Work, Revised data released 11-17-2006.
Percentage of cases
Workers 65+ more likely to be out a month or more
Workers 65+ more likely to
be out two weeks than one
No Help from Medicare …
Medicare law has long specified that
• If Workers Compensation is available, Medicare will pay nothing,
• Medicare will pay if costs remain after all WC medical benefits are exhausted, and
• If Medicare does pay a bill, it has a right of recovery from the employer or WC insurer.
Workers Compensationand Medicare
Source: Title 42 Code of Federal Regulations, Section 411 et seq.
and Maybe a Fight from Medicare
Medicare is worried that, for workers who are covered by, or eligible for, Medicare, it will be stuck with costs shifted from those responsible for paying WC costs.
So, in those cases,
• It wants to review, and maybe disapprove, Workers Compensation settlements, if it believes there is insufficient WC money to pay for future medical costs,
• This may align Medicare with workers against employers and WC insurers
• This will increase WC administration costs
Workers Compensationand Medicare
Effect on WC Claims of Social Security Retirement Income
When a SS DI recipient reaches the “full benefit” retirement age, the DI benefit becomes a retirement benefit
• Social Security Retirement Income is not offset for WC indemnity paymentsSo disabled workers age 66 and over can collect both – moral
hazard?
Workers Compensation andSocial Security
#3Emerging (Mega) Trend
Resurgent Claim Severity
Consumer Price Index for Medical Care vs. All Items, 1960-2007
207.3
351.1
0
100
200
300
400
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07
Ind
ex V
alu
e (1
982-
84=
100)
All Items Medical Care
Source: Department of Labor (Bureau of Labor Statistics; Insurance Information Institute.
(Base: 1982-84=100)
Inflation for Medical Care has been surging
ahead of general inflation (CPI) for 25
years. Since 1982-84, the cost of medical care has
more than tripled
Soaring medical inflation is among the most serious
long-term challenges facing
casualty, disability and LTC insurers
Inflation Rate (CPI-U, %),1990 – 2009F
4.9 5.1
3.0 3.2
2.6
1.51.9
3.3 3.4
1.3
2.5 2.3
3.0
3.8
2.8
5.0
4.2
2.92.82.92.4
0
1
2
3
4
5
6
90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08* 08F 09F
*12-month change June 2008 vs. June 2007; Source: US Bureau of Labor Statistics; Blue Chip Economic Indicators, July 10, 2008; Ins. Info. Institute.
Inflation on year-over-year basis was 5.0% in June, well above the recent historical average
Inflation was just 2.8% in 2007 but is accelerating. Medical cost inflation, important
in WC, auto liability and other casualty covers is running far ahead of inflation. Rising inflation can also lead to adverse reserve development
and inadequate reinsurance.
Comparative 2007 Inflation Statistics Important to Insurers ( %)
2.8
4.43.9
2.3
4.1
6.7
0
1
2
3
4
5
6
7
8
CPI-U Core CPI* TotalMedical
Care
PhysicianServices
HospitalServices
LegalServices
Infl
atio
n R
ate
(%)
*Core CPI is the Consumer Price Index for all Urban Consumers (CPI-U) less food and energy costs.Source: US Bureau of Labor Statistics; Insurance Information Institute.
CPI and “Core” CPI are not representative of
many of the costs insurers face
Medical/Legal costs typically run well ahead of inflation
Tort Cost Growth & Medical Cost Inflation vs. Overall Inflation (CPI-U), 1961-2008*
0%
2%
4%
6%
8%
10%
12%
14%
1961-70 1971-80 1981-90 1991-2000 2001-08E
Tort Costs Medical Costs CPI
*Medical cost and CPI-U through April 2008 from BLS. Tort figure is for full-year 2008 from Tillinghast.
Tort System is an Inflation Amplifier
Avg. Ann. Change: 1961-2008*
Torts Costs: +8.4%Med Costs: +6.0%
Overall Inflation: +4.2%
Sources: US Bureau of Labor Statistics, Tillinghast-Towers Perrin, 2007 Update on U.S. Tort Costs; Insurance Info. Inst.
Tort costs move with inflation but at twice the rate
$8.4 $8.5 $8.3$9.1 $9.5
$10.3$11.3
$12.2$13.5
$14.5
$16.5$17.7
$19.0$20.2
$22.1
$24.0$25.4
$5
$10
$15
$20
$25
91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07p
Annual Change 1991–1993: +1.9%Annual Change 1994–2001: +8.9%Annual Change 2002-2006: +7.8%
Accident Year
MedicalClaim Cost ($000s)
2007p: Preliminary based on data valued as of 12/31/20071991-2006: Based on data through 12/31/2006, developed to ultimateBased on the states where NCCI provides ratemaking services; Excludes the effects of deductible policies
Workers Comp Medical Claims Costs Continue to Climb
Cumulative Change = +200%(1993-2007p)
4.5%3.5%
2.8% 3.2% 3.5%4.1%
4.6% 4.7%4.0% 4.4% 4.2% 4.0% 4.4%
5.1%
7.4%
10.1%
8.3%
10.6%
7.3%
13.6%
7.6% 7.2%6.2%
9.2%8.6%
6.0%
0%
2%
4%
6%
8%
10%
12%
14%
16%
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007p
Change in Medical CPIChange Med Cost per Lost Time Claim
WC Medical Severity Rising at Double the Medical CPI Rate
Sources: Med CPI from US Bureau of Labor Statistics, WC med severity from NCCI based on NCCI states.
Average annual increase in WC medical severity from
1995 through 2007 was more than twice the medical CPI
rate (8.2% vs. 4.0%)
Med Costs Share of Total Costs is Increasing Steadily
Indemnity54%
Medical46%
Source: NCCI (based on states where NCCI provides ratemaking services).
Indemnity47% Medical
53%
Indemnity41%
Medical59%1987
1997
2007p
WC Med Cost Will Equal 70% of Total by 2017 if Trends Hold
Source: Insurance Information Institute.
Indemnity30%
Medical70%
2017 Estimate
This trend will likely be supported
by the increased labor force
participation of workers age 55 and
older.
$9
.9
$9
.6
$9
.4
$9
.8
$1
0.0
$1
0.6
$1
1.4
$1
2.4
$1
3.7
$1
5.0
$1
6.4
$1
6.8
$1
7.5
$1
9.8
$1
9.1
$1
7.7
$1
8.2
+4.0%
+1.0%-3.1%-2.8%+4.9%+1.7%+5.9%
+7.7%+9.0%
+10.1%
+10.1%
+8.9%+2.3%+4.5%+1.1%
+2.7%+5.0%
5
7
9
11
13
15
17
19
21
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007p
IndemnityClaim Cost ($ 000s)
Annual Change 1991–1993: -1.7%Annual Change 1994–2001: +7.3%Annual Change 2002–2006: +3.1%
2007p: Preliminary based on data valued as of 12/31/20071991–2006: Based on data through 12/31/2006, developed to ultimateBased on the states where NCCI provides ratemaking servicesExcludes the effects of deductible policies
Workers Compensation IndemnityClaim Costs Growth Is Moderate
Lost-Time Claims
Accident Year
3.0%
4.3%5.0%
4.4%5.2%
4.4%
2.4%2.0%
2.4%2.8%
3.4% 3.3%
5.9%
7.7%
9.0%
10.1%
4.8%
1.9%
3.0%
5.5%
4.0%
3.0% 2.4%
9.7%10.9%
1.7%
0%
2%
4%
6%
8%
10%
12%
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007p
Change in CPS Wage Change in Indemnity Cost per Lost-Time Claim
WC Indemnity Severity vs. Wage Inflation
2006p: Preliminary based on data valued as of 12/31/2006; 1991-2005: Based on data through 12/31/2005, developed to ultimate. Based on the states where NCCI provides ratemaking services. Excludes the effects of deductible policies. CPS = Current Population Survey.Source: NCCI
WC indemnity severity is once again outpacing
wage inflation
#4Emerging (Mega) Trend
Returning InjuredWar Veterans to the
Workforce
Injury Count from March 19, 2003through Aug 2, 2008
0
200
400
600
800
1,000
1,200
1,400
1,600
Mar
-03
Apr
-03
May
-03
Jun-
03Ju
l-03
Aug
-03
Sep
-03
Oct
-03
Nov
-03
Dec
-03
Jan-
04F
eb-0
4M
ar-0
4A
pr-0
4M
ay-0
4Ju
n-04
Jul-
04A
ug-0
4S
ep-0
4O
ct-0
4N
ov-0
4D
ec-0
4Ja
n-05
Feb
-05
Mar
-05
Apr
-05
May
-05
Jun-
05Ju
l-05
Aug
-05
Sep
-05
Oct
-05
Nov
-05
Dec
-05
Jan-
06F
eb-0
6M
ar-0
6A
pr-0
6M
ay-0
6Ju
n-06
Jul-
06A
ug-0
6S
ep-0
6O
ct-0
6N
ov-0
6D
ec-0
6Ja
n-07
Feb
-07
Mar
-07
Apr
-07
May
-07
Jun-
07Ju
l-07
Aug
-07
Sep
-07
Oct
-07
Nov
-07
Dec
-07
Jan-
08F
eb-0
8M
ar-0
8A
pr-0
8M
ay-0
8Ju
n-08
Jul-
08
Non-Fatal Injuries to Military Personnel Deployed in Iraq
Source: Brookings Institution, Iraq Index Archive, updated August 18, 2008.
Injury counts can fluctuate dramatically from month to month but are now near their
lowest levels since the start of the war
30,480 military personnel were reported wounded through July 2008 in Operation Iraqi Freedom. There
are important employer issues associated with their return to work
Injury Rate of Troops Deployed in Iraq May 2003 through July 2008 (Injuries as % of Total Troops Deployed)
0.0%
0.2%
0.4%
0.6%
0.8%
1.0%
1.2%
May
-03
Jun-
03Ju
l-03
Aug
-03
Sep-
03O
ct-0
3N
ov-0
3D
ec-0
3Ja
n-04
Feb-
04M
ar-0
4A
pr-0
4M
ay-0
4Ju
n-04
Jul-
04A
ug-0
4Se
p-04
Oct
-04
Nov
-04
Dec
-04
Jan-
05Fe
b-05
Mar
-05
Apr
-05
May
-05
Jun-
05Ju
l-05
Aug
-05
Sep-
05O
ct-0
5N
ov-0
5D
ec-0
5Ja
n-06
Feb-
06M
ar-0
6A
pr-0
6M
ay-0
6Ju
n-06
Jul-
06A
ug-0
6Se
p-06
Oct
-06
Nov
-06
Dec
-06
Jan-
07Fe
b-07
Mar
-07
Apr
-07
May
-07
Jun-
07Ju
l-07
Aug
-07
Sep-
07O
ct-0
7N
ov-0
7D
ec-0
7Ja
n-08
Feb-
08M
ar-0
8A
pr-0
8M
ay-0
8Ju
n-08
Jul-
08
Non-Fatal Physical Injury Rates Among Troops in Iraq
Source: Insurance Information Institute calculations based in data from the Brookings Institution, Iraq Index Archive, updated August 18, 2008.
About 1-in-300 troops is wounded in any given month. On an annual basis,
a soldier in Iraq has about a 4% chance of being wounded
Troops Deployed from May 2003 through July 2008
100
110
120
130
140
150
160
170
180
May
-03
Jun-
03Ju
l-03
Aug
-03
Sep
-03
Oct
-03
Nov
-03
Dec
-03
Jan-
04F
eb-0
4M
ar-0
4A
pr-0
4M
ay-0
4Ju
n-04
Jul-
04A
ug-0
4S
ep-0
4O
ct-0
4N
ov-0
4D
ec-0
4Ja
n-05
Feb
-05
Mar
-05
Apr
-05
May
-05
Jun-
05Ju
l-05
Aug
-05
Sep
-05
Oct
-05
Nov
-05
Dec
-05
Jan-
06F
eb-0
6M
ar-0
6A
pr-0
6M
ay-0
6Ju
n-06
Jul-
06A
ug-0
6S
ep-0
6O
ct-0
6N
ov-0
6D
ec-0
6Ja
n-07
Feb
-07
Mar
-07
Apr
-07
May
-07
Jun-
07Ju
l-07
Aug
-07
Sep
-07
Oct
-07
Nov
-07
Dec
-07
Jan-
08F
eb-0
8M
ar-0
8A
pr-0
8M
ay-0
8Ju
n-08
Jul-
08
Troop Strength Levels in Iraq Guarantee Significant Flow of Injured
Source: Brookings Institution, Iraq Index Archive, updated August 18, 2008.
Approximately 30% - 40% of deployed troops are National Guard or Reservists,
meaning up to 200,000+ people have been or will be returned to the workforce soon
(Thousands)
Status of Personnel Deployed to Iraq and Afghanistan*
61.3%70.6%
86.7% 93.5% 89.1%
24.0%18.8%
14.8% 10.6% 13.3% 6.5% 10.9%
0%
20%
40%
60%
80%
100%
Army Air Force Marines Navy CoastGuard
Reserves
National Guard
Active Duty
Nearly 40% of Army and 30% of Air Force personnel deployed to Iraq and Afghanistan
are National Guard or Reservists
*September 2001 through January 2005. (latest available).Source: Brookings Institution, Iraq Index Archive, updated June 5, 2006.
513
197
53
0
100
200
300
400
500
600
Since 2003 More than Once Three or MoreTimes
Source: Brookings Institution, Iraq Index Archive, updated August 18, 2008.
There have been more than a half million Iraq deployments
since 2003 (as of August 2008). Many troops are deployed
multiple times. The likelihood of exhibiting symptoms of PTSD increase with each deployment
Total Number of U.S. Army Troops Deployed to Iraq (Thousands)
Percentage of Non-Commissioned Officers Suffering from Symptoms of PTSD by Number of Deployments…
12.0%
18.5%
27.0%
0%
5%
10%
15%
20%
25%
30%
% Suffering from PTSD
First Deployment
Second Deployment
Third or Fourth Deployment
Symptoms of PTSD are 54% more likely to be
observed in second deployments and 125% higher in third or fourth
deployments
Source: Brookings Institution, Iraq Index Archive, updated August 18, 2008.
9,1408,672
5,397
8,996
10,854
0
2000
4000
6000
8000
10000
12000
2003 2004 2005 2006 2007
Source: Brookings Institution, Iraq Index Archive, updated August 18, 2008.
The number of troops declared medically unfit for duty increased
69% from 2005 to 2007
U.S. Troops Deployed to Iraq or Afghanistan Deemed Medically Unfit for Combat, 2003-2007
#5Emerging (Mega) Trend
Non-EnglishSpeaking Workers
Fatal Worker Injury Rates byRace and Ethnicity, 2006
4.03.7
5.0
0.00.51.01.52.02.53.03.54.04.55.0
White Black or AfricanAmerican
Hispanic
Source: U.S. Dept. of Labor, Bureau of Labor Statistics, Census of Fatal Occupational Injuries, 2006
Hispanic workers experience highest rate of fatal injuries on the job
Fatality Rate per 100,000 Workers Employed
Fatal Worker Injury Rates byRace and Ethnicity, 2002*
3.80
2.97
4.78
2.32
0.00.51.01.52.02.53.03.54.04.55.0
White, Non-Latino
Black Latino Asian
Source: Worker Health Chart Book, 2004: Centers for Disease Control and III calculations.
Latino workers experience highest
rate of fatal injuries on the job, 25% more
than whites, 61% more than blacks and more than double the
rate for Asians
Fatality Rate per 100,000 Workers Employed
742810
1091
420
0
200
400
600
800
1000
1200
White, Non-Latino
Black Latino Asian
Source: Worker Health Chart Book, 2004: Centers for Disease Control and III calculations.
Latino workers experience highest rate of non-fatal
injuries on the job as well; 46% more than
whites, 34% more than blacks and 150%
the rate for Asians
Injury Rate per 100,000 Workers Employed
Non-Fatal Worker Injury Rates by Race and Ethnicity, 2002
Fatality Rates in Construction: 1992-2001
0
5
10
15
20
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
Latino Non-Latino
Source: Worker Health Chart Book, 2004: Centers for Disease Control and author’s calculations.
Persistent gap (average 60%) between Latino and non-Latino fatality rates in construction attributed to: (1) language gap between workers and managers and (2)
overrepresentation of Latinos in construction
Fatality Rate per 100,000 Workers Employed
Employment and Non-Fatal Injuryby Race, 2002
Group Percent of Injuries
Percent Employment
White, Non-Latino 68.2% 74.1%
Latino 17.1% 10.2%
Black, Non-Latino 11.9% 9.8%
Asian 2.3% 3.8%
Source: Worker Health Chart Book, 2004: Centers for Disease Control and author’s calculations.
Latino workers experience a disproportionate share of non-fatal injuries relative to their share of employment as compared to all other groups
A Look Ahead…
• Rapid rise in Latino population over the next decade (including a substantial share of undocumented workers) suggests increasing worker injury and death in industries where Latinos are over-represented.
• Shift of Latino populations to lower risk jobs due to improvements in educational attainment will reduce Latino workplace injury and deaths rates.
Insurance Information Institute On-Line
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