The Metabolic Syndrome and All-Cause Mortality in an Insured Lives Population

Abstract

Metabolic syndrome and its association with mortality have not been studied in insured lives populations. The Swiss Re Study evaluated metabolic syndrome prevalence and associated mortality from all causes and circulatory disease in a cohort of 35,470 predominantly healthy individuals, aged 18–83 years, who were issued life insurance policies between 1986 and 1997. Metabolic syndrome was defined using the National Cholesterol Education Program (NCEP) Expert Panel Adult Treatment Panel (ATP) III guidelines. The NCEP obesity criteria were modified with a prediction equation using body mass index, gender, and age substituted for waist circumference. Adjustments also were made for nonfasting triglyceride and blood glucose values. Risk ratios for policyholders identified with metabolic syndrome were 1.16 (P = .156) for mortality from all causes and 1.45 (P = .080) for mortality from circulatory disease compared with individuals without the syndrome. Risk was proportional to the number of components, or score, of the metabolic syndrome present. Risk ratios for metabolic syndrome score were 1.14 (P < .001) for mortality from all causes and 1.38 (P < .001) for mortality from circulatory disease compared with individuals without metabolic syndrome factors. In both all-cause and circulatory death models, relative risk was highest for the blood pressure risk factor. Based on a modified NCEP definition, increased mortality risk is associated with metabolic syndrome in an insured lives cohort and has life insurance mortality pricing implications.     

Economic and environmental impacts of trade liberalization: The case of Indonesia

In recent years, there has been a growing interest in the environmental impacts of trade liberalization. This paper provides further discourse in this area with a study on Indonesia and its trade agreements with Japan (IJEPA) and ASEAN (AFTA). A static global CGE model, known as the Global Trade Analysis Project, was used to project the Indonesian economy to the year 2022, with and without tariff reforms agreed under the agreements. Environmental impacts are assessed using different pollution indicators—air, water and waste. The study suggests that Indonesia would grow rapidly over the period considered with a large deterioration in its environment. Following these, however, the agreements only have a marginal positive impact on Indonesia's output but with a noticeable increase in trade flows and signs of trade diversion. Overall AFTA has a greater impact on the Indonesian economy compared to IJEPA. Similarly, the impact of trade liberalization on the environment is marginal. On the whole, tariff reform is inducing air pollution and reducing water pollution. In conclusion, the study suggests that Indonesia's participation in the AFTA and IJEPA agreements is not likely to bring drastic changes to her economic and environmental performance.     

The roles of insurance and well-specified standards in dealing with environmental risks

The present liability system for managing environmental risks has had huge transaction costs through the courts with limited funds actually utilized for compensation (except to the lawyers) and cleanup of wastes. This paper discusses the use of insurance coupled with well-specified standards as an alternative to the current system. It illustrates the potential for the use of these policy tools in the context of two environmental risk management problems: providing liability protection to contractors involved in asbestos removal and protecting commercial property lenders and owners from liabilities associated with environmental contamination.     

Employee perceptions of well-being and organizational wellness offerings: A study of line-level employees in select-service hotels

ABSTRACT

This research assessed line-level employee perceptions of their own well-being and their awareness of wellness benefits offered by their organizations. Completed questionnaires were collected from 187 employees of select-service hotels in the Midwest. Employees had above average levels of well-being with full-time employees having significantly higher levels of well-being than part-time employees. Employees who are aware of available wellness programs had higher levels of well-being than those who are not aware of these programs. The findings suggest the need for organizations and managers to implement and communicate wellness program offerings to all employees.     

Who Cares about Skills? The Impact and Limits of Statutory Regulation on Qualifications and Skills in Social Care

This article examines the impact of statutory regulation on qualifications and skills in the social care sector in the UK. It draws on various sources and a set of case studies, first carried out in 2003 and replicated in 2008. The analysis shows that the advent of the statutory regime has had a positive effect on the volume of training and qualifications in the sector. However, few organizations have combined training with a broader set of human resource management practices of the kind required for the establishment of a high‐performance work system. This constitutes one of the continuing limits to further skill development. Changes in the regulatory regime risk losing benefits that have been gained.     

The UK and the Euro: Debating the British Decision

This article seeks to inform and enliven the debate on whether or not Britain should join the euro. The central focus of the article involves interviews with two leading economists, Professor Willem Buiter (Chief Economist and Special Counsellor to the President, European Bank for Reconstruction and Development) who strongly supports the case for joining, and Professor Patrick Minford (Professor of Applied Economics, Cardiff Business School) who takes the opposite stance. The article begins with an introduction which places the interviews in context and concludes with a final section summarising the central points of commonality and departure arising in the interviews with Professors Buiter and Minford.