Genetic health risks, insurance, and retirement

Genetic health information is becoming increasingly accessible and affordable.
Widespread genetic testing for diseases can have major implications for consumer
behavior in insurance, pension, and annuity markets, and insurance providers are
concerned about adverse selection and escalating premiums. Here we estimate to
what extent measures of genetic liability (polygenic scores) are informative about
differences in longevity, health expectations, and economic behavior. We construct
polygenic scores for 27 common diseases and mortality risks among 9,272 respondents
of the Health and Retirement Study, a longitudinal household survey of elderly
Americans, by leveraging results from genetic studies in hundreds of thousands of
participants. Survival analysis suggests that the median lifespan is up to 4.5 years
shorter in the highest decile of genetic risk. In particular, the scores for Alzheimer’s
disease, parental lifespan, and smoking intensity are strongly associated with
survival. Our results highlight that polygenic scores can already be combined to stratify
survival similar to or better than some conventional actuarial risk factors, including
sex, and we find that greater genetic risk is negatively associated with various
economic behaviors, including long-term care insurance. We conclude that the rapid
developments in genetic epidemiology pose new challenges for regulating consumer
genetics and insurance markets, and that these need to be urgently considered by
policymakers.