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  • What if Mortality Stops Improving? Introducing a Product Idea that Shares the Risks and Benefits of Changes in Mortality Rates
    What if Mortality Stops Improving? Introducing a Product Idea that Shares the Risks and ... companies and policyholders. We have not modeled “dynamic” lapse rates for the mortality scenarios described ...

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    • Authors: Craig Reynolds, Aatman Dattani
    • Date: Aug 2023
    • Competency: Technical Skills & Analytical Problem Solving
    • Publication Name: Product Matters!
    • Topics: Experience Studies & Data; Experience Studies & Data>Mortality; Life Insurance; Life Insurance>Product development - Life Insurance
  • Session 174: R 101: Available Actuarial Packages & Creating Reproducible Actuarial Analyses
    Session 174: R 101: Available Actuarial Packages & Creating Reproducible Actuarial Analyses The session ... flexible deployment of aggregate data – think dynamic Excel Pivot Tables Output R resources4 ...

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    • Authors: Nicholas Hanewinckel, Matthew Zhang, Hadrien Dykiel, Ron Curran
    • Date: Mar 2020
    • Competency: Technical Skills & Analytical Problem Solving
    • Topics: Experience Studies & Data; Experience Studies & Data>Mortality; Modeling & Statistical Methods
  • Session 113: Mortality Gaps by Socioeconomic Status
    Session 113: Mortality Gaps by Socioeconomic Status The presenters will highlight differences in mortality ... tools and user interface 17© Oliver Wyman Dynamic validation vs MP-2018 Data follows general trend ...

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    • Authors: Steven Baxter, Mark Spong, Donald Sampson
    • Date: Feb 2020
    • Competency: Technical Skills & Analytical Problem Solving
    • Topics: Experience Studies & Data; Experience Studies & Data>Mortality; Experience Studies & Data>Table construction
  • Session 041: Why Health and Wellness Initiatives Matter for Actuaries
    data about our policyholders post-issue enables dynamic premiums based on Vitality status earned each ... and young  Reward, gamification, community  Dynamic UW  Post-issue ongoing UW  Liver cancer protection ...

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    • Authors: Lauren Cross, Richard Pretty, Dustin Yoder, Mandy Luo
    • Date: Jan 2020
    • Competency: Technical Skills & Analytical Problem Solving
    • Topics: Experience Studies & Data; Experience Studies & Data>Mortality; Technology & Applications>Wearables & implants
  • Mortality and Morbidity Data Sources
    Old (AHEAD) study was designed to examine the dynamic interactions between health, family, and economic ... active worker into retirement, and they examine the dynamic interactions between health, family, and economic ...

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    • Authors: R Holman
    • Date: Mar 2019
    • Competency: External Forces & Industry Knowledge
    • Topics: Experience Studies & Data>Morbidity; Experience Studies & Data>Mortality
  • Proactively Managing Life Insurance Risks
    Proactively Managing Life Insurance Risks The article explores the possibility of using the ... addition, imple- menting and maintaining real- time Dynamic Monitoring and Intervention System (DMIS) over ...

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    • Authors: Feng Sun, Amy Tran
    • Date: Aug 2018
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Risk Management
    • Topics: Enterprise Risk Management; Experience Studies & Data>Mortality; Life Insurance>Product development - Life Insurance; Predictive Analytics
  • Value of Longevity Pooling
    2001. Note. They did the work numerically via dynamic programing. I prefer closed-form analytic approximations ... to solve (or replicate) their own stochastic dynamic program if they seek personalized numbers. This ...

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    • Authors: Moshe Arye Milevsky
    • Date: Oct 2017
    • Competency: External Forces & Industry Knowledge
    • Topics: Demography>Longevity; Experience Studies & Data>Mortality
  • Transcript-Session 3B:Comparing Mortality Different Groups
    delta quite frequently. That will turn into a dynamic hedge, where in this paper, it is a static hedge ... it would turn into a dynamic hedge, and there are papers working on how dynamic hedging could be possible ...

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    • Authors: Society of Actuaries
    • Date: Sep 2017
    • Competency: Technical Skills & Analytical Problem Solving
    • Topics: Experience Studies & Data>Mortality
  • Using Relevant Experience Data to Increase Credibility and Reduce Margins
    qualifying for tax-related advantages; and 4. Dynamic policyholder behavior functions reflecting scenario- ... the significant predictors of experi- ence and dynamic policyholder behavior functions that will serve ...

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    • Authors: Mark Birdsall, Marianne C Purushotham
    • Date: Sep 2017
    • Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Professional Values>Practice expertise; Technical Skills & Analytical Problem Solving>Innovative solutions
    • Publication Name: Small Talk
    • Topics: Actuarial Profession>Best practices; Enterprise Risk Management>Risk measurement - ERM; Experience Studies & Data>Mortality; Life Insurance>Pricing - Life Insurance; Life Insurance>Reserves - Life Insurance
  • Using Relevant Experience Data to Increase Credibility and Reduce Margins
    qualifying for tax-related advantages; and 4. Dynamic policyholder behavior functions reflecting scenario-dependent ... identify the significant predictors of experience and dynamic policyholder behavior functions that will serve ...

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    • Authors: Marianne C Purushotham, Mark Birdsall
    • Date: Sep 2017
    • Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Professional Values>Practice expertise; Technical Skills & Analytical Problem Solving>Innovative solutions
    • Publication Name: The Financial Reporter
    • Topics: Actuarial Profession>Best practices; Enterprise Risk Management>Risk measurement - ERM; Experience Studies & Data>Mortality; Life Insurance>Pricing - Life Insurance; Life Insurance>Reserves - Life Insurance
  • Mortality in Social Security Actuarial Projections
    benefit from a comprehensive understanding of the dynamic demographic drivers and the characteristics of ... shape of mortality projections will likely remain dynamic and controver- sial. Special care is needed if ...

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    • Authors: Sam Gutterman
    • Date: Aug 2017
    • Competency: Leadership>Thought leadership
    • Publication Name: In The Public Interest
    • Topics: Demography>Longevity; Experience Studies & Data>Mortality
  • The Future of Retirement in China, EDITION SIX
    The Future of Retirement in China, EDITION SIX The Society of Actuaries (SOA) and the LIMRA Secure ... popular than others, we need to consider today’s dynamic Chinese consumers. 42% 13% 14% 12% 9% 4% 6% ...

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    • Authors: Lauren Finnie
    • Date: Jun 2017
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Professional Values>Public interest representation; Strategic Insight and Integration>Big picture view
    • Topics: Demography>Longevity; Experience Studies & Data>Mortality
  • PBA Corner
    PBA Corner Summary of the NAIC and SOA's PBR Survey. Life insurance valuation;Mortality ... Henry is Mostly Rightabout IFRS for Insurance Dynamic Assumption-Setting for Variable andNon- Variable ...

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    • Authors: Karen Rudolph
    • Date: Mar 2017
    • Competency: Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: The Financial Reporter
    • Topics: Experience Studies & Data>Mortality; Financial Reporting & Accounting>Statutory accounting
  • Living to 100 - Insight on the Challenges and Opportunities of Longevity
    rates (as used in life insurance).[B-12] 3. Dynamic reliability in estimating mortality at advanced ... mono-2002-m-li-02-1-bourbeau.pdf A-13 Using Dynamic Reliability in Estimating Mortality at Advanced ...

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    • Authors: Society of Actuaries
    • Date: Oct 2016
    • Competency: Technical Skills & Analytical Problem Solving
    • Topics: Demography>Mortality - Demography; Demography>Longevity; Experience Studies & Data>Morbidity; Experience Studies & Data>Mortality
  • Mortality and Other Implications of Principle-Based Reserving (PBR) Survey Report
    Mortality and Other Implications of Principle-Based Reserving (PBR) Survey Report A survey report ... governance  Will rely on documentation, static and dynamic validations, etc. Forty-three percent of the ...

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    • Authors: Society of Actuaries
    • Date: Jun 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations
    • Topics: Experience Studies & Data>Mortality
  • Good Research Reads
    Good Research Reads Recently completed experience and research studies from the SOA. Mortality;Long-term ... flow risk management of insurance firms under a dynamic factor modeling framework. To view a complete ...

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    • Authors: Society of Actuaries
    • Date: Jan 2015
    • Competency: Leadership>Thought leadership
    • Publication Name: The Actuary Magazine
    • Topics: Experience Studies & Data>Mortality; Long-term Care>Long-term care insurance; Pensions & Retirement>Retirement risks
  • Good Research Reads
    Good Research Reads Recently completed experience and research studies from the SOA. behavioral economics;mortality ... faced when performing model validation in a dynamic environment. Finally, a case study is provided ...

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    • Authors: Society of Actuaries
    • Date: Aug 2014
    • Competency: Leadership>Thought leadership
    • Publication Name: The Actuary Magazine
    • Topics: Economics>Behavioral economics; Experience Studies & Data>Mortality; Long-term Care>Long-term care insurance
  • Letter from the Editor
    Letter from the Editor In this article the editor previews the issue. longevity;mortality tables;mortality ... risk management, in the article “Flight Paths – A Dynamic Investment Strategy,” I introduce a conceptual ...

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    • Authors: Philip McCaulay
    • Date: May 2014
    • Competency: External Forces & Industry Knowledge
    • Publication Name: Pension Section News
    • Topics: Experience Studies & Data>Mortality
  • Obesity and Mortality
    Obesity and Mortality The percentage of the population who are obese has grown dramatically worldwide ... have produced mixed findings in this regard, a dynamic measure of weight status (incorporating weight ...

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    • Authors: Sam Gutterman
    • Date: Jan 2014
    • Competency: Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Topics: Demography>Population data; Experience Studies & Data>Morbidity; Experience Studies & Data>Mortality
  • Update on Mortality Tables and Application
    a departure from current tables in that it is dynamic and requires the use of projection factors. The ... each valuation date. This makes the table more dynamic with the intention to keep the table from becoming ...

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    • Authors: Mary J Bahna-Nolan
    • Date: Sep 2013
    • Competency: Technical Skills & Analytical Problem Solving
    • Publication Name: Small Talk
    • Topics: Annuities>Reserves - Annuities; Experience Studies & Data>Mortality
  • The Impact of Life - How Mortality Improvement Affects the Life Insurance Industry Today
    The Impact of Life - How Mortality Improvement Affects the Life Insurance Industry Today This article ... the underlying mortality assump- tion is a key dynamic for understanding the impact of the mortality ...

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    • Authors: Jay Biehl
    • Date: Feb 2013
    • Competency: Strategic Insight and Integration>Big picture view
    • Publication Name: Product Matters!
    • Topics: Experience Studies & Data>Mortality
  • Living to 100 - Insight on the Challenges and Opportunities of Longevity
    Living ... to one year. [A-39] 16 | P a g e 3. Dynamic reliability in estimating mortality at advanced ... o-2002-m-li-02-1-bourbeau.pdf A-13 Using Dynamic Reliability in Estimating Mortality at Advanced ...

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    • Authors: Jennifer Haid, Christopher Raham, Michael Kwan Yu Chan
    • Date: Jan 2013
    • Competency: Technical Skills & Analytical Problem Solving
    • Topics: Demography>Mortality - Demography; Demography>Longevity; Experience Studies & Data>Morbidity; Experience Studies & Data>Mortality
  • Mortality Improvement Scale BB Q&A
    Mortality Improvement Scale BB Q&A The Q&A’s contain additional background ... Report. RPEC’s intention is for this to be a dynamic document that could be expanded to address additional ...

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    • Authors: Society of Actuaries
    • Date: Sep 2012
    • Competency: Technical Skills & Analytical Problem Solving
    • Topics: Experience Studies & Data>Mortality; Pensions & Retirement
  • Mortality Improvement Life Reinsurance Survey Report
    Mortality Improvement Life Reinsurance Survey Report The Mortality Improvement Survey Subcommittee ... conservatism. Planning does not.  Valuation uses dynamic lapses rates that may be either higher or lower ...

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    • Authors: Society of Actuaries
    • Date: May 2012
    • Competency: External Forces & Industry Knowledge
    • Topics: Experience Studies & Data>Mortality
  • An Alternative View of Future Mortality
    An Alternative View of Future Mortality The author discusses the various components that ... of a disease that may yet assume a different dynamic going forward than it has in the past, and consequently ...

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    • Authors: Frank Grossman
    • Date: Jul 2011
    • Competency: External Forces & Industry Knowledge
    • Publication Name: Predictive Analytics and Futurism Newsletter
    • Topics: Experience Studies & Data>Mortality
  • Alternative Tools for Mortality Risk Management Survey Subcommittee Report
    Alternative Tools for Mortality Risk Management Survey Subcommittee Report The attached report presents ... validate well 25% Experience not credible yet 5% Dynamic validation not done 5% # of Respondents 20 ...

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    • Authors: Society of Actuaries
    • Date: Aug 2009
    • Competency: Technical Skills & Analytical Problem Solving
    • Topics: Experience Studies & Data>Mortality; Modeling & Statistical Methods
  • Natural Hedging of Life and Annuity Mortality Risks
    static process. Dynamic natural hedging is required for new life or annuity business. Dynamic natural hedging ... even if an insurer is keenly interested in the dynamic natural hedging, whether it can sell ad- equate ...

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    • Authors: Samuel Cox, Yijia Lin
    • Date: Sep 2008
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations
    • Topics: Experience Studies & Data>Mortality; Finance & Investments>Portfolio management - Finance & Investments
  • Securitization of Mortality Risks in Life Annuities
    Securitization of Mortality Risks in Life Annuities Securitization of mortality risks is ... traditional reinsurance. The longevity risk is a dynamic phenomenon. Life expectancy through- out the world ...

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    • Authors: Samuel Cox, Yijia Lin
    • Date: Sep 2008
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Strategic Insight and Integration>Strategy development
    • Topics: Experience Studies & Data>Mortality; Finance & Investments>Investment strategy - Finance & Investments
  • Human Behavior: An Impediment to Future Mortality Improvement A Focus on Obesity and Related Matters
    Human Behavior: An Impediment to Future Mortality Improvement A Focus on Obesity and Related ... behavior, understanding the contributions of its dynamic nature and effects on mortality, particularly of ...

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    • Authors: Sam Gutterman
    • Date: Jan 2008
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Topics: Experience Studies & Data>Mortality; Health & Disability>Chronic health management - Health & Disability
  • On Simulation-Based Approaches to Risk Measurement in Mortality with Specific Reference to Binomial Lee-Carter Modeling Abstract
    On Simulation-Based Approaches to Risk Measurement in Mortality with Specific Reference to Binomial ... values in both period and cohort frameworks. Dynamic simulation models;Mortality modeling;Predictive ...

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    • Authors: Steven Haberman, Arthur Renshaw
    • Date: Jan 2008
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Topics: Experience Studies & Data>Mortality; Pensions & Retirement>Retirement risks
  • On Simulation-Based Approaches to Risk Measurement in Mortality with Specific Reference to Binomial Lee-Carter Modeling
    On Simulation-Based Approaches to Risk Measurement in Mortality with Specific Reference to Binomial ... values in both period and cohort frameworks. Dynamic simulation models;Mortality modeling;Predictive ...

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    • Authors: Steven Haberman, Arthur Renshaw
    • Date: Jan 2008
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Topics: Experience Studies & Data>Mortality; Pensions & Retirement>Retirement risks
  • A Study of the Lee-Carter Model with Age-Shifts
    A Study of the Lee-Carter Model with Age-Shifts We propose an age-shift model to modify the LC model ... can be hedged. These studies all make use of a dynamic mortality model to deal with mortality risk.

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    • Authors: Ching-Syang Jack Yue, HONG-CHIH HUANG, Sharon Yang
    • Date: Jan 2008
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Topics: Annuities>Pricing - Annuities; Demography>Longevity; Experience Studies & Data>Mortality; Global Perspectives; Pensions & Retirement>Retirement risks
  • Human Behavior: An Impediment to Future Mortality Improvement A Focus on Obesity and Related Matters Abstract
    Human Behavior: An Impediment to Future Mortality Improvement A Focus on Obesity and Related ... behavior, understanding the contributions of its dynamic nature and effects on mortality, particularly of ...

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    • Authors: Sam Gutterman
    • Date: Jan 2008
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Topics: Experience Studies & Data>Mortality; Health & Disability>Chronic health management - Health & Disability
  • Update on Preferredand PreNeed ValuationMortality Tables
    Update on Preferredand PreNeed ValuationMortality Tables Two committees continue work on experience ... tables needed to form a founda- tion for more dynamic reserves. Over the remainder of this year, we ...

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    • Authors: Roger Annin
    • Date: Jun 2006
    • Competency: External Forces & Industry Knowledge
    • Publication Name: Small Talk
    • Topics: Experience Studies & Data>Mortality
  • Medical Science and Life Insurance
    Medical Science and Life Insurance Attendees learn the most important advances in medical science ... this committee began what we hope to be a more dynamic system to deliver more timely results from a wider ...

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    • Authors: Bradley T Roudebush, Anthony Milano, Jeremy Maninger Stanley, Anna Hart
    • Date: May 2002
    • Competency: Technical Skills & Analytical Problem Solving>Innovative solutions
    • Publication Name: Record of the Society of Actuaries
    • Topics: Experience Studies & Data>Mortality; Health & Disability>Health risks
  • Mortality - Do the Limbo?
    Mortality - Do the Limbo? The panel examined the trend of a large proportion of new and in-force ... how to formularize the table and make it on a dynamic basis so that it can change from year to year that ...

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    • Authors: Jay Biehl, James B Keller, Steven A Moorhead
    • Date: Oct 1999
    • Competency: External Forces & Industry Knowledge
    • Publication Name: Record of the Society of Actuaries
    • Topics: Experience Studies & Data>Mortality; Reinsurance>Life reinsurance
  • The UP-94 and GAR-94 Tables: Issues in Choosing the Appropriate Table
    particular state. Since most states have adopted the Dynamic Valuation Law, these reserves are based on standard ... considered crucial, as opposed to approximating the dynamic table with a projected static one. Of course, ...

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    • Authors: Christopher M Bone, Lindsay Malkiewich, Marilyn Miller Oliver, Application Administrator, Henry N Winslow
    • Date: Oct 1995
    • Competency: External Forces & Industry Knowledge
    • Publication Name: Transactions of the SOA
    • Topics: Experience Studies & Data>Mortality
  • Death Takes a Holiday: The Selection of Mortality Tables
    Death Takes a Holiday: The Selection of Mortality Tables 1993 SOA Spring Meeting, San Diego. ... in conjunction with an urgent proposal to use a dynamic interest rate standard. Unfortunately the committee ...

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    • Authors: Marilyn Miller Oliver, William S Wright
    • Date: Apr 1993
    • Competency: Technical Skills & Analytical Problem Solving
    • Publication Name: Record of the Society of Actuaries
    • Topics: Annuities>Group plans - Annuities; Experience Studies & Data>Mortality
  • Intervention Effects Among a Collection of Risks
    the relationship among the parameters of the dynamic equations are made ex- plicit, as are the actuarial ... a collection of risks can be calculated under dynamic situations by determining the value of f` over ...

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    • Authors: H Tolley, Kenneth G Manton
    • Date: Oct 1991
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Transactions of the SOA
    • Topics: Experience Studies & Data>Morbidity; Experience Studies & Data>Mortality; Modeling & Statistical Methods; Modeling & Statistical Methods>Markov Chain
  • Development of the 1983 Group Annuity Mortality Table
    Development of the 1983 Group Annuity Mortality Table This paper describes the analysis made ... December of 1979. A Standard Valuation law based on dynamic interest rates had been introduced which would ...

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    • Authors: Robert M Chmely
    • Date: Oct 1983
    • Competency: Technical Skills & Analytical Problem Solving
    • Publication Name: Transactions of the SOA
    • Topics: Experience Studies & Data>Mortality
  • Report of The Task Force on Smoker/Nonsmoker Mortality
    Report of The Task Force on Smoker/Nonsmoker Mortality Covers experience from 1973 - 1978 ... Commissioners (NAIC) Technical Advisory Committee on Dynamic Interest and Related Matters. That Committee was ...

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    • Authors: Society of Actuaries
    • Date: Jan 1982
    • Competency: Technical Skills & Analytical Problem Solving
    • Publication Name: Transactions of the SOA
    • Topics: Experience Studies & Data>Mortality; Life Insurance>Claims - Life Insurance
  • Report of the Committee to Recommend a New Mortality Basis for Individual Annuity Valuation Derivation of the 1983 Table a
    Report of the Committee to Recommend a New Mortality Basis for Individual Annuity Valuation Derivation ... Adop- tion by the states of the concept of dynamic interest rates for valuation may further erode ...

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    • Authors: Society of Actuaries
    • Date: Jan 1981
    • Competency: Technical Skills & Analytical Problem Solving
    • Publication Name: Transactions of the SOA
    • Topics: Annuities>Group plans - Annuities; Annuities>Individual annuities; Annuities>Reserves - Annuities; Experience Studies & Data>Mortality
  • Report of the Special Committee to Recommend New Mortality Table for Valuation
    issues of $1 billion on both a dynamic and static basis. The dynamic basis assumed a 10 percent increase ... various tables tested under both the static and dynamic bases. Exhibit 11 compares the results for each ...

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    • Authors: Society of Actuaries
    • Date: Jan 1981
    • Competency: Technical Skills & Analytical Problem Solving
    • Publication Name: Transactions of the SOA
    • Topics: Experience Studies & Data>Mortality; Life Insurance>Reserves - Life Insurance
  • Book Reviews and Notices
    in the predecessor book--an indication of the dynamic state of social security now as compared with ... mis- understanding, is likely to play a more dynamic role in determining the shape of the 342 BOOK ...

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    • Authors: Society of Actuaries
    • Date: Oct 1976
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Technical Skills & Analytical Problem Solving
    • Publication Name: Transactions of the SOA
    • Topics: Experience Studies & Data>Morbidity; Experience Studies & Data>Mortality; Life Insurance>Non-forfeiture benefits; Pensions & Retirement>Public sector plans; Social Insurance>Social Security
  • National Center For Health Statistics
    National Center For Health Statistics This article contains a listing of the publications ... A. Rettig and 0. Nichols, Some Aspects of the Dynamic Projection of Benejits Under the 1973 Social Security ...

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    • Authors: Application Administrator
    • Date: May 1974
    • Competency: External Forces & Industry Knowledge
    • Publication Name: The Actuary Magazine
    • Topics: Demography; Experience Studies & Data>Mortality; Health & Disability
  • More About Mortality
    More About Mortality Provides a brief review of World Population: An Analysis of Vital Data by N. ... A. Rettig and O. Nichols, Some Aspects o] the Dynamic Projections o] Bene]its Under the 1972 Social ...

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    • Authors: Frederic Seltzer
    • Date: Feb 1973
    • Competency: Results-Oriented Solutions>Actionable recommendations
    • Publication Name: The Actuary Magazine
    • Topics: Experience Studies & Data>Mortality
  • Mortality of Smokers and Nonsmokers
    Mortality of Smokers and Nonsmokers This is a panel discussion on the mortality of smokers ... the total ecological picture. He tries to see a dynamic interaction between the host, the agent or agents ...

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    • Authors: William J November, E Cuyler Hammond, Robert C Hockett, W Harding Le Riche
    • Date: Jan 1964
    • Competency: External Forces & Industry Knowledge
    • Publication Name: Transactions of the SOA
    • Topics: Experience Studies & Data>Mortality