Changes

In 1903, the Specialized Mortality Investigation, a study commissioned by the insurance industry, identified risks factors such as “build, occupation, medical history, and residence” as related to premature mortality. The risk factors provided the companies with easily ascertainable criteria which could be used to identify “substandard risks” or “impaired lives.” (p. 63.) Based on these risks, insurance companies could raise or lower premiums accordingly. One of the key factors identified as having a strong relationship to mortality was an individual’s build. Contrary to the prevailing medical opinion of the time, the study found that overweight people were much more likely to meet an early demise. Other studies quickly determined that blood pressure was also useful in predicting mortality. Blood pressure had never been considered especially important to the medical community before its identification as a risk factor.

Not only did the insurance industry identify risk factors, it educated a generation of physicians “about new developments of diagnosis,” created education programs for the general public and provided nurses to their clients. (p. 74.) Throughout the early twentieth century, insurance companies conducted innovative research designed to improve the accuracy of medical diagnosis. Scores of young doctors were hired by insurance companies to examine potential clients and indoctrinated regarding the importance of risk factors in general health. These early experiences shaped their attitudes regarding the utility of statistics and probability in medical research. On the other hand, the Metropolitan’s health education and visiting nursing programs promoted preventive health care among the general population. The primary motivation behind the Metropolitan’s health programs was financial and not philanthropic. Despite the companies mercenary motivations the programs were overwhelming beneficial and widely praised.