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Life Health > Health Insurance

10 deadliest states for flu

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Influenza is something that can give an agent selling any life- or health-related product an urgent reason to reach out to clients and prospects.

A U.S. flu season typically creaks to a start in October and winds down around April or May.

The U.S. Centers Disease Control and Prevention recorded about 4,600 deaths directly caused by the flu in 2014, the latest year for which full, detailed mortality figures are available. Physicians listed flu as a contributing cause of death in a few thousand other cases. 

But, even in an ordinary bad flu season, flu can cause enough health insurance claims to get the attention of health insurance companies’ chief financial officers, and the securities analysts that keep tabs on health insurance companies for investors.

Related: CFOs notice the flu

For consumers, flu can produce the kinds of out-of-pocket hospital bills that make a good hospital indemnity insurance policy a nice thing to have.

Complications of flu, such as pneumonia, can lead to short-term disability insurance claims and, of course, life insurance claims. Flu occasionally brings on Guillain-Barre syndrome, a paralytic condition that may result in long-term disability insurance or long-term care claims.

Related: Could Zika paralyze hundreds of U.S. adults?

A really bad flu season could temporarily paralyze much of the U.S. economy. Financial regulators consider pandemic flu to be such a serious threat that they require large insurers, banks and securities brokers to develop plans to keep basic operations going during a major flu outbreak.

In 1918, the “Spanish flu” influenza pandemic killed more than 500,000 people in the United States and about 20 million people around the world. Researchers are still not sure why the Spanish flu pandemic was so deadly, or how well current medical science could control a similar pandemic.

Public health teams develop a new flu vaccine formula every year, based on predictions about which strains of flu will be circulating. The vaccine reduces the odds that an individual will catch the flu about 50 percent to 60 percent, and it usually reduces the severity of any cases of the flu that an individual does get. Even though the effectiveness rate looks low, the partial effectiveness usually seems to help keep the flu from spreading rapidly enough to get out of control. Occasionally, however, the flu vaccine itself can cause serious problems, such as allergic reactions, or even occasional cases of Guillain Barre syndrome.

For agents and brokers, the flu is a great conversation starter.

You can tell clients and prospects that:

  • Asking their physicians about the idea of getting a flu shot is a great thing to do.

  • The Affordable Care Act now requires all non-grandfathered major medical policies to cover annual flu shots in the basic preventive services package, without imposing co-payments or deductibles on the patients.

  • Medicare Part B covers an annual flu shot with imposing any deductible or other cost-sharing amount on the insured.

What you can’t tell clients is how light, or severe, the 2016-2017 flu season will be.

Here’s a look at the states with the 10 worst death rates in 2014, along with peeks at the first 2016-2017 flu season data. (It’s possible that the look of the numbers may have some relationship with how well prepared a state’s health care system is to fight the flu: States with comprehensive, up-to-date flu tracking reports on the web might be in a good position to notice and contain outbreaks early.)

Colorado flu - Colorado Department of Public Health & Environment

At press time, Colorado had not yet posted a 20160-2017 flu season report. The 2015-2016 was milder than the previous season and peaked later. (Image: Colorado Department of Public Health & Environment)

10. Colorado

Deaths: 114.

Death rate: 2.1.

The Colorado Department of Public Health & Environment had not posted any 2016-2017 flu season data on the influenza section of its website as of Oct. 23.

A Google Trends search for Colorado combined with flu suggests that mid-October interest in flu in Colorado is at its lowest level in about five years. But interest was only slightly higher in October 2012. A frightening outbreak drove search activity levels to about six times the normal level just a few weeks later, in January 2013.

Related: Most life insurance underwriters expect more pandemics


Flu - Kansas Department of Health and Environment

Kansas (Image: Kansas Department of Public Health and Environment

9. Kansas

Deaths: 61.

Death rate: 2.1.

Few patients who visited Kansas outpatient clinics in the first half of October had either the flu or an illness that looked like the flu. But the percentage of outpatient patients with influenza-like illness was also low in October 2014, and 2014-2015 turned out to be a bad flu season for Kansas. In January 2015, more than 8 percent of the patients who went to the doctor had a flu-like illness.  

Related: A billion in pandemic prevention is worth a trillion in cure

Flu - Nebraska Division of Public Health

In Nebraska, the 2015-2016 flu season was milder than the 2014-2015 season and got off to a late start, but it caused more cases of flu in the summer. This year, early October activity is light. (Image: Nebraska Division of Public Health)

8. Nebraska

Deaths: 39.

Death rate: 2.1.

Nebraska public health officials have published detailed 2016-2017 flu season data for the week ending Oct. 8.

Only 1.2 percent of the patients who had a flu-like illness and were tested for the flu actually had the flu.

About 2.3 percent of all emergency room patients, and 5.1 percent of patients ages 4 and younger, had a flu-like illness.

Related: Influenza pandemics: Time for a reality check? 

Flu - Rhode Island Department of Health

Rhode Island has not yet reported flu surveillance data for the 2016-2017 season. Last year, it appeared to have a milder flu season than the rest of the country. (Image: State of Rhode Island Department of Health)

7. Rhode Island

Deaths: 22.

Death rate: 2.1.

Rhode Island had not published any 2016-2017 flu season data as of Oct. 23.

A Google Trends search showed that the search activity level for “Rhode Island” combined with “flu” has been and continues to be at a very low level.

The five-year peak occurred around January 2013. At that time, search activity for that topic was about 12 times higher than the current level of activity. 

Related: Mild flu season hurts CVS profits 


Arkansas flu - Arkansas Department of Health

At press time, the Arkansas Department of Health had not yet posted 2016-2017 flu reports. The 2015-2016 season was mild and got off to a late start, but more of the cases that did occur hit people in April. (Image: Arkansas Department of Health)

6. Arkansas

Deaths: 65.

Death rate: 2.2.

Arkansas officials had not yet posted 2016-2017 flu season data at press time. A Google Trends search showed that search activity for “Arkansas” combined with “flu” is higher than it was in the summer, but lower than it was in October 2015 and October 2014. Arkansas had recent Google flu search activity peaks in January 2013 and against in January 2014.

Related: Actuaries: Flu could be expensive

Iowa Department of Public Health - Center for Acute Disease Epidemiology

In Iowa, the percentage of outpatient health care visits resulting from influenza-like illness, or ILI, appears to be lower this year than it was at the same time a year ago. (Image: Iowa Department of Public Health — Center for Acute Disease Epidemiology)

5. Iowa

Deaths: 75.

Death rate: 2.4.

Like Kansas and Nebraska, Iowa has been recording few outpatient hospital visits due to flu-like illness. Just one of the 411 hospital inpatients surveyed had the flu. Thirteen of the patients tested for the flu turned out to have parainfluenza virus.

Related: Fewer fevers, aches in mild flu season help health insurers

Tennessee Department of Health Laboratory Services

The percentage of all Tennessee outpatient visits resulting from flu-like illnesses seems to be noticeably higher this year than it was at the same time last year. (Image: Tennessee Department of Health Laboratory Services)

4. Tennessee

Deaths: 159.

Death rate: 2.4.

Only 4 of 95 Tennessee counties had any patients test positive for the flu during the week ending Oct. 15, and just 1.7 percent of the patients in outpatient clinics had flu-like illnesses.

Related: CDC: More deaths may be flu deaths

(Image: West Virginia Department of Health & Human Resources)

In West Virginia, the first batch of 2016-2017 flu season data looks similar to the first batch from the previous few years. (Image: West Virginia Department of Health & Human Resources) 

3. West Virginia

Deaths: 44.

Death rate: 2.4.

In West Virginia, the 2013-2014 flu season hit hard from early January through early February, and the 2014-2015 flu season hit hard in early January. The 2015-2016 flu season was mild but peaked later, from mid-February through mid-April.

In early October, emergency room activity related to flu-like illness was about the same as it was two years earlier, at the start of the 2014-2015 flu season.  

Related: 5 worst influenza pandemics


Google Kentucky flu search trends

Google search activity for the search term “Kentucky + flu” may be higher than it was two years ago and about the same as one year ago. (Image: Allison Bell/LHP)

2. Kentucky

Deaths: 111.

Death rate: 2.5.

Kentucky does not appear to post current flu activity data on the Web. A Google Trends search shows that search activity for “Kentucky” combined with “flu” is somewhat lower than it was in October 2015, noticeably lower than in October 2014, and about the same as in October 2013. Flu search activity in the state soared in January 2013, January 2014 and January 2015 but has held steady since January 2015.

Related: Federal HR agency sets flu rules


Flu - North Dakota Department of Health

(Image: North Dakota Department of Health)

1. North Dakota

Deaths: 21.

Death rate: 2.8.

North Dakota has not seen many cases of flu this year, but, even in recent years in which it’s had a large number of case cases, flu activity has typically been slow up until December.

Related: Health insurers unite against flu

State influenza death rates for 2014


Deaths caused by flu

Deaths per 100,000 residents

Alabama   54 1.1
Alaska   Suppressed Suppressed
Arizona   78 1.2
Arkansas   65 2.2
California   457 1.2
Colorado   114 2.1
Connecticut   59 1.6
Delaware   Suppressed Suppressed
District of Columbia   Suppressed Suppressed
Florida   211 1.1
Georgia   113 1.1
Hawaii   13 Unreliable
Idaho   18 Unreliable
Illinois   198 1.5
Indiana   127 1.9
Iowa   75 2.4
Kansas   61 2.1
Kentucky   111 2.5
Louisiana   84 1.8
Maine   23 1.7
Maryland   49 0.8
Massachusetts   83 1.2
Michigan   161 1.6
Minnesota   102 1.9
Mississippi   41 1.4
Missouri   124 2
Montana   12 Unreliable
Nebraska   39 2.1
Nevada   23 0.8
New Hampshire   Suppressed Suppressed
New Jersey   66 0.7
New Mexico   35 1.7
New York   195 1
North Carolina   152 1.5
North Dakota   21 2.8
Ohio   212 1.8
Oklahoma   76 2
Oregon   41 1
Pennsylvania   180 1.4
Rhode Island   22 2.1
South Carolina   80 1.7
South Dakota   13 Unreliable
Tennessee   159 2.4
Texas   418 1.6
Utah   38 1.3
Vermont   Suppressed Suppressed
Virginia   127 1.5
Washington   90 1.3
West Virginia   44 2.4
Wisconsin   97 1.7
Wyoming   10 Unreliable

CDC Wonder Underlying Cause of Death database. 

The CDC suppresses a state’s flu death data when the state has 0 to 9 flu deaths, and printing the data could hurt people’s privacy. The CDC replaces the data with the term “unreliable” when a state has 10 to 19 deaths, and the flu death count is high enough not to invade people’s privacy but is too low to be statistically credible.


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