Middle-aged English are healthier than US counterparts.

Blackleaf · Middle-aged English are healthier than US counterparts.

The Mirror.

2 May 2006

English healthier than Americans in middle age - study

[[I wonder if Scots are]]

CHICAGO (Reuters) - Considerably more middle-aged Americans suffer from chronic illnesses than their English counterparts, probably because more Americans are obese, researchers said on Tuesday.

"You don't expect the health of middle-aged people in these two countries to be too different, but we found that the Americans are a lot less healthy than the English," said James Smith, a RAND economist and one of the study's authors.

An analysis of health surveys showed the prevalence of diabetes and cancer were nearly twice as high among white American 55- to 64-year-olds than English in that age group.

Heart disease was 50 percent more common in the United States than in England, and rates of stroke, high blood pressure and lung disease were more common among middle-aged Americans as well.

African-Americans and Hispanic-Americans were excluded from the study because those populations would have skewed the U.S. illness rates even higher, the report said.

In weighing the source of the health gap, the researchers said the answer most likely stemmed from higher U.S. rates of obesity and Americans' tendency to avoid exercise -- though the English were catching up.

The prevalence of obesity in the United States rose to 31 percent in 2003 from 16 percent in 1980, while U.K. obesity rates increased to 23 percent from 7 percent in the same period.

"It may be that America's longer history of obesity or differences in childhood experiences create the problems seen among middle-aged Americans," said study co-author James Banks, an economist at University College London.

"This may mean that over time the gap between England and the United States may begin to close."

Smoking rates were similar in the two countries, while excessive drinking was more common in England, said the study published in the Journal of American Medical Association.

Based on income and education, illnesses except for cancer were more common among the less well-off in both countries.

"The less education and income people had the worse their health," study co-author Michael Marmot of University College London said.

"We cannot blame either bad lifestyle or inadequate medical care as the main culprits in these socio-economic differences in health. We should look for explanation to the circumstances in which people live and work."

Overall, 15 percent of middle-aged Americans suffered from heart disease compared to 10 percent of their English counterparts, diabetes afflicted 12.5 percent of Americans versus 7 percent of the English, and cancer hit 9.5 percent of the Americans compared to 5.4 percent of the English.

The surveys were conducted between 1999 and 2003.

mirror.co.uk

Blackleaf

Here's a mystery: America spends more money, per person, on health than Britain does. So how is it that the English are healthier than Americans?

Transatlantic rivals
May 4th 2006
From The Economist print edition

Middle-aged Americans are puzzlingly sicker than their English counterparts

AMERICA'S medical system has long seemed a poor bargain. Americans spend far more on health care than the inhabitants of other rich countries, but their life expectancy is below the wealthy world's average. Annual medical costs, measured by the Organisation for Economic Co-operation and Development using purchasing-power parities, which take account of price differences, amount to $5,635 per person in America compared with $2,231 in Britain. Yet an American's life expectancy at birth is 77.2 years compared with 78.5 for a Brit.

Life expectancy, though, is a crude and indirect measure of health. For example, two factors contributing to America's poor showing have nothing to do with the victim's health. These are a high rate of road-accident mortality, and the highest homicide rate in the rich world. To overcome this deficiency, a study just published in the Journal of the American Medical Association by Michael Marmot, of University College, London, and his colleagues uses direct measures to compare the health of middle-aged Americans and Britons—and the results still favour the Limeys.

Strictly, the comparison was between Americans and the English. Scots, with their notoriously high rates of heart disease, were conveniently excluded by the choice of the English Longitudinal Study of Ageing as the source of the British data, as were the Welsh and the Northern Irish. With this caveat, Dr Marmot's research revealed that people who are between 55 and 64 years of age are a lot sicker in America than they are in England (see chart). Diabetes is twice as common: 12.5% of Americans suffer from it, compared with 6.1% in England. Cancer is nearly twice as prevalent in America, while heart disease is half as high again.

The findings are based on people's own reports of their health. That could be misleading if, for example, Americans are more likely to describe themselves as sick than stiff-upper-lip Englishmen are. So, as a cross-check, Dr Marmot and his colleagues examined direct biological markers of health in the two populations by analysing blood samples taken during surveys of middle-aged people in both countries. These generally confirm the results. For example, levels of C-reactive protein (a marker of inflammation) and high-density lipoprotein (a cholesterol-transport molecule correlated with good cardiac health) both indicate that Americans are at much more risk of cardiovascular diseases than the English.

All of which raises the question of why middle-aged Americans are so much sicker than their English counterparts. Here, the researchers are more successful in ruling out explanations than in providing them.

America's greater ethnic diversity is not the reason, since the research excludes blacks and Latinos (in England, it excludes Asians and blacks, to make the populations comparable). Access to health care is an obvious suspect, because America, unlike other rich countries, does not have universal coverage. Official figures show that 16% of the population is uninsured. However, only 7% of the middle-aged Americans in the survey lacked health insurance, while within the top third by income, access was almost universal. Yet such people were generally sicker than the top third of the English group. Insurance gaps are thus not to blame for Americans' poorer health.

Nor are unhealthy lifestyles the main culprit, say the researchers. Smoking rates among this age group are slightly higher in England. Obesity is more common in America, but heavy drinking is more widespread in England. Altogether, these risk factors explain very little of the health disparity between the two countries. For example, they account for less than a fifth of the difference in diabetes.

The study thus establishes that middle-aged Americans are much sicker than their English counterparts without being able to pinpoint why. One possibility is that ill health in America reflects obesity in the past as well as today. In 1980, 15% of Americans were already obese compared with 7% of Britons. England might, thus, simply be lagging behind America in the medical impact of prolonged obesity.

The study also has an intriguing implication: that America's medical system may not be such a poor bargain after all. As Dr Marmot's colleague James Banks observes, if Americans are sicker, then more should be spent on treating them.

economist.com

Wolf of Badenoch · Re: Middle-aged English are healthier than US counterparts.

Stockholm · Re: Middle-aged English are healthier than US counterparts.

Middle-aged English are healthier than US counterparts.

Re: Middle-aged English are healthier than US counterparts.

Re: Middle-aged English are healthier than US counterparts.