Americans 'more ill than English'

[Demi]

BBC News
London, UK
3 May, 2006


White middle-aged Americans are less healthy than their English counterparts, research suggests.

Americans aged 55 to 64 are up to twice as likely to suffer from diabetes, lung cancer and high blood pressure as English people of the same age.

The healthiest Americans had similar disease rates to the least healthy English, the Journal of the American Medical Association study found.

The US-UK research found greater links between health and wealth in the US.

The joint team from University College London, the University of London and health research organisation Rand Corporation, chose two groups of comparable white people from large, long-term health surveys in the US and in Britain.

In total, the study examined data on around 8,000 people in the two countries.

Each group was divided into three socio-economic groups based on their education and income.

They then compared self-reports of chronic diseases such as diabetes, high blood pressure, heart disease, heart attacks, stroke and lung disease.

The American group reported significantly higher levels of disease than the English.

Rates of diabetes were twice as high among the US group as the English.

One of the study's authors, James Smith of Rand, said: "You don't expect the health of middle-aged people in these two countries to be too different, but we found that the English are a lot healthier than the Americans."

'Medical care'

Those on the lowest incomes in both countries reported most cases of all diseases, except for cancer, and those on the highest incomes the least.

But these health inequalities were more pronounced in the US than they were in England.

The researchers suggested the lack of social programmes in the US, which in the UK help protect those who are sick from loss of income and poverty, could partly help explain why there was a greater link between Americans' wealth and disease.

But the study also found that differences in disease rates between the two nations were not full explained by lifestyle factors either.

Rates of smoking are similar in the US and England but alcohol consumption higher in the UK.

'Bad lifestyle'

Obesity is more common in the US and Americans tend to get less exercise, but even when the obesity factor was taken out, the differences persisted.

One of the researchers Professor Sir Michael Marmot, of the department of epidemiology and public health at University College London, said people would automatically presume the differences were caused by the variance in healthcare systems.

But he pointed out that Americans spent almost double per head on health care than the English, even though the system was organised in a different way.

He said: "There is more uneven distribution in the US and something like 15% of Americans have no health insurance and a bigger number who are under-insured."

But this could not fully explain the differences because the richest Americans with access to the universal healthcare still had worse health than the worst off in England.

Infant mortality

"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.

"We have to take a much broader look at social determinants of health in both countries.

"We need to do further research to fill in the jigsaw pieces of the puzzle," he added.

A Department of Health spokeswoman acknowledged health inequalities in England of the kind revealed in the research and said the government was anxious to tackle them.

It aims to reduce health inequalities in life expectancy and infant mortality by 10% and improve health generally.

"Health trainers, targeted initially at the most deprived communities, are one of the many initiatives which will help narrow this gap by supporting people to make healthier choices in their daily lives," she added.



http://news.bbc.co.uk/1/hi/health/4965034.stm

[ojoj]

thats alright then cos I'm english LOL!!!

[Lez]

Me too :lol:

but alcohol consumption higher in the UK.

Have you seen the price of a Bud in the USA? :yum:

lez

[Araminta]

I'm not surprised that Americans are less healthy than the English.
It is bewildering that the main difference wasn't obesity. I would
like to see further research on this topic.

Whatever the reasons though, I feel that England will follow close
behind the US. When we visited in March (dh is English, I'm American
and we go over regularly) I was saddened to see how many
English people are becoming overweight and shocked to see that
McDonald's have installed drive through windows everywhere.

Regarding drink, I think it is a matter of attitude towards drinking.
Here (rural Tennessee) when people drink, they do so to intoxicated.
In England (at least this is what I observed) alcohol is excepted
much more and not seen as only a tool to get drunk (not that it isn't
that too!) I was surprised to see people having a drink on their
lunch hour for instance.

[kwikdriver]

The answer is here:



"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.

"We have to take a much broader look at social determinants of health in both countries.

"We need to do further research to fill in the jigsaw pieces of the puzzle," he added.

A Department of Health spokeswoman acknowledged health inequalities in England of the kind revealed in the research and said the government was anxious to tackle them.


In the U.S. nobody talks like this. The poor don't get the same healthcare as the wealthy? Then don't be poor -- it's a matter of "personal responsibility." And healthcare isn't about "We;" it's about me -- again, "personal responsibility." That attitude has a profound impact, beyond just hospital care.

Whoever in this article was talking about total costs was missing the boat, as well. Much of our healthcare spending is backloaded -- people go to the doctor after they are sick, usually very sick, when it's more expensive to do so, rather than seeing the doctor pro-actively. It all adds up. Of course we spend more on healthcare, but that in no way eliminates class as a culprit for the disparity of health.

[meredith70]

I lived in London for a few years, and my personal, non-scientific theory about this is that Brits do not live such an individually-owned-car-centric lifestyle. There is much more walking on a day-to-day basis throughout the country, not just in London.

Also, sport is a mandatory, non-negotiable part of public education for kids throughout their education. I swam, played basketball and "rounders" (softball) whether I liked it or not!

[Nancy LC]

In the UK everyone has healthcare while in the US something like 15% of the people are not covered.

I also think work a lot more hours, commute to/from work for hours a day and have a whole lot more stress here.

[Lez]

was surprised to see people having a drink on their
lunch hour for instance.

then don't go to Germany the Germans think nothing of drinking a beer at work at any time.

You must remember the we in europe drank beer because the water was undrinkable/poisoned with all kinds of disease and habits stick

[Angeline]

Americans Less Healthy Than the British
05.02.06, 12:00 AM ET

TUESDAY, May 2 (HealthDay News) -- Americans may have won the Revolutionary War, but 230 years later they're losing the battle for good health to the British.

An extensive new study comparing the health of middle-aged, white residents of both countries finds that "we get sicker, sooner," according to American co-researcher James Smith, a senior economist at Rand Corp.

The gap between the two countries is significant, despite the fact that people in the United States have a standard of living that is 25 percent higher than their counterparts across the Atlantic, and that they spend more than double on health care than the British -- $5,274 per capita vs. $2,164, respectively.

The health gap between the two nations "persists even after you take out things such as the large role of African-Americans with very poor health in the United States, or that people may be reporting health differences differently in the two countries," Smith said. "We also looked at biological markers of disease -- you take away the fact that there may be risk-factor differences in obesity, smoking and drinking."

Even with those factors taken into account, "you are basically back where you started," Smith said. "You find enormous differences in health between the two countries among non-Hispanic whites."

How big a difference? Using well-respected national survey data on the health and lifestyles of more than 6,400 Americans and 9,300 English people aged 40 to 70, the researchers found that U.S. citizens aged 55 to 64 are twice as likely as their peers in England to be diabetic (12.5 percent of Americans surveyed vs. 6.1 percent of British); 10 percentage points more likely to have high blood pressure (42.4 percent vs. 33.8 percent); 6 percentage points more likely to suffer from heart disease (15.1 percent vs. 9.6 percent); and at nearly double the risk for cancer (9.5 percent vs. 5.5 percent). Americans also had higher rates for heart attack, stroke and lung disease when compared to the British.

The findings appear in the May 3 issue of the Journal of the American Medical Association.

Smith said his team assumed that one possible explanation for the disparity might lie in differences in access to care: The United States relies on a patchwork system of private and public health care, whereas England offers universal, socialized medicine to its citizens. To account for the difference, the researchers factored out health-care access by limiting their analysis to financially well-off, non-Hispanic whites -- the vast majority of whom have access to care in both countries. The result: The gap persisted.

At this point, Smith said, he and his British colleagues who helped conduct the study are left scratching their heads.

"We have some plausible hypotheses for the difference in health outcomes," Smith said. A leading theory is that "it may matter how long you've been in an epidemic, and the big epidemic that separates the two countries right now is the obesity epidemic," he said. "We started first, and the English are catching up with us. It may really matter that we have had [rising obesity rates] 20 years longer than they have."

According to a Rand statement, the overall incidence of obesity in the United Kingdom rose steadily from 7 percent of the population in 1980 to 23 percent in 2003. However, in 1980, 16 percent of Americans were already obese, and that number climbed to 31 percent by 2003.

Furthermore, despite spending billions more on health care than the British, Americans "are not treating obesity," said Lona Sandon, an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center in Dalla. "We're treating the symptoms -- the heart disease, the diabetes, the hypertension, everything else. We're not addressing the underlying problem."

Sandon also noted that the English and their European counterparts are much less reliant on cars for transport than people in the United States. "When you go to England, Europe, you'll still see many people walking or using bicycles," she said. "In the United States, we've moved away from that and lessened our physical activity to a bare minimum."

Then there's the ever-expanding American dinner plate. According to Sandon, "our portion sizes are triple or four times what they should be, or what they were 20 to 30 years ago."

Smith stressed, however, that obesity may not be the only reason explaining the health gap. "It may also trace back to childhood health differences between the two countries," he said. And because stress is known to negatively affect health, it's possible that "we may live in a more stressful country than the English do."

Smith noted that the English don't live any longer than Americans do -- they just develop chronic or acute illnesses much later. The real challenge is to prevent or postpone these conditions in the first place, he said.

"The mortality rates among people around age 60 is about the same in both countries," Smith said. This means the U.S. health-care system may do a better job of keeping individuals alive after they develop diabetes, health disease or other illnesses. "But we don't do a better job at preventing people from getting sick in the first place."

However, with obesity rates rising in England, the British may not have much cause to be complacent. "We've had a few more years to get obese and develop chronic illnesses, whereas they are just beginning," Sandon said. "So, if they can look at these comparisons and say, 'We need to stop this now,' they might be better off in the long run."

The study has a different message for policymakers back in the former colonies.

"We have a 25 percent higher standard of living here in the U.S. than the English do," Smith said, "so achieving the level of health of the English should not be outside our reach.

[grandpa]

Stress may play a part as mentioned in another review of this research at: http://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/tb/3214

[seyont]

I'm betting on high-fructose corn syrup, not stress.

Why are the authors surprised that we spend double on healthcare and yet we're not healthier? It's not healthcare, after all, it's sick-care. The doctor is the last person you should turn to if you're healthy.