Study Shows Americans Sicker Than English

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[DitzisDumpster] Study Shows Americans Sicker Than English

 

 

 

 

 

http://news./s/ap/20060502/ap_on_he_me/sick_america

 

Study Shows Americans Sicker Than English

By CARLA K. JOHNSON and MIKE STOBBE, Associated Press WritersTue May

2, 7:59 PM ET

 

White, middle-aged Americans — even those who are rich — are far less

healthy than their peers in England, according to stunning new

research that erases misconceptions and has experts scratching their

heads.

 

Americans had higher rates of diabetes, heart disease, strokes, lung

disease and cancer — findings that held true no matter what income or

education level.

 

Those dismal results are despite the fact that U.S. health care

spending is double what England spends on each of its citizens.

 

" Everybody should be discussing it: Why isn't the richest country in

the world the healthiest country in the world? " asks study co-author

Dr. Michael Marmot, an epidemiologist at University College London in

England.

 

The study, based on government statistics in both countries, adds

context to the already-known fact that the United States spends more

on health care than any other industrialized nation, yet trails in

rankings of life expectancy.

 

The United States spends about $5,200 per person on health care while

England spends about half that in adjusted dollars.

 

Even experts familiar with the weaknesses in the U.S. health system

seemed stunned by the study's conclusions.

 

" I knew we were less healthy, but I didn't know the magnitude of the

disparities, " said Gerard Anderson, an expert in chronic disease and

international health at Johns Hopkins University who had no role in

the research.

 

Just why the United States fared so miserably wasn't clear. Answers

ranging from too little exercise to too little money and too much

stress were offered.

 

Even the U.S. obesity epidemic couldn't solve the mystery. The

researchers crunched numbers to create a hypothetical statistical

world in which the English had American lifestyle risk factors,

including being as fat as Americans. In that model, Americans were

still sicker.

 

Smoking rates are about the same on both sides of the pond. The

English have a higher rate of heavy drinking.

 

Only non-Hispanic whites were included in the study to eliminate the

influence of racial disparities. The researchers looked only at people

ages 55 through 64, and the average age of the samples was the same.

 

Americans reported twice the rate of diabetes compared to the English,

12.5 percent versus 6 percent. For high blood pressure, it was 42

percent for Americans versus 34 percent for the English; cancer showed

up in 9.5 percent of Americans compared to 5.5 percent of the English.

 

The upper crust in both countries was healthier than middle-class and

low-income people in the same country. But richer Americans' health

status resembled the health of the low-income English.

 

" It's something of a mystery, " said Richard Suzman of the U.S.

National Institutes of Health, which helped fund the study.

 

Health experts have known the U.S. population is less healthy than

that of other industrialized nations, according to several important

measurements, including life expectancy. The U.S. ranks behind about

two dozen other countries, according to the World Health Organization.

 

Some have believed the United States has lagged because it is more

ethnically diverse, said Suzman, who heads the National Institute on

Aging's Behavioral and Social Research Program. " Minority health in

general is worse than white health, " he said.

 

But the new study showed that when minorities are removed from the

equation, and adjustments are made to control for education and

income, white people in England are still healthier than white people

in the United States.

 

" As far as I know, this is the first study showing this, " said Suzman.

The study, supported by grants from government agencies in both

countries, was published in Wednesday's Journal of the American

Medical Association.

 

Other studies have measured the United States against other countries

in terms of health care spending, use of medical care and availability

of health care services. But this is the first to focus on prevalence

of chronic conditions, said Anderson, the Johns Hopkins professor.

 

Differences in exercise might partly explain the gap, he suggested.

One of the study's authors, Jim Smith, said the English exercise

somewhat more than Americans. But physical activity differences won't

fully explain the study's results, he added.

 

Marmot offered a different explanation for the gap: Americans'

financial insecurity. Improvements in household income have eluded all

but the top fifth of Americans since the mid-1970s. Meanwhile, the

English saw their incomes improve, he said.

 

Robert Blendon, a professor of health policy at the Harvard School of

Public Health who was not involved in the study, said the stress of

striving for the American dream may account for Americans' lousy health.

 

" The opportunity to go both up and down the socioeconomic scale in

America may create stress, " Blendon said. Americans don't have a

reliable government safety net like the English enjoy, Blendon said.

 

However, Britain's universal health-care system shouldn't get credit

for better health, Marmot and Blendon agreed.

 

Both said it might explain better health for low-income citizens, but

can't account for better health of Britain's more affluent residents.

 

Marmot cautioned against looking for explanations in the two

countries' health-care systems.

 

" It's not just how we treat people when they get ill, but why they get

ill in the first place, " Marmot said.

___

EDITOR'S NOTE: Carla K. Johnson reported from Chicago, and Mike Stobbe

reported from Atlanta.

___

On the Net:

JAMA: http://jama.ama-assn.org