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05.02.06
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." |
