British healthier than Americans in middle-age

May 2 2006

According to a large international study middle-aged Americans are not as healthy as their British cousins.

Joint research between the U.S. and Britain has shown that Americans suffer from more chronic illnesses than their British counterparts, even though the U.S. spends far more on medical care than the UK, and the researchers lay some of the blame on obesity.

Obesity in the United States rose to 31 percent in 2003 from 16 percent in 1980, while UK obesity rates increased to 23 percent from 7 percent in the same period.

Sir Michael Marmot, professor of epidemiology at University College London, who led the British leg of the study, said the findings would surprise international health policy experts.

According to his U.S. colleague James Smith, an economist with the Rand Corporation in California, and one of the study's authors, the results of the study were unexpected as it was not thought the health of middle-aged people in the two countries would be too different.

Smith says the English are a lot healthier than the Americans.

The research which was funded by several U.S. and UK government agencies, initially aimed to examine the social and economic factors affecting health but when large differences between the two countries became apparent the aim changed.

The study looked both at the way people reported their own health and in order to guard against any bias from self-reporting biological markers of disease from blood tests were carried out.

In all there were about 15,000 participants.

Samples in both countries were limited to whites and excluded African-Americans and Hispanic-Americans and recent immigrants, so as to control for racial and ethnic factors.

The researchers say the inclusion of those groups would have raised the U.S. illness rates even higher.

Even when all relevant factors are taken into account, the researchers have difficulty completely explaining their findings and say that their analysis shows that lifestyle factors, in particular the higher rate of obesity in Americans who do less exercise does not totally account for the discrepancy.

They suspect the complete picture might involve the difference in health systems; whereas Britain’s National Health Service provides publicly funded medicine for everyone, Americans under the age of 65 depend on private insurance.

Marmot suggests that, while the healthcare provided by the British state health service was not superior to the private U.S. system, it provided important psychological reassurance.

Banks says America's longer history of obesity or differences in childhood experiences may have helped create the problems currently being seen among middle-aged Americans.

The study also found that while smoking rates were similar in the two countries,excessive drinking was more common in England.

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

Overall, the surveys, which were conducted between 1999 and 2003, found that 15 percent of middle-aged Americans suffered from heart disease compared to 10 percent of their British counterparts, diabetes afflicted 12.5 percent of Americans versus 7 percent of the British, and cancer hit 9.5 percent of the Americans compared to 5.4 percent of the British.

The researchers say England has more programmes aimed at isolating individuals from the economic consequences of poor health in terms of their medical expenditure and especially earnings and wealth reduction.

The study is published in the Journal of the American Medical Association.