Americans sicker but live longer than the English: Study

By Dr. Ananya Mandal, MDNov 5 2010

According to a new study in the journal Demographics, and elderly American is not quite as healthy as his English counterpart, but does live just as long, if not longer. The study found that Americans aged 55 to 64 and 70 to 80 had higher rates of chronic diseases than same-aged English people, but they died at about the same rate. Americans aged 65 and older could be sicker than their English peers but lived longer.

Study author James P. Smith economist of the nonprofit RAND Corporation in Santa Monica, California said, “If you get sick at older ages, you will die sooner in England than in the United States… It appears that at least in terms of survival at older ages with chronic disease, the medical system in the United States may be better than the system in England.” Smith co-authored the study with James Banks and Alastair Muriel of the IFS (Institute for Fiscal Studies)

For the study the team analyzed information from the U.S. Health and Retirement Survey and the English Longitudinal Survey of Ageing to determine the prevalence of illness among people aged 55 to 64 and 70 to 80. They also looked at the development of any new illnesses during these years. They noted that disease prevalence and the onset of new disease were higher among Americans for diabetes, high blood pressure, heart disease, heart attack, stroke, chronic lung diseases, and cancer. This high prevalence among Americans carried over to their 70s. Especially diabetes rates were nearly twice as high in the United States than in England, and cancer was more than twice as prevalent in the United States for senior citizens in their 70s.

Deaths from chronic diseases during the ages of 55 to 64 were similar for the English and Americans but not when the Americans were in their 70’s. At the higher age even ill Americans lived longer. The authors write that this may be due to the fact that these same illnesses are more likely to be fatal in England than in America, or that English people may be diagnosed at later stages in their disease, which would result in a higher mortality rate. Smith said, “Both of these explanations imply that there is higher-quality medical care in the United States than in England, at least in the sense that these chronic illnesses are less likely to cause death among people living in the United States.”

Organization for Economic Co-operation and Development (OECD) data show the United States spends more on healthcare than any other nation, and Banks said spending on healthcare for the elderly in the U.S. is almost double that in England. The United States spent 16 percent of its national output or $7,538 per person on health, a figure well over double the $3,000 per person average of all OECD countries.

Epidemiologist David Rehkopf, an assistant professor of epidemiology and biostatistics at the University of California, San Francisco added, “The better care that Americans get from their health-care system occurs very late in the disease process… This does have an important benefit for reducing mortality… However, because less focus is put on prevention, we have to live and manage chronic disease and illness for long periods of time. The findings suggest that the main deficiencies in the U.S. health system may be in preventing disease from occurring. This is important to begin to address if people want to also live disease-free, rather than just longer.”