PUBLIC HEALTH
March 19, 2011

US Unhealthier Than UK

Americans' health is worse than their British counterparts' in everything from asthma to angina. Is our healthcare system to blame?

As if the American healthcare system wasn’t already under the gun, a new study reports that Americans suffer from significantly more health problems than their British counterparts. What’s more, the disadvantage seems to start at a very early age. But the researchers suggest that it may be our medical practices that are to blame, rather than our genes.

The new research combined data from two large-scale studies, together totaling almost 110,000 people, from ages 0 to 80. The incidence of various chronic diseases, as well as common markers for disease (for example, c-reactive protein, or CRP, which is linked to inflammation and certain health problems like heart disease), were compared across American and British participants.

Since per capita spending on healthcare is double in the US what is in the UK, the results present a particular conundrum.

Americans faired significantly worse in the following categories: obesity, HDL ("good") cholesterol levels, cholesterol ratio, CRP, diabetes, asthma, angina (chest pain), and stroke (in women). Hypertension was the only condition that did not differ significantly between the two countries. For certain conditions the differences were more pronounced in women than in men (CRP, hypertension, angina, and stroke).

Even more striking was the fact that the differences seen in the US and UK samples were present at a very early age. For example, obesity was higher in US children in the 4-11 age group, and cholesterol profiles were worse in US adolescents as young as 12-19.

Since per capita spending on healthcare is double in the US what is in the UK, the results present a particular conundrum. The authors point out that earlier evidence has shown that the health differences in the two countries cannot be explained by other variables like health behaviors, health insurance, obesity, and socioeconomic status. Rather, they suggest that the healthcare system itself may explain at least some of the problem. Study author Julien Teitler says in the study’s press release that "[d]espite the greater use of health-care technology in the United States, Americans receive less preventive health care than their English counterparts." For example, Americans have fewer doctor visits per year, which may contribute to inadequate preventive care in the States.

Teitler adds that "given the emergence of large health differences at the youngest ages for which we have data, the causes of the U.S. health disadvantage are likely rooted in early life (or even prenatal) experiences or environments." More research will clearly be needed to tease apart just why we are so much unhealthier than our relatives across the pond – once we understand this, we will, with luck, be able to change the pattern.

The study was carried out by researchers at Princeton University, Columbia University, and the University of Medicine and Dentistry of New Jersey. It was published in the March 9, 2011 issue of the American Journal of Epidemiology.

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