The United States spends considerably more money on medical care per capita ($5,274) than the United Kingdom ($2,164). However, whether greater financial expenditures translate into better health for a country's citizens is uncertain. Strong links between socioeconomic position and health exist in both the U.S. and the U.K. Comparing social differences in illness across both countries can give insight into possible causal explanations for the relationship between socioeconomic status and health.
James Banks, Ph.D., of University College London and Institute for Fiscal Studies, London, and colleagues compared data from the U.S. and England to assess the relative health of older individuals and how health varies by socioeconomic status in the two countries. The researchers used data from the U.S. Health and Retirement Survey (HRS; n = 4,386 residents) and the English Longitudinal Study of Aging (n = 3,681 residents) to compare self-reported health, income and education. To determine whether the tendency to report illness explained health differences, the researchers also used data from the National Health and Nutrition Examination Survey (NHANES; n = 2,097 residents) and Health Survey for England (n = 5,526 residents) to compare biological markers of disease. The study was limited to non-Hispanic whites in both countries.
The researchers found that U.S. citizens in late middle age are much less healthy than their English counterparts for diabetes, hypertension, heart disease, heart attack, stroke, lung disease and cancer. Diabetes prevalence was twice as high in the U.S. (12.5 percent) than in England (6.1 percent) and hypertension was approximately 10 percentage points more common in the U.S. Smoking behavior was simi
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Contact: Michael Marmot, M.D.
m.marmot@ucl.ac.uk
JAMA and Archives Journals
2-May-2006