Americans Have Worse Health Than English Peers, Study
WEDNESDAY, March 9 (HealthDay News) -- From birth through old
age, Americans have poorer health than their British counterparts,
a new study finds.
Researchers used data on nearly 40,000 residents of the United
States and 70,000 residents of England taken from nationally
representative health surveys of the respective countries.
After all the numbers were crunched, Americans had higher rates
of nearly all chronic diseases and markers of diseases than people
of a similar age in England.
Those diseases and signs of poor health included: obesity, low
HDL (good) cholesterol, high overall cholesterol, high C-reactive
protein (a sign of inflammation), diabetes and asthma.
American women had significantly higher rates of high blood
pressure, stroke, heart attack or angina than English women of a
similar age. For males, heart attack or angina is higher in the
United States only at younger ages. High blood pressure is the one
measure that was higher in England than in the United States at
young ages among males.
Taken together, the worse health of Americans by nearly every
measure should be a wake-up call for the public and policymakers,
said study author Melissa Martinson, a postdoctoral research
associate in the Office of Population Research at Princeton
"Across most of these markers of health, Americans fare worse than the English, and the health differences are just as large at very young ages as they are later in life," Martinson said.
And the findings held true even when researchers took into
account income level and broke out their sample into groups
including only whites, the insured, the non-obese, non-smokers,
non-drinkers and the affluent.
In other words, not only were the American poor worse off than
the English poor, the affluent in the United States were worse off
than the affluent in England.
Likewise, the obese in England were generally healthier than the
obese in the United States, and so on.
The finding that even American youths are less healthy than
English youths came as something of a surprise, Martinson said.
They expected to find that middle-aged and older Americans were in
poorer health than those of a similar age in England because of the
higher rates of obesity in the United States, higher rates of
diabetes, heart disease and other lifestyle and behavioral
But even among kids, some of the differences were stark. For
example, 12 percent of American girls and 11 percent of boys aged 4
to 11 are obese, compared to 7 percent in England. More than 17
percent of U.S. boys and girls aged 12 to 19 have asthma, compared
to about 8 percent of English youths of that age.
For all age groups over age 4, about 50.5 percent of people in
England have a normal weight, compared to only 41 percent of
Americans; about 18 percent of people in England are obese,
compared to 29 percent of Americans.
More than 13 percent of Americans of all ages have asthma,
compared to 6.5 percent of England's residents, the study
Nearly 22 percent of Americans aged 12 and up have high
cholesterol, compared to 16 percent of their peers in England, the
researchers reported in the March 9 online edition of the
American Journal of Epidemiology.
The worse health comes in spite of consuming far more
health-care dollars than other countries, according to Mauricio
Avendano, a research fellow at the Harvard Center for Population
and Development Studies, who co-wrote an accompanying
Americans make up just 5 percent of the world's population, yet
they represent more than half of every medical dollar spent on the
planet, Avendano said.
And all that money isn't doing them as much good as one might
think it would. American life expectancy is near the bottom of
rankings that include European nations, he explained.
It's especially notable that this paper compared Americans to
people in England, who are considered among the least healthy
Europeans, Martinson said.
"I presented this paper in England, and they were all surprised because they are known as the 'sick' European country," she said. "They were saying, 'The U.S. must be doing really bad because they're worse than us, and we're worse than the rest of the European countries.'"
So, how to explain the differences?
There are likely multiple explanations, including obesity,
diabetes and higher rates of poverty, Avendano said. The United
States actually has lower rates of smoking than England, although
that didn't used to be true.
And though lack of access to health care for many Americans
certainly isn't good for their health -- England, like other
European countries, has universal coverage -- it's not the only
explanation for the differences, Avendano said.
Certain aspects of American labor markets and social policy may
matter just as much or more. American workers generally have less
protection from losing their jobs, and when they do, they get lower
unemployment benefits. Americans can expect unemployment benefits
to replace 48 percent of lost wages compared to 78 percent in the
United Kingdom, 81 percent in Germany and 95 percent in Sweden,
according to the editorial.
Women in the United States get no or only limited paid maternity
leave, while women in the United Kingdom get more than nine weeks,
French women get 47 weeks and Swedish women get 62 weeks, the
The United States also has higher poverty rates, they added.
Among children, for instance, in 2005, 21 percent of children in
the United States lived in poverty, compared with 10 percent in the
United Kingdom, 4 percent in Sweden and 8 percent in France.
The relative weakness of the U.S. social safety nets may mean
less security and more stress, and that can also take a toll on
health, Avendano suggested.
"These benefits may not be good for the economy, but we believe these benefits have an impact on health," he said of the system in England.
James P. Smith, a senior economist at the RAND Corp., said prior
research has shown the health disparities at older ages, but this
study is among the first to look at disparities at younger
"Americans are less healthy than the English across the board," Smith said.
For more on life expectancy, go to the
Organization for Economic Co-operation and
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