Recent research has revealed that middle-aged to older U.S. residents appeared to have higher rates of chronic diseases than their English counterparts. The results of the study have been published in the May 3 issue of JAMA.
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.
"Although access to health care is important, differential access can only offer a partial explanation for our findings," the authors write. "... health insurance cannot be the central reason for the better health outcomes in England because the top socioeconomic status (SES) tier of the U.S. population have close to universal access but their health outcomes are often worse than those of their English counterparts."
"Two simple but powerful conclusions follow from our comparisons using biological and self-reports of disease in England and the United States. First, Americans are much sicker than the English. ... Second, the SES-health gradient is also not a reporting mirage... Instead, the SES-health gradient appears with equal force in either self-reports or biological measures of health."