From Medscape Medical News
English Are Healthier Than Americans at Almost Every Age
Μια ενδιαφέρουσα μελέτη
Norra MacReady and Jacqueline A. Hart, MD
April 20, 2011
Americans have higher rates of chronic illness at almost every age than people in England, a new study shows.
Americans were significantly more likely to be obese or underweight, have diabetes or asthma, or suffer a heart attack than their counterparts across the Atlantic, lead author Melissa L. Martinson, PhD, from Princeton University, New Jersey, and colleagues report in the April issue of the American Journal of Epidemiology. American women also were more likely than English women to have a history of angina, or a stroke after age 20 years (P < .05 for all comparisons). Among men, the differences in the prevalence of heart attack and angina were most striking at younger ages.
This pattern persisted even when the investigators restricted the analysis to white, insured, nonobese, nonsmoking teetotalers in both countries.
The findings suggest that "US health disadvantages compared with England arise at early ages and that differences in the body weight distributions of the 2 countries do not play a clear role," the authors write.
Researchers are baffled by the health disparities between England and the United States, they explain. The United States spends twice as much on healthcare as does the United Kingdom, yet "adults aged 50 years or older in the United States have significantly worse health status and lower life expectancy than those in England." Previous studies, which focused on elderly people or infants, have shed little light on these differences, but little attention has been paid to people of other ages. The role of body weight, which is on average much higher in the United States than the United Kingdom, also has not been fully explored. In this study, the authors used data from 2 nationally representative surveys spanning the ages from 0 to 80 years to compare the health status of the populations in the 2 countries in an effort to learn more about their disparities.
The data came from the National Health and Nutrition Examination Survey in the United States and the Health Survey for England in the United Kingdom. "Both are large, nationally representative health surveys that have comparable measures of health assessed through interviews and physical examinations," the researchers write. The analysis included data on 39,849 Americans from the 1999 to 2006 National Health and Nutrition Examination Survey, and on 69,084 English people from the 2003 to 2006 Health Survey for England.
Overall, rates of chronic conditions and markers of disease, such as C-reactive protein, were higher among Americans. The single exception was hypertension, which was more prevalent in England among people aged 12 to 34 years (P < .05) and similar between the populations at older ages. Most of the cross-country differences were observed in all age groups, except for heart attack and angina, which was higher among American men only at younger ages, and hypertension, which was, again, higher in England at younger ages.
Whatever the reason for these differences in health, they appear to arise early in life, the authors write. "Our findings suggest that body weight is not the driving force behind the observed health differences between the United States and England and that, if weight plays a role, it is a complicated one."
One contributing factor to the differences may be that "Americans receive less preventive health care than English counterparts," the authors note. In contrast, differences in the use of healthcare technology, higher screening rates for certain conditions, greater use of some healthcare procedures (eg, coronary bypass grafting and angioplasties), and higher survival rates for both cardiovascular and cerebrovascular diseases in the United States may also partially explain the disparities. However, "given that the United States has higher age-specific mortality for every age group (except for those 75 years or older), these differences cannot fully account for the observed cross-country differences in health conditions and markers of disease," the authors say. They suggest that a promising focus of future research might be health differences between the populations in the 0-to-11-year age groups.
Health Discrepancy in United States May Be a Result of Social Inequalities
As Mauricio Avendano, PhD, from the Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands, and Ichiro Kawachi, PhD, from the Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massachusetts, point out in an accompanying editorial, "Although Americans make up just 5% of the world's population, they represent more than half of every medical dollar expended on the planet."
Life expectancy in the United States is amongst the lowest worldwide, the editorialists add, and remark that the work of Dr. Martinson and colleagues reinforces that fact: "American adults live in poorer health than most Europeans," they write.
Dr. Avendano and Dr. Kawachi suggest that the answer to this paradox may be in the examination of social policies stating that the United States differs from other developed countries "in terms of the weakness of its social safety nets, the magnitude of social inequalities, and the harshness of poverty." They agree with Dr. Martinson and associates that "broadening the scope of their inquiry to include the social and policy contexts of nations might help to solve the puzzle of the US health disadvantage."
In a response to the editorial, however, Dr. Martinson and colleagues caution against jumping to conclusions before more data are examined and all possible distinguishing factors are explored.
The study was supported by the National Institutes of Health. The authors have disclosed no relevant financial relationships. Dr, Avendaon is supported by the Netherlands Organization for Scientific Research, a Eur-Fellowship from the Erasmus University, and a Bell Fellowship from Harvard University. The editorialists have disclosed no relevant financial relationships.
Am J Epidemiol. 2011;173(8):858-865. Full text
Co-Author(s)Jacqueline A. Hart, MDFreelance Clinical Editor, MedscapeCME, WebMD, Boston, Massachusetts
Disclosure: Jacqueline A. Hart, MD, has disclosed no relevant financial relationships.
English Are Healthier Than Americans at Almost Every Age
Μια ενδιαφέρουσα μελέτη
Norra MacReady and Jacqueline A. Hart, MD
April 20, 2011
Americans have higher rates of chronic illness at almost every age than people in England, a new study shows.
Americans were significantly more likely to be obese or underweight, have diabetes or asthma, or suffer a heart attack than their counterparts across the Atlantic, lead author Melissa L. Martinson, PhD, from Princeton University, New Jersey, and colleagues report in the April issue of the American Journal of Epidemiology. American women also were more likely than English women to have a history of angina, or a stroke after age 20 years (P < .05 for all comparisons). Among men, the differences in the prevalence of heart attack and angina were most striking at younger ages.
This pattern persisted even when the investigators restricted the analysis to white, insured, nonobese, nonsmoking teetotalers in both countries.
The findings suggest that "US health disadvantages compared with England arise at early ages and that differences in the body weight distributions of the 2 countries do not play a clear role," the authors write.
Researchers are baffled by the health disparities between England and the United States, they explain. The United States spends twice as much on healthcare as does the United Kingdom, yet "adults aged 50 years or older in the United States have significantly worse health status and lower life expectancy than those in England." Previous studies, which focused on elderly people or infants, have shed little light on these differences, but little attention has been paid to people of other ages. The role of body weight, which is on average much higher in the United States than the United Kingdom, also has not been fully explored. In this study, the authors used data from 2 nationally representative surveys spanning the ages from 0 to 80 years to compare the health status of the populations in the 2 countries in an effort to learn more about their disparities.
The data came from the National Health and Nutrition Examination Survey in the United States and the Health Survey for England in the United Kingdom. "Both are large, nationally representative health surveys that have comparable measures of health assessed through interviews and physical examinations," the researchers write. The analysis included data on 39,849 Americans from the 1999 to 2006 National Health and Nutrition Examination Survey, and on 69,084 English people from the 2003 to 2006 Health Survey for England.
Overall, rates of chronic conditions and markers of disease, such as C-reactive protein, were higher among Americans. The single exception was hypertension, which was more prevalent in England among people aged 12 to 34 years (P < .05) and similar between the populations at older ages. Most of the cross-country differences were observed in all age groups, except for heart attack and angina, which was higher among American men only at younger ages, and hypertension, which was, again, higher in England at younger ages.
Whatever the reason for these differences in health, they appear to arise early in life, the authors write. "Our findings suggest that body weight is not the driving force behind the observed health differences between the United States and England and that, if weight plays a role, it is a complicated one."
One contributing factor to the differences may be that "Americans receive less preventive health care than English counterparts," the authors note. In contrast, differences in the use of healthcare technology, higher screening rates for certain conditions, greater use of some healthcare procedures (eg, coronary bypass grafting and angioplasties), and higher survival rates for both cardiovascular and cerebrovascular diseases in the United States may also partially explain the disparities. However, "given that the United States has higher age-specific mortality for every age group (except for those 75 years or older), these differences cannot fully account for the observed cross-country differences in health conditions and markers of disease," the authors say. They suggest that a promising focus of future research might be health differences between the populations in the 0-to-11-year age groups.
Health Discrepancy in United States May Be a Result of Social Inequalities
As Mauricio Avendano, PhD, from the Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands, and Ichiro Kawachi, PhD, from the Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massachusetts, point out in an accompanying editorial, "Although Americans make up just 5% of the world's population, they represent more than half of every medical dollar expended on the planet."
Life expectancy in the United States is amongst the lowest worldwide, the editorialists add, and remark that the work of Dr. Martinson and colleagues reinforces that fact: "American adults live in poorer health than most Europeans," they write.
Dr. Avendano and Dr. Kawachi suggest that the answer to this paradox may be in the examination of social policies stating that the United States differs from other developed countries "in terms of the weakness of its social safety nets, the magnitude of social inequalities, and the harshness of poverty." They agree with Dr. Martinson and associates that "broadening the scope of their inquiry to include the social and policy contexts of nations might help to solve the puzzle of the US health disadvantage."
In a response to the editorial, however, Dr. Martinson and colleagues caution against jumping to conclusions before more data are examined and all possible distinguishing factors are explored.
The study was supported by the National Institutes of Health. The authors have disclosed no relevant financial relationships. Dr, Avendaon is supported by the Netherlands Organization for Scientific Research, a Eur-Fellowship from the Erasmus University, and a Bell Fellowship from Harvard University. The editorialists have disclosed no relevant financial relationships.
Am J Epidemiol. 2011;173(8):858-865. Full text
Co-Author(s)Jacqueline A. Hart, MDFreelance Clinical Editor, MedscapeCME, WebMD, Boston, Massachusetts
Disclosure: Jacqueline A. Hart, MD, has disclosed no relevant financial relationships.
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