Want to be healthier? Move to Britain (another reason to hate America)

Milwaukee Journal Sentinal ^ | 05/03/06 | By JOHN FAUBER

[baldeagle390]

Maybe we should have remained a colony.

Americans Sicker Than Britons?

Calvin Malone of Milwaukee says he runs four times per week to stay in shape. He was working out at the Downtown YMCA on Tuesday. Throughout the facility are signs encouraging patrons to exercise and embrace a healthy lifestyle. A report released today says middle-aged Britons are much healthier than their American counterparts.

Richard Nord, 71, from Shorewood, shown at the Downtown YMCA on Tuesday, says he has had a disciplined exercise routine since he was 40 years old. Despite paying more than twice as much for health care, Americans are less healthy than Britons, says a new study.

Disease Rates: Ages 55-64 Disease rates among 4,386 white Americans and 3,681 white Britons, ages 55-64.

U.S. 12.5% Have diabetes

15.1% Have heart disease

5.4% Have had heart attacks

9.5% Have had cancer

3.8% Have had strokes

8.1% Have had lung disease

Spend $5,274 in annual medical costs

U.K. 6.1% Have diabetes

9.6% Have heart disease

4.0% Have had heart attacks

5.5% Have had cancer

2.3% Have had strokes

6.3% Have had lung disease

Spend $2,164 in annual medical costs

Source: Journal of the American Medical Association GRAPHIC: More health comparisons between England and the U.S.

Compared with the British, white, middle-aged Americans are substantially less healthy, according to a study published today in the Journal of the American Medical Association.

Pick the disease - diabetes, heart disease, stroke, cancer, lung disease, high blood pressure - and Americans are much more likely to have it than their counterparts on the other side of the pond.

"Americans are much sicker than the English," the study concluded.

Adding insult to injury, Americans pay more than twice as much for their medical care as the Brits, $5,274 a year per person in the U.S. vs. $2,164 in England, the study notes.

Doctors not associated with the study say it is the latest evidence of befuddling health disparities in the U.S. compared with other industrialized countries. It also dispels the often-cited erroneous claim that America has the best health care in the world, doctors said.

"In some cases, the wealthiest Americans were sicker than England's poorest," said Julie Mitchell, an assistant professor of medicine at the Medical College of Wisconsin who practices at Froedtert Memorial Lutheran Hospital. "That's crazy."

Indeed, when the researchers divided people from the two countries by both education and income levels, Americans with higher incomes and who were more educated often had higher rates of ailments such as diabetes, cancer and heart disease than English who were in the bottom strata.

The study looked at health data and self-reported disease rates among 4,386 Americans aged 55 to 64 and 3,681 Brits in the same age range. To eliminate the confounding issue of race and health status, only non-Hispanic whites were included in the analysis.

The data came from government-funded health surveys in the two countries. The study was sponsored by the governments of the two countries.

Overall, the diabetes rate was 6.1% in England vs. 12.5% in the U.S. The cancer rate was 5.5% in England, compared with 9.5% in the U.S. The heart disease rate was 9.6% in England, compared with 15.1% in the U.S.

Attempts to compare illnesses The study is one of the few attempts to compare illness rates in the U.S. and England while doing so for people with comparable social status, said co-author Michael Marmot, a physician and epidemiologist at University College London.

Marmot said that it has been known for years that life expectancy is shorter in the U.S. than in the United Kingdom. More than 20 countries have greater life expectancy than the U.S. Now there is evidence that disease rates also are higher, he said.

"And they are higher for people of high education, intermediate education and low education," he said.

The disparity remained even after researchers adjusted for various risk factors such as smoking and obesity.

Obesity is much more common in the U.S., while heavy drinking is more prevalent in England. Smoking rates in the two countries are about the same.

Doctors said the differing illness rates likely are the result of a variety of factors.

Even though much more money is spent on health care in the U.S., the emphasis is different.

In England, much more attention is paid on primary care and making sure everyone gets basic medical care.

"You get to the problems earlier," said Barbara Starfield, a distinguished professor of health policy and management at Johns Hopkins University. "They are much better with children, also."

She noted that health care in the U.K. itself is not the best in the industrialized world. So, for the U.S. to have higher disease rates than England supports other research showing that American health care ranks well below many other industrialized countries.

Is our strategy working? The study suggests that the U.S. is not using its health care dollars to the greatest benefit, said Andrew Bindman, a professor of medicine at the University of California, San Francisco who has studied the health care systems of the two countries.

"Is our strategy of innovation, technology and specialization getting us the return on investment?" said Bindman, who was not a part of the study.

Bindman also said lower rates of exercise in the U.S. and a propensity for eating processed junk food here also may explain some of the higher U.S. disease rates.

To bolster their findings, the researchers used a separate database of biological markers of disease among more than 7,600 white people aged 40 to 70 from the two countries.

Once again, they found a troubling pattern in the U.S. For instance, there were higher levels of inflammatory substances such as C-reactive protein and lower levels of HDL cholesterol (the good kind) in Americans.

The study's authors did not identify the causes of health disparities between the two countries.

However, they suggested it might be related to stress from the circumstances under which people live and work in the two countries.

Some of it may be due to the effects of social rank and status, they added.

Whatever the causes, doctors said, the U.S. health care system needs to devote a lot more attention to the issue.

"We need to figure this out because it's making us sick," Mitchell said.

[stacytec]

Lest we forget the home of Cadburys...

We were talking about healthy foods, right?

[Our man in washington]

So if we had more primary care we'd have less diabetes?

I'll make sure to ask for a diabetes-prevention pill the next time I go to my primary doctor.

And with this all, the average life span in England is only about a year longer. If 40 percent lower rates of heart disease occurrence only buy you a year, it's hard to argue your health system is better.

[absolootezer0]

is the disparity possibly caused by the fact that since brits can't get in, they don't get diagnosed?

[Celtic Conservative]

We were talking about healthy foods, right?

I was talking about comfort food, some of which is good, and some is bad.

Cadburys easter eggs,mmm

Too bad I can't eat 'em anymore, they're like kryptonite to a diabetic :^(

(yeah, I know diabetics shouldn't drink either, but now I buy more expensive beers, drink less and enjoy it more)

[Wiseghy]

People are using this as an argument for nationalizing the small portion of health care (about 40%) that is not yet government provided. To argue that "our system is failing" and is too expensive is actually to indite the 60% of the system that is controlled by the state and federal governments.

I would question the basis of the data, however. It is quite possible that different definitions of "disease" are being applied. National systems often understate disease as a way to ration care by delaying aggressive treatment.

Nonetheless, our culture does not put enough emphasis on preventive care and chronic disease management. However, that is more of a cultural problem rather than an issue of access or cost.

[On the Road to Serfdom]

what's the deal with dental care?

You must be British. Dental care is where we go to a 'Dentist' and have our teeth checked out, cleaned, etc. ;)

[maica]

I agree that Americans probably have poor eating habits and don't exercise enough. I am told that Britain is becoming more like the US (people are getting fatter).

More prosperity and more leisure, more driving places, less walking. I expect that life expectancy will be going downhill from this decade onward, as the generation who were born before antibiotics, before processed foods, and before a car in front of every house die off (in their nineties and hundreds.) They are the ones who are the healthiest of all.

Another Brit hospital story. My husband worked in the Caribbean, but paid his National Health Insurance premium year after year, because he worked for a British company. We were in England when I needed maternity care, and a lot of (snobbish) nurses and new mothers thought that I, an American, had come to England just to take advantage of their maternity care. The fact that my husband was a contributing member of their health system did not change their minds.

It just showed me that people can be very inward looking, no matter where they live.

[GeorgefromGeorgia]

Milton Friedman has proposed that Medicare/Medicaid be eliminated and replaced with universal coverage for catastrophic case. Also, tax subsidies for health insurance would be eliminated and individuals would purchase whatever coverage they desired or HSA accounts. It would eliminate the tremendous cost of regulation and much paperwork, and allow the focus on competition for basis services.

[driftless]

Take it from my wife who grew up in England, American health care is much better. I'll hazard to say that Brits probably practice better self healthcare, but if you've got a serious medical problem or have an emergency, you are better off in America. And that's my "still proud to be a limey" wife talking.

[MarkL]

As long as you don't really need critical medical care for chronic diseases, Britain is terrific, as is Canada. As soon as you need specialists, or critical care for a chronic disease, the costs go up, and the supply goes down, and there are shortages. When you most need the medical care, right now, that's where their medical systems tend to fail.

It's a typical leftist utopia... "As long as you really don't need medical care, we've got the best in the world, and look! It's free!"

Mark

[prion]

Another thing that impacts US numbers is that we attempt to save the lives of much younger preemies than most other countries. This badly skews our stats for both infant mortality and life expectancy.