International study directly compares the health of English and American adults

Middle aged Americans have worse health than their English counterparts and the difference in health between rich and poor is much larger too, a new study has revealed.

Research on middle-aged people showed even the top income earners in their late 50s and early 60s in the United States have higher rates of disease.

Diabetes, high blood pressure, arthritis and mental health conditions were more common for Americans than their English peers, despite earning nearly twice as much in after-tax income.

Health outcomes were compared among high- and low-income adults age 55 to 64 in the US and England in the observational study.

But the biggest differences in health between the two nations were seen among those who make the least money.

Middle-aged English people in the bottom 20 per cent income bracket enjoyed better health than the poorest Americans of the same age group.

Low-income Americans were much more likely to have been diagnosed with high blood pressure, arthritis, diabetes, heart problems, stroke, chronic lung disease, and mental health conditions than their low-income limey counterparts.

They were also much more likely to have a higher reading when tested for a C-reactive protein, a bodily chemical linked to inflammation.

Clearest comparison to date

The new findings, made by a joint team from both sides of the Atlantic, from the University of Michigan (U-M) in the US and University College London, have been published in the journal JAMA Internal Medicine.

The researchers, led by Dr HwaJung Choi (Corr) from U-M, and Dr Kenneth Langa (Corr) of the University of Michigan Medical School, focused on people approaching 65 – the age at which Americans can access Medicare – a US government program which offers subsidised health care for older people.

Unlike in the US, English people of all ages are covered by the NHS.

Dr Andrew Steptoe, head of the Research Department of Behavioural Science and Health at University College London, said: ‘These are remarkable results, and confirm the value of comparisons between countries.

‘Differences in health care are part of the story, but even in England where care is free for everyone at the point of delivery, there are still marked differences in health related to income.’

The researchers used data from two large, long-term studies carried out between 2008 and 2016.

These included interviews, income data, and biomarkers – measures of how severe diseases are, from nearly 13,000 Americans and 5,700 English people.

Even when the researchers took into account age, gender, race, household size, marital status, immigrant status, and education level, the differences between the two nations were clear.

The research team boast that their study provides the clearest comparison of the two countries to date – when looking specifically at income.

But they hope their findings lead to many more around the world.

According to the researchers, more than 30 countries are now collecting similar data to allow this kind of ‘apples-to-apples’ comparison in future.

Dr Choi, a health economist and research assistant professor of internal medicine at U-M, said: ‘This approach lets us shed a lot more light on the within-country differences as well as the differences between countries.

‘If we looked at older adults, we likely wouldn’t see this level of discrepancy partly because of the effects of Medicare coverage.

She added: ‘At the same time, we may observe even greater income discrepancy in health, within and between countries, for Americans, if we examine younger cohorts.

‘As income inequality continues to increase in the US the health of subsequent cohorts seems even worse.’

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