Surprise: Older Americans Sicker than Brits, but Live Longer
Older Americans are less healthy than their English counterparts, according to new research. Even so, Americans live just as long, or longer, than their cousins across the pond.
And Americans can give credit to their much maligned health care system for keeping them alive, despite their higher rates of illnesses.
The study analyzed nationally representative data on American and English 55- to 80-year-olds and found that while Americans are significantly sicker, their illnesses don't cost them years of life compared with the English. [Why Are Humans Always so Sick?]
"The conventional look is that the NHS (National Health Service, England's publicly funded health care system) is terrific and much better than anything in the United States," study co-author James Smith, distinguished chairman in labor markets and demographic studies at RAND Corp. in Santa Monica, Calif., told LiveScience. "That's going to involve another look right now."
Living longer, sicker
The overall life expectancy in the United States is 75.4 years for men and 80.4 years for women as of 2007, according to the Centers for Disease Control and Prevention, meaning that a baby boy born in that year can expect 75.4 years of life. In England, life expectancy for those born between 2007 and 2009 is 78 years for men and 81.9 years for women, according to the U.K. Office for National Statistics.
The current study looked not at overall life expectancies, but at disease and death rates in people in the age groups 55 to 64 and 70 to 80. The researchers gathered data on illness, income and demographics from the U.S. Health and Retirement Survey, a survey of a representative sample of more than 20,000 Americans 50 and older that began in 1991. For the English cohort, the researchers used an equivalent survey, the Health Survey for England, which began in 2002 and queries a representative sample of 12,000 English residents ages 50 and older.
Americans are sicker by far than the English, the researchers report today (Nov. 4) in the journal Demography. The finding echoes a 2006 report from the same research group that found white Americans were much sicker than white English residents.
The new study found that 12 percent of the American sample had diabetes compared with 5.9 percent of the English. Cancer was 74 percent more common in the United States, with 9.6 percent of American respondents reporting a cancer diagnosis compared with 5.5 percent of English respondents. America also higher rates of lung disease, heart disease and stroke.
But despite all that extra illness, older Americans don't die earlier than their British counterparts. In the 55 to 64-year-old age group, death rates were equivalent. After age 65, Americans had a slightly greater probability of survival than the English.
The disconnect between disease and mortality is likely due to the tendency of the American health care system to aggressively diagnose and treat illness, Smith said. Americans undergo more screening for diseases such as cancer than Western Europeans and are more likely to get intensive treatment sooner.
"The route that we've chosen to go is a very expensive route," Smith said. "That's why we spend twice as much [on health care] relative to GDP [gross domestic product] as the English do. But we get a benefit from it."
Wealth and health
The researchers investigated the effects of wealth on health in both countries. They calculated the change in wealth between 1992 and 2002 in the American sample and found that the connection between wealth and health wasn't as simple as expected. Gains in wealth didn't protect people from death, the researchers found. And while people in the bottom wealth quintile (or bottom fifth) did have a higher likelihood of death than those in the top, lack of money didn't make people sick. Instead, being sick cost people money.
"Getting sick in your 50s has a big impact on the amount of wealth you have," Smith said. Not only do sick people have to spend money on medical care, they lose out in the workforce, he said. Those pressures drained people's wealth, propelling them down the socioeconomic ladder.
The findings have policy implications for the English government, Smith said.
"They're cutting back expenditures at a time when the health care system is not performing that great relative to the United States, so they have a dilemma," he said.
On the U.S. side, Smith said, the paper hints at a question not dealt with by the health care reform bill: how to maintain a strong but expensive health care system.
"We have a system that has good outcomes at an unsustainable cost, and I'm not sure health care reform has changed that equation," he said.
One problem, Smith said, is that Americans' high rate of illness may fall outside the control of doctors and hospitals.
"Take, just for example, the fact that Americans have bigger bellies than the English," Smith said. "That wasn't done to us by our doctors … It has a lot to do with what we eat and how much exercise we do."
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