New York Times  [Printer-friendly version]
May 3, 2006


By Alan Cowell

LONDON, May 2 -- Americans 55 and over are much sicker than their
British counterparts even though the United States spends more than
twice as much per person on health care as Britain, researchers said

Writing in {The Journal of the American Medical Association},
researchers from University College, London, also seemed to confirm
stereotypes tossed across the Atlantic, concluding that Americans are
prone to obesity while Britons drink too much.

The conclusions followed an inquiry that used data from American and
British health surveys to compare the relative health of people ages
55 to 64 and how their health varies as a result of social and
economic status.

The researchers wrote that "health insurance cannot be the central
reason for the better health outcomes in England because the top
socioeconomic-status tier of the U.S. population have close to
universal access but their health outcomes are often worse than those
of their English counterparts."

In Britain, many people depend on the widely available, state-run
National Health Service, which is facing huge deficits that have
eliminated thousands of hospital beds.

Dr. Michael Marmot, an author of the report, said the research showed
that differences in health could not be ascribed to the "usual
suspects," like rates of smoking, obesity or alcohol abuse.

Nor could varying levels of health be attributed to differences
between the health care systems of the United States and Britain, he

"I'm arguing that it's due to the differences in the circumstances in
which people live," he said Tuesday in a telephone interview. "Work,
job insecurity, the nature of communities, residential communities, et
cetera I think that's the place we should try to look."

The article, in the issue of JAMA to be published Wednesday, said
"middle-aged to older U.S. residents have higher rates of diabetes,
hypertension, heart disease, heart attack, stroke, lung disease and
cancer than their English counterparts."

American per capita expenditure on medical care is $5,274 a year
compared with $2,164 in Britain, according to the article.

"Whether greater financial expenditures translate into better health
for a country's citizens is uncertain," JAMA said in a news release
summarizing the article. Researchers found that diabetes was twice as
prevalent in the United States as in England and that hypertension was
10 percent more common in the United States.

Comparing the habits of the people surveyed, the researchers wrote
that "smoking behavior was similar in both countries, with about one
in five people between the ages of 55 and 64 years currently smoking."

But they added, "Obesity rates were much higher in the U.S., and heavy
drinking was more common in England."

Wealthier and better-educated people in both countries were much
healthier than poorer and less-educated people, the researchers

But, the press release said, the study found that "differences in
socioeconomic groups between the two countries were so great that
those in the top education and income level in the U.S. had similar
rates of diabetes and heart disease as those in the bottom education
and income level in England."