It’s commonly said that the United States has the best healthcare in the world. A new study in the Journal of the American Medical Association provides new evidence that that belief is perversely untrue.
The first study [Abstract: Disease and Disadvantage in the United States and in England; see newspaper article: Study shows British enjoy healthier lives than Americans] compares the health of Americans to that of the British. In terms of most diseases examined – diabetes, hypertension, heart disease, myocardial infarction, stroke, lung disease, and cancer – Americans were less health than were their British counterparts.
Of course, as usual, the poor do worse than the better off:
“Within each country, there exists a pronounced negative socioeconomic status (SES) gradient with self-reported disease so that health disparities are largest at the bottom of the education or income variants of the SES hierarchy.”
However, these differences do not just affect the poor. The wealthy Americans are sicker too:
“These differences are not solely driven by the bottom of the SES distribution. In many diseases, the top of the SES distribution is less healthy in the United States as well.”
According to a doctor cited in the newspaper report:
“’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.”
To give a sense of how bad off we Americans are:
“Overall, the diabetes rate was 6.1 percent in England vs. 12.5 percent in the United States. The cancer rate was 5.5 percent in England, compared with 9.5 percent in the United States. The heart disease rate was 9.6 percent in England, compared with 15.1 percent in the United States.”
And lest people start saying its because we Americans have bad habits, the study carefully controlled for this:
“This conclusion is generally robust to control for a standard set of behavioral risk factors, including smoking, overweight, obesity, and alcohol drinking, which explain very little of these health differences.”
And the results are not due to Americans being worse liars than Brits:
“These differences between countries or across SES groups within each country are not due to biases in self-reported disease because biological markers of disease exhibit exactly the same patterns. To illustrate, among those aged 55 to 64 years, diabetes prevalence is twice as high in the United States and only one fifth of this difference can be explained by a common set of risk factors. Similarly, among middle-aged adults, mean levels of C-reactive protein are 20% higher in the United States compared with England and mean high-density lipoprotein cholesterol levels are 14% lower.”
Is any better argument needed for a universal National Health Plan with a greater emphasis on prevention and management of illness and less on the cutting-edge high-tech care that cost a fortune and accomplishes so little?
1 comment May 3rd, 2006