15 November 2010

Americans less healthy than the English but live as long or longer

An article in Medical Daily on some research by the RAND corporation in the USA and the Institute for Fiscal Studies in England found that:

Click her to go directly to the Medical Daily article.

The study found that both disease prevalence and the onset of new disease were higher among Americans for the illnesses studied - diabetes, high-blood pressure, heart disease, heart attack, stroke, chronic lung diseases and cancer. Diabetes and cancer rates were around twice as high in the United States as in England.

However, death rates among Americans were about the same in those aged 55-64 years and lower for those in their 70s as the English research participants.

Two possible explanations have been suggested:
1) The diseases studied result in higher numbers of deaths in England than in the United States. 
2) English participants were diagnosed at a later stage in the disease process than Americans.

The implication being that there is higher quality medical care in the United States than in England for the chronic illnesses studied leading to less deaths from these chronic illnesses.

The study also investigated the relationship between the financial resources of individuals in both countries and how soon they would die in the future.The researchers found that poorer people are more likely to die sooner and consider that the causal pathway between health and wealth is that poor health leads to a reduction in household wealth, rather than being poor causes one's health to decline. Researchers found that the substantial changes in wealth that occurred in the years 1992 and 2002 in the United States through increases in stock prices and housing prices did not alter the probability of subsequent death.

My thoughts are that this makes sense, it is poor people's reduced ability to withstand life stresses that lead to them ageing more quickly and becoming less healthy over time compared to richer people. The reduction in household wealth therefore links to a reduction in resilience or buffering of life stress i.e. that less money in the future means less ability to withstand personal, family crises from the mundane a household repair to future illnesses and the ability to pay for holidays, education and other quality of life improving material goods and services.

It also confirms something that Ben has written about, that healthcare is an important determinant of health and should not be forgotten in low and high income country contexts.

Have I got that right? Or have I missed something?