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Study Compares US and English Adult Health

The study looks at the health and wellbeing of adults aged 55 to 64 in the USA and England

Published on July 14, 2020

A medical study has been published which compares the health of adults aged 55 to 64 in the United States with their counterparts in England. The primary purpose of the study was to answer the question: "What is the difference in health status between high- and low-income individuals in the US vs England?"

The study, which was published in the JAMA Internal Medicine Journal, found that "the health gap between the bottom 20% and top 20% of income distribution was significantly greater for US adults aged 55 to 64 years than their English peers on 13 of 16 health measures. In addition, for most measures, the health of US adults appeared to be poorer than that of their peers in England, especially those from the lower end of the income distribution." Among the conditions which US adults tended to suffer from more than adults in England overall were diabetes, stroke, arthritis and chronic lung disease.

Introducing the study, the researchers noted that the two countries offered an interesting insight into health because "The US and England have a relatively similar culture, language, and economic system, yet have substantially different health care and social welfare systems." As many Americans in the UK will know, the US's insurance driven medical system is a very different one to the universal coverage offered by the UK's National Health Service.

Responding to the study's findings, co-author Professor Andrew Steptoe of University College London said that "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."

Dr HwaJung Choi, one of the leaders of the study from the University of Michigan, also explained that focusing on this particular demographic "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. 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, and the health of subsequent cohorts seems even worse."

Although broadly finding that income had a major impact on health, the study also noted that wealthier Americans had poorer health than their England based counterparts. In the University of Michigan's report on the study, the University writes that "even high incomes didn’t protect Americans from having worse health. Even the top 10% by earnings – whose after-tax median incomes were $144,000 for Americans and $71,000 for the English – had significantly worse health on four of the 16 outcomes that were studied. Americans did not have better outcomes than English adults on any of the 16 health measures, even in the highest income group."

Among the study's conclusions was a recommendation that "Public policy and public health interventions aimed at improving the health of adults with lower income should be a priority in the US."

For more insights into the study, check out the University of Michigan report, and insights from UCL.

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