- The Washington Times - Tuesday, May 2, 2006

CHICAGO (AP) — White, middle-aged Americans are far less healthy than their peers in England, according to research that has specialists scratching their heads.

Americans had higher rates of diabetes, heart disease, strokes, lung disease and cancer — findings that held true regardless of income or education levels.

However, the United States spends about $5,200 per person on health care while about half that in adjusted dollars is spent in England. It is a known fact that the United States spends more on health care than any other industrialized nation, yet trails in rankings of life expectancy.

“Everybody should be discussing it: Why isn’t the richest country in the world the healthiest country in the world?” said study co-author Dr. Michael Marmot, an epidemiologist at University College London in England.

Even those familiar with the weaknesses in the U.S. health system seemed stunned by the conclusions of the study, which was based on government statistics from both countries.

It was not clear why the United States fared so miserably. Answers ranging from too little exercise to too little money and too much stress were offered.

Even the U.S. obesity epidemic couldn’t solve the mystery. The researchers crunched numbers to create a hypothetical statistical world in which the English had American lifestyle risk factors, including being as fat as Americans. In that model, Americans were still sicker.

Smoking rates are about the same on both sides. The English have a higher rate of heavy drinking.

Only non-Hispanic whites were included in the study to eliminate the influence of racial disparities. The researchers looked only at people 55 through 64, and the average age of the samples was the same.

Americans reported twice the rate of diabetes compared with the English, 12.5 percent versus 6 percent. For high blood pressure, it was 42 percent for Americans versus 34 percent for the English; cancer showed up in 9.5 percent of Americans compared with 5.5 percent of the English.

The upper crust on both sides was healthier than middle-class and low-income people in the same country. But richer Americans’ health status resembled that of the low-income English.

“It’s something of a mystery,” said Richard M. Suzman of the U.S. National Institutes of Health, which helped fund the study.

Health specialists have known the U.S. population is less healthy than that of other industrialized nations, according to several important measurements, including life expectancy. The World Health Organization ranks the United States behind about two dozen other countries.

Some have thought the United States has lagged because it is more ethnically diverse, said Mr. Suzman, who heads the National Institute on Aging’s Behavioral and Social Research Program. “Minority health in general is worse than white health,” he said.

But the new study showed that when minorities are removed from the equation, and adjustments are made to control for education and income, white people in England are still healthier than white people in the United States.

“As far as I know, this is the first study showing this,” Mr. Suzman said. The study, supported by grants from government agencies in both countries, was published in the Journal of the American Medical Association.

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