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> Americans Much Less Healthy Than British, Why?
Victoria Silverw...
post May 7 2006, 03:37 AM
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Here's the story:


Middle-aged, white Americans are much sicker than their counterparts in England, startling new research shows, despite U.S. health care spending per person thatís more than double what Britain spends.

A higher rate of Americans tested positive for diabetes and heart disease than the British. Americans also self-reported more diabetes, heart attacks, strokes, lung disease and cancer.

The gap between the countries holds true for educated and uneducated, rich and poor.

This study is interesting, because it eliminates the complex factor of race. It is also interesting, because there isn't a huge cultural gap between the two nations. (Americans are more likely to be obese, but the British are more likely to be heavy drinkers. Smoking rates are roughly the same.)

This really amazed me:

The upper crust in both countries was healthier than middle-class and low-income people in the same country. But richer Americansí health status resembled the health of the low-income British.

(Bold added for emphasis)

The article goes on to offer possible explanations, but they don't seem very convincing. Frankly, this seems to be something of a mystery.

To be debated:

What factors might be contributing to the large gap between the health of the British and Americans?

What, if anything, does this say about the health care systems of both nations?
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post May 7 2006, 04:04 AM
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As someone in the medical field- it is a great big "DUH" for me-

#1 reason- universal health care. Means greater utilization of health care. If it is free, or very cheap, and I don't care what your economic means are, you won't add cost into your thinking of whether it is "worth it" to go to the Dr. Of course it is "worth it"- it is free!

#2 Purely anecdotal- but I noticed alot less sedentary poeple in Britain. they simply walk more than we do.

But it is pretty obvious we need universal health insurance in the US, for a variety of reasons, and the health insurance companies are fighting it tooth and nail.
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post May 7 2006, 02:26 PM
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What factors might be contributing to the large gap between the health of the British and Americans?

CruisingRam mentioned it, but the biggest single difference has nothing to do with healthcare systems and eeverything to do with lifestyle.

It can be summed up in four bullet points:
  • Americans
  • don't
  • walk

Somewhere along the line in American culture, excercise stopped being something that was simply a by-product of normal life, and started being a thing you have to set aside specific time to do.

This has also happened elsewhere in the developing world to an extent, facilitated by labour saving devices of all kinds, the decline of heavy industry, and the ubiquity of cheap to run automobiles (even at today's gas prices, we're some way behind the cost of the 1970s price spike in real terms, and even that didn't force people to abandon cars altogether).

But America has taken the divorcing of exercise from the daily routine to an unprecedented extreme. A healthcare system, even if it costs as much as in the US, can only fix problems. It can't make you healthier than you otherwise would be. That's down to ordinary citizens.

Well, it isn't JUST down to ordinary citizens. Planning authorities have a part to play too - when you mix building use between residential, business and leisure, people tend to walk around more than when you put all the retailing in one place, all the homes 10 miles way, and all the industry and other businesses 10 miles in the other direction. For example, I daresay that most Bostonians or San Franciscans do a heck of a lot more walking than an Angeleno.

There ARE plenty of fit and healthy Americans, whose balance of diet and exercise is healthy, but only a tiny minority of these just get their exercise form their daily routine. The rest have to set time aside to go to the gym, for a run, swim, etc. And most people feel themselves to be under severe time pressure, so if it comes to a choice between work, taking care of the kids, or going to the gym, it doesn't take the Jet Propulsion Laboratory's finest minds to work out which will be put off until another day.

What, if anything, does this say about the health care systems of both nations?

Having said that exercise is the big difference, I think that the healthcare systems do have a (smaller) part to play. The top end of American healthcare is, without question, the best anywhere in the world. But then, the wealthy elite that can afford the top end are not exclusively limited to US citizens - a first class plane ticket to NYC or LA isn't going to deter someone who's going there for treatment costing $30,000 or more. And if you don't have $30,000 to spare, living next door to the clinic isn't going to make the treatment of benefit to you.

I think the type of system operated in the UK is going to show up in surveys like this mainly because of it's lifetime effects - rich or poor, and despite the healthcare 'rationing' that comes with taxpayer-funded healthcare, the almost automatic and free at the point of use treatment that all British kids get is going to show up in the statistics when they reach maturity & middle age.

While a middle-aged US adult might have access to the top notch healthcare (if they're lucky), it doesn't automatically follow that they've had that access their whole life long, the effects of which are bound to be cumulative to some extent; many of the people who have access to the best healthcare only qualify for it because of their job, and can only get into the sort of job that will pay for it once they have worked their way up the career ladder. (If nothing else, this is reason enough for the Blair government to stop trying to marketise the NHS, never mind what is might say about how the US health system should be reformed.)

But I think it would be instructive to do a similar comparison of the UK and US with other countries - say, Germany, France, Italy and Japan. I'd bet cash that they - France and Italy especially - would knock us both into a cocked hat, despite (the French at least) drinking even more than us Brits do.

VictoriaSilverwolf - thanks for starting this topic; I saw the story in the British media last week and meant to start a topic myself, but it slipped my mind.
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English Horn
post May 7 2006, 10:57 PM
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In addition to all the reasons mentioned above, particularly the lack of natural excercise, I'd like to add another one: the food we eat. I am not even talking about fast food (which is healthier in Europe, by the way, than here; the study shows that same franchises sell healthier food in Europe than back home).
But aside from junk food, look at any carbonated drink, any package of bread, mustard, cookies, etc. One of the first ingredients that you will see is high fructose corn syrup. That stuff is everywhere. According to Washington Post, an average American consumes 147 pounds of sweeteners (mostly HFCS) per year. We like our food sweet, even though it kills us - slowly. HFCS is actually much, much worse than cane or beet sugar.
Generally speaking, until organic foods become mainstream (surprisingly, Wal-mart made a first step in that direction) our waistlines will only grow - and the health will decline accordingly.

This post has been edited by English Horn: May 8 2006, 01:59 AM
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