A new study shows the British are healthier than Americans despite U.S. health care spending per person that is more than double what Britain spends.
The study, published in the Journal of the American Medical Association concludes:
The US population in late middle age is less healthy than the equivalent British population for diabetes, hypertension, heart disease, myocardial infarction, stroke, lung disease, and cancer. 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. 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. 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. 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.
Based on self-reported illnesses and biological markers of disease, US residents are much less healthy than their English counterparts and these differences exist at all points of the SES distribution.
No one is sure why the two similar cultures have such different results. Gina Kolata of The New York Times takes a crack at it.
The question of which country is healthier, Dr. Nortin M. Hadler, professor of medicine at the University of North Carolina and others say, turns out to be a perfect illustration of an issue that has plagued American medicine: the more health problems you look for, the more you find. And Americans, medical researchers say, are avid about looking.
The British, doctors say, are different.
"The U.K. has a tradition of independent and perhaps more skeptical primary-care practitioners who are probably slower to label and diagnose people and more reluctant to follow guidelines than their U.S. counterparts," says Dr. Iona Heath, a general practitioner in London. "I have heard it argued that the U.S. believes more in the perfectibility of humanity and the role of science than the Europeans."
Some people call it disease-mongering, says Dr. Lisa Schwartz of Dartmouth Medical School. She once calculated that if everyone had the recommended tests for blood cholesterol, blood sugar, body mass index and diabetes, 75 percent of adults in the United States would be labeled as diseased. And new diseases arise by the minute, she says, her favorite example being "restless legs."
Maybe it's overanalysis. Maybe it's stress. Maybe it's something else. We can all guess why it might be that Americans are "sicker" than Brits even though we spend more money on healthcare. (Your thoughts?)
But one thing is certain: the killer diseases in America today, afflictions like type-II diabetes, cancer, and heart disease, need not ruin your health no matter where you live. On DiseaseProof we have trotted out study after study showing that we could make a huge dent in those diseases by abandoning the standard American diet (SAD) in favor a diet based on vegetables, fruit, legumes, nuts, and seeds.
This post summarizes many of the benefits of a healthy diet in preventing disease. Here is a collection of some of the most important research behind Dr. Fuhrman's work. The role diet can play in precenting cancer is discussed in detail here and here. Dr. Fuhrman says you need not settle for diabetes and that there is a counter attack for heart disease.
The result? Let's not wait around until researchers unravel the mystery of what makes English people seem to be healthier. Instead, let's do what has already been shown to be effective preventing and reversing the chronic diseases that are killing so many of us, starting with a plant-based, nutrient-dense diet that is effective in both Americans and the British.