Health Disadvantage in US Adults Aged 50 to 74 Years: A Comparison of the Health of Rich and Poor Americans With That of Europeans

Department of Public Health, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
American Journal of Public Health (Impact Factor: 4.55). 02/2009; 99(3):540-8. DOI: 10.2105/AJPH.2008.139469
Source: PubMed


We compared the health of older US, English, and other European adults, stratified by wealth.
Representative samples of adults aged 50 to 74 years were interviewed in 2004 in 10 European countries (n = 17,481), England (n = 6527), and the United States (n = 9940). We calculated prevalence rates of 6 chronic diseases and functional limitations.
American adults reported worse health than did English or European adults. Eighteen percent of Americans reported heart disease, compared with 12% of English and 11% of Europeans. At all wealth levels, Americans were less healthy than were Europeans, but differences were more marked among the poor. Health disparities by wealth were significantly smaller in Europe than in the United States and England. Odds ratios of heart disease in a comparison of the top and bottom wealth tertiles were 1.94 (95% confidence interval [CI] = 1.69, 2.24) in the United States, 2.13 (95% CI = 1.73, 2.62) in England, and 1.38 (95% CI = 1.23, 1.56) in Europe. Smoking, obesity, physical activity levels, and alcohol consumption explained a fraction of health variations.
American adults are less healthy than Europeans at all wealth levels. The poorest Americans experience the greatest disadvantage relative to Europeans.

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Available from: Johan Mackenbach, Feb 26, 2014
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    • "Additionally, greater egalitarianism does not raise the population's health levels but does weaken the wealthehealth gradient (Semyonov et al., 2013). Another study by Avendano et al. (2009) shows that health tends to increase with wealth among populations over the age 50 in the United States and Europe. Although their analysis focuses on the wealthehealth gradient, it does not classify countries by healthcare system types, and treats 10 European countries uniformly, disregarding possible country-specific effects. "
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    Social Science & Medicine 10/2014; 119:18–26. DOI:10.1016/j.socscimed.2014.08.013 · 2.89 Impact Factor
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    • "Likewise, Eikemo et al. (2008) show that self-reported health tends to increase with income in the 23 European countries included in their study. Similar conclusions were also reached by Avendano et al. (2009) in a study that focused on the US, Europe, and the UK. The third group of research is composed of macro-level ecological analysis of the relationship between structural characteristics of spatial units (i. "
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    • "Turning to both measures of disability, average numbers are highest in the US, followed by England and continental Europe – again a finding that is in line with previous studies [6]. For example, US respondents report on average more than two mobility limitations, whereas values are below two in the remaining studies. "
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