If our health care's so great, why does study say we're "sicker than the English"?

MILWAUKEE — Maybe we should have remained a colony.

Compared with the British, white, middle-aged Americans are substantially less healthy, according to a study published today in the Journal of the American Medical Association.

Pick the disease — diabetes, heart disease, stroke, cancer, lung disease, high blood pressure — and Americans are much more likely to have it than their counterparts on the other side of the pond.

"Americans are much sicker than the English," the study concluded.

Adding insult to injury, Americans pay more than twice as much for their medical care as the British: $5,274 a year per person in the United States versus $2,164 in England, the study notes.

Doctors not associated with the study say it is the latest evidence of befuddling health disparities in the United States compared with other industrialized countries. It also undermines the often-cited claim that America has the best health care in the world, doctors said.

"In some cases, the wealthiest Americans were sicker than England's poorest," said Dr. Julie Mitchell, an assistant professor of medicine at the Medical College of Wisconsin. "That's crazy."

Indeed, when the researchers divided people from the two countries by both education and income levels, Americans who had higher incomes and who were more educated often had higher rates of ailments such as diabetes, cancer and heart disease than English who were in the bottom level.

The study looked at health data and self-reported disease rates among 4,386 Americans ages 55 to 64 and 3,681 Brits in the same age range. To eliminate the confounding issue of how race affects health status, only non-Hispanic whites were included in the analysis.

The data came from government-funded health surveys in the two countries. The study was sponsored by the governments of the two countries.

Overall, the diabetes rate was 6.1 percent in England vs. 12.5 percent in the United States. The cancer rate was 5.5 percent in England, compared with 9.5 percent in the United States. The heart-disease rate was 9.6 percent in England, compared with 15.1 percent in the United States.

The study is one of the few attempts to compare illness rates in the United States and England while doing so for people with comparable social status, said co-author Dr. Michael Marmot, a physician and epidemiologist at University College London.

It has been known for years that life expectancy is shorter in the U.S. than in the United Kingdom. More than 20 countries have greater life expectancy than the U.S. Now there is evidence that disease rates also are higher, Marmot said.

"And they are higher for people of high education, intermediate education and low education," he said.

The disparity remained even after researchers adjusted for various risk factors such as smoking and obesity.

Obesity is much more common in the U.S., while heavy drinking is more prevalent in England. Smoking rates in the two countries are about the same.

Doctors said the differing illness rates likely are the result of a variety of factors.

Even though more money is spent on health care in the United States, the emphasis is different. In England, more attention is paid on primary care and making sure everyone gets basic medical care.

"You get to the problems earlier," said Barbara Starfield, a distinguished professor of health policy and management at Johns Hopkins University.

However, Marmot said that Britain's universal health-care system might explain better health for low-income citizens but can't account for better health of Britain's more affluent residents.

Marmot offered a different explanation for the gap: Americans' financial insecurity. Improvements in household income have eluded all but the top fifth of Americans since the mid-1970s. Meanwhile, the English saw their incomes improve, he said.

Robert Blendon, a professor of health policy at the Harvard School of Public Health who was not involved in the study, said the stress of striving for the American dream may account for Americans' lousy health.

"The opportunity to go both up and down the socioeconomic scale in America may create stress," Blendon said.

Material from The Associated Press is included in this report.