Despite similar mortality rates, Americans are significantly more disease-prone than English counterparts.

Despite a nation-wide obsession with dieting and exercise that our English counterparts tend not to share, Americans—at least white, middle-aged ones—are far less healthy than white, middle-aged Brits, according to a comprehensive new study. 

The discrepancy between English and American morbidity rates uncovered by the study is startling: Middle-aged Americans are twice as likely to contract diabetes or cancer than the English. Americans are also 60% more likely to have heart disease.

“The differences in health between these two countries is really, really big,” said James Smith, an economist at the RAND Corporation, who headed the American team that jointly performed the study with a group at the University College London.

Although comparative studies showing less dramatic results have been done in the past, this recent research, published in the May 3rd issue of the Journal of the American Medical Association, is the first to include data from blood tests along with self-reported instances of diabetes, cancer and heart disease.

“It’s not just people saying what they have,” Smith said. “Biological data—blood that we’ve examined from the English and the Americans—says exactly the same thing.”

The study also eliminated distorting factors such as behavioral risks like smoking, drinking and obesity, in order to come up with a truly comparable pair of study sets. Further, the study’s authors eliminated any racial differences by limiting participation to non-Hispanic whites between the ages of 55 and 64.

Smith cautioned that the research was solely an assessment and did not include definite theories for the comparatively poor health of Americans. But, he did suggest risk factors that are more prevalent in America than the UK, including stress, obesity and childhood disease.

“It’s very unlikely, in my view, since the differences occur across all diseases—cancer, diabetes, heart disease—that we’re going to find a single smoking gun explanation,” Smith said.

Angus Deaton, a Princeton economist and UK citizen unconnected with the study, highlighted a peculiarity not mentioned in its text: Even as rates of disease differed substantially between the two sets of subjects, WHO statistics show that their death rates are very similar.

“I think [the study is] very, very good and very strange and puzzling,” Deaton said, suggesting that the disjuncture between morbidity and mortality could be due to a more effective medical system in the United States, allowing middle-aged Americans to stay alive in spite of themselves.

Smith and his colleagues across the Atlantic plan to expand their research in two directions. First, they will compare younger Brits with younger Americans to determine the age at which these health differences begin. Second, they want to expand the scope of their work, comparing the English and American data to similar data from other countries in Europe and Asia.

Smith said one goal of future studies would be to determine if Americans are uniquely sickly or if the British are distinctly healthy.

Originally published May 4, 2006

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