A new study by Choi et al. (2020) compares the health of individuals aged 55-64 in the US compared to England. They use data from Health and Retirement Study (HRS)–in the US–and the English Longitudinal Study of Ageing (ELSA) for 2008-2016. Health is measured across 16 outcomes: 5 self-assessed outcomes, 3 directly measured outcomes, and the prevalence of 8 key comorbidties. They find:
Cross-country differences in health were in favor of England for all health outcomes except ADL limitations, depression, and measured blood pressure, which were not significantly different between countries.
Of perhaps more interest is that they compare health outcomes among individuals in the top compared to bottom income deciles across countries. In this analysis, they find:
Among individuals in the lowest income group in each country, those in the US group vs the England group had significantly worse outcomes on many health measures (10 of 16 outcomes in the bottom income decile); the significant differences in adjusted prevalence of health problems in the US vs England for the bottom income decile ranged from 7.6% (95% CI, 6.0%-9.3%) vs 3.8% (95% CI, 2.6%-4.9%) for stroke to 75.7% (95% CI, 72.7%-78.8%) vs 59.5% (95% CI, 56.3%-62.7%) for functional limitation. Among individuals in the highest income group, those in the US group vs England group had worse outcomes on fewer health measures (4 of 16 outcomes in the top income decile); the significant differences in adjusted prevalence of health problems in the US vs England for the top income decile ranged from 36.9% (95% CI, 33.4%-40.4%) vs 30.0% (95% CI, 27.2%-32.7%) for hypertension to 35.4% (95% CI, 32.0%-38.7%) vs 22.5% (95% CI, 19.9%-25.1%) for arthritis.
The authors do note that these differences persist even after statistically controlling for demographic factors, educational level, smoking, and body mass index. Note that the outcomes are relatively crude measures and the data cover only individuals aged 55 to 64. Further, the study describe what these differences are, but not they why of why these occur. Nevertheless, these results do provide a helpful snapshot comparing the health of Americans and the English across income strata.