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The English are healthier than the Americans: really?

The English are healthier than the Americans: really?
The English are healthier than the Americans: really?
Background: When comparing the health of two populations, it is not enough to compare the prevalence of chronic diseases. The objective of this study is therefore to propose a metric of health based on domains of functioning to determine whether the English are healthier than the Americans.

Methods: We analysed representative samples aged 50 to 80 years from the 2008 wave of the Health and Retirement Study (N?=?10?349) for the US data, and wave 4 of the English Longitudinal Study of Ageing (N?=?9405) for English counterpart data. We first calculated the age-standardized disease prevalence of diabetes, hypertension, all heart diseases, stroke, lung disease, cancer and obesity. Second, we developed a metric of health using Rasch analyses and the questions and measured tests common to both surveys addressing domains of human functioning. Finally, we used a linear additive model to test whether the differences in health were due to being English or American.

Results: The English have better health than the Americans when population health is assessed only by prevalence of selected chronic health conditions. The English health advantage disappears almost completely, however, when health is assessed with a metric that integrates information about functioning domains.

Conclusions: It is possible to construct a metric of health, based on data directly collected from individuals, in which health is operationalized as domains of functioning. Its application has the potential to tackle one of the most intractable problems in international research on health, namely the comparability of health across countries.
0300-5771
229-238
Cieza, A.
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Oberhauser, C.
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Bickenbach, J.
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Jones, R.N.
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Bedirhan Üstün, T.
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Kostanjsek, N.
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Morris, J.N.
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Chatterji, S.
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Cieza, A.
a0df25c5-ee2c-4580-82b3-d0a75591580e
Oberhauser, C.
19bd72f4-7be9-42f2-9152-b91eec5689e0
Bickenbach, J.
3be81bd0-7d1d-4e2a-9a98-0e1097614d96
Jones, R.N.
966c74c4-4079-4bc9-ad7a-e5f57a1ad63a
Bedirhan Üstün, T.
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Kostanjsek, N.
67b66f74-a7fe-424e-9692-df6980cfdfb4
Morris, J.N.
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Chatterji, S.
0d10ce3d-518a-4d87-a3bc-6dcb7b365ac6

Cieza, A., Oberhauser, C., Bickenbach, J., Jones, R.N., Bedirhan Üstün, T., Kostanjsek, N., Morris, J.N. and Chatterji, S. (2015) The English are healthier than the Americans: really? International Journal of Epidemiology, 44 (1), 229-238. (doi:10.1093/ije/dyu182).

Record type: Article

Abstract

Background: When comparing the health of two populations, it is not enough to compare the prevalence of chronic diseases. The objective of this study is therefore to propose a metric of health based on domains of functioning to determine whether the English are healthier than the Americans.

Methods: We analysed representative samples aged 50 to 80 years from the 2008 wave of the Health and Retirement Study (N?=?10?349) for the US data, and wave 4 of the English Longitudinal Study of Ageing (N?=?9405) for English counterpart data. We first calculated the age-standardized disease prevalence of diabetes, hypertension, all heart diseases, stroke, lung disease, cancer and obesity. Second, we developed a metric of health using Rasch analyses and the questions and measured tests common to both surveys addressing domains of human functioning. Finally, we used a linear additive model to test whether the differences in health were due to being English or American.

Results: The English have better health than the Americans when population health is assessed only by prevalence of selected chronic health conditions. The English health advantage disappears almost completely, however, when health is assessed with a metric that integrates information about functioning domains.

Conclusions: It is possible to construct a metric of health, based on data directly collected from individuals, in which health is operationalized as domains of functioning. Its application has the potential to tackle one of the most intractable problems in international research on health, namely the comparability of health across countries.

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Accepted/In Press date: 5 August 2014
e-pub ahead of print date: 16 September 2014
Published date: February 2015
Organisations: Psychology

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Local EPrints ID: 369189
URI: http://eprints.soton.ac.uk/id/eprint/369189
ISSN: 0300-5771
PURE UUID: 7c1cd816-3607-4603-86c1-4d8d92b25abe

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Date deposited: 29 Sep 2014 12:25
Last modified: 14 Mar 2024 17:59

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Contributors

Author: A. Cieza
Author: C. Oberhauser
Author: J. Bickenbach
Author: R.N. Jones
Author: T. Bedirhan Üstün
Author: N. Kostanjsek
Author: J.N. Morris
Author: S. Chatterji

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