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

Avendaño, Mauricio; Glymour, M. Maria; Banks, James; Mackenbach, J. P.

doi:10.2105/ajph.2008.139469

Cited by 219 publications

(195 citation statements)

References 41 publications

Supporting

Mentioning

177

Contrasting

Unclassified

Order By: Relevance

“…26 Those findings were replicated in a representative survey among people age fifteen or older, although prevalences of the conditions in the United States were quite similar to those in Australia and New Zealand. 27 However, a detailed analysis has shown that differences in common risk factors can explain only a small part of the observed differences in the prevalence of chronic diseases between the United States and, for example, England.…”

mentioning

confidence: 83%

In Amenable Mortality—Deaths Avoidable Through Health Care—Progress In The US Lags That Of Three European Countries

Nolte

McKee

2012

Health Affairs

View full text Add to dashboard Cite

We examined trends and patterns of amenable mortalitydeaths that should not occur in the presence of timely and effective health care-in the United States compared to those in France, Germany, and the United Kingdom between 1999 and 2007. Americans under age sixty-five during this period had elevated rates of amenable mortality compared to their peers in Europe. For Americans over age sixty-five, declines in amenable mortality slowed relative to their peers in Europe. Overall, amenable mortality rates among men from 1999 to 2007 fell by only 18.5 percent in the United States compared to 36.9 percent in the United Kingdom. Among women, the rates fell by 17.5 percent and 31.9 percent, respectively. Although US men and women had the lowest mortality from treatable cancers among the four countries, deaths from circulatory conditions-chiefly cerebrovascular disease and hypertensionwere the main reason amenable death rates remained relatively high in the United States. These findings strengthen the case for reforms that will enable all Americans to receive timely and effective health care.T he United States stands out among other countries for its high expenditure on health care. At $7,960 per capita in 2009, this was roughly double the average in Western European countries.1 Despite this investment, the United States lags behind on a number of indicators of health system performance. 2-4Given the multiple causes of many health outcomes, it remains a challenge to assess the contribution of health care to population health. One approach that has been shown to provide a useful approximation is the concept of amenable mortality.5 It derives from work undertaken in the 1970s in the United States, which proposed a list of conditions in which death should not occur in the presence of timely and effective health care. 6 Deaths from such conditions were to be interpreted as "sentinel" health events and to serve as an index of the quality of care. 5 Examples include diabetes, which should be treated by insulin and other medication; appendicitis, treated by surgery; and acute infections, treated by antibiotics.The key issue is the prevention of death. For example, although the acquisition of tuberculosis is largely driven by socioeconomic conditions, timely treatment is effective in preventing death. So the number of deaths from, for example, diabetes, provides a yardstick of access-or the lack of it-to effective care.Based on this line of reasoning, the concept of amenable mortality has since been applied widely as a way to assess the quality of care in different health systems across countries and over time. [7][8][9][10][11] Recent work using this concept has demonstrated that the United States is increasingly lagging behind other industrialized nations. [12][13][14] This study seeks to better understand some of the reasons behind the comparatively poor per-

show abstract

mentioning

confidence: 83%

In Amenable Mortality—Deaths Avoidable Through Health Care—Progress In The US Lags That Of Three European Countries

Nolte

McKee

2012

Health Affairs

View full text Add to dashboard Cite

show abstract

“…3 In several countries, these later years are accompanied by compromised quality of life, adverse drug events, and disability arising from chronic diseases, such as heart or mental disorders, cancer, stroke, diabetes, and rheumatic disease. 4 Several of these chronic diseases occur in clusters and are associated with health-related behaviours, such as physical inactivity and unhealthy diets. 5,6 This leads to the multimorbidity concept, which has been defined as the coexistence of two or more chronic diseases at the same time.…”

Section: Introductionmentioning

confidence: 99%

Challenges of Ageing in Portugal: Data from the EpiDoC Cohort

et al. 2018

View full text Add to dashboard Cite

RESUMOIntrodução: A esperança de vida está a aumentar em Portugal, contudo desconhece-se o estado de saúde dos idosos. Pretende-se determinar a prevalência de multimorbilidade, caracterizar estilos de vida e outros fatores relacionados com a saúde dos idosos. Material e Métodos: Efetuou-se uma avaliação transversal a 2393 adultos com 65 ou mais anos de idade, da coorte EpiDoC que é constituída por uma amostra representativa da população portuguesa. Os inquiridos responderam a um questionário estruturado através de uma entrevista telefónica, tendo-se recolhido dados socioeconómicos demográficos, estilo de vida, doenças crónicas e consumo de recursos em saúde. Análise de clusters foi realizada para a identificação de padrões alimentares. Efetuou-se análise descritiva e analítica para estimar a prevalência de multimorbilidade e fatores associados. ABSTRACT Introduction: Portuguese adults have a long lifespan, but it is unclear whether they live a healthy life in their final years. We aimed to determine the prevalence of multimorbidity and characterize lifestyle and other health outcomes among older Portuguese adults. Material and Methods:We performed a cross-sectional evaluation of 2393 adults, aged 65 and older, during the second wave of follow-up of the EpiDoC cohort, a population-based study involving long-term follow-up of a representative sample of the Portuguese population. Subjects completed a structured questionnaire during a telephone interview. Socioeconomic, demographic, lifestyle behaviours, chronic diseases, and health resources consumption were assessed. Cluster analysis was done to identify dietary patterns. Descriptive and analytic analysis was performed to estimate multimorbidity prevalence and its associated factors. Results: Multimorbidity prevalence among older adults was 78.3%, increased with age strata (72.8% for 65 -69 years to 83.4% for ≥ 80 years), and was highest in Azores (84.9%) and Alentejo (83.6%). The most common chronic diseases were hypertension (57.3%), rheumatic disease (51.9%), hypercholesterolemia (49.4%), and diabetes (22.7%). Depression symptoms were frequent (11.8%) and highest in the oldest strata. The mean health-related quality of life (EQ-5D-3L) score was 0.59 ± 0.38. Hospitalization in the previous 12 months was reported by 25.8% of individuals. Overall, 66.6% of older adults were physically inactive. 'Fruit and vegetables dietary pattern' was followed by 85.4% of individuals; however, regional inequalities were found (69% in Azores). Obesity prevalence was 22.3% overall and was highest among Azoreans (33%). Conclusion:The high prevalence of multimorbidity, combined with unhealthy lifestyle behaviours, suggests that the elderly population constitutes a vulnerable group warranting dedicated intervention.

show abstract

“…Findings from a recent study suggest that older people in continental Europe have better health compared with the USA and the UK (Avendano et al 2009). However, differences between European countries in the health of their older populations have also been widely reported and seem consistent regardless of the health outcome analysed (Eikemo et al 2008;Karlsson et al 2010;Mackenbach et al 2008;Minicuci et al 2004;Olsen and Dahl 2007;Verropoulou 2009).…”

Section: Introductionmentioning

confidence: 99%

Later life health in Europe: how important are country level influences?

2012

View full text Add to dashboard Cite

In this article, we examine the extent and pattern of country level differences in later life health in Europe and compare five competing explanations for this variation. We used data from 14 European countries, drawn from Northern (Denmark and Sweden), Western (Austria, France, Ireland, Germany Belgium, the Netherlands and Switzerland), Mediterranean (Spain, Italy and Greece) and Eastern (Poland and Czechia) regions of Europe, = 33,528. Our results suggest that about a quarter (24%) of the overall variation in later life health in Europe appears to be due to country level differences. The Scandinavian countries along with Germany, the Netherlands and Switzerland appear to have the best health, whereas Spain, Italy and Poland had the lowest health score. Country level influences on health were largely associated with differences in the level of egalitarianism of each country as measured by the Gini coefficient, with more inequality being associated with poorer health. Differences in health-related lifestyle, as approximated by the prevalence of obesity in each country, also had a substantial macrolevel influence on later life health, with a lower national prevalence of obesity being associated with better health. Our results indicate the presence of systematic macrolevel health variation in Europe and suggest that policies to reduce income inequality as well as population interventions to promote healthier lifestyles and decrease the prevalence of obesity have the potential to improve population health and potentially offset some of the challenges posed by population ageing in Europe.

show abstract

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

Abstract: American adults are less healthy than Europeans at all wealth levels. The poorest Americans experience the greatest disadvantage relative to Europeans.

Cited by 219 publications

References 41 publications

In Amenable Mortality—Deaths Avoidable Through Health Care—Progress In The US Lags That Of Three European Countries

In Amenable Mortality—Deaths Avoidable Through Health Care—Progress In The US Lags That Of Three European Countries

Challenges of Ageing in Portugal: Data from the EpiDoC Cohort

Later life health in Europe: how important are country level influences?

Contact Info

Product

Resources

About