Health across the life span in the United States and England

Am J Epidemiol. 2011 Apr 15;173(8):858-65. doi: 10.1093/aje/kwq325. Epub 2011 Mar 9.


This study systematically compared health indicators in the United States and England from childhood through old age (ages 0-80 years). Data were from the 1999-2006 National Health and Nutrition Examination Survey for the United States (n = 39,849) and the 2003-2006 Health Survey for England (n = 69,084). Individuals in the United States have higher rates of most chronic diseases and markers of disease than their same-age counterparts in England. Differences at young ages are as large as those at older ages for most conditions, including obesity, low high-density lipoprotein cholesterol, high cholesterol ratio, high C-reactive protein, hypertension (for females), diabetes, asthma, heart attack or angina (for females), and stroke (for females). For males, heart attack or angina is higher in the United States only at younger ages, and hypertension is higher in England than in the United States at young ages. The patterns were similar when the sample was restricted to whites, the insured, nonobese, nonsmoking nondrinkers, and specific income categories and when stratified by normal weight, overweight, and obese weight categories. The findings from this study indicate that US health disadvantages compared with England arise at early ages and that differences in the body weight distributions of the 2 countries do not play a clear role.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Asthma / epidemiology
  • Biomarkers
  • Body Mass Index
  • Cardiovascular Diseases / epidemiology
  • Child
  • Child, Preschool
  • Chronic Disease / epidemiology*
  • Cross-Cultural Comparison*
  • Diabetes Mellitus / epidemiology
  • England / epidemiology
  • Female
  • Health Surveys / statistics & numerical data*
  • Humans
  • Infant
  • Infant, Newborn
  • Life Expectancy*
  • Lipids / blood
  • Male
  • Middle Aged
  • Sex Distribution
  • United States / epidemiology
  • Young Adult


  • Biomarkers
  • Lipids