Invited Commentary: The Search for Explanations of the American Health Disadvantage Relative to the English

TY - JOUR

T1 - Invited Commentary

T2 - The Search for Explanations of the American Health Disadvantage Relative to the English

AU - Avendano, Mauricio

AU - Kawachi, Ichiro

PY - 2011/4/15

Y1 - 2011/4/15

N2 - Although Americans make up just 5% of the world's population, they represent more than half of every medical dollar expended on the planet. Yet, American life expectancy appears near the bottom of rankings by the Organization for Economic Cooperation and Development, and American adults live in poorer health than most Europeans. In this issue of the Journal, Martinson et al. (Am J Epidemiol. 2011;173(8):870) provide us with further evidence of the generality of this phenomenon, showing a pattern of poorer health in the United States relative to England across the entire life course. Recent research points at single risk factors such as smoking as potential explanations, but such hypotheses are of limited scope to explain the pervasive US health disadvantage across the entire life course. In this commentary, a potentially promising line of inquiry based upon differences in social policy contexts is proposed. Life in the United States can be distinguished from that of the rest of the member countries of the Organization for Economic Cooperation and Development in terms of the weakness of its social safety nets, the magnitude of social inequalities, and the harshness of poverty. The authors argue that broadening the scope of their inquiry to include the social and policy contexts of nations might help to solve the puzzle of the US health disadvantage.

AB - Although Americans make up just 5% of the world's population, they represent more than half of every medical dollar expended on the planet. Yet, American life expectancy appears near the bottom of rankings by the Organization for Economic Cooperation and Development, and American adults live in poorer health than most Europeans. In this issue of the Journal, Martinson et al. (Am J Epidemiol. 2011;173(8):870) provide us with further evidence of the generality of this phenomenon, showing a pattern of poorer health in the United States relative to England across the entire life course. Recent research points at single risk factors such as smoking as potential explanations, but such hypotheses are of limited scope to explain the pervasive US health disadvantage across the entire life course. In this commentary, a potentially promising line of inquiry based upon differences in social policy contexts is proposed. Life in the United States can be distinguished from that of the rest of the member countries of the Organization for Economic Cooperation and Development in terms of the weakness of its social safety nets, the magnitude of social inequalities, and the harshness of poverty. The authors argue that broadening the scope of their inquiry to include the social and policy contexts of nations might help to solve the puzzle of the US health disadvantage.

KW - Age Distribution

KW - Chronic Disease

KW - Cross-Cultural Comparison

KW - England

KW - Health Status Disparities

KW - Health Surveys

KW - Humans

KW - Life Expectancy

KW - Risk Factors

KW - Sex Distribution

KW - Smoking

KW - United States

U2 - 10.1093/aje/kwq484

DO - 10.1093/aje/kwq484

M3 - Article

C2 - 21389039

SN - 0002-9262

VL - 173

SP - 866

EP - 869

JO - American Journal of Epidemiology

JF - American Journal of Epidemiology

IS - 8

ER -