Socioeconomic inequalities in health dynamics: A comparison of Britain and the United States

The Issue. A major independent inquiry into inequalities in health—and policies that would reduce them—was published in December 1998.1 It identified >40 recommendations designed to reduce inequalities in health. Lifting children out of poverty is among the most important strategies to improve child health. If we want to change policies on health and poverty, then we have to consider the broad political context within which our health systems work. In the United Kingdom, we have a welfare state that sends checks and cash income to 85% of households every month. Many people pay into the welfare state, many people get money back, and everybody receives services.2 In the United States, the situation is different. There, many people pay into the state, but only the poor and corporations actually receive a check. I leave you to decide who gets the most out of these respective systems. We also have fundamental differences in our health systems. In the United Kingdom, 97% of expenditures on health are made by the state; there is virtually no private spending. In the United States, only 44% of health expenditures are made by the state. The limited amount of private health expenditures in the United Kingdom will be reduced further as the National Health Service provides more dentistry in the future. In terms of the amount of resources, the United States spends 14% of its gross domestic product on health, compared with 6% in the United Kingdom. The United States spent $3700 per person on health care in 1997. In the United Kingdom, we spent less than one third of that.

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Cross-national comparison of socioeconomic inequalities in obesity in the United States and Canada

International Journal for Equity in Health ◽

10.1186/s12939-015-0251-2 ◽

2015 ◽

Vol 14 (1) ◽

Cited By ~ 10

Author(s):

Arjumand Siddiqi ◽

Rashida Brown ◽

Quynh C. Nguyen ◽

Rachel Loopstra ◽

Ichiro Kawachi

Keyword(s):

United States ◽

The United States ◽

Socioeconomic Inequalities ◽

National Comparison ◽

Cross National

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The impact of socioeconomic inequalities and lack of health insurance on physical functioning among middle-aged and older adults in the United States

Health & Social Care in the Community ◽

10.1111/j.1365-2524.2011.01012.x ◽

2011 ◽

Vol 20 (1) ◽

pp. 42-51 ◽

Cited By ~ 17

Author(s):

Jinhyun Kim ◽

Virginia Richardson

Keyword(s):

United States ◽

Older Adults ◽

Health Insurance ◽

Physical Functioning ◽

The United States ◽

Socioeconomic Inequalities ◽

Middle Aged ◽

The Impact

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Socioeconomic Inequalities in Disability-free Life Expectancy in Older People from England and the United States: A Cross-national Population-Based Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glz266 ◽

2020 ◽

Vol 75 (5) ◽

pp. 906-913 ◽

Cited By ~ 9

Author(s):

Paola Zaninotto ◽

George David Batty ◽

Sari Stenholm ◽

Ichiro Kawachi ◽

Martin Hyde ◽

...

Keyword(s):

United States ◽

Life Expectancy ◽

The United States ◽

Population Based ◽

Socioeconomic Inequalities ◽

Similar Magnitude ◽

Population Based Study ◽

Socioeconomic Groups ◽

Total Life Expectancy ◽

Disability Free Life Expectancy

Abstract Background We examined socioeconomic inequalities in disability-free life expectancy in older men and women from England and the United States and explored whether people in England can expect to live longer and healthier lives than those in the United States. Methods We used harmonized data from the Gateway to Global Aging Data on 14,803 individuals aged 50+ from the U.S. Health and Retirement Study (HRS) and 10,754 from the English Longitudinal Study of Ageing (ELSA). Disability was measured in terms of impaired activities and instrumental activities of daily living. We used discrete-time multistate life table models to estimate total life expectancy and life expectancy free of disability. Results Socioeconomic inequalities in disability-free life expectancy were of a similar magnitude (in absolute terms) in England and the United States. The socioeconomic disadvantage in disability-free life expectancy was largest for wealth, in both countries: people in the poorest group could expect to live seven to nine fewer years without disability than those in the richest group at the age of 50. Conclusions Inequalities in healthy life expectancy exist in both countries and are of similar magnitude. In both countries, efforts in reducing health inequalities should target people from disadvantaged socioeconomic groups.

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