Bridger Staatz Charis, Gutin Iliya, Tilstra Andrea, Gimeno Laura, Moltrecht Bettina, Moreno-Agostino Dario, Moulton Vanessa, Narayanan Martina K, Dowd Jennifer B, Gaydosh Lauren, Ploubidis George B
Centre for Longitudinal Studies, University College London, London, UK.
Department of Sociology, University of Texas at Austin, Austin, TX, USA.
Int J Epidemiol. 2024 Aug 14;53(5). doi: 10.1093/ije/dyae127.
Older adults in the USA have worse health and wider socioeconomic inequalities in health compared with those in Britain. Less is known about how health in the two countries compares in mid-life, a time of emerging health decline, including inequalities in health.
We compare measures of current regular smoking status, obesity, self-rated health, cholesterol, blood pressure and glycated haemoglobin using population-weighted modified Poisson regression in the 1970 British Cohort Study (BCS70) in Britain (N = 9665) and the National Longitudinal Study of Adolescent to Adult Health (Add Health) in the USA (N = 12 300), when cohort members were aged 34-46 and 33-43, respectively. We test whether associations vary by early- and mid-life socioeconomic position.
US adults had higher levels of obesity, high blood pressure and high cholesterol. Prevalence of poor self-rated health and current regular smoking was worse in Britain. We found smaller socioeconomic inequalities in mid-life health in Britain compared with the USA. For some outcomes (e.g. smoking), the most socioeconomically advantaged group in the USA was healthier than the equivalent group in Britain. For other outcomes (hypertension and cholesterol), the most advantaged US group fared equal to or worse than the most disadvantaged groups in Britain.
US adults have worse cardiometabolic health than British counterparts, even in early mid-life. The smaller socioeconomic inequalities and better overall health in Britain may reflect differences in access to health care, welfare systems or other environmental risk factors.
与英国的老年人相比，美国的老年人健康状况更差，且在健康方面存在更广泛的社会经济不平等。对于这两个国家在中年时期（这是健康开始下降的时期，包括健康方面的不平等）的健康状况对比，我们了解得较少。
我们在英国的1970年英国队列研究（BCS70）（N = 9665）和美国的青少年到成人健康全国纵向研究（Add Health）（N = 12300）中，使用人口加权修正泊松回归，比较当前规律吸烟状况、肥胖、自评健康、胆固醇、血压和糖化血红蛋白的测量值，此时队列成员分别为34 - 46岁和33 - 43岁。我们检验这些关联是否因早期和中年社会经济地位而有所不同。
美国成年人的肥胖、高血压和高胆固醇水平更高。英国自评健康状况差和当前规律吸烟的患病率更高。我们发现，与美国相比，英国中年健康方面的社会经济不平等较小。对于某些结果（如吸烟），美国社会经济最优越的群体比英国的同等群体更健康。对于其他结果（高血压和胆固醇），美国最优越的群体表现与英国最劣势的群体相当或更差。
即使在中年早期，美国成年人的心脏代谢健康状况也比英国同龄人差。英国较小的社会经济不平等和更好的整体健康状况可能反映了在获得医疗保健、福利系统或其他环境风险因素方面的差异。
