Old Folks In the US Unhealthier Than Europeans. A LOT Unhealthier

For example, heart disease was diagnosed in nearly twice as many Americans as Europeans 50 and older. More than 16% of American seniors had diagnosed diabetes, compared with about 11% of their European peers. And arthritis and cancer were more than twice as common among Americans as Europeans.

The study published on the Web today by the journal Health Affairs found that Americans were nearly twice as likely as Europeans to be obese (33.1% versus 17.1%), and they also were more likely to be current or former smokers (53% versus 43%).

"We expected to see differences between disease prevalence in the United States and Europe, but the extent of the differences is surprising," said lead author Kenneth Thorpe, a public health professor at Emory and former deputy assistant secretary of the U.S. Department of Health and Human Services.

Thorpe said the findings suggested that "we spend more on healthcare because we are, indeed, less healthy."

Is it all due to bad health? Well no, some is screening, but a lot isn't. It's all in the waddle (and the corn syrup):

When it comes to cancer, the higher diagnosis rate appears to be due to more intensive screening in the U.S., they said. But higher rates of obesity-related diseases and conditions, such as high blood pressure, suggest Americans also are, indeed, sicker.

"I think the big difference is the doubling of obesity rates," Thorpe said.

"If you look at the doctor-diagnosed rates of diabetes and other chronic diseases related to obesity, it's just startling," he said. "It just jumped out at us when we looked at it."

Might it have something to do with overwork?

The study concludes that the best way to trim U.S. healthcare spending -- or at least curb its rate of increase -- is to put Americans on a diet and encourage other measures aimed at preventing the diseases.

Physicians such as Rob Blackman, a Los Angeles internist, already counsel their patients to take a cue from Europeans in the way they eat -- less fast food -- and the way they pace their lives. Six-week vacations and afternoon siestas help reduce stress that makes people vulnerable to disease, he said.

Such conventions are commonplace in Europe but unheard of in the U.S., so the advice is often easier given than taken.

"Last year I took a 15-day vacation -- first time I took more than 10 days in 30 years," Blackman said. "I couldn't believe how much better I felt. It's like the old saying, 'You don't know how sick you are until you get better.' "

I suspect the authors are correct to point at obesity. And when one points at obesity, I'd point at the fact that empty calories (junk food based on corn syrup, etc...) on the inner lanes are prices much lower in the US than good calories (vegetables, lean properly cared for meat) on the outer aisles. And that is a deliberate decision of the US government based on the spending (and subsidies) in the farm bill, which subsidizies production of industrial foods, and does almost nothing for healthier ones. So a bag of chips, or a bottle of pop, gets you far more calories per dollar than healthy food. And such sugar laden crap tends to cause rises and falls in blood sugar which have lead to historically high rates of diabetes, including what used to be known as "juvenille diabetes" being disagnosed in adults.

To put this in a systems and economic perspective - the government needs to be more on the hook for health care costs. When every heart attack victim and diabetic has to be cared for by the government, suddenly the desire for large agricultural producers (not small farmers, they get squat) for pork, will suddenly seem a lot less important than the out of control medical spending.

Of course, the American disease - obesity - is spreading to Europe. I often hear Americans laugh about that, but it's not a good thing. And, as health care costs rise uncontrollably around the world (and most especially in the US) it's going to become a lot less funny, and a lot less a good thing, because it's just going to become unaffordable. Current trends for health care costs cannot continue rising as fast as they are, because we simply can't afford them.

And that means that if you don't do large scale systemic reform, part of which has to be to fix externalities like food and pollution which are causing unhealthiness, that you're going to have to ration even further. Every country rations health care in different ways. The US does it based primarily on money. Every year more and more people get cut off because they don't have enough money. That will not just increase, the rate at which it is increasing will accelerate. Already many middle class folks with insurance are effectively not covered, leaving aside the rise in the uninsured.

As with many things, this is a complicated problem in the sense that there are a lot of moving parts. But in another sense it's not hard at all. Stop subsidizing bad foods - instead, tax them heavily and subsidize good foods. Cut back on pollution. Mandate longer holidays. Get off private insurance for primary coverage of health care (you can have it for add-on insurance). Do most drug research through universities and not through companies. Make all studies open to the public and test drugs against each other not just against placebos. Don't let surgeons cut open so many people, there's no evidence of better results by doing so (in general, use science based medicine in picking treatments, which, in fact, often is not done.)

There are lots of moving parts to the medical system, but there are some obvious big things that can be fixed. And really, who the hell likes being overweight, stressed, overworked and unhealthy?

Ian Welsh October 3, 2007 - 11:00am

Ian Welsh's diary | printer friendly version |

( categories: Health Issues )

using science

"use science based medicine in picking treatments, which, in fact, often is not done"

Good point. A friend recently went to the local hospital that cares for the uninsured in our town. He was impressed that, because insurance was not involved, the order of the tests he received was based on medical, as opposed to financial, logic. Only after they had ruled out cancer and heart disease did they begin testing for other possibilities. My friend noted that if he been insured, they would have done the cheapest tests first.

someofparts October 3, 2007 - 12:35pm

Living on the Canada-US border

What really amazed me at the time was the type of meat sold on both sides, In Quebec, meat cuts tended to be a lot less fatty then on the US side, where you would see a fatty network inside the muscle, of course the fat meat is a lot tastier, those molecules that give flavor are more solubes in fat.
Then I worked as a volunteer in the US for 2 years, I was the healthy part of the team, great peoples but most weigthed 300 +, half where diabetic and when we went for breakfast in the morning I couldn't beleive the portion size being served, I ordered from the children's menu and then it was to much for my appetite and I have a very good fork.
You don't have to search to far to find most of the causes of ill health in the US, just go to any greasy spoon, order from the menu.
Even school menus where comprized mostly of pizzas, fries and all sorts of fast food, so when bad eating habbits start at the crib, it's not easy to modify them.
And on the R&R side, most americans feel guilty if they take vacations or sick days, I mean, for Chr... sake's, get a life and live it up you might be healthier for it.

Jelco Cathlon October 3, 2007 - 12:53pm

Ban high fructose corn syrup

Ban the HFCS and Americans will be much healthier. The stuff is like crack to your blood suger, and spikes insulin so you become insulin resistant. That leads to the obesity and diabetes.

“It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is the most adaptable to change.”

Charles Darwin

darwin October 3, 2007 - 1:11pm

I'm reading this as

I sip my Pepsi... ugh. I really do need to find an alternative caffeinated drink. Tea would be best, I suppose. I'll just have to get used to the taste.

Bolo October 3, 2007 - 3:25pm

the wonderful world of tea

Bolo, the world of tea is much broader than the packing-room-floor sweepings that wind up in your Lipton's tea bag -- and thanks to the yuppification of tea, odds are there are good black teas, green teas, and tisanes available wherever you live.

If you are accustomed to the intense flavour of Pepsi, you might want to start with something like (a real) Chai, where all the warming spices make for a (how do I say this?) wider taste.

Plus drinking tea is a lovely life-long custom to cultivate, replacing the damage of a cola habit with the health-building, anti-oxidant properties of tea. One cup either way won't make or break you, but over the length of a lifetime, it is the kind of good (or bad) habit that can add up.

I am a tea fan of long standing, and know my way around the tea aisle pretty well. Any time you want to talk tea, drop me a note.

Shaula Evans October 3, 2007 - 3:46pm

Lung Ching Forever!

shah8 October 3, 2007 - 5:01pm

Wang Chung, you mean. :P eom

"You know something is wrong when the New England Patriots face stiffer penalties for spying on innocent Americans than Dick Cheney and George Bush." - Bill Richardson

ww October 3, 2007 - 6:31pm

I hear ya

I recently took myself of coke. Wasn't easy. Don't like the taste of tea. Mostly just taking myself off caffeine.

Ian Welsh October 3, 2007 - 9:05pm

Pill-pushing

Many of the elderly that I am acquainted with have been prescribed buckets of medication. After my mother-in-law passed away, we cleaned out her stash and had several grocery bags woth of meds. There was no way any pharmacist was going to keep track of the interactions between the many pills.

Rather than a change in diet or activity, the US custom seems to be to shove a new pill at an ailment--and the newer, the better.

Another trend seems to be overly-aggressive treatment, seemingly without regard to age. A friend who is about a year short of his 75th birthday discovered a small lump on his neck. It was determined to be cancerous and was removed. He was then placed on a program of heavy radiation and chemo. He was feeling okay before the surgery, and not bad before the chemo and rad, but it now appears that the toll placed on his body by the latter will likely kill him. He needs a feeding tube to take in nutrition and can't hold much down, even a month after his followup. He is becoming weaker and weaker--I suspect it's just a matter of time now.

Petronius October 3, 2007 - 1:47pm

Customs

Rather than a change in diet or activity, the US custom seems to be to shove a new pill at an ailment--and the newer, the better.

It's a custom that's stuffed down the throat by the big Pharma industry.

I love the flexibility of my current job - I can take of any time at a moment's notice. Since April I've taken 8 weeks of vacation. I may be a little poorer in the pocket but I'm a lot healthier in the head.

And food-wise, since I made a drastic change from the traditional North Ameriacan diet, I have never felt better. Although I must say that diet, because of its association with memories of comfort, is the most difficult to change. It would be easier if changing your diet is viewed as an adventure. We need to practise more 'fearless' cooking. How about 'extreme' cooking..... lol

adrena October 3, 2007 - 3:00pm

Very sorry

"He was feeling okay before the surgery, and not bad before the chemo and rad, but it now appears that the toll placed on his body by the latter will likely kill him."

I'm very sorry to hear about your friend, Petronius.

I had an uncle, around the same age, go through the same routine about 10 years ago: went in for back pain, docs found a tumor, removed it, the dressings weren't changed over the weekend, the damage from the resulting unhealable wound was so severe that he went in the course of 3 days from a robust, healthy, able-bodied man to a bed-ridden cancer patient who never recovered, and was increasingly disabled by the effects of chemo and radiation.

As a result of watching what his slow, uncomfortable, prolonged demise was like for him, and for his wife, several family members have confided to me that if they face treatment choices, they'll opt for quality of life and palliative care over the horrific extremes of "heroic" medicine.

But I'm not in my 70's just yet...and in the same position, I realize I have no idea what I'd actually choose. I'd like to hope that I'd do a lot of homework, and go for science-based decisions myself, but my personal experience with much less severe medical situtions have been that doctors can be very invested in certain protocols to the extent of being absolute bullies about it, and it has been hard to stand up to bad advice even when I've been fairly healthy and not overly panicked at the time. I can't imagine how that changes when you're dealing with a terminal disease.

Shaula Evans October 3, 2007 - 3:53pm

From an old man

Colonoscopy is a preventative test for colon cancer. My doctor told me that everyone over 50 should get one of these. Cost above what my insurance will pay = $5,000 and I, relatively speaking, have good health insurance. I have not had this done because I don't have the money.

Joaquin October 3, 2007 - 4:13pm

There are risks

to this test. I know at least one person who had an artery or vein cut. I personally think this test should only be used in people who have symptoms or who have a family history. It's another way for the makers of the test to make money. But then, I'm not a doctor, only the daughter of one.

jtruett October 3, 2007 - 6:11pm

Yup, read this.

Check out the Table as well. Sigmoidoscopy may be a good compromise.

http://www.cancer.gov/cancertopics/factsheet/Detection/colorectal-screening

"What methods are used to screen people for colorectal cancer?

Health care providers may suggest one or more of the tests listed below for colorectal cancer screening.

* A fecal occult blood test (FOBT) checks for hidden blood in the stool. Studies have proven that this test, when performed every 1 to 2 years in people ages 50 to 80, reduces the number of deaths due to colorectal cancer by as much as 30 percent.

* A sigmoidoscopy is an examination of the rectum and lower colon using a lighted instrument called a sigmoidoscope. Sigmoidoscopy can find precancerous or cancerous growths in the rectum and lower colon. Studies suggest that regular screening with sigmoidoscopy after age 50 can reduce the number of deaths from colorectal cancer.

* A colonoscopy is an examination of the rectum and entire colon using a lighted instrument called a colonoscope. Colonoscopy can find precancerous or cancerous growths throughout the colon, including the upper part of the colon, where they would be missed by sigmoidoscopy. However, it is not known whether this benefit outweighs the risks of colonoscopy, which include bleeding and puncturing of the lining of the colon. More research is needed to address these issues.

* A double contrast barium enema (DCBE) is a series of x-rays of the entire colon and rectum. The x-rays are taken after the patient is given an enema with a barium solution and air is introduced into the colon. The barium and air help to outline the colon and rectum on the x-rays. Research shows that DCBE may miss small polyps.

* A digital rectal exam (DRE) is often part of a routine physical examination. The health care provider inserts a lubricated, gloved finger into the rectum to feel for abnormal areas. DRE allows for examination of only the lower part of the rectum.

Scientists are still studying colorectal cancer screening methods, both alone and in combination, to determine how effective they are. Studies are also under way to clarify the risks of each test.

See Question 5 for a table outlining some of the advantages and disadvantages of colorectal cancer screening tests. Additional information about these tests is available from the National Cancer Institute’s (NCI) Web site at http://www.cancer.gov/colon on the Internet."

creativelcro October 3, 2007 - 6:19pm

healthy tea lover

Bolo - there are a lot of great tasting teas out there. But spring for real tea. I actually get most of my tea imported from the UK. I discovered several years ago that the Twinings tea you get in the US tastes nothing like the Twinings tea from the UK. I use British Express http://www.britishtea.com/ for my tea (although their website sucks). I guess the Brits are foisting the crappy tea on us because most Americans don't know any better ;)

RE US health: Two years ago I moved to a part of the country where I can get meat that is not injected with sodium, and that is locally grown without hormones. I also stopped eating fast food. Since then, my health has drastically improved. Mentally I feel better and my cholesterol is really good. Every now and then I'll eat fast food and I always regret it because I feel bad the next day. And I agree that high fructose corn syrup is evil and should be banned.

arlinora October 3, 2007 - 9:32pm

Tea

If considering a switch to tea why not go all the way and explore organic herbal teas. Most of these are chockfull of anti-oxidants. There is a tea for each ailment in the universe, from Kukicha - an alkaline tea that neutralizes the acidity of Western diets to Chamomile that soothes nerves and enhances sleep. Some herbal teas contain a small amount of caffeine. When used to drinking caffeinated drinks, it's better to wean yourself off gradually.

adrena October 4, 2007 - 6:49am

What is high

blood pressure? What are the numbers used for screening it? 140/90? Or something else?

What is high blood sugar(fasting)? 101? When is a pre diabetic a diabetic?

I'd have to see the numbers used on both sides of the sea before I got carried away talking about comparative national healths.

What about skin cancers? Are they grouped in the cancer totals? Which ones?

We're fatter than pigs here, but I still want to see the numbers.

http://mauberly.blogspot.com/

mauberly October 4, 2007 - 7:19am

Well

I imagine you can track them down if you wish. Let's just say the results match up with everything else we know about comparative health between the two areas. This isn't an anomolous finding.

And yeah, every time I travel to the US I really am shocked at the heaviness. It's not just a matter of more obesity, it's that the obese are bigger.

Not that we're doing wonders. It's a worldwide plague that the US just happens to be in the front pack on (along with some pacific islanders, iirc).

Ian Welsh October 4, 2007 - 7:39am

You and I have had this discussion before.

I don't see any reason to make a wrong turn. Blue Cross is an insurance company, a big one. It has a vested interest in promoting and possibly demanding "lifestyle" changes. Its costs may go down if enough people believe this article and others like it. You might raise the cost of the fat man's insurance, etc. You already have movements against fat people at some workplaces. Somebody, maybe me, posted an article on it.

So I take the conclusion of the article with a grain of salt(one only for the sake of low sodium), even though it is done by Emory, which is a very good school.

If you go to WebMd, you find very aggressive approaches here in this country to prediabetic conditions. If you don't take these approaches many people will not be treated and Blue Cross lowers its bill.

Just a second blood test a week later to see if the 101 drops to 85 and hence is a fluke runs up the bill. Blue Cross would love not to do the test or get everyone below 100 the first time the test is done.

The same goes for high blood pressure. Many doctors are now trying to get blood pressure below 120/80 and are doing it with medications. Are they doing this in Europe? Can you even tell?

So unless other countries in Europe are practicing under similar protocols, the conclusions may be the result of comparing apples and oranges.

But we are too damn fat; most guys half my age with my build weigh more than I do. They are beefing up early here.

http://mauberly.blogspot.com/

mauberly October 4, 2007 - 9:53am

Not sure

how health insurance underwriting works in the US with regards to what they're allowed to take into account. I do know for life insurance underwriting fat people pay more, or if they're really fat, are uninsurable. As an actuarial/underwriting principle they should pay more - they're more at risk, after all (not necessarily as a political principle).

Ian Welsh October 4, 2007 - 10:22am

What are the political weights...

...of the health insurance industry vs. the corn, food processing, distribution, fast-food and prepared food industries?

The insurance industry (not the health care industry) may not be terribly interested in our health. It's an excuse to raise rates. And it's all in a day's work for a politician to lecture us that we need to eat healthy while feeding us crap.

Gordon October 4, 2007 - 8:14pm

Just give me the coefficients of

those weights, Gordon, and we'll get rich and/or get a big laugh.

http://mauberly.blogspot.com/

mauberly October 4, 2007 - 9:24pm

Less sugar, more fish oil!

CNN recently had an interesting article on what is causing the general downturn of our health. The main culprits appear to be tons of sugar (US kids today average half a punchbowl of sugar per week), plus a severe imbalance between Omega 6 fatty acids (from omnipresent soybean oil) and Omega 3 fatty acids, which are in cold water fish like cod and salmon.

Links:

The story, balancing Omega 6 with Omega 3 supplements:
http://www.cnn.com/2007/HEALTH/diet.fitness/07/06/hm.omega.3/index.html
Canned salmon a good source:
http://www.cnn.com/2007/HEALTH/diet.fitness/04/30/cl.can.fish/index.html
Krill oil pills even better than fish oil pills:
http://www.proteinpower.com/drmike/?p=262
...Last, here's why I don't fully trust Dr. Sanjay Gupta:
http://www.pharmaomega.com/shop/freetrial/omega3-news-cnn.aspx
--Note the close ties to a corporate interest.

There does seem to be a lot of positive buzz (delivered in a fairly plausible fashion) about Omega 3 fatty acids. If there's a chance it could help kids (and older folks like us) be healthier, then it's worth buying a bottle or two of fish oil pills, which are relatively cheap ($20 for 300 pills), or bottles of krill oil, which are about $21 for 60 pills.

For testing purposes I'd get the fish oil pills first, take two per day for a couple months, then see if your eyesight, belt line and memory improve. We could even do an Agonist member study of fish oil pills. It's almost scientific!

"Death before being dishonored any more." - Col. Ted Westhusing

Jimbo92107 October 4, 2007 - 12:08pm

The use of real meat

won't work in Ontario.
Our government is trying to remove local Abbatoirs to keep large companies working.
These small businesses are the crux of small communities.
But they are forced out by regulations that help the big companies.
Who is being served?
It is all about big business.
Not about the local community.

_{repressive governments mix administrative clumsiness & inefficiency with authoritarian tendencies.}

kimmy October 4, 2007 - 6:59pm

Why the the super sweet herb Stevia has been vilified by the FDA

The bitter sweetener battle - sweet-tasting herb stevia held back by Food and Drug Administration

If you're looking for a natural sweetener with a history of safe use and practically no calories, tough. There is one, but you won't find it next to those little blue packets. Many in the herb industry believe that's because stevia (Stevia rebaudiana), a sweet-tasting herb native to Paraguay, has been the subject of an aggressive campaign by the Food and Drug Administration (FDA) to keep it away from American consumers.
.....
Many industry insiders hold firm that the FDA's reasons for blocking stevia consumption have more to do with protecting vested trade interests than protecting consumers. "The FDA took action against stevia not based on any proclamation by FDA toxicologists or consumer complaints, but because of a complaint from a company that didn't want stevia on the market," asserts Rob McCaleb, president and founder of the nonprofit Herb Research Foundation in Boulder. The FDA admits that a complaint was filed, but will not reveal who filed it.
More

Stevia is available in liquid or powder form in health food stores

adrena October 4, 2007 - 7:35pm

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Old Folks In the US Unhealthier Than Europeans. A LOT Unhealthier

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