It is surprising that it was not until 2006 that the first epidemiological study comparing England and the United States found a social health gradient in both. What was unanticipated was that America as a whole was sicker than England (10). Even those at the top of the U.S. social ladder, despite their access to a vast and costly health-care system, fared worse than their British counterparts. An extended analysis (11) compared the United States to 11 European countries. “Americans face a health disadvantage” that “is remarkably pervasive and affects even the wealthy but is largest for the poor”
As this op-ed in Science argues, some of the poor overall health in the U.S. may rise from its sharp economic inequalities.
That said, my own guess, having lived in both countries and seen how good the UK’s National Health Service is at delivering high-quality health care to people because they’re alive rather than in accordance to their ability to pay (a policy that degrades and shames the U.S.), is that one of the reasons the U.S. has worse overall health than the U.K. does is the abominable level of access to health care in the U.S. Thus the poor have worse access to health, put off care longer, get worse care even when they desperately need it, and in general face a completely different healthcare system than those with good insurance and enough cash to absorb the deductibles. These differences I suspect, greatly amplify the economic inequality counted in income, along with the psychological effect of such inequality.
As the linked essay notes, to be poor and surrounded by those better off imposes a self-reinforcing strain on mind, body, and prospects. To be poor and denied healthcare because you can’t afford the shameless profiteering and scandalous overpricing in the U.S. healthcare system is to have this sense of exclusion and insult greatly magnified.
This is a sick country.
See Confronting the Sorry State of U.S. Health.
