Primary Submission Category: Socioeconomic status
Health in Midlife in the UK and USA: Comparison of Two Nationally Representative Cohorts
Authors: Jennifer Dowd Charis Bridger Staatz Iliya Gutin George Ploubidis Andrea Tilstra Lauren Gaydosh
Presenting Author: Jennifer Dowd*
International comparisons typically show that the USA has worse health than the UK. However, previous comparisons are typically in older age, with little understanding of differences in midlife. Socioeconomic inequalities in health have been demonstrated in both countries, but how inequalities in midlife health vary across the USA and UK is not known.
We compare mid-life health in the USA and UK using data from the 1970 British Cohort Study (BCS70) (N= 9,665) and the National Longitudinal Study of Adolescent to Adult Health (Add Health) (N=12,297), when cohort members were aged 34-46 and 32-42, respectively. Health is measured by sedentary time, smoking status, alcohol consumption, body mass index, self-rated health, cholesterol, blood pressure, and glycated haemoglobin (HbA1c) using modified Poisson regression We also test whether associations vary by parental education, and own income and education level in midlife.
Midlife USA adults had worse health, particularly for unhealthy levels of cholesterol (RR 1.98, 95% CI: 1.27 to 3.1), alcohol consumption (RR 2.06, 95% CI: 1.80 to 2.37) and HbA1c (RR 3.61, 95% CI 2.11 to 6.19). Sedentary behaviour and smoking were the only outcomes with lower risk in the USA.
We find that for the majority of outcomes, the USA health disadvantaged was confirmed in mid-life. Moreover, there were smaller socioeconomic inequalities in midlife health in the UK. This may reflect different UK social policies such as the national health care and welfare that attenuate the impact of socioeconomic inequalities on health.