Midlife Health Inequalities in Britain and US: Comparison of Two Nationally Representative Cohorts

Charis Bridger Staatz , University College London
Iliya Gutin, The University of Texas at Austin
Andrea M Tilstra, University of Oxford
George Ploubidis, UCL Centre for Longitudinal Studies
Jennifer Dowd, University of Oxford
Lauren Gaydosh, The University of Texas at Austin

International comparisons typically show worse health in the US compared to the UK as measured by life expectancy and health at older ages. Less is known about comparative health in midlife, a time when health deterioration is emerging and may foreshadow chronic disease at older ages. Better understanding of US-UK differences in socioeconomic inequalities in health can also shed light on how different sociopolitical contexts shape health and disparities throughout the life course. We compare harmonised measures of smoking status, alcohol consumption, body mass index, self-rated health, cholesterol, blood pressure, and glycated haemoglobin (HbA1c) using population-weighted modified Poisson regression in the 1970 British Cohort Study (BCS70) in Britain (N= 9,665) and the National Longitudinal Study of Adolescent to Adult Health (Add Health) in the US (N=12,297), when cohort members were aged 34-46 and 32-42, respectively. Additionally, we test modification of associations by parental education level in adolescence, and own education level and income in midlife. US adults had worse health in midlife particularly as measured by heavy drinking, obesity, high blood pressure and unhealthy cholesterol levels. Self-rated health and smoking were the only outcomes with lower risk in the US. We found smaller educational inequalities in midlife health in Britain compared to the US. US adults are in worse cardiometabolic health than their British counterparts, even in their 30s and 40s. Smaller SEP inequalities in midlife health in the UK may reflect differences in access to health care, welfare systems, or other environmental risk factors

See paper

 Presented in Session 67. Flash session Social and Behavioral Determinants of Health, Wellbeing and Morbidity