title: The English are healthier than the Americans:  really?
abstract: BACKGROUND
  When comparing the health of two populations, it is not enough to compare the prevalence of chronic diseases. The objective of this study is therefore to propose a metric of health based on domains of functioning to determine whether the English are healthier than the Americans.
  
  
  METHODS
  We analysed representative samples aged 50 to 80 years from the 2008 wave of the Health and Retirement Study (N=10 349) for the US data, and wave 4 of the English Longitudinal Study of Ageing (N=9405) for English counterpart data. We first calculated the age-standardized disease prevalence of diabetes, hypertension, all heart diseases, stroke, lung disease, cancer and obesity. Second, we developed a metric of health using Rasch analyses and the questions and measured tests common to both surveys addressing domains of human functioning. Finally, we used a linear additive model to test whether the differences in health were due to being English or American.
  
  
  RESULTS
  The English have better health than the Americans when population health is assessed only by prevalence of selected chronic health conditions. The English health advantage disappears almost completely, however, when health is assessed with a metric that integrates information about functioning domains.
  
  
  CONCLUSIONS
  It is possible to construct a metric of health, based on data directly collected from individuals, in which health is operationalized as domains of functioning.
authors.forename: Alarcos
authors.initials: A
authors.lastname: Cieza
authors.forename: Cornelia
authors.initials: C
authors.lastname: Oberhauser
authors.forename: Jerome
authors.initials: J
authors.lastname: Bickenbach
authors.forename: Richard N
authors.initials: RN
authors.lastname: Jones
authors.forename: Tevfik Bedirhan
authors.initials: TB
authors.lastname: Üstün
authors.forename: Nenad
authors.initials: N
authors.lastname: Kostanjsek
authors.forename: John N
authors.initials: JN
authors.lastname: Morris
authors.forename: Somnath
authors.initials: S
authors.lastname: Chatterji
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002908:Chronic Disease / Q000453:epidemiology*; D003625:Data Collection / Q000379:methods*; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D012720:Severity of Illness Index; D012737:Sex Factors; D066107:Social Skills; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology