Older U.S. adults are more likely than their European counterparts to be diagnosed with costly chronic diseases and to be treated for those diseases, adding about $100 billion to $150 billion per year in U.S. health care spending, according to research published today by Emory University public health researchers in the journal Health Affairs.
The study, the first of its kind, shows that Americans are also nearly twice as likely as those who live in Europe to be obese.
Kenneth E. Thorpe, PhD, professor of health policy and management at Emory's Rollins School of Public Health, and his team compared 2004 data on the prevalence and treatment of diseases among adults ages 50 and older in the U.S. and 10 European countries (Austria, Denmark, France, Germany, Greece, Italy, Netherlands, Spain, Sweden and Switzerland).
They found that while 17.1 percent of European adults are obese, the rate is nearly double for U.S. adults -- 33.1 percent. American adults were also more likely than Europeans to have chronic diseases, such as heart disease, cancer, diabetes and chronic lung disease that are correlated with obesity and smoking, says Dr. Thorpe and colleagues.
The U.S. spends more on health care than any country in Europe, according to Organization for Economic Cooperation and Development (OECD) data. In 2004, U.S. per capita spending on health care was $6,102 -- about twice the rate in the Netherlands and Germany and nearly twice that of France.
"We expected to see differences between disease prevalence in the U.S. and Europe, but the extent of the differences is surprising," says Dr. Thorpe, Robert W. Woodruff Professor, and chair of the Department of Health Policy and Management, Rollins School of Public Health, Emory University.
"It is possible that we spend more on health care because we are, indeed, less healthy," adds Dr. Thorpe. "If the U.S. could bring its obesity rates more in line with Europe's, it could save $100 billion a year or more in health care costs."
More specifically, the researchers estimate that per capita U.S. spending could be reduced by $1,195 to $1,750 per year if Americans ages 50 and older were diagnosed and treated at the lower European rates for 10 common chronic conditions: heart disease, high blood pressure, high cholesterol, stroke/ cerebrovascular disease, diabetes, chronic lung disease, asthma, arthritis, osteoporosis and cancer.
Dr. Thorpe and colleagues estimate that this would reduce health spending by $100 billion to $150 billion per year or would trim 12.7 percent to 18.7 percent off the total budget for personal health care spending among those ages 50 and older.
Why is disease prevalence higher in the U.S.?
Explanations for the differences in disease prevalence remain varied. While it is possible that Americans are actually sicker than Europeans, it is also possible that more aggressive diagnosis and pretreatment of chronic diseases in this country raises disease prevalence rates, the researchers say.
Dr. Thorpe and coauthors David Howard, PhD, associate professor, and Katya Galactionova, research manager, both in Emory's Rollins School of Public Health, also note that higher U.S. disease prevalence rates may vary by condition. For example, Americans have higher levels of obesity-related disease markers, such as high blood pressure, so they appear to be actually sicker than Europeans. On the other hand, the higher rate of diagnosed cancer in the U.S. -- more than double that of Europe -- appears to be due to more intensive screening here.
Researchers also found that the differences in the prevalence of chronic diseases affected the amount of medications used and treatments for those diseases. Despite the lack of universal health coverage in the U.S., adults in the U.S. ages 50 and older were more likely than European adults to receive medications for six of nine conditions, including heart disease, diabetes and asthma. This increased treatment for chronic disease and medication use is helping drive higher health care spending in the U.S., the researchers conclude.