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dc.contributor.authorMarshall, Alan David
dc.contributor.authorNazroo, James
dc.contributor.authorFeeney, Kevin
dc.contributor.authorLee, Jinkook
dc.contributor.authorVanhoutte, Bram
dc.contributor.authorPendleton, Neil
dc.identifier.citationMarshall , A D , Nazroo , J , Feeney , K , Lee , J , Vanhoutte , B & Pendleton , N 2015 , ' A comparison of hypertension healthcare outcomes among older people in the USA and England ' , Journal of Epidemiology and Community Health , vol. In press .
dc.identifier.otherPURE: 209446730
dc.identifier.otherPURE UUID: de84c6a5-e82a-44f6-9b9d-9c70ab3a6236
dc.identifier.otherScopus: 84959543057
dc.identifier.otherWOS: 000369963400011
dc.descriptionFunding: Economic and Social Research Council. G1001375/1. Medical Research Council. G1001375/1. US Department of Health and Human Services. National Institutes of Health. National Institute on Aging. 2R01 AG030153.en
dc.description.abstractBackground The US and England have very different health systems. Comparing hypertension care outcomes in each country enables an evaluation of the effectiveness of each system. Method The English Longitudinal Study of Ageing and the Health and Retirement Survey are used to compare the prevalence of controlled, uncontrolled and undiagnosed hypertension in the population aged over 50 in the US and in England. Results Controlled hypertension is more prevalent in the US (age 50 to 64: 0.53 (0.50-0.57) and age 65+: 0.51 (0.49-0.53)) than in England (age 50 to 64: 0.45 (0.42-0.48) and age 65+: 0.42 (0.40-0.45)). This difference is driven by lower undiagnosed hypertension in the US (age 50 to 64: 0.18 (0.15-0.21) and age 65+: 0.13 (0.12-0.14)) relative to England (age 50 to 64: 0.26 (0.24-0.29) and age 65+: 0.22 (0.20-0.24)). The prevalence of uncontrolled hypertension is very similar in the US (age 50 to 64: 0.29 (0.26-0.32) and age 65+: 0.36 (0.34-0.38)) and England (age 50 to 64: 0.29 (0.26-0.32) and age 65+: 0.36 (0.34-0.39)). Hypertension care outcomes are comparable across US insurance categories. In both countries undiagnosed hypertension is positively correlated with wealth (ages 50-64). Uncontrolled hypertension declines with rising wealth in the US. Conclusions Different diagnostic practices are likely to drive the cross-country differences in undiagnosed hypertension. US government health systems perform at least as well as private health care and are more equitable in the distribution of care outcomes. Higher undiagnosed hypertension among the affluent may reflect less frequent medical contact.
dc.relation.ispartofJournal of Epidemiology and Community Healthen
dc.rightsCopyright 2015 the Authors. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:
dc.subjectAccess to health careen
dc.subjectHealth inequalitiesen
dc.subjectPublic healthen
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.subjectSDG 3 - Good Health and Well-beingen
dc.titleA comparison of hypertension healthcare outcomes among older people in the USA and Englanden
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews. Geography & Sustainable Developmenten
dc.description.statusPeer revieweden

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