b'AGING IN THE 21ST CENTURYCHAPTER 4 | CROSS-NATIONAL HEALTHDISPARITIES AND US DISADVANTAGEDespite having the highest level of health care spending in the worldnearly$9,000 per capita annuallythe US ranks among the lowest of high-income nations for life expectancy (OECD 2014). Other health indicators besides longevity show a similar pattern (Crimmins, Preston and Cohen 2011). For example, research examining the health of the US and English populations shows that Americans in middle age at every socioeconomic level are much less healthy than their English counterparts (Banks et al. 2006). Using the HRS sister studieswhich are designed to facilitate direct comparisons of health, wealth, and well-being across countriesresearchers are beginning to elucidate reasons for these discrepancies. While other national and international data sources provide more depth on health, the HRS and the network of harmonized aging studies around the world provide rich longitudinal measurement across several topic areas including income and wealth; health, cognition, and use of health care services; work and retirement; and family connections. T his combination of data resources provideswill certainly involve further improvements toon economic disadvantage, neighborhood the foundation for research that maybehavioral factors like diet, smoking and physicalquality, and childhood health reveals important help explain cross-national variation inactivity. Yet health is also powerfully determineddirections for future policy research. As more health outcomes such as disease prevalence andby social and environmental conditions. data become available from other HRS sister incidence, physical limitations and disability,The association between socioeconomicstudies, the opportunities will grow, especially and mortality. Information on health behaviorsstatus (SES) and healthpoorer people areto compare developed and developing countries and socioeconomic indicators may also yieldless healthy and die at younger ages than richerwith similar challenges (Weir et al. 2014).insights about the nature of US disadvantage.peopleis nearly universal. Understanding Life expectancy in the US varies widely depend- more about the SES-health gradient in the US ing on things like education, income, race andmay shed light on the cause of the nations residential characteristics. Improving the outlookglobal disadvantage in health. HRS research 66'