b'CHAPTER 4 | CROSS-NATIONAL HEALTH DISPARITIES AND US DISADVANTAGEFIGURE 4-1Prevalence of chronic disease and disability among those aged 50-74 in the US, England and Europe: 2004Source: Avendano et al. (2009).60%50%40%30%20%10%0%Heart disease Stroke Hypertension Diabetes Cancer Lung disease 1+ IADL 1+ mobiliylimitations limitationsUS-HRS England-ELSA Europe-SHAREhigher prevalence of disease compared to the(McWilliams et al. 2007), which may helpincome benefits, which raises the income floor English, but also a higher risk of new diseaseaccount for smaller cross-national differencesfor poorer households. Interestingly, a recent incidence. The incidence rates of disease arein health at older ages.study using ELSA and HRS shows that the closer in the two countries in the older ageWork and marital status, as well as obesity,English health advantage is reduced signifi-group. Comparison of mortality, on the otherexercise and smoking explain income gradientscantly when data includes information about hand, tells a somewhat different story. Age- for the younger groups in the US and the UK,physical functioning (Cieza et al. 2015).specific mortality is only slightly higher in theand to a large extent in the 70- to 80-year-old US in the younger age group, and is actuallyAmericans. For both birth cohorts and in both lower in the older age group. This may suggestcountries, many individuals who smoked in theAge-specific mortality is only that investments in health care at older agespast are able to stop. Yet relative to those withslightly higher in the US in the in the US helps offset earlier life health prob- higher income and wealth, individuals with low-lems. Another line of HRS research shows thater income and wealth appear to have a harderyounger age group, and is actually health care utilization increases after age 65time quitting. The absence of an SES gradient forlower in the older age group.when Americans become eligible for Medicarethe older cohort relates to the English system of 69'