b'AGING IN THE 21ST CENTURYSole-Auro et al. (2015) use HRS and SHARElife expectancy had fallen behind that of mostin a wide age range from 50 to 85 years old. Two data from 2004 and 2006 for participants agedWestern European countries. This longevity gap isnew studies were added to SHARE in 2006: Czech 50 to 79 to study age-specific differences inexplained by declines in the health of AmericansRepublic and Poland. Because of important dif-prevalence and incidence of heart disease, stroke,over age 50 relative to Western Europeans atferences within SHARE, they group the European lung disease, diabetes, hypertension, and cancer,similar ages. countries into North/West (Sweden, Denmark, and mortality associated with each disease.Germany, Austria, Netherlands, Belgium, France Americans have higher disease prevalence acrossDifferences in Physical Functioning and Switzerland), South (Italy, Spain and Greece), all diseases. Incidence of lung disease is higher inStudies also compare countries in the HRS familyand East (Poland and Czech Republic). The highest Europe, though, and there is no difference in theacross a range of measures of physical function- disability rate is in the US, with the next highest incidence of hypertension and stroke betweening, disability and limitations. As with healthin Eastern Europe, followed by England and Europe and the US. Incidence of heart disease,conditions, the pattern of gender differences inSouthern Europe. Northern and Western Europe diabetes and cancer incidence is higher in thephysical functioning and disability are similarhave the lowest levels of disability overall. US. They suggest that the basis of higher diseaseacross countries (Crimmins, Kim and Sole-AuroThe analyses account for cross-country dif-prevalence at older ages in the US is higher prev- 2010). One set of measures assesses difficultyference in relevant risk factors like hypertension, alence of disease at younger ages and, for someperforming at least one of 10 tasks related todiabetes, obesity, smoking and physical inactiv-conditions, higher incidence over age 50. Amongmobility, strength and endurance. Another setity. The prevalence of disability increases with those who have a disease, however, they find noof questions assesses activities of daily livingage, but increases most sharply in Eastern and mortality difference between Europe and the US. (ADLs), which indicate difficulty performing self- Southern Europe. The prevalence of disabilities at care tasks. Instrumental activities of daily livingolder ages is higher in these regions than in the (IADLs) assess the ability to live independently.US. Physical limitations are most severe for those Physical limitations are mostWomen are more likely than men to havewith lower levels of wealth across the US, England severe for those with lower levelsfunctioning problems related to mobility,and European countries, but these differences strength and endurance, and to have IADL dif- are larger in the US and England, especially at of wealth across the US, Englandficulties. Gender differences for ADLs are not asyounger ages. and European countries, butconsistent across countries. As noted, women alsoA sense of personal control may buffer the these differences are larger inreport more arthritis, which may help explainimpact of disability. Clarke and Smith (2011) the US and England, especiallythe gender difference in physical limitations. Thecompare the impact of this outlook on physical higher rate of physical difficulties also appearsfunctioning in older American and English at younger ages. to explain womens poorer self-reported health.adults. US adults over age 50 have higher levels Men are significantly more likely than womenof disability than their counterparts in England. to smoke, and to be overweight and obese acrossAs shown in Figure 4-2, however, Americans Another study tracks changes in life ex- countries. Accounting for this difference doesreport a very high sense of personal control, pectancy between the US and Europe usingnot eliminate the gender difference in physicalwhereas older adults in England are much more information from SHARE and HRS (Michaudfunctioning and disability. likely to agree that events in life are not always et al. 2011). Prior to 1975, the US held theWahrendorf et al. (2013) use data from theunder their control. Accounting for other risks, advantage in life expectancy at age 50 compared2006 HRS, ELSA and SHARE to study differencesdisability is much lower for Americans with a to Western Europeans. But by 2005, Americanin mobility limitations and limitations in IADLshigh sense of control.70'