b'CHAPTER 4 | CROSS-NATIONAL HEALTH DISPARITIES AND US DISADVANTAGEFIGURE 4-4Percent obese in the US and Europe: 2004Source: Michaud et al. (2007).35%30%25%20%15%10%5%0%United Austria Germany Sweden Netherlands Spain Italy France Denmark Greece TotalStates EuropeMen WomenLack of physical activity, caloric intake, timelower SES linked to higher weight. Yet account- Inclusion of health behavior risks spent on cooking, and time and money spenting for the differences in physical activity andsmoking, obesity, low physical activity levels, on eating at home and away from home are allother behavioral risks in this study, the gradientand alcohol consumptionexplains part but associated with obesity, but not consistently sobetween SES and obesity is not eliminated. not all of the cross-national health disparities, across countries. For example, men from SpainModerate alcohol use is shown to have healthaccording to Banks et al. (2006), Avendano and Italy have the highest levels of physicalbenefits, but the amount of alcohol use consid- et al. (2009), and Crimmins, Garcia and Kim inactivity but lower levels of obesity thanered harmful depends on age. Ten percent of US(2010). Moreover, these risks are also socially American men who are slightly more active.men, 28.6% of English men, 2.9% of US women,and economically patterned, and research Whereas physical activity is strongly correlatedand 10.3% of English women drink more thanusing HRS and sister studies investigates the with obesity in the US, it is only weakly associat- the US National Institute on Alcohol Abuse andpossibility that they can help explain some of ed with obesity in southern European countries.Alcoholism recommended limit for people agedthe SES-health gradient. Yet after accounting Eating out is also much more prevalent in the65 and older (Lang et al. 2007). However, physicalfor health behaviors, poorer Americans remain US and associated with obesity; in Europe, therefunctioning and mortality outcomes in olderat significantly greater risk for disease than is no clear association between eating out andpeople with alcohol intakes above US recommend- their English or European counterparts. Higher obesity rates. A strong association between SESed levels for the old (but within recommendationswealth Americans report similar health to much and obesity appears across all countries withfor younger adults) are not poor in either country.poorer Europeans (Avendano et al. 2009). 73'