Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 36 Page 37 Page 38 Page 39 Page 40 Page 41 Page 42 Page 43 Page 44 Page 45 Page 46 Page 47 Page 48 Page 49 Page 50 Page 51 Page 52 Page 53 Page 54 Page 55 Page 56 Page 57 Page 58 Page 59 Page 60 Page 61 Page 62 Page 63 Page 64 Page 65 Page 66 Page 67 Page 68 Page 69 Page 70 Page 71 Page 72 Page 73 Page 74 Page 75 Page 76 Page 77 Page 78 Page 79 Page 80 Page 81 Page 82 Page 83 Page 84 Page 85 Page 86 Page 87 Page 88 Page 89 Page 90 Page 91 Page 92 Page 93 Page 94 Page 95 Page 96 Page 97 Page 98 Page 99 Page 100 Page 101 Page 102 Page 103 Page 104 Page 105 Page 106 Page 107 Page 108AGING IN THE 21S T CENTURY 66 CHAPTER 4 | CROSS-NATIONAL HEALTH DISPARITIES AND US DISADVANTAGE Despite having the highest level of health care spending in the world — nearly $9,000 per capita annually — the 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 studies — which are designed to facilitate direct comparisons of health, wealth, and well-being across countries — researchers 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 provides the foundation for research that may help explain cross-national variation in health outcomes such as disease prevalence and incidence, physical limitations and disability, and mortality. Information on health behaviors and socioeconomic indicators may also yield insights about the nature of US disadvantage. Life expectancy in the US varies widely depend- ing on things like education, income, race and residential characteristics. Improving the outlook will certainly involve further improvements to behavioral factors like diet, smoking and physical activity. Yet health is also powerfully determined by social and environmental conditions. The association between socioeconomic status (SES) and health — poorer people are less healthy and die at younger ages than richer people — is nearly universal. Understanding more about the SES-health gradient in the US may shed light on the cause of the nation’s global disadvantage in health. HRS research on economic disadvantage, neighborhood quality, and childhood health reveals important directions for future policy research. As more data become available from other HRS sister studies, the opportunities will grow, especially to compare developed and developing countries with similar challenges (Weir et al. 2014).