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 68 Differences in Disease Rates and Mortality It is not surprising that developing countries have worse health outcomes than developed nations. Striking differences exist, however, in the health status of developed countries. Researchers are beginning to use the rich data available in the network of HRS sister studies to understand more about these differences. One of the first published cross-national comparisons of health status using HRS sister-study data finds prominent differences between the US and England (Banks et al. 2006). This study uses 2002 data from ELSA and HRS to compare the prevalence of diabetes, hyperten- sion, heart disease, myocardial infarction, stroke, lung disease and cancer among 55- to 64-year- olds. Because of well-documented racial health disparities in the US, the analysis is limited to non-Hispanic whites. Despite much greater per-capita annual spending on health care in the US, $7,014 (in 2016 dollars) versus $2,878 in England, Americans aged 54 to 64 are much less healthy than English of the same age. SES is indicated by education and income. The health- SES gradient exists in both countries for all diseases except cancer. However, the US health disadvantage is present at every level of SES. Extending the comparison to Europe by using 2004 data from SHARE (along with 2004 data from ELSA and HRS) and expanding the ages covered from 50 to 74, Avendano et al. (2009) identify a strong US health disadvantage in com- parison to western Europeans as well. As in Banks et al. (2006), the analysis is limited to non-His- panic whites. In 2004, SHARE included Sweden, Denmark, Germany, the Netherlands, France, Switzerland, Austria, Italy, Spain and Greece. Rates of heart disease, stroke, hypertension, diabetes, cancer, lung disease and disability are highest in the US, lower in the UK, and in some cases substantially lower in Western Europe. For example, the prevalence of hypertension is about 45% in the US, compared to about 40% in in England and 30% in Western Europe (Figure 4-1). Health disparities by wealth are significantly smaller in Europe than in the US and England. Some of the difference could be explained by low- er disease incidence in Europe and longer survival with disease in the US, which combine to create higher prevalence. But even wealthier Americans are worse off and have health that is comparable to poorer Europeans. Crimmins, Garcia and Kim (2010) report sim- ilar findings on the prevalence of diabetes, stroke and heart disease in the 2004 waves of SHARE, ELSA and HRS. Nearly 11% of American men over age 50 and almost 9% of American women report having more than one of these conditions. Europeans and the English, by contrast, are far less likely to report more than one condition. Across all countries studied, women experience more arthritis, depres- sive symptoms and hypertension, whereas self-reported heart disease is higher for men. There are no consistent differences between men and women in prevalence of stroke and diabetes. Women’s self- reported health is worse than men’s across nations, but accounting for gender differences such as physical functioning, disability, and disease reduces the difference. In 2010, the first wave of TILDA launched. The health of 57- to 64-year-olds in Ireland is closer to that of the English than the Americans (Savva et al. 2013). Health inequalities across educational levels are present in all three coun- tries but are strongest in the US. Despite these differences, Americans are less likely to report having fair or poor health than their counter- parts in England or Ireland. Part of the observed cross-national differences in health could be accounted for by differences in rates of disease diagnosis. Rates of undiagnosed hypertension are higher in Ireland compared to the US (Mosca and Kenny 2014). In follow-up work to their earlier study, Banks et al. (2010) again compare data from ELSA and HRS using information from 2002 to 2006 to determine the rate of new illness and mortality. For both younger (55 to 64) and older (70 to 80) individuals, Americans have a