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 70 Sole-Auro et al. (2015) use HRS and SHARE data from 2004 and 2006 for participants aged 50 to 79 to study age-specific differences in prevalence and incidence of heart disease, stroke, lung disease, diabetes, hypertension, and cancer, and mortality associated with each disease. Americans have higher disease prevalence across all diseases. Incidence of lung disease is higher in Europe, though, and there is no difference in the incidence of hypertension and stroke between Europe and the US. Incidence of heart disease, diabetes and cancer incidence is higher in the US. They suggest that the basis of higher disease prevalence at older ages in the US is higher prev- alence of disease at younger ages and, for some conditions, higher incidence over age 50. Among those who have a disease, however, they find no mortality difference between Europe and the US. Another study tracks changes in life ex- pectancy between the US and Europe using information from SHARE and HRS (Michaud et al. 2011). Prior to 1975, the US held the advantage in life expectancy at age 50 compared to Western Europeans. But by 2005, American life expectancy had fallen behind that of most Western European countries. This longevity gap is explained by declines in the health of Americans over age 50 relative to Western Europeans at similar ages. Differences in Physical Functioning Studies also compare countries in the HRS family across a range of measures of physical function- ing, disability and limitations. As with health conditions, the pattern of gender differences in physical functioning and disability are similar across countries (Crimmins, Kim and Sole-Auro 2010). One set of measures assesses difficulty performing at least one of 10 tasks related to mobility, strength and endurance. Another set of questions assesses activities of daily living (ADLs), which indicate difficulty performing self- care tasks. Instrumental activities of daily living (IADLs) assess the ability to live independently. Women are more likely than men to have functioning problems related to mobility, strength and endurance, and to have IADL dif- ficulties. Gender differences for ADLs are not as consistent across countries. As noted, women also report more arthritis, which may help explain the gender difference in physical limitations. The higher rate of physical difficulties also appears to explain women’s poorer self-reported health. Men are significantly more likely than women to smoke, and to be overweight and obese across countries. Accounting for this difference does not eliminate the gender difference in physical functioning and disability. Wahrendorf et al. (2013) use data from the 2006 HRS, ELSA and SHARE to study differences in mobility limitations and limitations in IADLs in a wide age range from 50 to 85 years old. Two new studies were added to SHARE in 2006: Czech Republic and Poland. Because of important dif- ferences within SHARE, they group the European countries into North/West (Sweden, Denmark, Germany, Austria, Netherlands, Belgium, France and Switzerland), South (Italy, Spain and Greece), and East (Poland and Czech Republic). The highest disability rate is in the US, with the next highest in Eastern Europe, followed by England and Southern Europe. Northern and Western Europe have the lowest levels of disability overall. The analyses account for cross-country dif- ference in relevant risk factors like hypertension, diabetes, obesity, smoking and physical inactiv- ity. The prevalence of disability increases with age, but increases most sharply in Eastern and Southern Europe. The prevalence of disabilities at older ages is higher in these regions than in the US. Physical limitations are most severe for those with lower levels of wealth across the US, England and European countries, but these differences are larger in the US and England, especially at younger ages. A sense of personal control may buffer the impact of disability. Clarke and Smith (2011) compare the impact of this outlook on physical functioning in older American and English adults. US adults over age 50 have higher levels of disability than their counterparts in England. As shown in Figure 4-2, however, Americans report a very high sense of personal control, whereas older adults in England are much more likely to agree that events in life are not always under their control. Accounting for other risks, disability is much lower for Americans with a high sense of control. Physical limitations are most severe for those with lower levels of wealth across the US, England and European countries, but these differences are larger in the US and England, especially at younger ages.