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 10875 CHAPTER 4 | CROSS-NATIONAL HEALTH DISPARITIES AND US DISADVANTAGE (Savva et al. 2013). The same measure of imme- diate recall used in Langa et al. (2009) is used, but a new measure of verbal fluency added to the surveys later is also used. This task asks partic- ipants to name as many items from a particular category as possible in 60 seconds. They also use a measure of self-reported assessment of memory as excellent, very good, good, fair or poor. In contrast to Langa et al. (2009), they find no signif- icant difference on the measure of immediate recall, and those in England and Ireland score better than Americans on the measure of verbal fluency. The English are the most likely to report fair or poor memory, however. Unlike findings from other studies of educational inequality in physical health, the difference in cognitive scores across educational levels is larger in England and Ireland than in the US. Detecting and Treating More Disease Disease prevalence results from a combination of incidence (new disease) and duration of disease. Better treatment of chronic diseases can mean that people with these diseases live longer. Some evidence suggests that the treatment rates for these conditions may be higher in the US. This may translate to a survival advantage, espe- cially at older ages, and could help explain the higher prevalence of chronic disease in the US. Americans are more likely than Europeans and the English to report that a doctor told them they had hypertension and high blood cholester- ol levels (Crimmins, Garcia and Kim 2010). Yet, when objectively measured hypertension and high blood cholesterol are considered, Americans have among the lowest levels of these conditions across all countries studied. It may be that Americans are more likely to be taking drugs to control hy- pertension and high cholesterol. Other research using HRS sister-study data confirms that treatment rates are relatively high in the US. Thorpe et al. (2007) use data from HRS and SHARE to examine differences in disease prevalence and treatment rates for heart disease, high blood pressure, stroke, diabetes, chronic lung disease and arthritis. They calculate treated prevalence by multiplying the prevalence of the condition by the prevalence of medication use; treated prevalence is higher in the US for all conditions. In the US, the expansion of coverage for pre- scription drugs with Medicare Part D means that control of blood pressure may improve further. Diebold (2016) finds that not taking medications because of cost decreased by 7% in those newly covered by Part D. This translated into a 4% decline in the likelihood of being diagnosed with high blood pressure. Another study uses these data to evaluate cross-national differences in cancer screening rates (Howard et al. 2009). More aggressive screening could lead to a higher rate of disease detection and earlier detection, both of which could contribute to higher disease prevalence at a given point in time. Medical practice guidelines between the US and Europe are very different, especially in screening recommendations for older individuals. Most European cancer screen- ing programs have firm upper age limits (usually between ages 60 and 70), whereas US guidelines only suggest less screening at older ages. Indeed, Americans over age 50 receive more cancer screening overall compared to their European counterparts. This is true at younger as well as older ages. For example, mammography screen- ing rates are 77% for 50- to 64-year-old women in the US, while only 46% in Europeans of the same age. The prevalence of mammography is 13% for Europeans over age 76, but is 58.5% for older Americans. Treated prevalence is higher in the US for all conditions. Americans over age 50 receive more cancer screening overall compared to their European counterparts.