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 76 Investigating the Source of US Disadvantage While socioeconomic health inequalities are present in all countries, they are more pro- nounced in the US. Many of the studies in this chapter examine the association between SES and health and seek to explain the generally sharper gradient in the US. Overall, most studies confirm greater SES disparities in health conditions in the US compared to other coun- tries. Even though the gradient is also present for mortality, the difference between countries is smaller. There are clear differences across countries in behavioral health risks like smoking and obesity, but they do not explain the US health disadvantage and also do not explain the fact that health disparities are greater in the US compared to other countries. The answers may lie elsewhere in the broader social and economic context of each nation. Several lines of research using HRS data seek to understand more about socioeconomic differentials in health in the US. Understanding Health Disparity in the US What does it mean to be poor in the US? What impact does it have on health? HRS is well-de- signed to address these important questions. Numerous studies using HRS data document the SES health gradient and try to disentangle the ways in which disadvantage can lead to poor health outcomes. Other studies consider the impact of neighborhood environment on health. Another line of research finds that the roots of health disparities at older ages may begin in childhood. Disease and Disadvantage Income and education are commonly used indi- cators of SES. Personal wealth may be an equally important resource for older people. Income, education and wealth are all independent risk factors for stroke in men and women aged 50 to 64 (Avendano and Glymour 2008). These results account for the negative effects of other known risk factors such as smoking, physical inactivity, higher BMI, hypertension, dia- betes and heart disease. Conversely, wealth, income and education are not associated with stroke risk past age 65. A potential explanation for this lessening of the impact of all three indicators of SES is selective survival. That is, those with lower SES tend to die at younger ages than those with higher SES, making the survivors a much healthi- er group at older ages. Health at middle age is a very important predictor of eventual death. The 10-year mortality rate is 4.7% for those reporting excellent health, and 35.8% for those reporting poor health in middle age. Attempting to elucidate the path through which SES affects mortality over the life course, Feinglass et al. (2007) use HRS data from 1992 to 2002 linked to the National Death Index to deter- mine all-cause mortality over the 10-year span. Health at middle age is a very important predictor of eventual death. The 10-year mortality rate is 4.7% for those reporting excel- lent health, and 35.8% for those reporting poor health in middle age. After accounting for baseline health and There are clear differences across countries in behavioral health risks like smoking and obesity, but they do not explain the US health disadvantage and also do not explain the fact that health disparities are greater in the US compared to other countries.