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12 Health, Economic Status, and Aging in High-Income Countries - Jinkook Lee and James P. Smith
Pages 339-368

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From page 339... ... around the world surveys.3 In this paper, we use harmonized panel data from high-income countries that are part of the HRS around the world surveys to describe levels and changes in health status and health behaviors for populations across these countries at middle age and older ages. For the high-income countries that are our focus in this paper, population aging due to declining fertility and improving mortality has taken place alongside very different trends across countries and across groups within countries in improved health behaviors, education, and income growth. Read the entire page →
From page 340... ... The second section documents harmonized HRS data that will be used in our research and the operational definition of variables in the analysis. The third summarizes levels and trends in two salient measures of health levels and trends in our set of high-income countries: mortality and disease prevalence. Read the entire page →
From page 341... ... Besides the U.S. HRS, the HRS network of high-income countries includes the English Longitudinal Survey of Ageing (ELSA) Read the entire page →
From page 342... ... This analysis uses data from the RAND HRS Version P, Harmonized MHAS Version A Beta.3, Harmonized ELSA Version D, Harmonized SHARE Version C.2, Harmonized KLoSA Version B, and Harmonized JSTAR Version B We use harmonized measures available from Gateway to examine cross-country differences in health and health behaviors. Read the entire page →
From page 343... ... TABLE 12-1 Life Expectancy at Age 50 by Calendar-Year Periods and Country Year U.S. Belgium Denmark France Ireland Italy Japan Netherlands Spain UK Male 1950–1959 22.9 23.0 25.3 22.6 23.3 23.9 21.9 25.8 23.3 22.4 1990–1999 27.0 26.7 26.0 27.5 25.7 27.7 29.0 27.0 28.0 26.6 2000–2009 28.7 28.6 28.0 29.4 28.7 30.1 30.7 29.0 29.6 29.1 2010–2015 29.9 30.1 29.8 30.9 30.8 31.3 31.7 30.7 31.2 30.9 ∆ 1950–1999 4.1 3.7 0.7 4.9 2.4 3.8 7.1 1.2 4.7 4.2 ∆ 1999–2015 2.9 3.3 3.8 3.4 5.1 3.6 2.7 3.7 3.2 4.3 ∆ 1950–2015 7.0 7.1 4.5 8.3 7.5 7.4 9.8 4.9 7.9 8.5 Female 1950–1959 27.3 26.6 27.0 27.0 25.5 26.7 25.1 27.6 26.6 26.8 1990–1999 31.6 32.1 30.2 33.8 30.2 33.0 34.5 32.1 33.5 31.0 2000–2009 32.4 33.3 31.6 35.3 32.6 34.8 36.8 33.0 35.1 32.7 2010–2015 33.5 34.3 33.2 36.4 34.1 35.5 37.6 34.1 36.3 34.0 ∆ 1950–1999 4.3 5.5 3.2 6.8 5.8 6.3 9.4 4.5 6.9 4.2 ∆ 1999–2015 1.9 2.2 3.0 2.6 2.9 2.5 3.1 2.0 2.8 3.0 ∆ 1950–2015 6.2 7.7 6.2 9.4 8.7 8.8 12.5 6.5 9.7 7.2 343 Read the entire page →
From page 344... ... Following the United States, the countries in Eastern Europe (Czech Republic) rank a solid second place in reported disease prevalence, with England in third place and Central and Northern Europe performing best in health outcomes. Read the entire page →
From page 345... ... In addition to cross-country differences in health status, we are interested in measures of the social gradient in health status within and across these high-income countries. We measure the social gradient using education and wealth as an alternative measure of socioeconomic status (SES) Read the entire page →
From page 346... ... TABLE 12-2 Self-Reported Health Status by Country/Region, Gender, and Age Group, 2006 and 2012 346 Diabetes Cancer Hypertension Heart Disease Stroke 2006 2012 2006 2012 2006 2012 2006 2012 2006 2012 Men Ages 55–65 Central Europe 10.9 13.6 4.2 5.8 34.5 37.4 13.4 12.0 4.1 3.9 Eastern Europe 16.5 19.1 4.0 4.4 46.2 53.8 13.5 14.5 3.4 6.5 Northern Europe 8.8 9.4 6.4 5.5 31.0 35.3 12.8 9.5 4.1 4.0 Southern Europe 12.1 13.8 4.2 5.4 35.5 41.9 10.7 10.0 3.4 3.2 Japan 12.4 15.6 2.9 4.4 28.0 36.8 7.3 8.8 1.8 2.9 Korea 14.3 14.3 2.4 3.2 24.6 28.9 4.6 5.4 3.9 4.3 England 9.4 11.0 4.3 5.0 40.4 38.2 12.7 14.3 3.0 2.5 USA 17.8 20.5 7.5 8.1 47.8 53.1 17.7 18.8 5.4 4.6 Women Ages 55–65 Central Europe 8.6 9.7 8.6 9.6 35.7 36.0 7.3 6.8 2.7 4.0 Eastern Europe 9.5 14.1 6.6 7.4 41.4 46.7 6.4 8.7 1.9 2.6 Northern Europe 6.1 6.6 9.3 10.3 31.7 31.8 7.7 5.8 2.6 3.0 Southern Europe 10.8 9.8 6.4 6.1 39.0 38.1 6.7 5.4 1.5 1.9 Japan 4.6 7.5 3.7 3.8 25.7 25.7 5.8 6.1 1.9 1.4 Korea 12.1 12.4 3.5 5.5 31.0 31.5 4.8 4.9 3.0 2.9 England 5.3 7.6 8.1 9.2 36.1 33.2 11.4 12.4 1.5 1.7 USA 16.0 18.2 10.3 11.5 45.5 47.0 12.8 14.1 4.0 4.3 Read the entire page →
From page 347... ... Northern Europe: Denmark, Sweden. Southern Europe: Italy, Spain. Read the entire page →
From page 348... ... TABLE 12-3 Health Status by Country/Region, Education Level, and Age Group, 2006 and 2012 348 Diabetes Cancer Hypertension Heart Disease Stroke 2006 2012 2006 2012 2006 2012 2006 2012 2006 2012 0–11 Years of Education, Ages 55–65 Central Europe 13.1 13.9 5.5 7.3 36.6 38.0 11.4 12.1 3.7 4.5 Eastern Europe 12.9 23.4 4.4 6.5 51.1 53.3 12.0 16.8 2.5 4.6 Northern Europe 9.8 10.7 8.1 8.4 36.6 35.0 12.9 8.8 3.9 3.6 Southern Europe 12.9 13.8 5.3 5.8 39.2 43.9 9.3 8.9 2.4 3.3 Japan 13.1 18.0 2.5 3.4 27.9 44.7 6.6 6.4 3.5 3.9 Korea 14.4 15.0 3.2 4.6 28.3 33.9 5.3 6.2 3.7 4.5 England 9.4 10.9 6.1 7.4 42.0 38.4 12.2 13.6 2.7 3.1 USA 27.6 31.3 7.5 9.0 56.2 60.8 19.1 21.2 7.8 9.4 12–15 Years of Education, Ages 55–65 Central Europe 7.9 10.7 6.4 7.5 35.1 37.4 9.9 7.6 3.0 3.2 Eastern Europe 13.5 15.1 5.7 6.4 40.7 50.2 8.3 9.7 2.0 4.6 Northern Europe 5.5 7.4 8.1 8.3 27.6 35.0 8.4 6.5 2.8 3.5 Southern Europe 9.3 8.9 6.9 5.9 35.9 32.8 7.5 6.3 2.9 1.3 Japan 9.0 10.2 3.0 4.0 26.9 29.0 7.4 7.5 1.6 1.3 Korea 11.9 11.8 2.3 4.6 27.9 27.1 3.4 4.2 3.8 3.1 England 6.8 9.9 5.7 7.0 37.2 37.4 12.0 14.6 2.4 2.0 USA 16.3 19.2 8.7 10.2 48.1 52.2 16.6 17.5 4.9 4.3 Read the entire page →
From page 349... ... Northern Europe: Denmark, Sweden. Southern Europe: Italy, Spain. Read the entire page →
From page 350... ... However, in the other countries, the same pattern of higher disease prevalence among the less educated still prevails, again for all diseases except cancer. Using wealth terciles as the marker for SES, we observe a very similar pattern to that just discussed for education: a very negative disease prevalence gradient by wealth levels for all countries and for all diseases but cancer, with the United States having the most negative disease social gradient. Read the entire page →
From page 351... ... 74.6 63.6 52.7 63.3 57.9 51.4 45.2 53.9 % Undiagnosed among hypertensives 34.8 46.2 28.3 16.9 39.2 36.2 28.1 15.6 % Undiagnosed among total population 26.0 29.4 14.9 10.7 22.7 18.6 12.7 8.4 Men Ages 66+ Women Ages 66+ Hypertensive a. Diagnosed 40.5 27.8 20.2 26.0 46.3 30.9 23.1 24.9 b. Read the entire page →
From page 352... ... . The flip side is that many people who had previously been diagnosed by a doctor as hypertensive have measured blood pressure levels now below the established diagnosis thresholds, an indication that they are exercising good control of their hypertension. Read the entire page →
From page 353... ... Obesity has continued to rise unabated in recent decades. The vigorous exercise questions refer to 8 The high-income countries that do not currently measure hypertension are all SHARE countries except Germany, plus Japan and Korea. Read the entire page →
From page 354... ... Δ 1980–2012 13.9 7.9 0.6 4.1 Δ 2012–2015 –12.7 –6.2 –2.0 –5.6 Δ 1980–2015 1.2 1.7 –1.4 –1.5 SOURCES: Smoking, obesity, exercise, and height data obtained from various waves of NHANES. Health insurance data are from various waves of NHIS. Read the entire page →
From page 355... ... Table 12-6 documents well-established salient health behaviors (ever and current smoking, binge drinking, vigorous exercise, and obesity) using our high-income set of HRS around the world surveys. Read the entire page →
From page 356... ... Central Europe 39.0 47.7 17.0 22.5 5.2 4.4 55.2 55.3 19.1 22.1 Eastern Europe 46.9 46.5 26.7 30.7 6.0 12.4 40.6 37.2 26.9 30.4 Northern Europe 57.9 60.1 25.6 19.7 7.0 6.9 51.7 63.7 15.4 16.3 Southern Europe 30.8 38.1 15.2 18.5 5.9 2.3 42.1 39.5 22.9 17.9 Japan 16.3 21.2 9.6 9.3 1.7 1.8 -- -- 1.8 2.5 Korea 3.0 4.0 2.6 2.5 2.4 4.6 39.3 38.0 3.4 2.2 England 58.9 56.7 18.9 16.8 18.9 10.7 30.9 30.0 31.8 36.5 USA 51.6 49.3 17.3 15.2 1.3 1.8 31.4 37.8 37.0 39.7 Read the entire page →
From page 357... ... Central Europe 19.3 26.7 6.9 8.6 2.3 2.4 31.4 31.5 16.7 19.7 Eastern Europe 21.5 27.7 9.2 12.6 3.5 6.7 23.1 22.3 21.0 27.3 Northern Europe 44.1 47.1 14.1 12.5 2.6 2.9 33.5 45.6 13.3 14.9 Southern Europe 13.8 17.6 5.3 5.4 3.5 1.1 19.5 19.2 21.1 20.9 Japan 11.9 11.6 4.9 4.8 0.2 0.9 -- -- 1.1 3.2 Korea 5.2 4.7 4.1 2.7 2.0 3.1 23.1 25.6 2.3 1.7 England 53.6 58.1 10.0 9.1 7.5 3.5 13.8 16.8 30.1 32.0 USA 46.3 48.1 8.5 8.5 0.3 0.5 20.1 27.7 25.1 28.6 NOTES: Data under 2006 are for calendar 2006 except that Japan data are for calendar 2007. Data under 2012 are calendar 2012 except that Japan data are for calendar 2011. Read the entire page →
From page 358... ... Current smoking rates tend to be significantly lower among those ages 66 and older compared to those ages 55–65, a difference that most likely indicates prior health problems with smoking in the older group. The second health behavior examined is binge drinking. Read the entire page →
From page 359... ... in obesity level, followed by the countries of Central and Southern Europe, with the highest levels of obesity occurring in Eastern Europe. Given the central role of obesity in health outcomes and its variability among countries and over time, Figure 12-1 plots age-adjusted percentages of obese men and women in many high-income countries, for calendar years 1975 and 2012, using World Health Organization data. Read the entire page →
From page 360... ... Improvements in education over time were also small for Germany, Israel, Estonia, and Finland. The central role that education has played in health improvements over time has important implications for the ranking of countries by their health status. Read the entire page →
From page 361... ... This correspondence could be used to increase comparability. To assess the pattern of health behaviors across education groups within countries, Table 12-7 displays three health behaviors -- current smoking, binge drinking, and obesity -- for our set of high-income countries in 2006 and 2012 among those ages 55–64. Read the entire page →
From page 362... ... Central Europe 23.0 25.5 7.7 6.4 17.9 20.9 Eastern Europe 31.1 31.6 7.0 18.6 24.5 29.6 Northern Europe 20.4 18.0 6.1 7.4 12.2 16.7 Southern Europe 25.3 23.4 8.0 3.0 16.1 14.0 Japan 28.6 19.5 4.2 2.1 2.5 2.7 Korea 27.4 25.3 24.3 22.8 1.1 1.3 England 15.4 16.9 25.5 12.3 29.9 36.7 USA 20.9 20.6 3.1 4.8 37.7 41.0 16+ Years of Education, Ages 55–65 (%) Central Europe 21.7 19.0 6.1 5.5 14.6 15.9 Eastern Europe 19.2 18.9 9.7 15.1 28.2 25.4 Northern Europe 21.1 13.3 7.1 9.0 10.7 11.9 Southern Europe 21.6 20.8 12.0 1.4 11.3 11.0 Japan 29.3 28.7 3.3 3.7 3.6 1.7 Korea 24.8 26.4 23.4 25.3 0.0 0.0 England 8.9 8.2 28.1 10.2 21.1 23.3 USA 9.1 7.7 1.8 2.0 27.7 31.1 NOTES: Data under 2006 are for calendar 2006 except that Japan data are for calendar 2007. Read the entire page →
From page 363... ... SOURCES: Data are from RAND HRS, Harmonized ELSA, Harmonized SHARE, armonized H JSTAR, Harmonized KLoSA. of health behaviors when wealth terciles are used to define the SES gradient. Read the entire page →
From page 364... ... TABLE 12-8 Men's Self-Reported Mean Probability of Living to Age 75, by Education Fraction That Expects to 364 Live to Age 75 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 Respondent Age Mean Mean Mean Mean Mean Mean Mean Mean Mean Mean Mean Mean 0–11 Years of Education 57–59 56.7 55.9 57.5 56.1 60.8 52.8 52.9 44.4 46.4 48.5 47.8 48.2 60–62 54.7 58.7 56.5 59.0 56.1 52.5 51.1 54.2 53.6 47.5 39.6 37.6 12–15 Years of Education 57–59 60.1 61.8 63.7 62.6 65.0 60.4 59.5 57.1 59.6 56.9 55.2 56.9 60–62 65.2 62.9 62.7 63.6 66.2 65.4 60.6 57.2 60.0 55.4 58.4 58.3 16+ Years of Education 57–59 67.5 67.7 69.8 68.5 70.3 71.5 67.3 68.4 70.6 67.9 65.9 66.7 60–62 69.5 69.8 71.7 70.4 70.0 69.2 69.1 68.0 70.5 66.2 66.8 66.3 SOURCE: Data are from RAND HRS. Read the entire page →
From page 365... ... . However, these subjective probabilities of future life expectancy have been shown to predict future mortality and to also predict future changes in behaviors such as retirement and social security claiming (Hurd, 2009) Read the entire page →
From page 366... ... Following the United States, countries of Eastern Europe rank second in terms of disease prevalence, England is in third place, and Central and Northern Europe are performing the best in terms of health outcomes. We also find a strong social gradient in health status by our two markers of SES -- years of education and terciles of wealth -- with apparently stronger gradients in the United States compared to the other high-income countries. Read the entire page →
From page 367... ... Socioeconomic status, poor health in childhood, and human capital development. Journal of Economic Literature, 47(1) Read the entire page →
From page 368... ... . Diverging trends in life expectancy at age 50; A look at causes of death. Read the entire page →

From page 339...

... around the world surveys.3 In this paper, we use harmonized panel data from high-income countries that are part of the HRS around the world surveys to describe levels and changes in health status and health behaviors for populations across these countries at middle age and older ages. For the high-income countries that are our focus in this paper, population aging due to declining fertility and improving mortality has taken place alongside very different trends across countries and across groups within countries in improved health behaviors, education, and income growth.

12 Health, Economic Status, and Aging in High-Income Countries - Jinkook Lee and James P. Smith Pages 339-368

12 Health, Economic Status, and Aging in High-Income Countries - Jinkook Lee and James P. Smith
Pages 339-368