Later life health in Europe: how important are country level influences?

Abstract

In this article, we examine the extent and pattern of country level differences in later life health in Europe and compare five competing explanations for this variation. We used data from 14 European countries, drawn from Northern (Denmark and Sweden), Western (Austria, France, Ireland, Germany Belgium, the Netherlands and Switzerland), Mediterranean (Spain, Italy and Greece) and Eastern (Poland and Czechia) regions of Europe, = 33,528. Our results suggest that about a quarter (24%) of the overall variation in later life health in Europe appears to be due to country level differences. The Scandinavian countries along with Germany, the Netherlands and Switzerland appear to have the best health, whereas Spain, Italy and Poland had the lowest health score. Country level influences on health were largely associated with differences in the level of egalitarianism of each country as measured by the Gini coefficient, with more inequality being associated with poorer health. Differences in health-related lifestyle, as approximated by the prevalence of obesity in each country, also had a substantial macrolevel influence on later life health, with a lower national prevalence of obesity being associated with better health. Our results indicate the presence of systematic macrolevel health variation in Europe and suggest that policies to reduce income inequality as well as population interventions to promote healthier lifestyles and decrease the prevalence of obesity have the potential to improve population health and potentially offset some of the challenges posed by population ageing in Europe.

Desigualdades en la salud autopercibida de la población española mayor de 65 años

“…Estos datos también se confirman en Europa mediante las encuestas de salud en personas mayores, en países de muy diversas estructuras políticas y económicas [41][42][43][44][45] .…”

Health Among the Elderly in Germany. New Evidence on Disease, Disability and Care Need

“…These inequalities have been found both in comparisons of population health measures between countries, and in health measures within countries that translate into country-level differences. For instance, Ploubidis et al (2012) reported a north/south gradient for a measure of later life health in Europe modeled as a latent variable combining a total of nine self-rated and observer-measured health indicators, in which Scandinavian and western European countries (with considerable variation within this group) showed the best population health, while countries in the south exhibited the worst population health. Minicuci et al (2004) compared the prevalence of disability in daily living activities and found that its prevalence is lower among seniors in the Netherlands than in Spain and Italy.…”

A condição sénior no Sul da Europa e na Escandinávia

“…Na Europa, os modelos de proteção social institucionalizada e organizada sob a égide do Estado-providência conferiram atenção particular à população idosa, nomeadamente na salvaguarda do acesso a condições mínimas de bem-estar. No entanto, a condição sénior não é alheia às diferentes formas institucionais de proteção e promoção social existentes nos diferentes países (Glaser;Tomassini;Grundy, 2004;Ploubidis;Dale;Grundy, 2012). São vários os modelos de proteção social que vigoram na Europa, baseados em princípios e formas de redistribuição variadas (Esping-Andersen, 1990).…”