Later life somatic health in Europe: is country level variation amenable to change?

George B. Ploubidis, London School of Hygiene and Tropical Medicine (LSHTM)
Emily Grundy, London School of Hygiene and Tropical Medicine (LSHTM)

National differences in health indices may be valuable in providing insights into macro level structural and policy influences on health in later life. Our aim was to investigate the possibility for country level variation in later-life health in Europe, using a between country invariant population health metric as well as to test five explanatory theories of county level variation. We employed data from 13 European countries included in the second SHARE wave (N = 32,421) and a latent health index derived by the combination of self reported and observer measured health indicators. We used gender, age, living arrangements and years of education as individual level predictors and as country level predictors we employed an indicator of obesity, the GINI coefficient, GDP per capita, social trust and a regime typology. Twenty-one percent 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 received the lowest health score. This country level variation is largely associated with differences in the level of egalitarianism of each country as measured by the GINI coefficient, with less inequality being associated with better somatic health. Differences in health related lifestyle as approximated by the prevalence of obesity in each country also have a substantive influence on later life health, with healthier lifestyle (lower prevalence of obesity) being associated with good health. Our results indicate the presence of systematic macro level health variation in Europe and that policies to reduce income inequality and population interventions to promote healthier lifestyles in order to decrease the prevalence of obesity will have a substantive effect in improving population health and therefore have the potential to offset the effects of ageing in Europe.