Cohort Differences in Physical Health and Disability in the United States and Europe
Year: 2024
Type: article
Abstract: OBJECTIVES: Declines in mortality have historically been associated with improvements in physical health across generations. While life expectancy in most high-income countries continues to increase, there is evidence that younger generations, particularly in the United States, are less healthy than previous generations at the same age. We compared generational trends in physical health in the United States, England, and continental Europe to explore whether other regions have experienced a similar pattern of worsening health across cohorts. METHODS: Using data from nationally representative studies of adults aged ≥50 years from the United States (Health and Retirement Study, n = 26,939), England (English Longitudinal Study of Ageing, n = 14,992) and 11 continental European countries (Survey of Health, Ageing and Retirement in Europe, n = 72,595), we estimated differences in the age-adjusted prevalence of self-reported chronic disease and disability and observer-measured health indicators across pseudo-birth cohorts (born <1925, 1925-1935, 1936-1945, 1946-1954, 1955-1959). RESULTS: Age-adjusted prevalence of doctor-diagnosed chronic disease increased across successive cohorts in all regions. Trends in disability prevalence were more regionally varied. Still, in both the United States and Europe, we observed a structural break in disability trends, with declines observed in prewar cohorts slowing, stalling, or reversing for cohorts born since 1945. DISCUSSION: In all regions, we found evidence for worsening health across cohorts, particularly for those born since 1945. While more chronic disease in younger cohorts need not necessarily translate to worse quality of life or higher rates of functional limitation, there is some suggestion that worsening chronic disease morbidity may be spilling over into worsening disability.
Institutions: University College London, University of Oxford
Language: English
Subfield: Health
Field: Social Sciences
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $4,628
Funders: U.S. Social Security Administration, Government of the United Kingdom, National Institute for Health and Care Research, Leverhulme Trust, European Commission, Max-Planck-Gesellschaft, National Institutes of Health, Medical Research Council, Economic and Social Research Council, European Research Council, National Institute on Aging, H2020 European Research Council
Awards: G1178032220, G1237079599, G1330667123, G1608581485, G1778268290, Centre for Longitudinal Studies, Resource Centre 2015-20, Understanding mortality: Biosocial determinants across cohorts, time and place, G2465118858, G2477700604, G2825804458, G3144399466, G3166864496, G3255683918, G3457581384, G3687180791, G3784121119, G4165969582, RAND Center for the Study of Aging, G4545110052, G4569152855, G466067567, G504669776, Centre for Longitudinal Studies Resource Centre 2022 - 2025, G5207492846, G5387586620, G5618942462, G6053673296, G6335267970, G6782909139, DTP Bid Led by University College London, Enhancing the Comparability of SHARE with HRS and ELSA, G8072554765, G8259478916, G8875743412, English Longitudinal Study of Ageing - Renewal 2024, Health and Retirement Study: Yrs 35-40
OpenAlex ID: W4399865997