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

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, N = 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.