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Objectives. We investigate cross-national differences in late-life health outcomes and focus on an intriguing difference in beliefs about personal control found between older adult populations in the U.K. and United States. We examine the moderating role of control beliefs in the relationship between physical function and self-reported difficulty with daily activities. Method. Using national data from the United States (Health and Retirement Study) and England (English Longitudinal Study on Ageing), we examine the prevalence in disability across the two countries and show how it varies according to the sense of control. Poisson regression was used to examine the relationship between objective measures of physical function (gait speed) and disability and the modifying effects of control. Results. Older Americans have a higher sense of personal control than the British, which operates as a psychological resource to reduce disability among older Americans. However, the benefits of control are attenuated as physical impairments become more severe. Discussion. These results emphasize the importance of carefully considering cross-national differences in the disablement process as a result of cultural variation in underlying psychosocial resources. This paper highlights the role of culture in shaping health across adults aging in different sociopolitical contexts. [ABSTRACT FROM PUBLISHER]

Objectives Policies aiming at reducing rates of hospitalization and death from coronavirus disease 2019 (COVID-19) encouraged older people to reduce physical interactions. In England, until July 2021, provision of care for grandchildren was allowed only under very limited circumstances. Evidence also suggests that reduced face-to-face interactions took a toll on mental health during the pandemic. This study aims to investigate associations between changes in grandchild care provision during the first 8/9 months of the pandemic and grandparents' mental health. Methods Using prepandemic data from Wave 9 (2018/2019) and the second COVID-19 substudy (November/December 2020) of the English Longitudinal Study of Ageing, we first describe changes in grandchild care provision during the pandemic to then investigate, using regression models, associations between changes in grandchild care provision and mental health (depression, quality of life, life satisfaction), while controlling for prepandemic levels of the outcome variables. Results About 10% of grandparents stopped looking after grandchildren altogether during the first 9 months of the pandemic, with 22% reporting an overall decrease in the amount of grandchild care provided. Compared to grandparents who mostly maintained unchanged their grandchild care provision, those who stopped altogether and those who mostly reduced the amount of grandchild care provided were more likely to report poorer mental health, even accounting for prepandemic health. Discussion While measures to limit physical contact and shield older people were necessary to reduce the spread of COVID-19, policymakers should acknowledge potential adverse consequences for mental health among grandparents who experienced changes in their roles as grandchild caregivers. [ABSTRACT FROM AUTHOR]

Objectives Disability in the United States has not improved in recent decades. Comparing temporal trends in disability prevalence across different income groups, both within and between the United States and England, would inform public policy aimed at reducing disparities in disability. Methods Using the Health and Retirement Study and the English Longitudinal Study of Ageing, we estimated annual percent change from 2002 to 2016 in disability among community-dwelling adults (197,021 person-years of observations). Disability was defined based on self-report of limitations with 5 instrumental activities of daily living and 6 activities of daily living. We examined the trends by age and income quintile and adjusted for individual-level sociodemographic status and survey design. Results The adjusted annual percent change (AAPC) in disability prevalence declined significantly in both countries for ages 75 and older during 2002–2016. For ages 55–64 and 65–74, disability prevalence was unchanged in the United States but declined in England. Both countries experienced a widening gap in disability between low- and high-income adults among the younger age groups. For example, for those ages 55–64 in each country, there was no significant improvement in disability for the low-income group but a significant improvement for the high-income group (AAPC = −3.60; 95% confidence interval [CI; −6.57, −0.63] for the United States; AAPC = −6.06; 95% CI [−8.77, −3.35] for England). Discussion Improvements in disability were more widespread in England than in the United States between 2002 and 2016. In both countries, the disparity in disability between low- and high-income adults widened for middle-aged adults. Policies targeted at preventing disability among low-income adults should be a priority in both countries. [ABSTRACT FROM AUTHOR]

Objectives To compare cardiovascular (CV) risks/conditions of Millennials (born 1981–1996) to those of Generation X (Gen X; born 1965–1980) at ages 20–34 years, across 2 countries (United States, England), by gender. Methods Using data from the National Health and Nutrition Examination Survey (United States) and Health Survey for England, we estimated weighted unadjusted and adjusted gender-specific proportions of CV risk factors/conditions, separately for Millennials and Generation X in each country. We also further calculated sex-specific generational differences in CV risk factor/conditions by income tercile and for individuals with normal body weight. Results Millennials in the United States were more obese compared to their Gen X counterparts and more likely to have diabetes risk but less likely to smoke or have high cholesterol. Millennials in England had higher diabetes risk but similar or lower rates of other CV risk/conditions compared to their Gen X counterparts. Generational changes could not be fully attributed to increases in obesity or decreases in income. Discussion We expected that Millennial CV risk factors/conditions would be worse than those of Gen X, particularly in the United States, because Millennials came of age during the Great Recession and a period of increasing population obesity. Millennials generally fared worse than their Gen X counterparts in terms of obesity and diabetes risk, especially in the United States, but had lower rates of smoking and high cholesterol in both countries. Secular trends of increasing obesity and decreased economic opportunities did not appear to lead to uniform generational differences in CV risk factors. [ABSTRACT FROM AUTHOR]

Explanations for lagging life expectancy in the United States compared to other high-income countries have focused largely on "deaths of despair," but attention has also shifted to the role of stalling improvements in cardiovascular disease and the obesity epidemic. Using harmonized data from the U.S. Health and Retirement Study and English Longitudinal Study of Ageing, we assess differences in self-reported and objective measures of health, among older adults in the United States and England and explore whether the differences in body mass index (BMI) documented between the United States and England explain the U.S. disadvantage. Older adults in the United States have a much higher prevalence of diabetes, low high-density lipoprotein cholesterol, and high inflammation (C-reactive protein) compared to English adults. While the distribution of BMI is shifted to the right in the United States with more people falling into extreme obesity categories, these differences do not explain the cross-country differences in measured biological risk. We conclude by considering how country differences in health may have affected the burden of coronavirus disease 2019 mortality in both countries. [ABSTRACT FROM AUTHOR]

Objectives To investigate whether the timing and nature of women's transitions out of full-time (FT) education are related to later-life subjective well-being and the life-course experiences that might explain any associations seen. Methods Data are from women in Wave 3 of the English Longitudinal Study of Ageing who have participated in the life history interview and were aged 50+ at the interview (n = 3,889). Using multichannel sequence analysis, we identified 6 types of transition out of FT education (ages 14–26). Regression models were used to examine associations between transition types and life satisfaction, quality of life, and depressive symptoms at age 50+. Results Women who made early transitions to married parenthood and FT domestic labor had lower levels of well-being on all 3 later-life well-being outcomes (p <.01), compared to women who made later transitions to family life and remained employed. Women who remained single up to age 26 also had lower life satisfaction (p <.05) and quality of life (p <.01) in later life than their counterparts who married and had children. These associations were explained by the life-course socioeconomic and relationship pathways. Advantaged childhood socioeconomic circumstances and higher educational qualifications set "Later Marriage and Later employment" women apart onto advantaged trajectories and a better quality of life later (p <.01). Discussion The timing and nature of exits from FT education played a pivotal role in setting people onto life-course trajectories that influence well-being in later life for this older generation of women. [ABSTRACT FROM AUTHOR]

Objectives The Gateway to Global Aging Data (Gateway; g2aging.org) is a data and information platform developed to facilitate cross-country analyses on aging, especially those using the international family of Health and Retirement studies. We provide a brief introduction to the Gateway to Global Aging Data, discussing its potential for cross-national comparisons of family, social environment, and healthy aging. Methods We summarize the survey metadata, study characteristics, and harmonized data available from the Gateway, describing the population represented in each study. We portray cohort characteristics and key measures of health and social environment from 37 countries in North America, Europe, and Asia using harmonized data. Results Significant cross-country heterogeneity was observed in many measures of family, social environment, and healthy aging indicators. For example, there was a threefold difference in coresidence with children, ranging from 14% in Sweden to over 46% in Spain and Korea in 2014. From 2002 to 2014, the difference between informal care receipt in individuals of low and high wealth decreased by 6% in the United States and remained unchanged in England. The percentage of individuals aged 50–59 living alone in 2012 varied 15-fold, from a low of 2% in China to a high of 30% in Mexico. Discussion By partnering with nationally representative studies around the globe, the Gateway to Global Aging Data facilitates comparative research on aging through the provision of easy-to-use harmonized data files and other valuable tools. [ABSTRACT FROM AUTHOR]

Objectives This study aims to examine the relationship between childhood socioeconomic position (SEP) and cognitive function in later life within nationally representative samples of older adults in the United States and England, investigate whether these effects are mediated by later-life SEP, and determine whether social mobility from childhood to adulthood affects cognitive function and decline. Method Using data from the Health and Retirement Study (HRS) and the English Longitudinal Survey of Ageing (ELSA), we examined the relationships between measures of SEP, cognitive performance and decline using individual growth curve models. Results High childhood SEP was associated with higher cognitive performance at baseline in both cohorts and did not affect the rate of decline. This benefit dissipated after adjusting for education and adult wealth in the United States. Respondents with low childhood SEP, above median education, and high adult SEP had better cognitive performance at baseline than respondents with a similar childhood background and less upward mobility in both countries. Discussion These findings emphasize the impact of childhood SEP on cognitive trajectories among older adults. Upward mobility may partially compensate for disadvantage early in life but does not protect against cognitive decline. [ABSTRACT FROM AUTHOR]

Objectives To examine the socioeconomic status (SES) health gradient for obesity, diabetes, and hypertension within a diverse group of health outcomes and behaviors among older adults (60+) in upper middle-income countries benchmarked with high-income countries. Method We used data from three upper middle-income settings (Colombia-SABE-Bogotá, Mexico-SAGE, and South Africa-SAGE) and two high-income countries (England-ELSA and US-HRS) to estimate logistic regression models using age, gender, and education to predict health and health behaviors. Results The sharpest gradients appear in middle-income settings but follow expected patterns found in high-income countries for poor self-reported health, functionality, cognitive impairment, and depression. However, weaker gradients appear for obesity, hypertension, diabetes, and other chronic conditions in Colombia and Mexico and the gradient reverses in South Africa. Strong disparities exist in risky health behaviors and in early nutritional status in the middle-income settings. Discussion Rapid demographic and nutritional transitions, urbanization, poor early life conditions, social mobility, negative health behavior, and unique country circumstances provide a useful framework for understanding the SES health gradient in middle-income settings. In contrast with high-income countries, the increasing prevalence of obesity, an important risk factor for chronic conditions and other aspects of health, may ultimately change the SES gradient for diseases in the future. [ABSTRACT FROM AUTHOR]

Objectives. Minority ethnic groups are often assumed to exchange higher levels of informal support than the majority population, despite evidence that controlling for socioeconomic and health inequalities eliminates differences. Using a unique data set from England and Wales, we examined instrumental support across ethnic groups in mid and later life. Method. Employing data from the Home Office Citizenship Survey 2005 (N = 14,081), we investigated ethnic group differences in instrumental support among people aged 55 and older in England and Wales (n = 4,710). Multiple logistic regression was used to investigate the determinants of support given and received, guided by the Andersen–Newman behavioral model. Results. Compared with the White British group, the Indian group reported significantly higher odds (odds ratio [OR] = 2.2, 95% confidence interval [CI] 1.0–4.7) of receiving instrumental support from household members but significantly lower odds of giving support to relatives outside the household (OR = 0.7, 95% CI 0.5–0.9). Three other ethnic groups (Pakistani and Bangladeshi, Mixed, Other) reported significantly lower odds in unadjusted findings, but when adjusted, ethnic group differences were no longer significant. Discussion. Our analyses suggest few ethnic group differences in instrumental support once need and enabling factors were taken into account. Such findings are contrary to the belief that minority groups exchange more informal support and therefore have less need for formal services. The Andersen–Newman model is useful for guiding the analysis of support both given and received. [ABSTRACT FROM PUBLISHER]

Objectives. This article presents findings from a study of the causes of homelessness among newly homeless older people in selected urban areas of the United States, England, and Australia. Methods. Interviews were conducted in each country with ≥122 older people who had become homeless during the last 2 years. Information was also collected from the subjects' key workers about the circumstances and problems that contributed to homelessness. Results. Two-thirds of the subjects had never been homeless before. Antecedent causes were the accommodation was sold or needed repair, rent arrears, death of a close relative, relationship breakdown, and disputes with other tenants and neighbors. Contributory factors were physical and mental health problems, alcohol abuse, and gambling problems. Discussion. Most subjects became homeless through a combination of personal problems and incapacities, welfare policy gaps, and service delivery deficiencies. Whereas there are nation-specific variations, across the three countries, the principal causes and their interactions are similar. [ABSTRACT FROM AUTHOR]