International comparisons in health economics: evidence from aging studies

International comparisons of health outcomes are growing in importance as a method of gaining insight into the determinants and consequences of health status. This paper attempts to provide an overview of the literature that uses micro-level data from multiple countries to investigate health outcomes, and their link to socioeconomic factors, at older ages.

The paper argues that much of the analysis in this area is at a very early stage and limited to only a handful of countries, with analysis for the US and England being by far the most common.

Main findings are that: 

• health differences between countries amongst those at older ages are real and large 
• countries are ranked differently according to whether one considers life-expectancy, prevalence or incidence of one condition or another 
• the magnitude of international disparities may vary according to whether measures utilise doctor diagnosed conditions or biomarker-based indicators of disease and poor health
• one key finding emerges—the US ranks poorly on all indicators with the exception of self-reported subjective health status
  

The author notes that the as yet unmet challenge of research agenda is to come up with ‘causal’ explanations of those international health differences. Nevertheless, the still relatively short time-series dimension of the data that are available and the still rather small set of countries for which that data exist are a real obstacle in this relevance. However, the author underlines that both these factors are changing rapidly and the opportunities for future research are expanding accordingly.