# Understanding Cross-National Health Differences at Older Ages and Their Causes

> **NIH NIH R01** · NATIONAL BUREAU OF ECONOMIC RESEARCH · 2021 · $628,338

## Abstract

OTHER PROJECT INFORMATION – Project Summary/Abstract
Understanding Cross-National Health Differences at Older Ages and Their Causes
This project aims to foster understanding of cross-national differences in health and their causes, especially
evaluating differences in health care systems, coverage and quality, health behaviors, life styles, income and
wealth distributions and historical life circumstances. Understanding differences and causes requires
comparable measurements of health which do not suffer from cross-national differences in data collection and
reporting styles. In this respect, analyses of blood samples are a gold standard of objective health measurement.
The project will extend earlier blood-based health comparisons between the US (based on the Health and
Retirement Study, HRS) and the UK (based on the English Longitudinal Study of Ageing, ELSA) to Continental
Europe (based on the Survey of Health, Aging and Retirement in Europe, SHARE). SHARE is a large
population-representative panel study modelled after the HRS and ELSA. Health variables strictly harmonized
across the three studies include self-reported health, ADLs and IADLs, physical measurements such as grip
strength, peak flow and chair stand, and a large battery of tests for cognition and mental health. SHARE has
obtained very rich data on health care systems and life styles, on economic, work and social circumstances over
the life course, and individual histories of health behaviors and health care interventions.
SHARE has also collected dried blood spot samples (DBSS) from about 27.000 respondents aged 50 and older
in 13 Continental European countries. HRS has also collected DBSS in recent waves. While DBSS are not perfect
substitutes for the venous blood (VB) samples obtained by ELSA and currently by HRS, much progress has
recently been made in understanding how values obtained from DBSS correspond to VB values. We have
performed extensive validations which show a tight alignment between DBSS and VB values after correcting for
systematic factors that occur during the laboratory and field processes.
The project has four specific aims:
1. Capitalize upon the expertise of the laboratory at the University of Washington by having the full set of
 DBSS collected in SHARE wave 6 assayed for the lipid panel and type-2 diabetes mellitus (T2DM)
 biomarkers relevant to general health and cognitive decline.
2. Link the laboratory analyses with the SHARE functional and subjective health, demographic, social, and
 economic data, create a user-friendly database and archive it.
3. Harmonize the data obtained from the assays of SHARE DBS, ELSA VB and HRS DBS and VB.
4. Use these data to perform statistical analyses on the relationships between cross-national differences in
 health, economic, work and social circumstances, health behaviors and health care interventions.

## Key facts

- **NIH application ID:** 10017814
- **Project number:** 5R01AG063944-02
- **Recipient organization:** NATIONAL BUREAU OF ECONOMIC RESEARCH
- **Principal Investigator:** AXEL H BOERSCH-SUPAN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $628,338
- **Award type:** 5
- **Project period:** 2019-09-15 → 2024-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10017814

## Citation

> US National Institutes of Health, RePORTER application 10017814, Understanding Cross-National Health Differences at Older Ages and Their Causes (5R01AG063944-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10017814. Licensed CC0.

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