BACKGROUND Whether worldwide increases in life expectancy are accompanied by a better health status is still a debate. People age differently, and there is a need to disentangle whether healthy-ageing pathways can be shaped by cohort effects. This study aims to analyse trends in health status in two large nationally representative samples of older adults from England and the USA. METHODS The sample comprised 55 684 participants from the first seven waves of the English Longitudinal Study of Ageing (ELSA), and the first 11 waves of the Health and Retirement Study (HRS). A common latent health score based on Bayesian multilevel item response theory was used. Two Bayesian mixed-effects multilevel models were used to assess cohort effects on health in ELSA and HRS separately, controlling for the effect of household wealth and educational attainment. RESULTS Similar ageing trends were found in ELSA (β = -0.311; p < 0.001) and HRS (β = -0.393; p < 0.001). The level of education moderated the life-course effect on health in both ELSA (β = -0.082; p < 0.05) and HRS (β = -0.084; p < 0.05). A birth-year effect was found for those belonging to the highest quintiles of household wealth in both ELSA (β = 0.125; p < 0.001) and HRS (β = 0.170; p < 0.001). CONCLUSIONS Health inequalities have increased in recent cohorts, with the wealthiest participants presenting a better health status in both the USA and English populations. Actions to promote health in the ageing population should consider the increasing inequality scenario, not only by applying highly effective interventions, but also by making them accessible to all members of society.

中文翻译：

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美国和英国的年轻人是否更容易衰老？

背景技术世界范围内预期寿命的增加是否伴随着健康状况的改善仍然存在争议。人们的年龄各不相同，因此有必要弄清楚健康老龄化途径是否可以通过群体效应来塑造。本研究旨在分析来自英国和美国的两个具有全国代表性的老年人样本的健康状况趋势。方法 样本由来自英国老龄化纵向研究 (ELSA) 前 7 波和健康与退休研究 (HRS) 前 11 波的 55 684 名参与者组成。使用基于贝叶斯多级项目反应理论的常见潜在健康评分。使用两个贝叶斯混合效应多水平模型分别评估 ELSA 和 HRS 对健康的队列效应，控制家庭财富和教育程度的影响。结果 ELSA (β = -0.311; p < 0.001) 和 HRS (β = -0.393; p < 0.001) 中发现了类似的老化趋势。在 ELSA (β = -0.082; p < 0.05) 和 HRS (β = -0.084; p < 0.05) 中，教育水平调节了生命历程对健康的影响。在 ELSA（β = 0.125；p < 0.001）和 HRS（β = 0.170；p < 0.001）中，家庭财富最高五分位数的人都发现了出生年份效应。结论 最近的队列中，健康不平等现象有所加剧，美国和英国人群中最富有的参与者都表现出更好的健康状况。促进老龄化人口健康的行动应考虑到不平等现象日益加剧的情况，不仅要采取高效的干预措施，还要让社会所有成员都能获得这些干预措施。