# Can countries shape the association between cumulative adversity and old-age health?

## TL;DR

This study shows that country-level factors like democracy and welfare policies can reduce the negative impact of lifelong adversity on health in old age.

## Contribution

The study reveals how welfare policies and democracy can modify the health effects of cumulative adversity in older adults.

## Key findings

- Lifetime Cumulative Adversity is negatively linked to self-rated health in old age.
- Democracy and welfare regimes reduce the harmful effects of adversity on health.
- The effects of adversity on health remain significant over time, influenced by societal inequalities.

## Abstract

The present study examined the relationships of Lifetime Cumulative Adversity (LCA) and country inequalities, as well as the interactions between them, with the self-rated health (SRH) in old age.

Using data from the Survey of Health, Aging and Retirement in Europe (SHARE), the study regressed self-rated health on Lifetime Cumulative Adversity and country-level inequality indices across European countries in two points in time. The analysis also considered adversity–inequality interactions, controlling for confounders. The sample was comprised of 28,789 adults, aged 50 to 80, from 25 European countries and Israel.

The findings pointed out that LCA is negatively associated with SRH, but democracy and welfare regimes modify the ill effects of LCA on health. These effects are reduced as the LCA level increases. The effects remained significant over two measurement time-points over three years, showing that life-course trajectories may be shaped by individual accumulated risk exposure to stress, along with inequalities at the society level.

The study provides constructive and important guidance for decreasing the harmful effect of lifetime adversity in old age, by the modification of the country’s welfare policies.