Beyond the "European health divide": Functional limitation disparities among older adults in Central and Eastern Europe

OBJECTIVES: Countries in Central and Eastern Europe (CEE) generally have worse health outcomes than the rest of Europe, commonly referred to as the "European health divide". Regional specificities and historical pathways can shape health outcomes later in life, although variance of older adult functional limitation within CEE is understudied. METHODS: We used wave 9 (2021-2022) data (n = 18,903) from the Survey of Health, Ageing and Retirement in Europe (SHARE) with mixed effects regression models to analyze difficulty with mobility, near vision, hearing, and episodic memory among those ages 65+ in the Baltic States (Estonia; Latvia; Lithuania), Visegrád Group (Czechia; Hungary; Poland; Slovakia), Former Yugoslavia (Croatia; Slovenia), and the Black Sea (Bulgaria; Romania) while accounting for demographic, socioeconomic, health, and social tie indicators. RESULTS: Age-adjustments showed the highest difficulty rates of: mobility in Romania and Hungary, near vision in Latvia and Bulgaria, hearing in Estonia and Poland, and episodic memory in Poland and Croatia. Compared to the Baltic States, odds of reporting mobility difficulty were greater in the Black Sea but accounted for by socioeconomic factors. Fully adjusted odds of reporting near vision difficulty were lower in Visegrád Group and Former Yugoslavia. Fully adjusted odds of reporting hearing difficulty were lower in Visegrád Group, Former Yugoslavia, and the Black Sea. There were no regional differences in episodic memory. DISCUSSION: Functional limitation disparities, which were largely shaped by socioeconomic factors, varied throughout CEE. These findings highlight the heterogenous health and long-term care needs of older adults throughout CEE.