How does engagement in multiple health behaviors consolidate into health promoting health lifestyles, and how does economic development provide a broadly shared living condition to enable participation in health promoting health lifestyles? To answer these questions, we harmonize information from the 2011 International Social Survey Programme and the 2014 European Social Survey to examine patterns of health lifestyles and subsequent associations with self-rated health in representative samples of 52 country-years nested in 35 countries, with repeated observations from 17 countries. We find individuals engage more frequently in health promoting behaviors in countries with higher levels of economic development. Moreover, we find a tighter connection between health lifestyles and health in countries with higher levels of economic development. Critically, we move health lifestyles research forward by testing the consequences of within country changes in economic development, finding that growth in economic development increases the engagement of health promoting health behaviors. Policy and theoretical implications are discussed.
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