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Background: Due to pressured social and health care systems, the role of health promoting lifestyle behaviors increases in importance. The aim of this study is to investigate the association between socioeconomic position (SEP) and health-promoting lifestyle among older adults in six Nordic regions - and potential regional variation in the associations.

Methods: Data from the Gerontological Regional Database survey collected in 2021/2022 (N = 11,984) is used. The regions in Finland are Aland, South Ostrobothnia, Swedish-speaking Ostrobothnia, and Finnish-speaking Ostrobothnia. In Sweden, the city of Umea and rural Vasterbotten were included. Lifestyle is defined as adherence to seven Blue Zone principles.

Results: A high SEP was associated with higher likelihood of a health-promoting lifestyle in several principles. Simultaneously, a high SEP was associated with risk-drinking, and lower likelihood of belief in a higher power and weekly contact with family members. The association between SEP and lifestyle was weaker in rural Vasterbotten (Swe) and Swedish-speaking Ostrobothnia (Fin), and stronger in Umea (Swe) and Aland (Fin).

Conclusions: There is a gradient of SEP for adopting a health-promoting lifestyle in old age in Nordic regions - although with some (regional) exceptions and unexpected directions of the relationship. The Nordic setting reflects a secularised, de-familialised culture with a comparatively heavy reliance on a mainly tax-based welfare system. Simultaneously, there is regional variation in culture and social and health care services between and within Nordic countries, which underline the need to adopt regional, contextual perspectives to identify clues to healthy ageing - such as equalising community measures.