We use cross-national, longitudinal data to explore the impact of educational level on changes in health outcomes among Europeans aged over 50. Our analyses are performed separately for Northern, Western and Southern Europe, as these regions broadly represent different welfare state regimes. We find that low education is associated with higher incident events - over a two-year period - of poor health, chronic diseases and disability, but it is less consistently associated with new events of long-standing illness. Net of behavioural risk factors, educational effects are more consistent in Western and Southern Europe than in the Nordic welfare states. In Northern Europe, lower education is associated with less financial and employment disadvantage than in Southern or Western Europe. After controlling for educational differences in these factors, effects of educational level on health deterioration remain significant for most outcomes in Western and Southern Europe, whereas they are weaker and non-significant after adjustment in Northern Europe.