Race-Discordant School Attendance and Cognitive Function in Later Life

Carr, Dawn; Reynolds, John R.

doi:10.1177/01640275221103791

Cited by 2 publications

(2 citation statements)

References 41 publications

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“…Previous studies evaluating the association between US school segregation and health outcomes in later life have been limited by a singular focus on indirect measures of school segregation, 18 reliance solely on self-reported data, 19 – 21 lack of nationally representative samples, 19 , 22 , 23 and inattention to later-life cognitive outcomes. 24 – 26 To bridge these research gaps, our study assesses whether and how childhood contextual exposure to school segregation is associated with cognitive outcomes in later life.…”

Section: Introductionmentioning

confidence: 99%

“…Effects on non-Hispanic Black (hereafter, Black) and non-Hispanic White (hereafter, White) Americans may also fundamentally differ, as attending segregated schools can predominantly expose Black children to discrimination, racism, diminished school resources, and childhood adversities. 16,17 Previous studies evaluating the association between US school segregation and health outcomes in later life have been limited by a singular focus on indirect measures of school segregation, 18 reliance solely on self-reported data, [19][20][21] lack of nationally representative samples, 19,22,23 and inattention to later-life cognitive outcomes. [24][25][26] To bridge these research gaps, our study assesses whether and how childhood contextual exposure to school segregation is associated with cognitive outcomes in later life.…”

Section: Introductionmentioning

confidence: 99%

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Association of Childhood Exposure to School Racial Segregation with Late-Life Cognitive Outcomes among Older Americans

Lin,

Wang,

Gill

et al. 2024

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IMPORTANCEDisparities in cognition, including dementia occurrence, persist between White and Black older adults, and are possibly influenced by early educational differences stemming from structural racism. However, the relationship between school racial segregation and later-life cognition remains underexplored.OBJECTIVETo investigate the association between childhood contextual exposure to school racial segregation and cognitive outcomes in later life.DESIGN, SETTING, AND PARTICIPANTSData from 16,625 non-Hispanic White (hereafter, White) and 3,335 non-Hispanic Black (hereafter, Black) Americans aged 65 or older were analyzed from the Health and Retirement Study.EXPOSURESState-level White-Black dissimilarity index for public elementary schools in the late 1960s (range: 0-100) was used to measure school segregation. States were categorized into high segregation (≥83.6) and low segregation (<83.6) based on the top quintile.MAIN OUTCOMES AND MEASURESCognitive scores, cognitive impairment (with or without dementia), and dementia were assessed using the Telephone Interview for Cognitive Status (TICS) and proxy assessment. Multilevel regression analyses were conducted, adjusting for demographic covariates, socioeconomic status, and health factors. Stratified analyses by race were performed.RESULTSThe mean (SD) age of participants was 78.5 (5.7) years, and 11,208 (56.2%) were female. Participants exposed to high segregation exhibited lower cognitive scores (12.6 vs. 13.6;P<0.001) and higher prevalence of cognitive impairment (50.8% vs 41.4%;P<0.001) and dementia (26.0% vs. 19.5%;P<0.001), compared to those with low segregation exposure. Multilevel analyses revealed a significant negative association between school segregation and later-life cognitive even after adjusting sequentially for potential confounders, and these associations were stronger among Black than White participants. Notably, in the fully adjusted model, Black participants exposed to high segregation displayed significantly lower cognitive scores (−0.51; 95% CI: −0.94, −0.09) and higher likelihood of cognitive impairment (adjusted Odds Ratio [aOR]: 1.45, 95% CI: 1.22, 1.72) and dementia (aOR: 1.31, 95% CI: 1.06, 1.63).CONCLUSIONS AND RELEVANCEOur study underscores that childhood exposure to state-level school segregation is associated with late-life cognition, especially for Black Americans. Given the rising trend of school segregation in the US, educational policies aimed at reducing segregation are crucial to address health inequities. Clinicians can leverage patients’ early-life educational circumstances to promote screening, prevention, and management of cognitive disorders.Key PointsQuestionsIs state-level school racial segregation during childhood associated with cognitive outcomes in later life among non-Hispanic Black (hereafter, Black) and non-Hispanic White (hereafter, White) Americans?FindingsIn this nationally representative sample, older adults exposed to high levels of school segregation had lower cognitive scores and an increased likelihood of cognitive impairment and dementia compared to those with low levels of exposure. These associations remained significant after adjusting for a comprehensive array of factors over the life course, and were more pronounced for Black than White participants.MeaningThese findings suggest that investments to reduce school racial segregation could have lasting benefits for cognition and racial equity, spotlighting school racial segregation as an important form of structural racism in the US. Ascertainment of school racial segregation during childhood could help to promote more efficient and equitable screening, prevention, and management of cognitive impairment in clinical settings.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of Childhood Exposure to School Racial Segregation with Late-Life Cognitive Outcomes among Older Americans

Lin,

Wang,

Gill

et al. 2024

Preprint

View full text Add to dashboard Cite

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Racial Composition in K-12 Schooling and Cognitive Health of Older Black Adults

Best,

Laurent,

Doyle

et al. 2024

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Systemic educational factors have implications for cognitive health across the life course. Due to de jure and de factor racial segregation in the United States (U.S.), K-12 school quality varies by racial composition, which we hypothesize contributes to higher risk of Alzheimer's disease and related dementias among non-Hispanic Black (NHB) older adults. This study adopts a life course perspective to investigate the association between K-12 schools' racial composition and later-in-life cognitive health among U.S.-born and educated NHB older adults in the Health and Retirement Study (N=2,105). Using the 2015, 2017, and 2019 Life History Mail Survey, we categorized racial composition of K-12 schools as only majority non-Hispanic White (NHW) schools (n=193), only majority NHB schools (n=1,387), or both school types (n=525). Multiple linear regressions assessed relationships between school racial composition and total cognition, episodic memory, and vocabulary, controlling for age, gender, childhood factors, and U.S. region of residence at age 10. Attending only NHW schools or both school types was associated with better total cognition (p<.01 and p<.001, respectively) and episodic memory (p<.05 and p<.01, respectively) than attending only NHB schools. Attending both school types was also associated with better vocabulary (p<.0001). Structural equation models revealed that 45-66% of these associations were mediated by participants' educational attainment. Our findings highlight the long-term cognitive benefits of attending some NHW schools and underscore the need for initiatives promoting equity in NHB schools. Further, our findings suggest bicultural education may provide language benefits, despite potential interpersonal discrimination toward NHB students.

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Race-Discordant School Attendance and Cognitive Function in Later Life

Cited by 2 publications

References 41 publications

Association of Childhood Exposure to School Racial Segregation with Late-Life Cognitive Outcomes among Older Americans

Association of Childhood Exposure to School Racial Segregation with Late-Life Cognitive Outcomes among Older Americans

Racial Composition in K-12 Schooling and Cognitive Health of Older Black Adults

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