Role of place in explaining racial heterogeneity in cognitive outcomes among older adults

Much research has focused on the demographic, familial, and social factors associated with racial disparity in cognitive outcomes among older adults. Less is known about the role of geographical and contextual factors. Historically, segregation in the US has led to drastically different living environments. Older African-Americans are more likely than their white counterparts to have grown up in disadvantaged areas. Using a life-course perspective, we hypothesize that childhood residence may affect cognitive outcomes in older adults through multiple pathways including socioeconomic opportunities. We assessed the extent to which geographic differences in childhood residence account for the disparity in cognitive test performance between older black and white Americans using multilevel models. We used data from the Health and Retirement Study (HRS), which contained self-reported state of residence in childhood and measured cognitive function for respondents age 50 and older. Specific cognitive outcomes included vocabulary, verbal episodic memory and general cognitive function.

After adjustment for age and gender, a significant proportion of the residual differences in cognitive performance could be attributed to state of residence during childhood for African Americans as estimated by the variance partitioning component (VPC=12% for vocabulary, 2% for memory, 7% for general cognitive function). Estimates of VPC were smaller for Whites (VPC=5% for vocabulary, 1% for memory, 3% for general cognitive function). These results suggest place of residence during childhood years may contribute to the racial disparity of cognitive performance among older Americans.