Abstract
Policy Points
- Education-cognition research overlooks the role of education quality in shaping cognitive function at midlife and older ages, even though quality may be more responsive to federal and state investment in public schooling than attainment.
- For older US adults who attended school during the early to mid-20th century, the quality of US education improved considerably as federal and state investment increased.
- Ensuring access to high-quality primary and secondary education may protect against poor cognitive function at midlife and older ages, particularly among Black Americans and persons who complete less education. It may also play an important role in reducing health inequities.
Context
Although educational attainment is consistently associated with better cognitive function among older adults, we know little about how education quality is related to cognitive function. This is a key gap in the literature given that the quality of US education improved considerably during the early to mid-20th century as state and federal investment increased. We posit that growing up in states with higher-quality education systems may protect against poor cognitive function, particularly among Black adults and adults who completed fewer years of school.
Methods
We used prospective data on cognitive function from the Health and Retirement Study linked to historical data on state investment in public schools, restricting our sample to non-Hispanic White and Black adults born between 1914 and 1959 (19,096 White adults and 4,625 Black adults). Using race-stratified linear mixed models, we considered if state-level education quality was associated with level and decline in cognitive function and if these patterns differed by years of schooling and race.
Findings
Residing in states with higher-resourced education systems during childhood was associated with better cognitive function, particularly among those who completed less than 12 years of schooling, regardless of race. For White adults, higher-resourced state education systems were associated with higher scores of total cognitive function and episodic memory, but there were diminishing returns as resources increased to very high levels. For Black adults, the relationship between state education resources and cognitive function varied by age with positive associations in midlife and generally null or negative associations at the oldest ages.
Conclusions
Federal and state investment in public schools may provide students with opportunities to develop important cognitive resources during schooling that translate into better cognitive function in later life, especially among marginalized populations.
Educational attainment is a key determinant of cognitive function among older adults and perhaps the most important protective factor against cognitive impairment and dementia.1-3 Because of this, historical increases in educational attainment are thought to be a main factor in the documented declines in the prevalence and incidence of dementia in the United States.4-7 Although it is true that variability in levels of educational attainment has diminished over time,8 the quality of education also changed during this period. Older adults who attended school in the 1920s and 1930s had significantly different educational experiences than individuals who completed their education in the 1960s and 1970s. In this short period, federal, state, and local funding for public education increased sixfold,9 the US Supreme Court declared “separate but equal” schools unconstitutional,10, 11 and the US Congress passed a series of acts to provide additional funding to schools to revamp their science and math curricula and educate poor children and children with special needs.12-14 Thus, inequalities in education systems may serve to differentiate individuals in their risk for poor cognitive function and decline.
Variation in educational quality, including school term length, per-pupil funding, and pupil to teacher ratio, may represent access to cognitively enriching opportunities during childhood. More advantaged education systems—at the state and/or local level—are associated with better cognitive function, independent of educational attainment.15-18 Few studies, however, have examined if these relationships vary by race or educational attainment. This is an important limitation given considerable state-level variation in education systems that often saw significantly shorter school terms and less investment in public schools across the US South, where almost 80% of Black adults born before 1954 resided, the year the US Supreme Court declared segregated schooling unconstitutional.18-20 Moreover, because those who complete less education may have fewer alternative resources to rely on, such as educational credentials,21 residing in a state that provides higher-quality public schools may be more protective against poor cognitive function among the least educated.
The purpose of our study is to examine Black–White variation in the relationship between state-level education quality and trajectories of cognitive function using nationally representative, prospective individual-level data linked to historical data on state investment in public schools. We also consider if the association of state-level education quality with the level of and decline in cognitive function differs by years of schooling.