State-Level Education Quality and Trajectories of Cognitive Function by Race and Educational Attainment.

IF 4.8 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Katrina M Walsemann, Heide Jackson, Emily Abbruzzi, Jennifer A Ailshire
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引用次数: 0

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.

州级教育质量与按种族和受教育程度划分的认知功能轨迹》(State-Level Education Quality and Trajectories of Cognitive Function by Race and Educational Attainment)。
政策要点 教育-认知研究忽视了教育质量在塑造中老年认知功能方面的作用,尽管教育质量可能比学业成绩更能反映联邦和州对公立学校教育的投资。对于 20 世纪早期至中期上学的美国老年人来说,随着联邦和州政府投资的增加,美国的教育质量有了很大提高。确保获得高质量的初等和中等教育,可防止中年和老年时认知功能低下,尤其是美国黑人和受教育程度较低的人。它还可能在减少健康不平等方面发挥重要作用:尽管受教育程度一直与老年人认知功能的改善相关,但我们对教育质量与认知功能的关系却知之甚少。鉴于美国的教育质量在 20 世纪早期到中期随着州政府和联邦政府投资的增加而大幅提高,这是文献中的一个重要空白。我们认为,在教育系统质量较高的州长大可能会避免认知功能低下,尤其是在黑人成年人和受教育年限较短的成年人中:我们使用了《健康与退休研究》(Health and Retirement Study)中有关认知功能的前瞻性数据以及各州对公立学校投资的历史数据,并将样本限制为 1914 年至 1959 年间出生的非西班牙裔白人和黑人成年人(19096 名白人成年人和 4625 名黑人成年人)。利用种族分层线性混合模型,我们研究了州一级的教育质量是否与认知功能的水平和下降有关,以及这些模式是否因受教育年限和种族而有所不同:无论种族如何,童年时期居住在教育资源较丰富的州与认知功能较好有关,特别是在那些完成学校教育少于 12 年的人中。对于白人成年人来说,资源较丰富的州教育系统与较高的认知功能总分和外显记忆分数有关,但当资源增加到非常高的水平时,回报就会递减。对于黑人成年人来说,州教育资源与认知功能之间的关系因年龄而异,中年时呈正相关,而在最年长时一般呈负相关:结论:联邦和州对公立学校的投资可为学生提供机会,在学校教育期间开发重要的认知资源,这些资源可转化为日后更好的认知功能,尤其是在边缘化人群中。
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来源期刊
Milbank Quarterly
Milbank Quarterly 医学-卫生保健
CiteScore
9.60
自引率
3.00%
发文量
37
审稿时长
>12 weeks
期刊介绍: The Milbank Quarterly is devoted to scholarly analysis of significant issues in health and health care policy. It presents original research, policy analysis, and commentary from academics, clinicians, and policymakers. The in-depth, multidisciplinary approach of the journal permits contributors to explore fully the social origins of health in our society and to examine in detail the implications of different health policies. Topics addressed in The Milbank Quarterly include the impact of social factors on health, prevention, allocation of health care resources, legal and ethical issues in health policy, health and health care administration, and the organization and financing of health care.
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