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Place of Birth and Cognitive Function Among Older Americans: Findings From the Harmonized Cognitive Assessment Protocol

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  • Zhuoer Lin
  • Xi Chen

Abstract

ObjectivesGrowing evidence suggests that place of birth (PoB) and related circumstances may have long-lasting and multiplicative contributions to various later-life outcomes. However, the specific contributions to different domains of cognitive function in late life remain less understood. This study investigated the extent to which state of birth contributes to a wide range of domains of later-life cognitive function.MethodsA nationally representative sample of Americans aged 65 and older (N = 3,333) from the Health and Retirement Study (HRS) Harmonized Cognitive Assessment Protocol (HCAP) was utilized. Cognitive function was assessed in HCAP and linked to HRS state of birth data to explore the contribution of PoB to later-life cognitive disparities. Regression-based Shapley decompositions were employed to quantify this contribution.ResultsPoB significantly contributed to all assessed cognitive domains including memory, executive function, language and fluency, visuospatial function, orientation, and general cognitive function. Geographic disparities in cognitive function were evident across PoB, with individuals born in U.S. southern states and foreign-born individuals performing worse than those born in other states. Overall, state of birth accounted for 2.2%–9.7% of the total variance in cognition after adjusting for age, sex, and race/ethnicity. This contribution declined to 2.0%–7.0% after further adjusting for comprehensive socioeconomic and health factors over the life course, and was robust to the control of current state of residence.DiscussionPoB has lasting contributions to later-life cognition, with significant geographic disparities observed. Addressing these disparities requires more equalized place-based policies, resources, and early-life environments to promote health equity over the life course.

Suggested Citation

  • Zhuoer Lin & Xi Chen, 2024. "Place of Birth and Cognitive Function Among Older Americans: Findings From the Harmonized Cognitive Assessment Protocol," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 79(9), pages 1598-1695.
    • Handle: RePEc:oup:geronb:v:79:y:2024:i:9:p:1598-1695.
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    1. Komro, K.A. & Livingston, M.D. & Markowitz, S. & Wagenaar, A.C., 2016. "The effect of an increased minimum wage on infant mortality and birth weight," American Journal of Public Health, American Public Health Association, vol. 106(8), pages 1514-1516.
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    More about this item

    Keywords

    Cognitive domains; Early-life circumstances; Geographic disparities; Health equity; Life course;
    All these keywords.

    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I10 - Health, Education, and Welfare - - Health - - - General
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare

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