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Lagged Associations of Metropolitan Statistical Area- and State-Level Income Inequality with Cognitive Function: The Health and Retirement Study

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  • Daniel Kim
  • Beth Ann Griffin
  • Mohammed Kabeto
  • José Escarce
  • Kenneth M Langa
  • Regina A Shih

Abstract

Purpose: Much variation in individual-level cognitive function in late life remains unexplained, with little exploration of area-level/contextual factors to date. Income inequality is a contextual factor that may plausibly influence cognitive function. Methods: In a nationally-representative cohort of older Americans from the Health and Retirement Study, we examined state- and metropolitan statistical area (MSA)-level income inequality as predictors of individual-level cognitive function measured by the 27-point Telephone Interview for Cognitive Status (TICS-m) scale. We modeled latency periods of 8–20 years, and controlled for state-/metropolitan statistical area (MSA)-level and individual-level factors. Results: Higher MSA-level income inequality predicted lower cognitive function 16–18 years later. Using a 16-year lag, living in a MSA in the highest income inequality quartile predicted a 0.9-point lower TICS-m score (β = -0.86; 95% CI = -1.41, -0.31), roughly equivalent to the magnitude associated with five years of aging. We observed no associations for state-level income inequality. The findings were robust to sensitivity analyses using propensity score methods. Conclusions: Among older Americans, MSA-level income inequality appears to influence cognitive function nearly two decades later. Policies reducing income inequality levels within cities may help address the growing burden of declining cognitive function among older populations within the United States.

Suggested Citation

  • Daniel Kim & Beth Ann Griffin & Mohammed Kabeto & José Escarce & Kenneth M Langa & Regina A Shih, 2016. "Lagged Associations of Metropolitan Statistical Area- and State-Level Income Inequality with Cognitive Function: The Health and Retirement Study," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-14, June.
    • Handle: RePEc:plo:pone00:0157327
    DOI: 10.1371/journal.pone.0157327
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    References listed on IDEAS

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    1. Shih, R.A. & Ghosh-Dastidar, B. & Margolis, K.L. & Slaughter, M.E. & Jewell, A. & Bird, C.E. & Eibner, C. & Denburg, N.L. & Ockene, J. & Messina, C.R. & Espeland, M.A., 2011. "Neighborhood socioeconomic status and cognitive function in women," American Journal of Public Health, American Public Health Association, vol. 101(9), pages 1721-1728.
    2. Kim, Daniel & Kawachi, Ichiro & Hoorn, Stephen Vander & Ezzati, Majid, 2008. "Is inequality at the heart of it? Cross-country associations of income inequality with cardiovascular diseases and risk factors," Social Science & Medicine, Elsevier, vol. 66(8), pages 1719-1732, April.
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    Cited by:

    1. Kelli A Komro & Phenesse Dunlap & Nolan Sroczynski & Melvin D Livingston & Megan A Kelly & Dawn Pepin & Sara Markowitz & Shelby Rentmeester & Alexander C Wagenaar, 2020. "Anti-poverty policy and health: Attributes and diffusion of state earned income tax credits across U.S. states from 1980 to 2020," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-18, November.
    2. Shuyang Yu & Meng Wei, 2021. "The Influences of Community-Enriched Environment on the Cognitive Trajectories of Elderly People," IJERPH, MDPI, vol. 18(16), pages 1-15, August.
    3. Daniel Kim, 2017. "Paid Sick Leave and Risks of All-Cause and Cause-Specific Mortality among Adult Workers in the USA," IJERPH, MDPI, vol. 14(10), pages 1-10, October.
    4. Rachel L. Peterson & Kristen M. George & Duyen Tran & Pallavi Malladi & Paola Gilsanz & Amy J. H. Kind & Rachel A. Whitmer & Lilah M. Besser & Oanh L. Meyer, 2021. "Operationalizing Social Environments in Cognitive Aging and Dementia Research: A Scoping Review," IJERPH, MDPI, vol. 18(13), pages 1-19, July.
    5. Daniel J. Pohl & Dominika Seblova & Justina F. Avila & Karen A. Dorsman & Erin R. Kulick & Joan A. Casey & Jennifer Manly, 2021. "Relationship between Residential Segregation, Later-Life Cognition, and Incident Dementia across Race/Ethnicity," IJERPH, MDPI, vol. 18(21), pages 1-16, October.
    6. Saloni Dev & Daniel Kim, 2020. "State-Level Income Inequality and County-Level Social Capital in Relation to Individual-Level Depression in Middle-Aged Adults: A Lagged Multilevel Study," IJERPH, MDPI, vol. 17(15), pages 1-12, July.

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