The measurement of service experiences is primary in understanding health implications of military service and projecting the health service needs of aging veterans. SREs are varied and complex and have differential connections to health. These connections remain unexplained by current behaviors and mental health, suggesting the need to examine earlier life course pathways and mechanisms.
Objectives
Although education is a key determinant of cognitive function, its role in determining Black-White disparities in cognitive function is unclear. This may be due, in part, to data limitations that have made it difficult to account for systemic educational inequities in the Jim Crow South experienced by older cohorts, including differences in the number of days Black students attended school compared to their White counterparts or Black peers in better funded southern states. We determine if accounting for differential rates of school attendance across race, years, and states in the Jim Crow South better illuminates Black-White disparities in trajectories of cognitive function.
Methods
We linked historical state-level data on school attendance from the 1919/20 to 1953/54 Biennial Surveys of Education to the Health and Retirement Study, a nationally representative, longitudinal study of U.S. adults over age 50. We restricted our sample to Black and White older adults who attended school in the Jim Crow South and began primary school in/after 1919/20 and completed primary/secondary school by 1953/1954 (n=4,343). We used linear mixed models to estimate trajectories of total cognitive function, episodic memory, and working memory.
Results
Self-reported years of schooling explained 28-33% of the Black-White disparity in level of cognitive function, episodic memory, and working memory. Duration of school, a measure that accounted for differential rates of school attendance, explained 41-55% of the Black-White disparity in these outcomes.
Discussion
Our study highlights the importance of using a more refined measure of schooling for understanding the education--cognitive health relationship.
Our findings point to the importance of psychological resilience in later life, especially within the realm of traumas occurring in early life. We discuss implications for current military training programs, stressing the importance of research considering individual resources and processes that promote adaptation in the face of adverse life events.
Although exposure to death early in life is traumatic, our research suggests that such adversity within the specific context of the military may help enhance resilience during the transition to widowhood.
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