Race Inequity in School Attendance Across the Jim Crow South and Its Implications for Black–White Disparities in Trajectories of Cognitive Function Among Older Adults

Abstract

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.

Structural racism theory, measurement, and methods: A scoping review

“…Duplicate articles ( n = 24) or articles whose main focus was not structural racism were removed ( n = 73), leaving a total of 138 articles evaluated ( Figure 1 ). Results were extracted by, and organized into, three broad sections: theory ( 4 – 8 , 12 , 13 , 17 – 24 , 37 – 41 , 45 , 46 , 50 , 51 , 57 , 61 , 63 , 64 , 72 , 73 , 78 , 80 , 82 – 84 , 88 , 89 , 97 , 101 – 103 , 106 – 108 , 113 , 115 ), construct measurement ( 12 , 13 , 16 , 23 , 32 , 53 , 54 , 57 , 58 , 61 – 63 , 65 – 69 , 74 , 76 , 79 , 81 , 84 – 86 , 88 , 90 – 92 , 98 , 106 , 109 , 110 , 112 ) and study practice and methods ( 11 , 12 , 23 , 33 , 54 , 55 , 62 , 67 – 70 , 74 , 75 , 77 …”

“…One example of a shift from an “actor-less” to “actor” approach is Walseman et al's study of differential rates of school attendance in the Jim Crow South and cognitive function among Black and white older adults ( 112 ). Educational attainment (i.e., an “actor-less” measure that if attributed to anyone is attributed to the individual themselves) has been identified as a key determinant of health with respect to cognitive function, an outcome with persistent Black-white disparities in the US.…”

“…However, the use of educational attainment alone, measured in years, does not sufficiently capture how structural racism (in the form Jim Crow educational policies) may impact the actual number of years and quality of school attendance, such as de jure and de facto segregation and school term length. Walseman et al's ( 112 ) creation of a measure to account for “actors” (i.e., states that legally mandated segregated schooling vs. states that did not) both better described the disparities in cognitive function between Black and white older adults, as well as more clearly articulated which actor(s) are responsible for creating such policies. This can extend to linking other domains of structural racism that precede more proximate social determinants of health.…”

Impact of educational attainment on time to cognitive decline among marginalized older adults: Cohort study of 20,311 adults

“…Black segregated school systems in the South pre-1954 had shorter school terms, lower attendance rates, lower per pupil expenditures, and greater rates of illiteracy than White segregated school systems in the South pre-1954. 28,29 Systemic racism and educational bias borne throughout one's lifespan will have substantial impacts on cognitive health in older age, yet we were unable to measure these confounding factors directly. Furthermore, contextual factors that further marginalize Black and Latinx adults such as occupational complexity, job demands and control, and psychosocial support and engagement were not measured and deserve further investigation.…”

Education in the Jim Crow South and Black-White inequities in allostatic load among older adults

“…This de jure school segregation led to large race inequities in the allocation of educational resources to Black and White segregated school systems, which resulted in significant inequities in school term length and how many days of instruction students received across racially segregated school systems. Annual school terms were, on average, 50–100% shorter for Black students than for White students ( Walsemann et al, 2022 ) and Black students consistently attended fewer days of schooling than their White peers. Importantly, almost 80% of Black older adults who completed school prior to Brown v. Board of Education were educated in the U.S. South ( Ruggles et al, 2020 ).…”