|Inter-Cohort Variations in the Education-Health Gradient: Socio-Historical Changes in Early-Life Selection Mechanisms in the U.S.
|Year of Publication
|J Gerontol B Psychol Sci Soc Sci
|Childhood, Educational Status, health disparity, Older adult, Socioeconomic factors
OBJECTIVES: Most prior studies on cohort-specific changes in the education gradient relative to health treat the distribution of education within a particular cohort as a "starting place" for understanding later life health disparities. This premise has obfuscated the role that socio-historical changes in early-life selection mechanisms play in the widening of education-based inequalities in functional limitations across birth cohorts.
METHOD: Drawing from the Health and Retirement Survey (1992-2016; n=20,920), this study employs inverse probability weight (IPW) to account for early-life selection mechanisms that are likely to impact both educational attainment and functional limitations. IPW adjusted generalized linear mixed effects models were used to estimate the total effect of education on functional limitations across birth cohorts (born 1924-1959).
RESULTS: A significant linear decline in the negative effects of childhood socioeconomic disadvantage on education (β =0.005, p<0.01) over birth year was documented. By contrast, the same variable's negative effect on functional health increased significantly (β =0.006, p<0.001) across cohorts. Adjustment for childhood socioeconomic status did yield narrower education-based inequalities in functional limitations, but the difference between IPW adjusted and unadjusted results was not statistically significant. The pattern of significant widening of education-based inequalities (β =-0.05, p<0.001) in functional limitations across birth cohorts was maintained.
DISCUSSION: This study underscores the role that socio-historical changes in early-life selection mechanisms play in modifying patterns of education-based inequalities in health across cohorts.