State Educational Contexts in Childhood and Systemic Inflammation in Later Life: Evidence from the Health and Retirement Study

ABSTRACT Chronic, low-grade inflammation is a key biological mechanism linking early-life adversity to morbidity and disability in later adulthood. Although educational attainment has been consistently associated with lower inflammation, the role of early educational environments remains understudied. We examined whether exposure to better-resourced state education systems during childhood predicts lower systemic inflammation in later life. We linked historical state-level measures of educational resources (1919–1974) to biomarker data from the 2016 Venous Blood Study of the Health and Retirement Study, a nationally representative cohort of U.S. adults aged 56 and older (n=7,524). A latent construct of inflammation was derived from six biomarkers (IL-10, IL-1RA, IL-6, TNFR1, IGF-1, and C-reactive protein). Linear regression models estimated associations between state educational resources and inflammation, sequentially adjusting for demographic characteristics, early-life and state-level covariates, individual educational attainment, and adult health behaviors. Higher state-level educational resources were associated with significantly lower inflammation (b=–0.033, 95% CI: –0.051, –0.015). This association persisted after adjusting for demographic and early-life factors and was attenuated but remained statistically significant after controlling for educational attainment (b=–0.025, 95% CI: –0.049, –0.009). Associations were strongest among individuals with higher educational attainment, although this interaction became non-significant after accounting for health behaviors. These findings suggest that early educational environments may have lasting physiological consequences independent of schooling completed, partly operating through socioeconomic and behavioral pathways. Investments in public education may represent an important strategy to promote healthy aging and reduce inflammation-related health disparities across the life course.