Type of high-school credentials and older age ADL and IADL limitations: is the GED credential equivalent to a diploma?

TitleType of high-school credentials and older age ADL and IADL limitations: is the GED credential equivalent to a diploma?
Publication TypeJournal Article
Year of Publication2013
AuthorsLiu, SY, Chavan, NR, M. Glymour, M
Date Published2013 Apr
ISSN Number1758-5341
KeywordsActivities of Daily Living, Adult, Aged, Aged, 80 and over, Aging, Disabled Persons, Educational Status, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Logistic Models, Male, Socioeconomic factors, United States

PURPOSE: Educational attainment is a robust predictor of disability in elderly Americans: older adults with high-school (HS) diplomas have substantially lower disability than individuals who did not complete HS. General Educational Development (GED) diplomas now comprise almost 20% of new HS credentials issued annually in the United States but it is unknown whether the apparent health advantages of HS diplomas extend to GED credentials. This study examines whether adults older than 50 years with GEDs have higher odds of incident instrumental or basic activities of daily living (IADLs) limitations compared with HS degree holders.

METHODS: We compared odds of incident IADL limitations by HS credential type using discrete-time survival models among 9,426 Health and Retirement Study participants followed from 1998 through 2008.

RESULTS: HS degree holders had lower odds of incident IADLs than GED holders (OR = 0.72, 95% CI = 0.58, 0.90 and OR = 0.69, 95% CI = 0.56, 0.86 for ADLs and IADLs, respectively). There was no significant difference in odds of incident IADL limitations between GED holders and respondents without HS credentials (OR = 0.89, 95% CI = 0.71, 1.11 for ADLs; OR = 0.88, 95% CI = 0.70, 1.12 for IADLs).

IMPLICATIONS: Although GEDs are widely accepted as equivalent to high school diplomas, they are not associated with comparable health advantages for physical limitations in older age.

User Guide Notes


Endnote Keywords

EDUCATION/disabilities/ADL/IADL/Activities Of Daily Living/Public Policy

Endnote ID


Alternate JournalGerontologist
Citation Key7865
PubMed ID22859434