Dataset Information

Lagged Associations of Metropolitan Statistical Area- and State-Level Income Inequality with Cognitive Function: The Health and Retirement Study.

ABSTRACT:

Purpose

Much variation in individual-level cognitive function in late life remains unexplained, with little exploration of area-level/contextual factors to date. Income inequality is a contextual factor that may plausibly influence cognitive function.

Methods

In a nationally-representative cohort of older Americans from the Health and Retirement Study, we examined state- and metropolitan statistical area (MSA)-level income inequality as predictors of individual-level cognitive function measured by the 27-point Telephone Interview for Cognitive Status (TICS-m) scale. We modeled latency periods of 8-20 years, and controlled for state-/metropolitan statistical area (MSA)-level and individual-level factors.

Results

Higher MSA-level income inequality predicted lower cognitive function 16-18 years later. Using a 16-year lag, living in a MSA in the highest income inequality quartile predicted a 0.9-point lower TICS-m score (? = -0.86; 95% CI = -1.41, -0.31), roughly equivalent to the magnitude associated with five years of aging. We observed no associations for state-level income inequality. The findings were robust to sensitivity analyses using propensity score methods.

Conclusions

Among older Americans, MSA-level income inequality appears to influence cognitive function nearly two decades later. Policies reducing income inequality levels within cities may help address the growing burden of declining cognitive function among older populations within the United States.

SUBMITTER: Kim D

PROVIDER: S-EPMC4917220 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Publications

Lagged Associations of Metropolitan Statistical Area- and State-Level Income Inequality with Cognitive Function: The Health and Retirement Study.

Kim Daniel D Griffin Beth Ann BA Kabeto Mohammed M Escarce José J Langa Kenneth M KM Shih Regina A RA

PloS one 20160622 6

<h4>Purpose</h4>Much variation in individual-level cognitive function in late life remains unexplained, with little exploration of area-level/contextual factors to date. Income inequality is a contextual factor that may plausibly influence cognitive function.<h4>Methods</h4>In a nationally-representative cohort of older Americans from the Health and Retirement Study, we examined state- and metropolitan statistical area (MSA)-level income inequality as predictors of individual-level cognitive fun ...[more]

PMID: 27332986

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Project description:BackgroundExpanding social protection programme is a major target of the Sustainable Development Goals. Previous studies provided evidence for the relationship of social protection programme to greater use of health services and some improved health outcomes for children. Yet, its impact on child mortality has not been clearly revealed. In this study, we examined the association between social protection programmes and child mortality.MethodsWe obtained child mortality data from 379 nationally representative surveys involving 101 low- and middle-income countries (LMICs). We included five child mortality outcomes in the study, which were neonatal mortality rate (NMR), post-neonatal mortality rate (PMR), childhood mortality rate (CMR), infant mortality rate (IMR), and under-5 mortality rate (U5MR). We extracted data on social protection programmes from multiple data sources (eg, Atlas of Social Protection Indicators of Resilience and Equity). Social protection and labour programme (SPL) was the major type of social protection we included. We also included four subtypes of SPL - social assistance, cash transfer, social insurance, and labour market protection. Both unadjusted and adjusted regressions were conducted to measure the associations between characteristics of social protection programmes and child mortality, as well as inequalities in child mortality.ResultsAmong the 101 countries, the median coverage rate of SPL was 28.5%, with an interquartile range between 6.5% and 55.2%. Using the adjusted model, we found a one-percentage-point increase in SPL coverage is associated with a reduction of 0.09 (95% confidence interval (CI) = 0.04, 0.14) per 1000 live births in NMR, 0.11 (95% CI = 0.04, 0.18) in PMR, and 0.25 (95% CI = 0.11, 0.38) in CMR. Social assistance programme was the only subtype of SPL to be significantly associated with lower mortality rates. A higher SPL coverage was associated with better equity in child mortality - as the coverage of SPL increased by one percentage point, the concentration index of CMR would increase by 0.08 (95% CI = 0.03, 0.13) in the adjusted model, suggesting an improvement in equity.ConclusionsThe strong association between social protection programme and child mortality suggests that to achieve the SDG targets of universal social protection and to reduce child mortality, LMICs shall consider prioritizing the expansion of social protection programmes.

Dataset Information

Lagged Associations of Metropolitan Statistical Area- and State-Level Income Inequality with Cognitive Function: The Health and Retirement Study.

Purpose

Methods

Results

Conclusions

Publications

Lagged Associations of Metropolitan Statistical Area- and State-Level Income Inequality with Cognitive Function: The Health and Retirement Study.

Similar Datasets

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