Mind the Gap: An Analysis of Early Life Adversity and Race - PDF document

Mind the Gap: An Analysis of Early Life Adversity and Race Disparities in Cognitive Aging in the U.S. Context Kyler J. Sherman-Wilkins, PhD Department of Sociology and Anthropology Missouri State University

2 Abstract One of the most enduring findings in health at older ages is that childhood matters. Research has explored whether racial inequalities in health over the life span result from racial differences in early life adversity. Two hypotheses have emerged to explain racial disparities in health: differential exposure (that racial differences in cognitive aging are due to differential exposure to early life adversity) differential vulnerability (which posits that group differences in cognitive aging are due to differential impacts of early life adversity across groups). Drawing on the life course perspective and data from eight waves of the Health and Retirement Study, this paper estimates growth curves of cognitive functioning and tests: a) whether blacks experience lower levels of cognitive decline over time than whites; b) whether exposure to early life adversity mediates the relationship between race and cognitive decline; and c) whether the relationship between early life adversity and cognitive aging varies by race. Findings show that race and gender are both significant predictors of episodic memory and mental status trajectory class membership. Blacks and men are more likely to belong in episodic memory trajectory classes characterized by low initial function with more rapid declines than their white and female counterparts. For mental status, blacks and women are more likely to be in lower initial functioning classes, but are advantaged with regards to rate of decline. Additionally, findings provide little evidence for the notion that early life adversity attenuates the relationship between race and/or gender and cognitive decline trajectory class membership, thereby no support for the differential exposure hypothesis was found. Lastly, lack of statistically significant interactions between both race and gender and early life adversity indicates that there is no support for the differential susceptibility hypothesis.

3 Differential Exposure and Susceptibility Perspectives on Cognitive Aging Disparities Perhaps one of the most enduring findings in health over the lifespan is that childhood matters. Consequently, the literature examining the impacts of early life factors on adult health, broadly defined, is rapidly growing. With regards to cognitive aging/decline, previous research has investigated dimensions of early life adversity early life socioeconomic adversity (Zhang et al. 2008; Zhang et al. 2016). Recall that evidence suggest race and gender differences in cognitive aging across the life course. What is missing from this literature is an investigation of whether early life adversity at least partially explains the aforementioned black-white and male-female disparity in cognitive functioning. The closest study was conducted by Zhang and colleagues (2016) in which they find that early life factors perpetuate Black-White differences in cognitive impairment. What is not clear is how this shapes distinct trajectories of cognitive aging nor whether early life adversity explains gender differences. Moreover, it is not clear whether race and/or gender moderate the relationship between early life adversity and cognitive decline Two hypotheses have emerged that connect racial/gender disparities, early life adversity, and poorer outcomes. The differential exposure hypothesis argues that the higher prevalence of early life adversity among blacks (Zhang et al. 2016) and women (Kessler and McLeod 1984; Matud 2004; Meyer et al. 2008; Turner and Lloyd 2004; Umberson et al. 1996) is what is responsible for disparities in cognitive aging. Consequently, the differential exposure hypothesis would predicts that exposure to early life adversity would at least partially explain any racial and/or gender differences in cognitive aging. Alternatively, the differential vulnerability hypothesis posits that there are not necessarily gender and racial differences in exposure to adversity (though this may be the case), but rather blacks and women react to adverse life exposures differently than their White and male counterparts, respectively. Interestingly, while women have been shown to be

4 more negatively influenced by early life adversity with outcomes such as obesity (Pudrovska et al., 2014), there is some evidence that blacks are actually less sensitive to early life adversity than Whites (Monnat et al., In Progress). It is not clear which hypothesis is more correct, but it should be noted that both hypotheses assert that gender socialization underlies the difference between men and women. Because women are socialized to be the nurturer and tend to the family, they are exposed to the more common stressors related to family and social relationships. Further, women are socialized to internalize and ruminate more than men, which would explain why they may be more adversely affected by stressful life events than men, who tend to be more detached (Rosenfield and Mouzon 2013). For blacks, their resistance to early life adversity may represent a type of resilience or hardiness perspective. The present analysis investigates the role of early life adversity in shaping later life cognitive functioning. To begin, I address the question as to whether early life adversity is indeed associated with one’s cognitive aging trajectory in advanced ages and formulate the following hypothesis: Hypothesis I: early life adversity is associated with membership in cognitive decline classes characterized by low initial functioning After confirming the relationship between early life adversity and cognitive functioning in later life, I move to address the extent to which early life adversity explains the racial and gender differences discussed above. In this vein, I test my next hypothesis inspired by the differential exposure literature: Hypothesis II: the relationship between race and gender and later life cognition will be at least partially mediated by early life adversity As discussed above, though it could be the case that exposure to early life adversity explains the black-white and male-female gap in cognitive aging, alternatively, race and

5 gender could condition the effect of early life adversity on cognitive decline. Specifically, women may be more negatively impacted while blacks may be more resilient to the deleterious effects of early life adversity. In line with the differential susceptibility, I test the final hypothesis: Hypothesis IIIa: the relationship between early life adversity and later life cognitive functioning is conditioned by gender such that the relationship is more predictive of belonging to low functioning classes of cognition for women than men Hypothesis IIIb: the relationship between early life adversity and later life cognitive functioning is conditioned by race such that the relationship is less predictive of belonging to low functioning classes of cognition for blacks than whites. Sample Data for this study were drawn from eight waves (1998-2012) of the ongoing, nationally representative, longitudinal Health and Retirement Study (HRS). The HRS is sponsored by the National Institute on Aging (grant number NIA U01AG009740) and is conducted by the University of Michigan. Initiated in 1992, the HRS and its sister survey Study of Asset and Health Dynamics Among the Oldest Old (AHEAD) were both conducted separately and biennially, before being integrated in 1998. The HRS collects measures on the health, employment, and familial conditions of non-institutionalized older adults aged 50+ in the United States via in-person interview or by telephone.