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Associations of local area level new deal employment in childhood with late life cognition: evidence from the census-linked health and retirement study
  1. Mark Lee1,
  2. Amal Harrati2,
  3. David H. Rehkopf3,
  4. Sepideh Modrek4
  1. 1Minnesota Population Center, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
  2. 2Mathematica Policy Research Inc, Berkeley, California, USA
  3. 3Medicine, Stanford University, Stanford, California, USA
  4. 4Economics, San Francisco State University, San Francisco, California, USA
  1. Correspondence to Mark Lee, Minnesota Population Center, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA; leex6611{at}umn.edu

Abstract

Background Emergency employment programmes during the 1930s and 1940s invested income, infrastructure and social services into communities affected by the Great Depression. We estimate the long-term associations of growing up in an area exposed to New Deal emergency employment in 1940 with cognitive functioning in later life.

Methods Members of the Health and Retirement Study cohort (N=5095; mean age 66.3 at baseline) who were age 0–17 in 1940 were linked to their census record from that year, providing prospective information about childhood contextual and family circumstances. We estimated the association between subcounty-level emergency employment participation in 1940 and baseline cognition and rate of cognitive decline between 1998 and 2016.

Results Compared with those living in the lowest emergency employment quintile in 1940, those who were exposed to moderate levels of emergency employment (third quintile) had better cognitive functioning in 1998 (b=0.092 SD, 95% CI 0.011 to 0.173), conditional on sociodemographic factors. This effect was modestly attenuated after adjusting for respondents’ adult education, finances and health factors. There were no significant effects of area-level emergency employment on rate of cognitive decline.

Conclusions Exposure to New Deal employment policies during childhood is associated with long-term cognitive health benefits. This is partially explained by increases in educational attainment among those with greater levels of emergency employment activity in the place where they were raised. Future research should investigate which types of New Deal investments may most be related to long-term cognitive health, or if the associations we observe are due to co-occurring programmes.

  • life course epidemiology
  • cognition
  • cohort studies
  • policy

Data availability statement

Data may be obtained from a third party and are not publicly available. Health and Retirement Study - 1940 Census data are available free of charge to approved users from the University of Michigan. The data are restricted and must be accessed using the University of Michigan’s secure virtual server.

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Data availability statement

Data may be obtained from a third party and are not publicly available. Health and Retirement Study - 1940 Census data are available free of charge to approved users from the University of Michigan. The data are restricted and must be accessed using the University of Michigan’s secure virtual server.

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Footnotes

  • Twitter @drehkopf, @smodrek

  • Contributors ML designed the study, conducted the data analysis and drafted the manuscript. AH contributed to the study design, interpreted results and revised the manuscript. DR acquired funding, contributed to the study design, interpreted results and revised the manuscript. SM acquired funding, contributed to the study design, provided data, interpreted results and revised the manuscript. All authors have approved the final version of this manuscript. ML is the guarantor.

  • Funding This work was supported by the National Institute on Aging (R01AG050300, R01AG059791) and the Minnesota Population Center, which receives core funding from the Eunice Kennedy Shriver National Institute on Child Health and Human Development (P2CHD041023).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.