Rural depopulation and the rural‐urban gap in cognitive functioning among older adults
Abstract
Purpose
As the population ages, the number of people with cognitive impairment will rapidly increase. Although previous research has explored the rural-urban gap in physical health, few studies have analyzed cognitive health. The purpose of this study was to examine rural-urban differences in cognitive health, with a focus on the moderating effect of population decline.
Methods
The study used individual-level nationally representative data from the 2000-2016 waves of the Health and Retirement Study (N = 152,444) merged to county-level contextual characteristics. Hierarchical linear models were used to predict the cognitive functioning of US adults aged 50 and over by rural-urban residence, county depopulation, and their interactions while controlling for individual-level and county-level demographic and contextual factors.
Findings
Older adults living in rural counties had lower cognitive functioning than urban adults. The interaction between living in a rural and depopulated county was statistically significant (P < .001). The rural penalty in cognitive functioning was 40% larger for those who lived in counties that lost population between 1980 and 2010 compared to those who lived in stable or growing rural counties. These results were independent of race-ethnicity, gender, age, education, income, region, employment status, marital status, physical health, and depression as well as the county's racial-ethnic composition, age structure, economic and educational disadvantage, and health care shortages.
Conclusions
The results have important implications for those seeking to reduce health disparities both between rural and urban older adults and among different groups of rural people. Interventions targeting those living in rural depopulating areas are particularly warranted.
Department
Sociology
Publication Date
2022
Grant/Award Number and Agency
National Institute on Aging, Grant/AwardNumber:R24-AG065159
Journal Title
The Journal of Rural Health
Publisher
Wiley
Digital Object Identifier (DOI)
Document Type
Article
Recommended Citation
Glauber, Rebecca, "Rural depopulation and the rural‐urban gap in cognitive functioning among older adults" (2022). The Journal of Rural Health. 1402.
https://scholars.unh.edu/faculty_pubs/1402