TY - JOUR T1 - Education in the Jim Crow South and Black-White inequities in allostatic load among older adults. JF - SSM Population Health Y1 - 2022 A1 - Walsemann, Katrina M A1 - Pearson, Jay A1 - Abbruzzi, Emily KW - Education KW - Measurement KW - race disparity AB -

In the U.S., Black adults consistently have higher allostatic load - an indicator of physiological dysregulation - than White adults. Education is considered a likely mechanism given racial differences in attainment, but evidence is mixed. This may be due, in part, to data limitations that have made it difficult for scholars to account for the structurally rooted systemic racism that shaped the U.S. education system and led to large racial inequities in school term length and school attendance among older adults who grew up in the Jim Crow South. Our study addresses this limitation by linking historical data on Black and White segregated school systems in the U.S. South from 1919 to 1954 to the Health and Retirement Study (HRS) to determine if a new measure of educational attainment that accounts for structural racism that led to differences in the number of school days attended by Black and White students across years and states better explains Black-White inequities in allostatic load among older adults who attended school during Jim Crow. We restrict our sample to HRS respondents racialized as White or Black, who resided in the South when they were school-aged, completed primary/secondary school between 1919 and 1954, and provided a measure of allostatic load (n = 1932). We find that our new measure of schooling - duration in school - reduced the Black-White inequity in allostatic load more so than self-reported years of schooling whether we measured allostatic load continuously (34% vs 16%) or categorically (45% vs 20%). Our findings highlight the importance of identifying and using historically informed measures of schooling that account for structurally rooted systemic racism when trying to understand how education shapes the health of individuals racialized as Black in the United States.

VL - 19 ER - TY - JOUR T1 - Future Directions for the HRS Harmonized Cognitive Assessment Protocol. JF - Forum for Health Economics and Policy Y1 - 2022 A1 - Torres, Jacqueline M A1 - M. Maria Glymour KW - Alzheimer KW - Dementia KW - HCAP KW - Measurement AB -

In the absence of effective pharmacological treatment to halt or reverse the course of Alzheimer's disease and related dementias (ADRDs), population-level research on the modifiable determinants of dementia risk and outcomes for those living with ADRD is critical. The Harmonized Cognitive Assessment Protocol (HCAP), fielded in 2016 as part of the U.S. Health and Retirement Study (HRS) and multiple international counterparts, has the potential to play an important role in such efforts. The stated goals of the HCAP are to improve our ability to understand the determinants, prevalence, costs, and consequences of cognitive impairment and dementia in the U.S. and to support cross-national comparisons. The first wave of the HCAP demonstrated the feasibility and value of the more detailed cognitive assessments in the HCAP compared to the brief cognitive assessments in the core HRS interviews. To achieve its full potential, we provide eight recommendations for improving future iterations of the HCAP. Our highest priority recommendation is to increase the representation of historically marginalized racial/ethnic groups disproportionately affected by ADRDs. Additional recommendations relate to the timing of the HCAP assessments; clinical and biomarker validation data, including to improve cross-national comparisons; dropping lower performing items; enhanced documentation; and the addition of measures related to caregiver impact. We believe that the capacity of the HCAP to achieve its stated goals will be greatly enhanced by considering these changes and additions.

ER - TY - JOUR T1 - The Validity and Reliability of Retrospective Measures of Childhood Socioeconomic Status in the Health and Retirement Study: Evidence from the 1940 U.S. Census. JF - The Journals of Gerontology, Series B Y1 - 2022 A1 - Warren, John Robert A1 - Lee, Mark A1 - Theresa L Osypuk KW - Data quality KW - family income KW - Measurement KW - Parental education AB -

OBJECTIVES: Retrospective measures of childhood socioeconomic status (SES) in widely used cohort studies of aging that first observe people late in life-such as the Health and Retirement Study (HRS)-are widely used. However, their measurement validity and reliability are unknown. We assess the reliability and validity of the HRS's retrospective measures of parental education and childhood family finances.

METHODS: We use records for 6,343 HRS sample members who were children in 1940 that have been linked to records from the complete-count 1940 U.S. Census. We assess interrater reliability by comparing (a) retrospective reports of childhood SES collected from sample members in the 1992-2018 HRS to (b) prospective measures of parallel concepts collected from HRS sample members' parents in the 1940 Census. We assess predictive validity by comparing the results of analyses that model later-life outcomes as a function of childhood SES as measured both prospectively and retrospectively.

RESULTS: Interrater reliabilities of retrospective measures of parental education are high; however, the same is not true of the retrospective measure of childhood family finances. Both retrospective and prospective measures of childhood SES are predictive of later-life outcomes, and with similar strengths and directions of associations for most outcomes.

DISCUSSION: Researchers who rely on retrospective indicators of childhood SES from the HRS should be aware of their measurement properties. They are measured with error, and that error modestly attenuates estimates of their associations with later-life outcomes. However, prospective and retrospective measures of childhood SES have similar predictive validity. These findings should reassure researchers who rely on retrospective measures of childhood SES in the HRS and similarly designed surveys.

VL - 77 IS - 9 ER - TY - JOUR T1 - Advancing research on psychosocial stress and aging with the Health and Retirement Study: Looking back to launch the field forward JF - The Journals of Gerontology: Series B Y1 - 2020 A1 - Alexandra D. Crosswell A1 - Suresh, Madhuvanthi A1 - Puterman, Eli A1 - Tara L Gruenewald A1 - Jinkook Lee A1 - Elissa S Epel KW - Aging KW - Measurement KW - Population Health KW - Psychosocial KW - Stress AB - The Health and Retirement Study (HRS) was designed as an interdisciplinary study with a strong focus on health, retirement, and socioeconomic environment, to study their dynamic relationships over time in a sample of mid-life adults. The study includes validated self-report measures and individual items that capture the experiences of stressful events (stressor exposures) and subjective assessments of stress (perceived stress) within specific life domains. UR - https://academic.oup.com/psychsocgerontology/advance-article/doi/10.1093/geronb/gby106/5096750 ER - TY - JOUR T1 - Development of Algorithmic Dementia Ascertainment for Racial/Ethnic Disparities Research in the US Health and Retirement Study. JF - Epidemiology Y1 - 2020 A1 - Kan Z Gianattasio A1 - Ciarleglio, Adam A1 - Melinda C Power KW - Algorithms KW - Alzheimer’s disease KW - Dementia KW - Disparities KW - Machine learning KW - Measurement AB -

BACKGROUND: Disparities research in dementia is limited by lack of large, diverse, and representative samples with systematic dementia ascertainment. Algorithmic diagnosis of dementia offers a cost-effective alternate approach. Prior work in the nationally representative Health and Retirement Study has demonstrated that existing algorithms are ill-suited for racial/ethnic disparities work given differences in sensitivity and specificity by race/ethnicity.

METHODS: We implemented traditional and machine learning methods to identify an improved algorithm that: (1) had ≤5 percentage point difference in sensitivity and specificity across racial/ethnic groups; (2) achieved ≥80% overall accuracy across racial/ethnic groups; and (3) achieved ≥75% sensitivity and ≥90% specificity overall. Final recommendations were based on robustness, accuracy of estimated race/ethnicity-specific prevalence and prevalence ratios compared to those using in-person diagnoses, and ease of use.

RESULTS: We identified six algorithms that met our prespecified criteria. Our three recommended algorithms achieved ≤3 percentage point difference in sensitivity and ≤5 percentage point difference in specificity across racial/ethnic groups, as well as 77%-83% sensitivity, 92%-94% specificity, and 90%-92% accuracy overall in analyses designed to emulate out-of-sample performance. Pairwise prevalence ratios between non-Hispanic whites, non-Hispanic blacks, and Hispanics estimated by application of these algorithms are within 1%-10% of prevalence ratios estimated based on in-person diagnoses.

CONCLUSIONS: We believe these algorithms will be of immense value to dementia researchers interested in racial/ethnic disparities. Our process can be replicated to allow minimally biasing algorithmic classification of dementia for other purposes.

VL - 31 IS - 1 ER - TY - JOUR T1 - Self-Perceptions of Aging: Factorial Structure and Invariance by Gender JF - The Gerontologist Y1 - 2020 A1 - Turner, Shelbie G A1 - Hooker, Karen A1 - G John Geldhof KW - Confirmatory factor analyses KW - Measurement KW - Views on aging AB - Self-perceptions of aging (SPA)—the appraisals people place on their own aging processes—predict well-being in later life. Researchers are increasingly hypothesizing that the overarching construct of SPA is comprised of two factors—positive SPA and negative SPA—and that SPA are gendered. The purpose of this study was to empirically test the hypothesized two-factor structure of SPA and to analyze how the two-factor structure varies between men and women.Data come from the 2012 wave of the Health and Retirement Study (N = 7,029; Mage = 68.08), which includes an 8-item SPA scale. We used confirmatory factor analysis (CFA) to assess (i) the positive SPA and negative SPA two-factor solution for the 8-item scale and (ii) whether the two-factor solution had configural, strong, or weak invariance across men and women.CFAs indicated a two-factor latent structure of the 8-item scale, with SPA being comprised of both a positive SPA factor and a negative SPA factor. The latent structure was the same for both men and women.Results suggest that SPA is a broader construct made up of positive and negative latent factors. Researchers should consider separating the SPA by positive and negative factors to analyze how each factor uniquely shapes health. Moreover, the two-factor solution was equivalent across men and women, possibly because of the generalized nature of the 8-item scale. Researchers can use the 8-item scale similarly for men and women and should continue to elucidate possible gender differences in SPA. SN - 0016-9013 ER - TY - JOUR T1 - Gendered Expectations Distort Male-Female Differences in Instrumental Activities of Daily Living in Later Adulthood JF - JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES Y1 - 2019 A1 - Connor M Sheehan A1 - Elliot M Tucker-Drob KW - Disability KW - gender KW - Independent Living KW - Measurement AB - Objectives: The ability of older adults to live independently is often assessed with a battery of questions known as Instrumental Activities of Daily Living (IADLs). Many of these questions query the difficulty conducting household activities that have been predominantly conducted by women (e.g., the ability to prepare a meal), especially for cohorts now in old age. Although previous research has documented gender differences in IADL limitations, it has not been documented whether IADLs equivalently measure the same latent construct for men and women. Methods: We apply psychometric tests of measurement invariance to data from the 1998 Health and Retirement Study. We then estimate corrected models that account for violations of measurement invariance across genders. Results: We find that IADLs do not equivalently measure same latent construct for men and women. We find that men are more likely not to do the IADL activities for reasons unrelated to health limitations, which may reflect gendered expectations regarding household activities. Accounting for this we still find that women report greater health-related IADL limitations than men. Discussion: Researchers should be cautious making gender comparisons for IADLs without attending to the gender-specific measurement properties of many of the items of which the IADL is comprised. VL - 74 ER -