Racial differences in the association of education with physical and cognitive function in older blacks and whites

Few studies have explicitly tested whether the health disadvantage among older blacks is consistent across the entire range of education. We examined racial differences in the cross-sectional association of education with physical and cognitive function performance in older adults.

Participants included over 9500 blacks and whites, aged ≥ 65 years, from the Chicago Health and Aging Project {64% black, 60% women, mean age = 73.0 (standard deviation [SD] = 6.9), mean education = 12.2 (SD = 3.5)}. Physical function was assessed using 3 physical performance tests, and cognitive function was assessed with 4 performance-based tests; composite measures were created and used in analyses.

In multiple regression models that controlled for age, age-squared, sex, and race, and their interactions, whites and those with higher education (>12 years) performed significantly better on both functional health measures. The association of education with each indicator of functional health was similar in older blacks and whites with low levels (≤ 12 years) of education. However, at higher levels of education, there was a significantly more positive association between years of education and these functional health outcomes among blacks than whites.

Results from this biracial population-based sample in the Midwest suggest that blacks may enjoy greater returns in functional health for additional education beyond high school.