318Earlier migration, better cognition? The role of urbanization in bridging the urban-rural cognition gaps

Abstract

Abstract Background With the process of population aging and urbanization, a vast amount of studies has confirmed the increasing urban-rural cognitive inequality. While less is known about the extent to which cognition gaps can be explained by birth inequality and urbanization. This study aimed to examine the role of urbanization and related factors in bridging the cognition gaps for middle-aged and older adults in China. Methods Based on the national representative China Health and Retirement Longitudinal Study (CHARLS) 2015, the Blinder-Oaxaca decomposition method was employed to decompose the cognition gaps. We quantified both the explained and unexplained parts of the cognition gaps, as well as the absolute and relative attribution of related factors. Results We found significant cognition gaps between urban and rural samples. Among the rural sample, the fully-urbanized and the semi-urbanized had better cognition than the non-urbanized. The fully-urbanized migrating at the age of 0-17 years old showed higher cognition scores than those migrating at 18+ years old. Besides urban-rural inequality and urbanization disparities, the cognition gaps could be largely explained by their socioeconomic status, and in part by their demographic background, physical functioning, life styles, social support and childhood status. Conclusions Urban-rural migration have a lasting effect in bridging the cognitive gaps in middle-aged and older adults, and those who migrating had more improvements in cognition than those migrating in adulthood. Public health actions targeting cognitive disparities could benefit from focusing on inequalities in urban-rural social and economic recourses. Key messages Rural-to-urban migration can bridge the urban-rural cognitive gaps in Chinese middle-aged and older adults. In the rural-to-urban migration groups, people migrating in childhood had more improvements in cognition than those migrating in adulthood.