Earlier migration, better cognition? The role of urbanization in bridging the urban-rural cognition gaps in middle and older age

Abstract

Objectives With the process of population aging and urbanization, a vast amount of studies have confirmed the increasing urban-rural cognition gaps, while less is known about the extent to which cognition gaps can be explained by urban-rural difference and urbanization status. This study aimed to examine the role of urbanization in bridging the cognition gaps for Chinese middle-aged and older adults. Method Based on the national representative China Health and Retirement Longitudinal Study (CHARLS) 2015, the Blinder–Oaxaca decomposition method was employed. The method uses stratified linear regression to disaggregate cognition gaps into explained and unexplained differences, as well as the absolute and relative attribution of explanatory factors. Results There were significant cognitive differences between urban and rural samples. Migrating to the urban predicts better cognition among the rural-born. A larger environment-related explained gap existed for those fully urbanized and those migrating earlier, indicating that migration can operate through a beneficial and cumulative change in the environment and bridge the urban-rural cognition gap. Conclusion Public health actions targeting cognitive disparities can benefit from focusing on the unequal distribution in urban-rural social and economic recourses. Areas of priority include promoting their socioeconomic status, physical functioning, social support, and lifestyles.