Life Course Factors and Societal Structures in the Development of Cognitive Health Inequalities

Liili Abuladze , Estonian Institute for Population Studies, Tallinn University
Luule Sakkeus, Estonian Institute for Population Studies, Tallinn University

Later life cognitive health depends on personal as well as broader structural characteristics with health inequalities being grounded in the long-term organisation of social life. This paper explores a context of social transformation into and out of state socialism, affecting the differential distribution and accumulation of resources by population groups. We analyse the role of childhood and adulthood socio-economic positions (SEP) in later life cognition change by cohort, gender and migrant origin. We include respondents aged 50+ from SHARE Estonia data (2010-2022), who report information on variables of interest (N=3,006). By running correlated random-effects models, we differentiate within- and between-effects in verbal recall change. Women of either origin have on average better cognition than men in Estonia, being in line with higher prevalence of tertiary education among women in these generations. Women benefit from advancements in adulthood SEP, explaining negative longitudinal change. While childhood SEP reinforces positive effects in cognition change somewhat for migrant men, it widens negative effects for migrant women. Therefore, childhood circumstances override the effects of adulthood advancements among migrants in Estonia – reflecting the inequalities created during the socialist regime and which persisted long-term. Younger cohort of women indicate better cognition outcomes and their change over time, significantly among migrants. Everyday activity limitations in conjunction with either SEP explains these differences. Difficulties in overcoming health-related societal barriers more recently in life matter for cognitive health of migrants, despite the long-term opportunities to access health care services in own language.

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 Presented in Session P5. Health, Mortality, and Ageing 1