Health Disparities
Early-life exposure to punitive school discipline is associated with adverse cognitive aging outcomes in early adulthood: Findings from the National Longitudinal Study of Adolescent to Adult Health (Add Health) Catherine Duarte* Catherine Duarte Jillian Hebert Tanisha Hill-Jarrett Anusha Vable
Exclusionary school discipline practices – like suspension or expulsion – are a mechanism of structural racism that disproportionately shape the experiences of minoritized children in US schools and may have implications for their health. An emerging literature links inequitable punitive school discipline exposure to racial inequity in midlife cognitive aging and later life dementia risk, however little work has evaluated if proposed pathways from punitive school discipline to dementia begin to diverge earlier in the lifecourse. In National Longitudinal Study of Adolescent to Adult Health (Add Health) cohort data (N=3,442), we use linear mixed effects models with bootstrapped confidence intervals (500 iterations) to evaluate if exclusionary discipline (3-levels: no discipline, ever suspended, ever expelled) in Grades 7-12 is associated with cognition (z-scored memory, attention, composite cognitive measure) in early adulthood (ages 24-32 years), adjusting for sociodemographic, childhood socioeconomic status, and childhood cognition indicators. In descriptive analyses, Black (22% of sample, but 31% of suspended and 44% of expelled) and Native/Indigenous participants (1% of sample, but 1.4% of suspended and 1.8% of expelled) bore a disproportionate burden of punitive school discipline in early life. In adjusted models, compared to no punitive discipline, both suspension (: -0.13, 95%CI: -0.21, -0.05) and expulsion (: -0.19, 95%CI: -0.32, -0.05) were associated with lower memory z-scores. There was no association between punitive school discipline and attention or the composite cognitive measure. Consistent with lifecourse epidemiology models, results suggest exposure to punitive discipline in secondary school may shape aging-related cognitive function in early adulthood, with implications for racial inequity in later life dementia risk.