Associations of local area level new deal employment in childhood with late life cognition: Evidence from the census-linked health and retirement study

Mark Lee, Amal Harrati, David H. Rehkopf, Sepideh Modrek

Research output: Contribution to journalArticlepeer-review


Background Emergency employment programmes during the 1930s and 1940s invested income, infrastructure and social services into communities affected by the Great Depression. We estimate the long-term associations of growing up in an area exposed to New Deal emergency employment in 1940 with cognitive functioning in later life. Methods Members of the Health and Retirement Study cohort (N=5095; mean age 66.3 at baseline) who were age 0-17 in 1940 were linked to their census record from that year, providing prospective information about childhood contextual and family circumstances. We estimated the association between subcounty-level emergency employment participation in 1940 and baseline cognition and rate of cognitive decline between 1998 and 2016. Results Compared with those living in the lowest emergency employment quintile in 1940, those who were exposed to moderate levels of emergency employment (third quintile) had better cognitive functioning in 1998 (b=0.092 SD, 95% CI 0.011 to 0.173), conditional on sociodemographic factors. This effect was modestly attenuated after adjusting for respondents' adult education, finances and health factors. There were no significant effects of area-level emergency employment on rate of cognitive decline. Conclusions Exposure to New Deal employment policies during childhood is associated with long-term cognitive health benefits. This is partially explained by increases in educational attainment among those with greater levels of emergency employment activity in the place where they were raised. Future research should investigate which types of New Deal investments may most be related to long-term cognitive health, or if the associations we observe are due to co-occurring programmes.

Original languageEnglish (US)
Pages (from-to)81-88
Number of pages8
JournalJournal of epidemiology and community health
Issue number2
StatePublished - Dec 6 2022

Bibliographical note

Funding Information:
We expand on previous research by investigating the long-term association between early life exposure to local area emergency employment activity and cognitive ageing. In response to the Great Depression, the Roosevelt administration launched an ambitious expansion of the social safety net via a myriad of ‘New Deal’ programmes. The largest of these programmes, the Works Progress Administration (WPA), combated unemployment by providing federal funding for public works, community education and social welfare. Between 1935 and 1943, the WPA employed approximately 8.5 million people. While the WPA was a federal programme with its own projects, funding and administration, it partnered with local governments to identify workers from local relief rolls and implement projects. State and local governments and local agencies often partially financed and sponsored projects. Thus, both the federal WPA and local sponsors had some discretion in determining the distribution of WPA funding across the USA. Due to real variation in local needs and political considerations, some areas were able to put more people to work and completed more projects than others.

Publisher Copyright:
© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.


  • cognition
  • cohort studies
  • life course epidemiology
  • policy

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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