Does cognitive ability buffer the link between childhood disadvantage and adult health?


Bridger, E. and Daly, M. Does cognitive ability buffer the link between childhood disadvantage and adult health? Health Psychology 36:966-976, 2017.


This article is sure to be viewed as a seminal investigation into the moderating factors affecting health. It is well-established that socioeconomic disadvantages in childhood are associated with poorer health in adulthood; but what factors could explain why some disadvantaged children enjoy good health later in life while others do not? It’s difficult to tease out the answers using retrospective study designs, in which causal relationships cannot be inferred. However, Bridger and Daly took advantage of longitudinal data from two studies in Britain that have followed a nationally representative sample from birth. They discovered that among those with disadvantaged backgrounds, cognitive ability (i.e., intelligence) measured at age 11 strongly moderated not only self-reported health later in life, but also levels of emotional distress and even risk of mortality. The authors speculate that higher intelligence could enable people to adapt more flexibly to environmental challenges, especially when resources are limited. Moreover, stronger executive function (which is assumed to be part and parcel of general intelligence) could support better ability to regulate one’s emotions in response to stressors or hardships.

I PICKED THIS ARTICLE BECAUSE, although it is not about rehabilitation, there are interesting implications for our field. Numerous studies have found level of education to be an important positive predictor of disability outcomes. The typical assumption that education is a proxy for general intelligence seems to be supported by the findings of this study. The speculations about executive function lead to the question as to whether some of the advantages conferred by native intelligence could be modifiable. For example, might we be able to embed problem-solving training or cognitive flexibility training into some of our standard rehabilitation methods? Introducing principles of self-management to our patients, even early in the rehabilitation process, could be one way to accomplish this.

THIS MONTH’S REHAB SCIENCE SPOTLIGHT was selected by Tessa Hart, PhD, Institute Scientist at Moss Rehabilitation Research Institute and a member of Division 22’s Science Committee.