Cognitive abilities and self-rated health: Is there a relationship? Is it growing? Does it explain disparities?

Although social epidemiologists have recently turned to the role of cognitive abilities in health, the ensuing debate has been largely speculative and numerous questions remain unanswered. Epidemiologists have speculated in three key areas: (i) whether cognitive abilities are associated with health; (ii) whether the association is growing; and (iii) whether cognitive abilities explain disparities. Using the cumulative 1974–2000 General Social Survey, this paper explores these questions using self-rated health as an outcome and a test of verbal ability as an indicator of cognitive abilities. On the one hand, the results suggest a significant and strictly monotonic association between verbal ability (with scores ranging from 0 to 10) and self-rated health. The association has been consistently strong since 1974; there is no evidence for a growing association. On the other hand, the results provide little to no evidence that verbal ability explains disparities. In multivariate models, the coefficients for income and education are reduced by only a small fraction with the introduction of controls for verbal ability (5 and 16%, respectively) and the relationship between verbal ability and self-rated health is, itself, very sensitive to controls for socioeconomic status. Furthermore, verbal ability cannot account for black–white differences in self-rated health: interaction-effect analyses indicate that, conditional on socioeconomic status, verbal ability has no discernable association with self-rated health among African Americans. Altogether, the results suggest that cognitive abilities are related to self-rated health, but also that cognitive abilities will do very little to explain disparities and may have benefits that are limited mostly—and sometimes entirely—to whites. The results are inconsistent with much of the previous speculation regarding cognitive abilities, but consistent with research on health’s “fundamental” causes and, more generally, with sociological research on the role of cognitive abilities in the process of stratification.