# Public health implications of the send-down movement: long-term effects on cognitive ability of rural older adults in China

## TL;DR

This study shows that a historical educational intervention in rural China improved cognitive health in older adults decades later.

## Contribution

It identifies specific long-term cognitive benefits of early-life exposure to human capital investments in rural China.

## Key findings

- Exposure to send-down youths increased cognitive ability scores by 0.857 points.
- Cognitive decline was reduced by 4.33 percentage points among exposed individuals.
- Cognitive impairment incidence decreased by 6.76 percentage points due to the intervention.

## Abstract

This study examines the long-term effects of the send-down movement on the cognitive ability of rural older adults in China, focusing on how early-life exposure to human capital interventions shapes late-life cognitive trajectories.

Leveraging four waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011–2018), we employ a cohort difference-in-differences (cohort DID) design to compare cognitive outcomes between rural residents exposed to send-down youths (SDYs) during childhood and non-exposed cohorts. Mechanisms are analyzed through a multi-mediation framework integrating educational attainment, non-agricultural work, social engagement, and fertility behaviors.

The analysis demonstrates that exposure to SDYs significantly enhanced cognitive ability among rural older adults, resulting in a 0.857-point increase in cognitive ability score, a 4.33 percentage-point reduction in cognitive decline, and a 6.76 percentage-point decrease in cognitive impairment incidence. Mechanism analysis reveals that exposure to SDYs primarily influenced late-life cognitive ability through four pathways: improving rural children's educational attainment, increasing their probability of obtaining non-agricultural work, enhancing social engagement, and reducing fertility rates.

The send-down movement positively influenced the cognitive health of rural older adults, underscoring the enduring impact of childhood access to educational resources on cognitive ability throughout the life course. Policy initiatives integrating early-life education with adult opportunity structures could yield compounded cognitive dividends, particularly in resource-limited rural settings.