Open Access Research article

Childhood school segregation and later life sense of control and physical performance in the African American Health cohort

Fredric D Wolinsky123*, Elena M Andresen4, Theodore K Malmstrom5, J Philip Miller6, Mario Schootman7 and Douglas K Miller89

Author Affiliations

1 Department of Health Management and Policy, College of Public Health, the University of Iowa, Iowa City, IA, USA

2 Department of Internal Medicine, Carver College of Medicine, the University of Iowa, Iowa City, IA, USA

3 Department of Adult Nursing, College of Nursing, the University of Iowa, Iowa City, IA, USA

4 Institute on Development and Disability, Oregon Health & Science University, Portland, OR, USA

5 Department of Psychiatry and Neurology, Saint Louis University, St. Louis, MO, USA

6 Department of Biostatistics, Washington University, St. Louis, MO, USA

7 Department of Internal Medicine, Washington University, St. Louis, MO, USA

8 Regenstrief Institute, Incorporated, Indianapolis, IN, USA

9 Department of Internal Medicine, Indiana University, Indianapolis, IN, USA

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BMC Public Health 2012, 12:827  doi:10.1186/1471-2458-12-827

Published: 27 September 2012



The association between childhood school desegregation and later life sense of control and physical performance among African Americans is not clear. We hypothesized that childhood school desegregation adversely affected the sense of control of in later life, and that this reduced sense of control accounts in part for reduced physical performance.


In-home follow-up assessments were completed in 2010 with 582 of the 58–74 year old men and women participating in the on-going African American Health cohort. We used these data to examine the relationship between (a) retrospective self-reports of attending segregated schools during one’s 1st-to-12th grade education and one’s current sense of control, as well as (b) the association between current sense of control and physical performance. Multiple linear regression analysis with propensity score re-weighting was used.


Attending segregated schools for at least half of one’s 1st-to-12th grade education was significantly associated with higher scores on the sense of control. Adjusting for all covariates and potential confounders, those receiving half or more of their 1st-to-12th grade education in segregated schools had sense of control scores that were .886 points higher (p ≤ .01; standardized effect size = .22). Sense of control scores were independently (all p < .01) associated with better systolic blood pressure, grip strength, peak expiratory flow, chair stands, balance tests, and the Short Portable Physical Battery even after adjusting for all covariates and potential confounders. Moreover, sense of control scores either partially or fully mediated the statistically significant beneficial associations between childhood school segregation and physical performance.


Childhood school desegregation was adversely associated with the sense of control of African Americans in later life, and this reduced sense of control appears, in part, to account for their poorer physical performance. The etiologic mechanism through which childhood school segregation at the time that this cohort experienced it improved the sense of control in later life, which subsequently led to better physical performance, has not been identified. We suspect, however, that the pathway involves greater exposure to racial solidarity, same-race students as peer role models and same-race teachers and principals as authority role models, the reduced likelihood of exposure to race-based discrimination or antagonism during their formative early lives, and greater exposure to encouragement and support for academic and life success.