About

Jennifer Ailshire, PhD, is a Professor of Gerontology and Sociology at the USC Leonard Davis School of Gerontology, where she also serves as Associate Dean of Research and Associate Dean of International Programs and Global Initiatives. She holds the UPS Foundation Chair in Aging and Justice. Her research addresses questions at the intersections of social stratification, urban sociology, and the sociology of health and aging, with a focus on the importance of neighborhood environment and social relationships in determining health over the life course. Her work emphasizes gender, socioeconomic, racial, and ethnic inequality in health, and includes current projects on the links between air pollution and health in older adults, neighborhood determinants of racial and ethnic health disparities, and social factors associated with poor sleep. Dr. Ailshire is an affiliate of the USC Schaeffer Center for Health Policy and Economics and the USC Population Research Center, and she serves as co-director of several research centers and programs related to biodemography, aging, and health disparities. She is a Fellow of the Gerontological Society of America and has received awards for mentoring from USC.

Research topics

• Sociology
• Psychology
• Psychiatry
• Medicine
• Political Science
• Gerontology
• Gender studies
• Developmental psychology
• Advertising
• Media studies
• Business
• Demography
• Nursing
• Virology
• Anthropology
• Clinical psychology
• Geography
• Social psychology

Selected publications

• Neighborhood social environment and physical activity among persons living with dementia

  The Gerontologist · 2026-04-12

  articleOpen accessSenior author

  BACKGROUND AND OBJECTIVES: Physical activity (PA) helps delay the progression of cognitive and functional decline among persons living with dementia. Neighborhood social environments are well-known to support or hinder PA among older adults, but their associations with PA among persons living with dementia remain poorly understood. This study examines how neighborhood characteristics (affluence, deprivation, safety, friends, relatives, cohesion, and disorder) relate to PA among U.S. community-dwelling persons living with dementia. RESEARCH DESIGN AND METHODS: We used 2006-2018 Health and Retirement Study data merged with census-tract data from the Contextual Data Resource. The analytic sample included 2,031 respondents classified as having dementia. PA was measured as a summary score reflecting activity frequency and intensity (light, moderate, and vigorous), along with binary indicators for being "regularly active" (≥1×/week) at each intensity. We used negative binomial regression to model total PA and logistic regression for intensity-specific activity. RESULTS: Neighborhood friendships were associated with higher overall PA score (B = 0.28; 95% CI = 0.16-0.41) and regular engagement across intensity levels. Social cohesion was also linked to increased total activity (B = 0.16; 95% CI = 0.03-0.29) and light PA (OR = 1.31; 95% CI = 1.01-1.71). Affluent neighborhoods supported moderate PA (OR = 1.39; 95% CI = 1.08-1.77), while having nearby relatives was associated with lower odds of vigorous activity (OR = 0.61; 95% CI = 0.42-0.88). No significant associations were observed for neighborhood deprivation, disorder, or safety. DISCUSSION AND IMPLICATIONS: Our findings provide empirical evidence for the importance of neighborhood social resources as facilitators of sustained PA among persons living with dementia and highlight neighborhoods as key components of the continuum of dementia care.

  PublisherOA PDFDOI

• How childhood state education quality shapes the risk of cognitive impairment in mid‐to‐later life

  Alzheimer s & Dementia Behavior & Socioeconomics of Aging · 2026-01-12

  articleOpen access

  Introduction: Education is a key predictor of cognitive impairment, yet most research focuses on educational attainment rather than educational quality as an early-life determinant. Methods: We linked data from the 2000-2020 Health and Retirement Study to historical records on state public education systems. Using multinomial logistic regression, we examined whether state-level education quality in childhood-measured by funding sources and educational resources-was associated with the incidence of cognitive impairment, with or without dementia, among Black and White adults aged 55 and older. Results: White adults who grew up in states with more heavily state-funded education systems had an increased risk of cognitive impairment. Greater state-level educational resources were associated with a decreased risk of cognitive impairment among both White and Black adults. Associations did not differ by race. Conclusion: State-level educational quality is an important determinant of later-life cognitive impairment risk for White and Black adults.

  PublisherDOI

• The relationship between housing, neighborhood and community infrastructure and older adult depression in Colombia

  Wellbeing Space and Society · 2026-01-10

  articleOpen accessSenior author

  • Home, neighborhood and community infrastructure is associated with older adults’ depression in different ways across urban and rural contexts in Colombia. • In urban areas, poor housing materials were associated with higher depression, while access to neighborhood amenities and community infrastructure was associated with lower depression for Colombian older adults. • Access to neighborhood amenities was associated with lower depression among rural older adults. • Findings highlight the need for context-specific interventions that address environmental disparities in low- and middle-income countries. Colombia is undergoing rapid population aging, yet its infrastructure to support healthy aging is limited. This study examines the associations between environmental conditions—home, neighborhood, and community infrastructure—and depression among older adults, separately for urban and rural settings. Using data from the 2015 SABE-Colombia survey, a nationally representative study of adults aged 60 and older, we analyzed depressive symptoms (GDS-15) in relation to home disorder, housing materials, neighborhood disorder, neighborhood amenities, and community infrastructure. Among urban older adults, poorer housing materials and fewer neighborhood amenities were significantly associated with higher depression scores. In rural areas, greater access to neighborhood amenities was associated to lower depression. Home and neighborhood disorder was not significantly associated with depression in either setting. These findings highlight the importance of examining environmental domains both independently and jointly, and of accounting for rural–urban differences when studying environmental determinants of mental health. The results highlight how contextual variation in infrastructure and housing quality can shape depression in later life in Colombia and may have broader relevance for other Latin American countries.

  PublisherDOI

• Exposure to Ambient Heat and Kidney Function in the Health and Retirement Study

  Innovation in Aging · 2025-12-01

  articleOpen accessSenior author

  Abstract Increased heat events are one of the defining characteristics of climate change affecting human health. The kidney’s role in homeostasis makes them particularly susceptible to heat, especially in older populations in which kidney function is declining. Using data from the Health and Retirement Study (HRS) Venous Blood Study (N = 9,933), we linked respondents to census tract level daily heat index from 7 days prior to blood collection. Kidney function was assessed with estimated glomerular filtration rate based on serum creatinine (eGFRcr). The average age of our analytic sample was 69 years (SD = 10). About 18% of the sample would be classified as having chronic kidney disease based on an eGFRcr < = 60 mL/min/1.83m2. Using linear models with cluster-adjusted standard errors, and controlling for age, gender, race/ethnicity, education, and urbanicity, we found that each unit increase in prior 7-day average heat-index was associated with a decreased eGFRcr of 0.04 (95% CI: -0.06, -0.02). We also categorized heat index days into cautionary (heat index > 80, the level at which the National Weather Service reports fatigue is possible) and extreme cautionary levels (heat index>90, the level at which NWS reports sunstroke, muscle cramps, and/or heat exhaustion is possible). We found that more days at cautionary level was associated with -0.96 lower (95% CI: -2.0, 0.05) eGFRcr and more days at extreme cautionary levels was associated with -2.5 lower (95% CI: -3.7, -1.3) eGFRcr. Our findings suggest kidney function in older adults can be adversely affected by exposure to short-term high heat.

  PublisherOA PDFDOI

• Sex variation in the relationship between <i>APOE</i> ε4, cognitive decline, and dementia

  Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring · 2025-04-01

  articleOpen access

  Abstract INTRODUCTION We examine if the relationship between apolipoprotein E ( APOE) ε4 and cognitive decline and dementia onset differs by sex in non‐Hispanic White and Black respondents from the Health and Retirement Study. METHODS We used race‐stratified linear mixed models to estimate cognitive decline and Cox proportional hazards models to estimate time to dementia onset. Sex differences were estimated using interaction terms. RESULTS APOE ε4 was associated with cognitive decline ( b = −0.4) and dementia onset (hazard ratio [HR] = 1.48) in White adults, and cognitive decline ( b = −0.5) in Black adults. The relationship between APOE ε4 and cognitive decline or dementia onset did not differ by sex in either group. DISCUSSION Our findings question a key hypothesis in the field—that female APOE ε4 carriers experience faster cognitive decline and earlier dementia onset than their male counterparts—and highlight the importance of using probability samples to reduce survivor and participation bias commonly found in genetics research. Highlights White apolipoprotein E ε4 allele ( APOE ε4) carriers had faster cognitive decline and earlier dementia onset. Black APOE ε4 carriers had faster cognitive decline. These patterns did not vary by sex for either Black or White adults.

  PublisherOA PDFDOI

• Population Intervention Effects of Spatial Social Polarization on Dementia Disparities

  Innovation in Aging · 2025-12-01

  articleOpen access

  Abstract Spatial social polarization (SSP), the unequal geographic distribution of privilege and deprivation, may contribute to disparities in dementia prevalence and incidence. This study used the Index of Concentration at the Extremes (ICE) to measure SSP across five domains: race, income, education, primary language, and homeownership. Using a 20% sample of 2019 Medicare claims data (N &amp;gt; 4 million), we applied Population Intervention Models (PIMs) with the parametric g-formula to estimate dementia outcomes under hypothetical scenarios where SSP disparities were eliminated. These counterfactual simulations compared current exposure distributions to idealized scenarios, such as universal privilege or universal deprivation. Dementia prevalence was 8%, with incidence at 3.5%, disproportionately affecting Black populations. In the hypothetical scenario where all individuals lived in high-income neighborhoods, dementia incidence was projected to decrease by 0.4%, whereas a scenario where all individuals lived in income-deprived neighborhoods was projected to increase incidence by 0.5%. In a scenario where all individuals lived in predominantly White neighborhoods, dementia incidence was projected to decrease by 0.1%, whereas residence in predominantly Black neighborhoods was projected to increase incidence by 0.3%. Similarly, a scenario where all individuals lived in neighborhoods with higher educational attainment was associated with a projected 0.4% reduction in dementia incidence, while lower educational attainment corresponded to a projected 0.8% increase in prevalence. These findings illustrate potential population-level impacts of SSP disparities under counterfactual scenarios and provide insight into how neighborhood factors may shape dementia risk.

  PublisherOA PDFDOI

• Living in Historically Redlined Neighborhoods and the Cognitive Function of Black and White Adults

  Journal of Aging and Health · 2025-01-18

  articleOpen access

  ObjectivesWe determined if living in historically redlined neighborhoods was associated with level and change in cognitive functioning and if this association differed for Black and White older adults.MethodsWe linked the Health and Retirement Study 1998-2018 data to redlining scores from the Historic Redlining Indicator data. Our sample included adults aged 50 years and older (24,230 respondents, 129,618 person-period observations). Using three-level linear mixed models, we estimated the relationship between living in historically redlined neighborhoods on level and change in cognitive functioning for pooled and race-stratified samples.ResultsResidents of historically redlined "Declining" and "Hazardous" neighborhoods had lower cognitive functioning scores compared to residents of "Best/Desirable" neighborhoods. Among Black adults, living in "Hazardous" neighborhoods was associated with slower declines in cognitive functioning compared to living in "Best/Desirable" neighborhoods.DiscussionHistorical redlining is associated with older adults' cognitive functioning, underscoring the importance of sociohistorical context for the neighborhood-cognition relationship.

  PublisherOA PDFDOI

• Fine Particulate Matter Air Pollution and Lung Function Among U.S. Older Adults

  Innovation in Aging · 2025-12-01

  articleOpen accessSenior author

  Abstract Although prior research has found associations between fine particulate matter air pollution (PM2.5) and lung function among older adults, the findings have come from region-specific studies and have focused on individuals with pre-existing conditions. Furthermore, it remains unclear how individual health behaviors contribute to variations in vulnerability to PM2.5 exposure. This study examines the association between outdoor PM2.5 levels and lung function in a nationally representative and diverse sample of U.S. older adults from the 2016 and 2018 Health and Retirement Study (HRS). Our study sample includes 7,119 adults aged 65 and older linked with 2015 and 2017 census tract-level annual average PM2.5 concentrations from the HRS Contextual Data Resource. Regression models examined the cross-sectional association between PM2.5 concentration quartiles and lung function, measured through the peak flow meter tests. Older adults living in areas with the second-highest PM2.5 quartile had significantly lower lung function (b = -1.95, p = 0.013) compared to those in the lowest quartile, even after adjusting for demographic, socioeconomic, and health characteristics. Living in the highest PM2.5 quartile was not associated with lower lung function (b = -0.53, p = 0.505). However, in this quartile, those who were physically active exhibited worse lung function compared to those who were physically inactive (predicted lung function: 80.91 vs. 83.49, p = 0.000). These findings highlight the negative impact of PM2.5 on older adults’ lung health and suggest that physical activity, potentially indicative of increased outdoor exposure, may heighten vulnerability to air pollution in highly polluted areas.

  PublisherOA PDFDOI

• Living in historically redlined neighborhoods and biological aging among older adults

  The Journals of Gerontology Series A · 2025-09-02

  articleOpen accessSenior author

  Living in historically redlined neighborhoods has deleterious effects on aging-related health outcomes, yet little is known about how historical redlining affects the physiological aging process and the role of current neighborhood socioeconomic status (SES) on this relationship. This study determined if living in historically redlined neighborhoods was associated with biological age and if this association was mediated by neighborhood-level socioeconomic status. We linked the Health and Retirement Study 2016 Venous Blood Study (HRS-VBS) to redlining scores from the Historic Redlining Indicator data and census tract-level data from the 2014-2018 American Community Survey 5-year estimates (N = 6466 respondents). Multivariable linear regression models were used to assess differences in biological age among older residents of historically redlined neighborhoods graded "Best/Desirable," "Declining," and "Hazardous." Mediation analyses using the khb method were used to assess whether measures of neighborhood affluence and disadvantage explained differences in biological age by historical redlining grade. Older residents of "Declining" or "Hazardous" neighborhoods were about 2.5 and 1.7 years older biologically than residents of "Best/Desirable" neighborhoods. Neighborhood SES mediated this relationship, with affluence explaining approximately 20% and disadvantage explaining about 8% ("Declining") and 25% ("Hazardous") of the association between historical redlining and biological age. Our study highlights the importance of evaluating measures of physiological functioning and current neighborhood conditions to clarify existing health disparities among residents of historically redlined neighborhoods.

  PublisherDOI

• Male Spousal Caregivers Are Increasing, but Only in Less Demanding Care Roles

  Journal of Marriage and the Family · 2025-09-26 · 3 citations

  articleOpen accessSenior author

  ABSTRACT Objective To determine if there are gender differences in trends in spousal caregiving among older adults. Background While some evidence suggests that men are increasingly adopting caregiving roles, this trend has yet to be demonstrated in population‐representative data, and little is known about the types of caregiving tasks men are providing. Method Using data from the Health and Retirement Study (2002–2018), we investigate trends in the prevalence of spousal caregiving among both men and women. We also analyze subcategories of caregiving, including primary versus secondary caregiving, activities of daily living versus instrumental activities of daily living, and high‐intensity versus low‐intensity care. Results While we observe no change in spousal caregiving rates among women over time, the prevalence of male spousal caregivers rose from approximately 6% to 11% between 2002 and 2018. However, this increase is mostly reflected in secondary, instrumental, and low‐intensity caregiving roles. The characteristics of male spousal caregivers have also shifted, with growing representation among Hispanic individuals, younger cohorts, highly educated men, those who are less depressed, more affluent, and those caring for older spouses. Conclusion The number of male spousal caregivers has been increasing, but significant gender disparities persist, particularly in primary caregiving, activities of daily living, and intensive caregiving roles.

  PublisherDOI

Recent grants

• NIH Grant K99AG039528

  NIH · $176k · 2014

• Network on Life Course Health Dynamics and Disparities in 21st Century America Renewal

  NIH · $4.8M · 2014–2029

• University of Southern California Alzheimer’s Disease (AD) and Alzheimer’s Disease-Related Dementias (ADRD) Resource Center for Minority Aging Research (USC AD/ADRD RCMAR)

  NIH · $15.2M · 2012–2028

• Neighborhood Context, Social Relationships, and Health: Examining the Pathways

  NIH · $738k · 2014–2018

• NIH Grant R21AG045625

  NIH · $447k · 2016

Frequent coauthors

• Eileen M. Crimmins

  University of Southern California

  80 shared

• Margarita Osuna

  University of Southern California

  26 shared

• Katrina M. Walsemann

  University of Maryland, College Park

  24 shared

• Jung Ki Kim

  University of Southern California

  19 shared

• Y Zhang

  Nanjing University

  18 shared

• Yeon Jin Choi

  Nongwoo Bio (South Korea)

  17 shared

• Lauren Brown

  University of Nevada, Reno

  16 shared

• Stephen Frochen

  Issues Research

  15 shared

Awards & honors

• Fellow of the Gerontological Society of America