Lifetime Patterns of Earned Income Tax Credit Eligibility and Cognition: A Sequence Analysis Approach.

Abstract

The Earned Income Tax Credit (EITC) is the largest poverty-alleviation program in the U.S. and has well-documented short-term health benefits. However, little work has characterized long-term EITC eligibility or evaluated associations with cognition. In a retrospective cohort study using data from the National Longitudinal Survey of Youth 1979 (1979-2018; analyzed in 2025), each year from ages 25 to 45 was categorized as EITC eligible, ineligible owing to no income, or ineligible because income exceeded the threshold. Sequence and cluster analysis identified groups with similar EITC eligibility trajectories. Associations between trajectory groups and cognition around age 48 years were examined using linear regressions adjusted for sociodemographic characteristics. Among 5,021 individuals, 11 EITC eligibility clusters were identified: mostly above threshold (ref); 5 EITC graduates trajectories (eligible followed by above-threshold income); 1 prolonged eligibility cluster; 1 intermittent, then consistent eligibility cluster; and 3 clusters characterized by long periods of no income. Compared with the reference group, the graduate clusters were associated with similar cognition (e.g., EITC early graduates: β=0.006, 95% CI= -0.12, 0.10). In contrast, participants with prolonged eligibility or intermittent and then consistent eligibility had worse cognition. Clusters characterized by long periods of no income had the poorest cognition (e.g., mostly no income: β= -0.38, 95% CI= -0.52, -0.23). Results suggest that temporary EITC may not be associated with poorer later-life cognition, while prolonged financial adversity, particularly for those with little or no labor force participation, may be associated with worse cognitive outcomes.