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Brain Health

Social Determinants of Health and Dementia

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DO NOT DELETE BETWEEN THESE LINES

The conditions in places where people are born, live, learn, work, and play are known as social determinants of health. These conditions can have a profound effect on a person’s health, including their risk for Alzheimer’s disease and related dementias. Lower levels of education, higher rates of poverty, and greater exposure to adversity and discrimination may also increase the risk of dementia. Understanding the disparities in Alzheimer’s disease and related dementias is the first step toward developing prevention strategies and targeting services to those most at risk for developing the disease. 

By 2060, the number of Alzheimer’s disease cases is predicted to rise to an estimated 14 million people, with minority populations being affected the most.

  • Cases among Hispanics will increase seven times over today’s estimates. 
  • Cases among Non-Hispanic Blacks will increase four times over today’s estimates. 
  • Women are nearly two times more likely to be affected by Alzheimer’s disease than men.  

There have been many studies on social and economic factors that may contribute to a person’s health status, including a person’s risk for dementia. In 2019, DC Health released a Health Equity Report for the District of Columbia focusing on social and structural determinants of health in the District. The report highlights nontraditional key factors that affect health, which include education, employment, income, housing, transportation, food environment, medical care, outdoor environment, and community safety. 

Social Determinants of Health and Dementia

Social Determinants

Health Disparity vs. Health Care Disparity

Health disparity: a higher burden of illness, injury, disability, or mortality experienced by one group relative to another. 

Health care disparity: differences between groups in health insurance coverage, access to and use of care, and quality of care. 

Both health disparity and health care disparity are differences that are not explained by variations in health needs, patient preferences or treatment recommendations and are closely linked with social, economic and/or environmental disadvantages. 

Barriers to Equity in Alzheimer’s and Dementia Care 

A Special Report on Race, Ethnicity and Alzheimer’s in America published by the Alzheimer’s Association shows these populations reported higher rates of discrimination when seeking health care than non-Hispanic White Americans: 

  • 50% of Black Americans
  • 42% of Native Americans
  • 34% of Asian Americans
  • 33% of Hispanic Americans

Non-Hispanic White Americans reported discrimination at a much lower rate of 9%. With the projected increases in Alzheimer’s disease among minority populations, it is highly important to address healthcare inequities. 

  • Half or more dementia caregivers of color say they have faced discrimination when navigating health care settings for their care recipient: 
    • 63% of Native Americans
    • 61% of Black Americans
    • 56% of Hispanic Americans
    • 47% of Asian Americans
  • People of color want health care providers who understand their unique experiences and backgrounds, but fewer than three in five feel confident that they have access to culturally competent providers. 
  • Black Americans and Hispanic Americans are more likely to have Alzheimer’s and other dementias but are less likely to be diagnosed than White Americans. 
  • Only 53% of Black Americans trust that a future cure for Alzheimer’s will be shared equally regardless of race, color or ethnicity. 
  • Hispanic Americans are about 1.5 times more likely to have Alzheimer’s and other dementia than Whites, yet three in 10 Hispanics do not believe they will live long enough to develop dementia. 
  • Hispanics, Blacks and Native Americans are twice as likely as Whites to say they would not see a doctor if experiencing thinking or memory problems 

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