“Entrenched systemic racism” is a significant risk factor for Alzheimer’s disease and dementia in non-White Americans, the Department of Health and Human Services (HHS) claimed in its 2022 update on how to fight the disease.
The HHS’ “National Plan to Address Alzheimer’s Disease” said Black, Hispanic and low-income populations are more likely to face health-related risk factors that contribute to Alzheimer’s and said this disparity is due to “structural inequities” that are the result of racism. Those inequities include “underinvestment in education systems, less walkable communities, decreased access to nutritious food, barriers to health care access and low quality of care in their communities.”
The report recommended that one way to reduce the risk of Alzheimer’s is to focus on “cultural competence and equity.”
“This requires that addressing SDOH [social determinants of health], entrenched systemic racism, and other forms of discrimination be prioritized, rather than focusing solely on individual behaviors,” the report said.
The Alzheimer’s Association, a nonprofit that advocates research and early detection of the disease, indicates that age is the biggest risk factor – the group says 73% of people with Alzheimer’s or dementia are 75 years and older but also notes that two-thirds are women.
Black people are twice as likely as White people to develop Alzheimer’s, and Hispanics are about 1.5 times more likely than Whites to get it.
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The group says high blood pressure and diabetes are suspected risk factors and said high blood pressure is “more prevalent in the African American community,” while diabetes is “more prevalent in the Hispanic community.”
“In fact, some studies suggest that after adjusting for health and socioeconomic risk factors, no differences in Alzheimer’s prevalence exist,” the group says.
The HHS report appears to conclude that these differences in overall health are a direct result of racism, which puts non-White people at a higher risk of Alzheimer’s disease and related dementia (AD/ADRD).
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“These disparities in the prevalence of risk factors – which are grounded in generations of structural racism and inequality in health care – contribute to disparities in the incidence of AD/ADRD that are further amplified by disparities in AD/ADRD diagnosis, treatment, and access to care and resources,” the report said. “It is therefore of critical importance that research, interventions, and infrastructure to address modifiable risk factors for AD/ADRD are culturally responsive and grounded in improving equity by addressing the social determinants of health (SDOH).”
“Accordingly, future efforts to reduce the burden of risk factors for AD/ADRD will focus on understanding not only what actions individuals can take to reduce their risks, but also what community and system-level investments are needed to facilitate risk reduction and support healthy aging,” it said.