Health Equity
Optimizing health for the U.S. population requires eliminating disparities and addressing social determinants of health. Focusing on communities at greatest risk and eliminating barriers to quality health care services will deliver significant results. Cognitive health is no exception. Alzheimer's and other dementias disproportionately affect Black Americans, Hispanic Americans, Asian Americans, American Indian/Alaska Natives, members of the LGBTQ+ community and women.
Black Americans are about two times more likely than White Americans to have Alzheimer's and other dementias.
Hispanic Americans are about one and one-half times more likely than White Americans to have Alzheimer's and other dementias.
By 2050, Asian Americans are projected to comprise nearly 8% of those aged 65 and older.
Native Americans have high rates of chronic conditions, including conditions that are suspected risk factors for Alzheimer's, such as obesity, diabetes and hypertension.
Almost two-thirds of those living with Alzheimer's are women.
More health equity resources from the Alzheimer's Association:
- Advancing Health Equity Issue Map (PDF).
- Health Equity in Dementia — Using a Public Health Lens to Advance Health Equity in Alzheimer’s and Other Dementias (online curriculum).
- Hispanic Americans and Alzheimer's.
- LGBTQ+ Community Resources.
- Native Americans and Alzheimer's.
- Race, Ethnicity and Alzheimer's in America (PDF).
- Women and Alzheimer's.
Several studies reported at the 2022 Alzheimer’s Association International Conference (AAIC) demonstrated the impact of inequities on cognitive decline. Experiences of structural, interpersonal and institutional racism are associated with lower memory scores and worse cognition in midlife and old age, especially among Black adults. Socioeconomic deprivation, including neighborhood disadvantages and persistent low wages, is associated with higher dementia risk, lower cognitive performance and faster memory decline. Both summaries are available in English and Spanish.
What public health can do
- In addressing dementia, public health should identify underserved populations and those that experience a disproportionate burden of disease.
- Public health officials must learn about the impact of Alzheimer's and other forms of dementia on these populations.
- Public health must identify the local causes of these disparities and collaborate with community partners and stakeholders to develop initiatives to address them.
- Public health practitioners should be sure to identify culturally, linguistically and age appropriate strategies for people living with Alzheimer's and their caregivers.
- Public health should collaborate with or lead initiatives to ensure that government agencies that serve these populations are trained in appropriate and effective strategies.
Featured Resources | |
| Stanford Geriatric Education Center | Webinar Series: Ethnicity and the Dementias |
| State University of New York-Plattsburgh | To support caregivers in the St. Regis Mohawk Nation, an Alzheimer's Navigator delivers education and coordinates support groups throughout the area. Additional services (including respite, transportation assistance, and caregiving training) are offered. | |
| AZ | Banner Alzheimer's Institute | The Banner Native American Outreach program increases awareness of Alzheimer's and other dementias among Arizona's American Indian communities, and works to establish better connections among tribal health organizations and urban Indian communities. |
| MN | Minnesota Department of Health | Educated community health workers on the oral health needs of people living with Alzheimer’s and other dementias by developing a curriculum and partnering with institutions that train these workers. |
| MN | Department of Health | With legislative support, Minnesota Department of Health created new program focused on providing outreach and dementia education to African-Americans, African-born residents, and Asian and Hispanic populations. |
| MO | Missouri Department of Health and Social Services | Enhanced public awareness of cognitive health and dementia among African Americans in the southeast region of Missouri by conducting a multi-faceted social marketing campaign that provides culturally appropriate messaging and information on risks, early diagnosis, treatment, and community resources. |
| MO | Missouri Department of Health and Social Services | Promoted cognitive assessments and early diagnosis in partnership with Washington University and the existing Community Health Worker Advisory Body through incorporation of these topics into existing community health worker programs for diabetes, cardiovascular health, and women’s health. |
| NY | New York State Department of Health | To address disparities, the New York State Department of Health funded a two-year referral and outreach demonstration project that primarily serves African-American and Hispanic communities |
| OR | Aging and Disability Resource Center (ADRC) of Oregon | To promote early detection of Alzheimer’s disease among Hispanic populations, the Aging and Disability Resource Center (ADRC) of Oregon adapted an English-language fotonovela -- an educational tool with photos and a story narrative -- for Spanish-language communities. Involvement of promotoras enhanced cultural relevance. The Alzheimer's Association, Oregon Chapter, the Oregon Health Authority, and many other partners now promote and distribute the fotonovela to Spanish-speaking communities, in part through public health networks. |
| OR | Oregon Health Authority | Aging and Disability Resource Connection of Oregon published ¡Unidos Podemos! Enfrentando la pérdida de memoria en familia, a fotonovela for Spanish-speaking community members on caring for loved ones with Alzheimer’s disease. The Oregon Department of Human Services, Alzheimer's Association Oregon Chapter, and Oregon Health Authority now promote and distribute the fotonovela to Spanish-speaking communities and public health networks. |
| SC | South Carolina Department of Health and Environmental Control | South Carolina Department of Health and Environmental Control worked with the Alzheimer’s Association South Carolina Chapter to distribute 48,000 of the association’s Know the 10 Signs brochures through its regional offices to raise awareness, especially among African Americans. |
| TX | City of San Antonio | Published a column on Alzheimer’s disease in the local Spanish-language paper, with an emphasis on increasing awareness and promoting early detection and diagnosis. |
| WA | Washington State Department of Health | Implementing the Healthy Brain Initiative Road Map: A Toolkit for Public Health Organizations |
| WA | Washington State Department of Health | With the National Asian Pacific Center on Aging, the Washington State Department of Health tested University of Pennsylvania media messages with Asian American adults who may have concerns about changes in their aging parents’ memory or cognition. |