Dementia Risk and Social Determinants of Health Among Adults Racialized as Black

A Community-Based System Dynamics Perspective

Dados Bibliográficos

ID2073556
AutoresJean-Francois Trani (0000-0002-9187-0946, Conservatoire National des Arts et Métiers, autor correspondente), R Hart (0000-0002-8803-8059, Missouri Botanical Garden), Alexis I B Walker (Adelphi University), Meena Safi (Washington University in St. Louis), Rahul Singh (0000-0003-1823-5732, Washington University in St. Louis), Ramkrishna K Singh (0000-0001-9022-2317), Yiqi Zhu (0000-0003-3400-589X, Washington University in St. Louis), Ganesh M Babulal (0000-0001-7966-3509, Washington University in St. Louis)
Ano2024
Volume13
Fascículo1
Páginas264-274
Data de publicação2024-11-29
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoJournal of Racial and Ethnic Health Disparities (JOURNAL)
Identificadores do periódicoISSN: 2196-8837 • E-ISSN: 2197-3792
EditoraSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1007/s40615-024-02242-3
PMID39612114
OpenAlexW4404851457
IdiomaEN
Citações recebidas1
Referências citadas41

Background The aging population in the USA is projected to increase significantly, with a corresponding rise in dementia cases, particularly among racial minorities. This study examines the key drivers of racial disparities in dementia risk among older Black adults in the St. Louis area, a region characterized by entrenched structural racism. Utilizing a Community-Based System Dynamics (CBSD) approach, we engaged cognitively normal Black adults (age ≥ 45) to explore the complex interplay of social and structural determinants of health (S/SDOH) affecting dementia risk. Methods Eight CBSD workshops were conducted, during which participants identified and analyzed various factors influencing dementia risk through group model-building techniques. These workshops revealed multiple reinforcing and balancing feedback loops, highlighting the intricate relationships between trauma, health literacy, social isolation, education, healthcare access, and systemic racism. Results There were 59 participants with an average age of 64, a majority of women (88%) and college-educated (15.9 years) residing in areas with moderately severe deprivation. The resulting Causal Loop Diagrams underscored the impact of poverty, discrimination, and limited access to quality education and healthcare on dementia risk across the lifespan. Participants proposed actionable interventions, including health information campaigns, community mobilization, and improvements in public transportation and healthcare accessibility. Conclusion This study emphasizes the necessity of addressing S/SDOH to mitigate dementia risk among Black Americans. The findings call for targeted public health initiatives and policy changes to improve socioeconomic conditions and reduce racial disparities in dementia outcomes

Dementia · Environmental health · Health equity · Political science · Population · Poverty · Psychiatry · Psychological intervention · Public health · Racism · Social determinants of health · Socioeconomic status · Sociology · Dementia and Cognitive Impairment Research · Geriatric Care and Nursing Homes · Health disparities and outcomes · Medicine · Nursing · Psychology · Gerontology