Report from UsAgainstAlzheimer’s and Urban Institute highlights the importance of addressing the social determinants of health in race to cure and prevent Alzheimer's

Washington, D.C. (November 17, 2020) – A new report released today highlights the effects of where people live on their brain health, finding deep social inequities in counties most highly impacted by Alzheimer’s disease among Latinos and Blacks.

The report by UsAgainstAlzheimer’s and the Urban Institute explores the social determinants of health in the counties most impacted by Alzheimer’s among Latinos and Blacks in the Medicare Fee-for-Service program. It compared counties with the highest prevalence of Alzheimer’s among Blacks, Latinos, and non-Latino Whites against counties with the lowest prevalence among these populations to identify trends related to the social determinants of health and risk factors for Alzheimer’s.

“This report offers a unique perspective on how geography and the social determinants of health impact the prevalence and effects of Alzheimer’s and related dementias,” said Dr. David Satcher, the 16th U.S. Surgeon General. “It represents a critical step in broadening our nation’s ability to identify high-impact, underserved areas and in directing resources and strategies where they are needed most to ensure the brain health of all communities.”

Levels of education, income, and food insecurity, plus the state of the physical environment — collectively known as social determinants of health — are emerging as key influences on dementia risk. These factors are directly shaped by where people are born, raised, and live.

“Where people live matters when it comes to health disparities and social determinants of health, and the effects of these factors are under-recognized and under-appreciated in our national response to effectively treat and prevent Alzheimer's,” said Jason Resendez, executive director of the UsAgainstAlzheimer’s Center for Brain Health Equity and contributing author of the report.

Counties with the highest prevalence of Alzheimer’s among Blacks and Latinos are more likely to have worse social determinants of health compared to counties with the lowest prevalence of Alzheimer's among these communities.

For example, counties with the highest prevalence of Alzheimer’s among these populations had:

• Higher percentages of families living in poverty
• Lower percentages of adults with a bachelor’s degree
• Lower median household incomes
• Lower rates of health insurance coverage for people under age 65
• Less access to exercise opportunities, such as parks

“In recent years, research on Alzheimer’s and related dementias has made great strides in increasing the understanding of the causes and origins of the disease, including genetic factors,” said Stipica Mudrazija, Ph.D., the report’s lead author and a senior research associate with the Urban Institute. “But there has been significantly less research on the impact of place and the social determinants of health that may shape Alzheimer’s risk.”

Understanding the geographic impacts of Alzheimer’s is critical given the growing burden the disease is placing on families, the nation’s healthcare system, and its economy. It is estimated that by 2030, nearly 40 percent of the more than 8 million Americans living with Alzheimer’s or a related dementia will be Latino or Black.

“Social determinants of health represent potential barriers to Alzheimer's public health interventions and research access that must be addressed,” said Stephanie Monroe, executive director of AfricanAmericansAgainsAlzheimer’s, a network of UsAgainstAlzheimer’s. “With further research and investment, a place-based framework that incorporates the social determinants of health could help improve access to brain-health-related health services, research opportunities and public health interventions for under-resourced communities.”

This report is part of UsAgainstAlzheimer’s larger strategy for driving brain health equity and builds on its recently established Center for Brain Health Equity, which is supported in part by the Centers for Disease Control and Prevention’s Healthy Brain Initiative. 

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About UsAgainstAlzheimer’s

UsAgainstAlzheimer’s (UsA2) is a disruptive advocacy and research-focused organization that is pushing for expanding treatments and accelerating towards a cure for Alzheimer’s disease. UsA2’s transformative programming is laser-focused on proactive brain health across the lifespan and understanding what matters most across the lived experiences of those affected by Alzheimer’s in the service of preventing, treating and curing this disease. We are working to ensure that all communities have their voices heard and get a chance to be brain healthy from the earliest years while building resistance against possible cognitive decline.