TY - JOUR
T1 - Dementia Risk and Social Determinants of Health Among Adults Racialized as Black
T2 - A Community-Based System Dynamics Perspective
AU - Trani, Jean Francois
AU - Hart, Robbie
AU - Walker, Alexis I.B.
AU - Safi, Meena
AU - Singh, Ramkrishna K.
AU - Zhu, Yiqi
AU - Babulal, Ganesh M.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
KW - Community-Based System Dynamics
KW - Dementia
KW - Racial disparities
KW - Social and structural determinants of health
KW - Structural racism
UR - http://www.scopus.com/inward/record.url?scp=85210590477&partnerID=8YFLogxK
U2 - 10.1007/s40615-024-02242-3
DO - 10.1007/s40615-024-02242-3
M3 - Article
C2 - 39612114
AN - SCOPUS:85210590477
SN - 2197-3792
JO - Journal of Racial and Ethnic Health Disparities
JF - Journal of Racial and Ethnic Health Disparities
ER -