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Impact of Structural Racism on Racial Disparities in Cognitive Impairment

结构性种族主义对认知障碍种族差异的影响

基本信息

批准号：
10572864
负责人：
Talha Ali
金额：
$ 11.71万
依托单位：
TUFTS UNIVERSITY MEDFORD
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-06-01 至 2028-02-29
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10572864
关键词：
3-Dimensional Accounting Address Adopted Adverse effects Affect Age Age Years Aging Alzheimer&apos s Disease Alzheimer&apos s disease related dementia American Area Belief Black American Black Populations Black race Buffers Cause of Death Censuses Chronic Clinical Trials Cognitive County Data Dementia Diagnosis Disease Management Disparity Economics Education Educational Status Elderly Environment Environmental Risk Factor Equity Exposure to Frequencies Future Goals Health Health Care Visit Health Services Research Health and Retirement Study Healthcare Home Home Care Services Hospitalization Housing Hypertension Impaired cognition Impairment Incidence Individual Institution Intervention Length of Stay Life Cycle Stages Link Measures Medicaid Medicare claim Mentors Methods Modeling Modification Neurobiology Obesity Observational Study Outcome Ownership Pathogenesis Pensions Persons Policies Policy Analysis Policy Maker Population Research Public Health Schools Quality of life Race Reduce health disparities Research Research Priority Resources Risk Risk Factors Skilled Nursing Facilities Social Justice Social Network Social support Source Statistical Data Interpretation Stress Structural Racism System Training United States Work black/white disparity cardiovascular health caucasian American cognitive function dementia care dementia risk design experience foster care functional decline functional disability health assessment health care availability health care service utilization health disparity health inequalities improved insight interest lifestyle factors negative affect neuropsychiatric symptom physical conditioning pollutant prevent protective factors psychosocial racial disparity racism resilience socioeconomic disparity statistics stressor toxicant

项目摘要

It cognitive estimated is estimated that 65% of individuals experience some level of cognitive impairment by 70 years of age. Within impairment, Alzheimer's disease and related dementias are a leading cause of death, affecting an 5.8 million Americans.Black Americans are twice as likely as White Americans to be diagnosed with cognitive impairment. And among older adults with cognitive impairment, Black, compared to White, individuals have worse cognitive function, greater functional disability, and more severe neuropsychiatric symptoms, indicating preventable racial disparities. Understanding preventing examining health disparities, using claims data to assess healthcare utilization, and policy analysis, sources of these disparities will provide great insight into and delaying cognitive impairment. The goal of the proposed K01 is to train the candidate in to build on her prior work, which has focused on interpersonal dynamics and social networks of older adults as risk factors for functional decline. practices, opportunities candidate The proposed research focuses on structural racism – the larger system of policies, and institutions that reinforces racial inequality by creating differential access to resources and – as a fundamental cause of racial disparities in cognitive impairment. Through this K01, t he will (1) link data from the US Census, Medicare claims, and the Health and Retirement Study, to examine how structural racism leads to health disparities in cognitive impairment and dementia; (2) develop an understanding of how population-based research can be leveraged to inform policies in health and non-health sectors for older adults; equity, is extensive domains design in across racism utilization and, the solutions training individual-level and (3) complete oursework in neurobiology of dementia, social justice and health methods in health services research, and policy modeling approaches. The Yale School of Public Health a phenomenal environment to pursue this training. The candidate's primary mentor, Dr. Danya Keene, has expertise in how structural racism in the domain of housing policies and practices, intersects with other of structura racism to create health inequalities. Dr. Heather Allore (co-mentor) is an expert in the and statistical analysis o observational studies and clinical trials for older adults, with a special interest racial disparities in the context of dementia. Dr. Belinda Needham (co-mentor) is an expert in health disparities the life course. The proposed project will examine the association between three dimensions of structural and risk of cognitive impairment, including dementia, and racial disparities in these outcomes; health care among individuals with cognitive impairment; and assess whether s ocial support, at the individual level, Medicaid expansion, at the structural-level, modify the adverse effects of structural racism. Consistent with research priorities of NIA, findings f rom this work will inform future multi-level interventions and policy to reduce health disparities in cognitive impairment (RFA: PA-15-349). Further, the combination of and research will serve as a spring board for the candidate's long-term goal to move the field beyond risk factors to evaluate and address structural-level risk factors for cognitive impairment. c l f

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