Impact of Historically Black Colleges and Universities on Late-life Cognition in Black Adults

项目总结/摘要 阿尔茨海默病和相关痴呆症（ADRD）的黑白不平等是一个紧迫的公共卫生问题 问题：在65-84岁的黑人成年人中，患病率几乎翻了一番。ADRD是导致死亡的主要原因， 美国，影响估计500万美国人。ADRD是一种进行性疾病， 控制思维、记忆和语言的大脑。与心脏病和癌症不同， ADRD正在上升。随着时间的推移，预计白色成人的ADRD患病率将下降，而黑人成人的患病率将上升。 高等教育是降低ADRD风险的一个强有力的社会决定因素。然而，黑人和白人之间的巨大不平等 ADRD在最高教育水平持续存在。不幸的是，大多数关于ADRD的国家代表性研究 都是白色成年人为了解决这种差异，我们必须考虑影响黑人的风险因素， 与白色人的经历相反，美国人的经历是独一无二的。尽管结构性种族主义被认为是一种基本的 由于高等教育的差距，很少有人知道，如果，以及在多大程度上，独特的黑人大学的经验， 影响黑人成年人的ADRD风险，特别是历史上的黑人学院和大学（HBCUs）。HBCUs 主要由黑人学生（76%）和黑人个人以及黑人社区组成 通过经济和文化赋权，增加社会和政治资本， 复兴和骄傲。因此，生命早期暴露于HBCU是一种有希望的和未探索的机制， 改善黑人成年人的晚年ADRD结果和不平等。 该K99/R 00研究提案利用三个大型、成熟的种族多元化国家小组数据集， 研究生命早期暴露于HBCU对ADRD血管危险因素的影响， ADRD和黑人成年人的全因死亡率;健康和退休研究（HRS），地理原因 中风研究中的种族差异（REGARDS）和人才项目。我们将应用准实验性的 方法来评估因果关系的影响（1）HBCU出席和完成相比，占主导地位的 白色机构（PWI），（2）通过教育程度与PWI相比的早期生活HBCU接近度，以及 (3)在大学年龄段，HBCU与PWI相比的州和联邦资助政策。 该研究计划是由一个特殊的多学科导师团队在大学的补充， 加州旧金山弗朗西斯科和培训活动，建立在候选人的背景，在种族主义有关的 通过提供以下方面的新培训进行研究：（1）ADRD的生命过程决定因素，（2）数据协调，以及（3） 社会和政策措施的因果效应。综合研究和培训计划将使申请人做好准备， 一个成功的独立流行病学研究职业生涯，专门从事结构性种族主义的研究， ADRD社会决定因素和不平等。这项研究符合NIA减少健康差距的战略 协调人口数据。这项提案的结果将为我们理解 独特的黑人大学经历作为黑人成年人认知弹性的来源。 OMB编号0925-0001/0002（修订版03/2020批准至02/28/2023）页码继续格式页码

PROJECT SUMMARY/ABSTRACT Black-White inequities in Alzheimer’s Disease and Related Dementia (ADRD) are a pressing public health problem: prevalence is almost double for Black adults aged 65-84. ADRD is a leading cause of death in the United States, affecting an estimated 5 million Americans. ADRD is a progressive disease impacting the parts of the brain that control thought, memory, and language. Unlike heart disease and cancer, death rates from ADRD are rising. ADRD prevalence is projected to decrease for White and increase for Black adults over time. Higher education is a strong social determinant of lower ADRD risk. However, large Black-White inequities in ADRD persist at the highest levels of education. Unfortunately, most nationally representative studies on ADRD are comprised of White adults. To address this disparity, we must consider risk factors that impact Black Americans uniquely as opposed to White experiences. Though structural racism is implicated as a fundamental cause of higher education gaps, little is known about if, and to what extent, uniquely Black college experiences influence ADRD risk in Black adults, specifically Historically Black Colleges and Universities (HBCUs). HBCUs are comprised of predominantly Black students (76%) and uplift Black individuals as well as Black communities through economic and cultural empowerment, increased social and political capital, and neighborhood revitalization and pride. Thus, early life exposure to HBCUs is a promising and unexplored mechanism that may improve later-life ADRD outcomes and inequities for Black adults. This K99/R00 study proposal leverages three large, well-established racially diverse national panel datasets to investigate the impact of early life exposure to HBCUs on vascular risk factors of ADRD, late-life incidence of ADRD, and all-cause mortality in Black adults; The Health and Retirement Study (HRS), Reasons for Geographic and Racial Differences in Stroke study (REGARDS), and Project Talent. We will apply quasi-experimental methods to evaluate the causal effects of (1) HBCU attendance and completion compared to a Predominantly White Institution (PWI), (2) early life HBCU proximity compared to a PWI through educational attainment, and (3) state and federal funding policy of HBCUs compared to PWIs during college-aged years. The research plan is complemented by an exceptional multidisciplinary mentorship team at the University of California San Francisco and training activities that build on the candidate’s background in racism-related research by providing new training in (1) life course determinants of ADRD, (2) data harmonization, and (3) causal effects of social and policy measures. The combined research and training plans will prepare the applicant for a successful independent epidemiology research career specializing in the study of structural racism as a social determinant of ADRD and inequities. This study aligns with NIA’s strategy for reducing health disparities and harmonizing population data. Findings from this proposal will provide critical insight into our understanding of uniquely Black college experiences as a source of cognitive resilience for Black adults. OMB No. 0925-0001/0002 (Rev. 03/2020 Approved Through 02/28/2023) Page Continuation Format Page