Association of state-level structural racism with subjective cognitive decline prevalence-Behavioral Risk Factor...

Area of Science:

• Public Health
• Sociology
• Gerontology

Background:

• Structural racism (SR) is a system of societal structures and policies that create and maintain racial inequality.
• Subjective cognitive decline (SCD) is a growing concern among aging populations, impacting quality of life and independence.

Purpose of the Study:

• To investigate the association between exposure to structural racism (SR) and subjective cognitive decline (SCD) in older adults.
• To explore potential differences in this association across racial and ethnic groups and age strata.

Main Methods:

• Utilized data from the 2010 Structural Racism-Related State Laws Database and the 2015-2016 Behavioral Risk Factor Surveillance System (n=184,731).
• Developed an exposure index based on 22 state laws across criminal justice, economics, healthcare, housing, immigration, and political participation.
• Employed adjusted mixed-effects logistic regression and effect measure modification models to analyze the relationship between SR exposure and self-reported SCD.

Main Results:

• No significant association was found between higher SR exposure and increased odds of SCD in the overall sample (OR=1.00).
• White and Black respondents did not show a significant difference in SCD odds related to SR exposure.
• Hispanic (OR=0.91) and Multiracial (OR=0.95) adults exhibited lower odds of SCD with greater SR exposure.
• Age-related differences emerged: younger Native Hawaiian/Other Pacific Islanders (OR=0.91) and older American Indian/Alaska Natives (OR=0.92) had lower SCD odds with increased SR exposure.

Conclusions:

• The study found no overall link between structural racism exposure and subjective cognitive decline in older adults.
• However, specific minority groups, including Hispanic, Multiracial, younger Native Hawaiian/Other Pacific Islanders, and older American Indian/Alaska Natives, demonstrated a protective association, with lower odds of SCD.
• Further research is needed to understand the complex, nuanced relationship between structural racism and cognitive health across diverse populations and age groups.