黑人成年人痴呆风险的结构性和社会决定因素:基于社区的系统动态方法的结果
Jean-Francois Trani1,2,3,4, Ramkrishna K Singh5, Alexis I B Walker5
1School of Public Health, Washington University in St. Louis, St. Louis, Missouri, USA.
概括
黑人成年人认为经济困难和结构性种族主义是痴呆的主要风险因素. 解决这些差异需要针对社会经济障碍的干预措施和改善医疗保健准入,以减轻认知健康影响.
科学领域:
- 神经科学是一个神经科学.
- 公共卫生 公共卫生
- 社会学 社会学 社会学
背景情况:
- 阿尔茨海默病和相关痴呆症 (ADRD) 不成比例地影响黑人美国人.
- 了解黑人成年人的痴呆风险因素对于解决健康差异至关重要.
研究的目的:
- 通过一种参与式的方法,检查圣路易斯黑人成年人对痴呆症的感知风险因素.
- 为了确定痴呆症风险影响和变化的共享模型,基于邻里剥夺.
主要方法:
- 36个基于社区的系统动态 (CBSD) 研讨会,涉及234名参与者.
- 参与者共同创建因果循环图来绘制痴呆症的影响.
- 用生态方法分析图表并确定核心模型和变异.
主要成果:
- 经济困难 (低收入,失业) 被确定为痴呆风险的主要驱动因素,因为减少了医疗保健的获得.
- 来自贫困地区的参与者强调需要改善健康教育,公共交通,医疗保健和就业机会.
- 结构性种族主义被确定为一种普遍的力量,加剧了其他风险因素,如贫困和不良医疗保健.
结论:
- 解决痴呆症差异需要针对可修改的社会和结构驱动因素,包括经济困难和种族主义.
- 量身定制的公共卫生干预应侧重于扩大医疗保健准入,减少社会经济障碍,减轻种族主义对认知健康的影响.
- 需要多层次的干预,从社区计划到政策变化,以抵消不利的循环,并减少资源不足社区的痴呆风险.
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