Structural and social determinants of health (S/SDOH) encompass a multitude of factors in the environments in which we live, learn, work, play, and worship. Structural determinants include upstream socioeconomic and political contexts such as laws and policies, cultural and societal values, and systemic racism and sexism. Social determinants, which are downstream from structural determinants, include factors such as access to education and health care and community social and built environments (e.g., racial and ethnic composition, park access, and transportation systems). S/SDOH are hypothesized to influence brain health and risk for Alzheimer’s disease and related dementias (ADRD) by influencing health-related exposures, behaviors, and outcomes across the life course, which in turn can result in disparities in ADRD risk in later life. S/SDOH are increasingly recognized in ADRD research due to evidence demonstrating that up to 40% of ADRD risk is attributable to modifiable risk factors (e.g., physical activity and diet) that are influenced by S/SDOH. In her presentation, Dr. Lilah M. Besser, Ph.D., M.S.P.H., from the University of Miami Miller School of Medicine will discuss conceptual frameworks for the connections between S/SDOH and brain health/ADRD outcomes and will describe related published and ongoing research, with a particular emphasis on neighborhood social and built environments.
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