The Hidden Link: How Life Factors Shape Brain Health - Part 2

Did you know that older Black Americans are twice as likely to develop Alzheimer’s disease as their white counterparts, and Latin Americans are one-and-a-half times as likely?

In Part 1 of this blog, we explored how the environments we live in shape stress levels and how chronic stress exposure affects brain health. Now, we’re going to dive deeper into how these same environmental factors drive disparities in brain health.

Leah Daley, Education Program Manager at the Alzheimer’s Foundation of America, emphasizes that, like most racial health disparities, these differences are not due to biology. Instead, they reflect the long-term effects of discrimination, which shapes who has access to resources, opportunities, and safe, stable environments.

To better understand how this happens, let’s return to the social determinants of health:

Education Access and Quality

As we discussed in Part 1, access to education helps build “cognitive reserve,” which can reduce the risk of developing Alzheimer’s and other forms of dementia over time.

People of color have long been excluded from educational institutions in the United States. Racial segregation in schools wasn’t outlawed until 1954, when the Supreme Court issued its Brown v. Board of Education decision. Even after this, integration was slow and often met with strong resistance.

Despite progress made in access, educational quality remains highly unequal, and Black students are far more likely to attend underfunded school districts than their white peers.

Health Care Access and Quality

Although Black and Latin Americans are more likely to develop Alzheimer’s disease and other forms of dementia, they are less likely to receive a timely diagnosis.

Delays in diagnosis limit access to early interventions, which are often most effective in the initial stages of the disease. Over time, this can lead to advanced symptoms, increased hospitalization, and more complex care needs. Ultimately, this places a greater burden on both people living with dementia and their caregivers.

Neighborhood and the Built Environment

While legal residential segregation ended when the Civil Rights Act of 1968 was signed into law, most Americans still live in segregated neighborhoods. As a result, there are significant racial differences in access to education, employment opportunities, healthcare, green spaces, and other community resources.

Black Americans are also less likely to feel safe in their communities, which can limit opportunities for physical activity, social engagement, and accessing services, all of which support long-term brain health.

Social and Community Context

Experiences of discrimination are a significant and often overlooked source of chronic stress. Repeated exposure to discrimination activates the body’s stress response and, over time, these exposures take a toll on the body and brain.

At the same time, community engagement and support systems can be a powerful buffer against the negative effects of stress. However, structural barriers can limit access to these supports, particularly in under-resourced communities.

Economic Stability

Economic inequality affects people of all races, but its effects are more pronounced for people of color. While the racial wealth gap has narrowed somewhat in recent decades, the median Black family’s net worth ($44,100) is a mere 15.5% of the median white family’s net worth ($282,310). For Latin American families, the gap is slightly less pronounced, with the median family holding 21.8% ($62,120) of the median white family's wealth.

Financial strain is one of the most persistent forms of chronic stress, impacting everything from housing and nutrition to healthcare access and caregiving capacity. In the long run, this contributes to worse health outcomes, including increased risk for cognitive decline.

When we look at all these factors, there is a clear pattern: the social and environmental conditions that drive chronic stress are unequally distributed along racial and socioeconomic lines. This is a direct result of policies and practices that shape where people live, what resources they can access, and what opportunities are available to them.

Inequities in brain health cannot be addressed through medical treatment alone. Instead, we must look upstream and work to change the social conditions that create and sustain health inequities in the first place.

At the Normandale Center for Healing & Wholeness, we are committed to supporting and uplifting all people living with dementia and their caregivers. Our staff of highly skilled social workers is available for one-on-one care consultations, which are offered on a sliding fee scale to ensure this service is available to all, regardless of ability to pay. In addition, we offer low-cost, evidence-based workshops, free educational sessions, and monthly caregiver support groups, which provide opportunities for connection with others on a similar journey. If you are interested in learning more about any of these services, please contact us via e-mail at info@normandalecenter.org, via phone at 952-929-1698, or use the contact form on this website.

One upcoming opportunity to learn about brain health is the Melodies for the Mind: How Music Supports the Aging Brain workshop, offered on Saturday, September 12^th, as part of our monthly Second Saturday for Caregivers program. This workshop, presented by Carolyn Beck, MT-BC, of Keynote Music Therapy, is free and will be followed by optional support group sessions. For more information, please follow this link.