Discrimination and bias found in dementia care | Alzheimer's Prevention Registry

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May 19, 2021

Discrimination and bias found in dementia care

By Alzheimer's Prevention Bulletin

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The Alzheimer’s Association released its 2021 Facts and Figures report and the statistics are daunting. More than six million Americans currently live with Alzheimer’s disease. By 2050 that number is projected to reach 12.7 million.

This year’s report is full of statistics about the incidence and prevalence of Alzheimer’s and dementia and its impact on society. It also includes a special report entitled Race, Ethnicity and Alzheimer’s in America which we will review here.

The special report explores the experiences of Black, Hispanic, Asian and Native Americans related to Alzheimer’s and dementia care. All four groups report some level of discrimination when accessing care as patients and caregivers.

Disparities in dementia care

Reducing or eliminating discrimination has been a focus of the US Department of Health and Human Services’ Healthy People Initiative for the last 20 years, yet significant health and health care disparities still exist. Why is this?

Let’s start by defining the types of disparities.

  • Health disparity – When one group has a higher incidence of disease, disability or mortality relative to another group. For example, there is a higher incidence of asthma and diabetes in Blacks and Native Americans than Whites.
  • Health care disparity – When one group faces more barriers to accessing care than another. This has been documented in minority and low-income communities.
  • Implicit bias - Cultural and language barriers that may impact the provision of care.

The report shows that awareness and understanding of dementia, cultural stigmas, and the ability to access care vary widely depending on race, ethnicity, geography and socioeconomic status. These disparities also impact research where minority populations are often underrepresented in clinical trials.

The Alzheimer’s Association survey reported:

  • Black, Hispanic and Asian Americans see discrimination as a barrier to receiving care.
  • Black Americans lack trust in research and half doubt advances in treatments will be shared.
  • Hispanic, Black and Native Americans are twice as likely as Whites to say they would not see a doctor for memory and thinking problems.
  • Caregivers also report discrimination as a barrier to care. A majority of Native American, Black and Hispanic caregivers reported experiencing racial discrimination when managing care for family members and clients.

Addressing discrimination and bias

The bottom line is there is much more work to do to eliminate these disparities. The Alzheimer’s Association recommends the following actions to address discrimination and bias:

  • Prepare providers to care for a racially and ethnically diverse population of older adults
  • Increase diversity in dementia care
  • Increase diversity of participants for research and clinical trials

The report stresses that health care providers and researchers must remain committed to addressing these disparities for older adults. It recommends actions be taken to ensure the burden of Alzheimer’s disease and dementia is not made worse by discrimination and unequal access to health care.

Read the full report for more details about the findings and the latest statistics on Alzheimer’s disease.