A lifetime of racism makes Alzheimer’s more prevalent in Black Americans

FREDERICKSBURG, Va. (AP) — Constance Guthrie is not yet dead, but her daughter has begun to plan her funeral.

It will be, Jessica Guthrie says, in a Black-owned funeral home, with the songs of her ancestors. She envisions a celebration of her mother’s life, not a tragic recitation of her long decline.

As it should be. Constance has lived 74 years, many of them good, as a Black woman, a mother, educator and businesswoman.

But she will die of Alzheimer’s disease, a scourge of Black Americans that threatens to grow far worse in coming decades.

Black people are more likely to develop Alzheimer’s than white people in the United States. They are less likely to be correctly diagnosed, and their families often struggle to get treatment from a medical system filled with bias against them.

About 14% of Black people in America over the age of 65 have Alzheimer’s, compared with 10% of white people, according to the Centers for Disease Control and Prevention. The disparity is likely even more, because many Black people aren’t correctly diagnosed.

And by 2060, cases are expected to increase fourfold among Black Americans.

While some risk factors may differ by race, the large disparities among racial groups can’t be explained just by genetics.

The problems start much earlier in life. Health conditions like heart disease and diabetes are known risk factors. Both are more common among Black populations, because of where they live in relation to polluting industries, lack of healthy food choices, and other factors. Depression, high blood pressure, obesity and chronic stress can also raise the likelihood of developing Alzheimer’s. So can poverty.

Across the board, Black people don’t receive the same quality of health care throughout life as white people.

So they don’t get high quality treatment — or any treatment — for all those conditions that are risk factors. Then, at the end, they’re less likely to get medication to ease the symptoms of Alzheimer’s and dementia-related disorders.

And there’s the insidious impact of a life experiencing racism.

Racism is trauma that can lead to increased stress, which can in turn cause health problems like inflammation, which is a risk factor for cognitive decline, said Dr. Carl V. Hill, chief diversity, equity and inclusion officer of the Alzheimer’s Association.

“But because of this structural racism that creates poor access to health, medication, housing, those who experience racism and discrimination are not provided a pathway to lower their risk,” Hill said.

It is, he said, “a one-two punch.”

For Jessica, it has meant the final years of her mother’s life have been filled not with peace, but heartache and frustration, as she navigates doctors who don’t believe her when she says her mom is suffering. In the slow, plodding walk that is her mother’s final years, she has few health care partners.

“It has been pervasive across multiple doctors, emergency rooms and hospital doctors,” Jessica said. “Not being listened to, not believed, not given the full treatment.”

“To be a caregiver of someone living with Alzheimer’s is that you watch your loved one die every day. I’ve been grieving my mom for seven years.”

More coming from this series

This story is part of an AP series examining the health disparities experienced by Black Americans across a lifetime.

Sunday: BirthWhy do so many Black women die in pregnancy? One reason: Doctors don’t take them seriously

Monday: ChildhoodBlack children are more likely to have asthma. A lot comes down to where they live

Tuesday: Teen yearsBlack kids face racism before they even start school. It’s driving a major mental health crisis

Wednesday: AdulthoodHigh blood pressure plagues many Black Americans. Combined with COVID, it’s catastrophic

Thursday: Elders A lifetime of racism makes Alzheimer’s more prevalent in Black Americans

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