Given estimates of a fivefold increase in Alzheimer’s disease (AD) diagnoses among American Indian and Alaska Native (AI/AN) people by 2060, researchers in a new NIMHD study examined whether social determinants of health (SDOH) account for these disparities. SDOH are the conditions in which people are born, grow, live, work, and age that are known to drive health outcomes. Evidence of SDOH is essential to improving health and advancing health equity.
Researchers used the CDC National Vital Statistics System to conduct a longitudinal analysis of AD mortality rates for AI/AN populations from 2011 to 2019 at the county level, then compared the data to measures for percentage of AI/AN people, the availability of physicians at the county level, area deprivation index, and rural-urban continuum codes.
In the 646 Indian Health Service purchased/referred care delivery area counties examined, there were 3,024 deaths among AI/AN people. The mortality rate increased by 22% during the nine years studied. Interestingly, the researchers’ analyses also revealed a 20% lower risk for AD mortality for AI/AN people living in rural counties. An unexpected finding was the more AI/AN people living in a county, the fewer deaths from AD. For every 10% increase in the percentage of AI/AN people, researchers discovered a 14% lower risk for AD mortality. More deprived counties had a 34% higher risk for AD mortality compared with less deprived counties.
Together, these results lead researchers to call for future studies examining the extent to which community resilience may be a protective factor against AD among AI/AN people. Comprehensive efforts to increase AD care access and awareness of the disease in AI/AN people living in rural areas are needed.
Page published Nov. 16, 2023