Journal
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY
Volume 30, Issue 11, Pages 1171-1179Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jagp.2022.04.010
Keywords
Structural racism and discrimination; health disparity; ADRD; care coordination; system integration; health information technology
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Black and Latinx Americans are at greater risk for Alzheimer's disease and related dementias due to health disparities, social inequities, and historical policies. Structural racism and discrimination have been linked to comorbidities of these diseases. Care coordination using health information technology systems can help address disparities for minoritized racial and ethnic populations with these conditions.
Black and Latinx Americans are disproportionately at greater risk for having Alzheimer's disease and related dementias (ADRD) than White Americans. Such differences in risk for ADRD are arguably explained through health disparities, social inequities, and historical policies. Structural racism and discrimination (SRD), defined as macro-level conditions that limit opportunities, resources, and well-being of less privileged groups, have been linked with common comorbidities of ADRD, including hypertension, obesity, diabetes, depression. Given the historical impact of SRD-including discriminatory housing policies resulting in racial residential segregation that has been shown to limit access to education, employment, and healthcare-Black and Latinx populations with ADRD are directly or indirectly negatively affected by SRD in terms of access, quality and cost for healthcare. Emerging studies have brought to light the value of structural-level hospital and public health collaboration on care coordination for improving healthcare quality and access, and thus could serve as a macro-level mechanism for addressing disparities for minoritized racial and ethnic populations with ADRD. This paper presents a conceptual framework delineating how care coordination can successfully be achieved through health information technology (HIT) systems and ultimately address SRD. To address health inequities, it is therefore critical that policy initiatives invest in HIT capacities and infrastructures to promote care coordination, iden-tify patient needs and preferences, and promote engagement of patients with ADRD and their caregivers. (Am J Geriatr Psychiatry 2022; 30:1171-1179)
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