Societal and equity challenges for Brain Health Services. A user manual for Brain Health Services-part 6 of 6

Brain Health Services are a novel approach to the personalized prevention of dementia. In this paper, we consider how such services can best reflect their social, cultural, and economic context and, in doing so, deliver fair and equitable access to risk reduction. We present specific areas of challenge associated with the social context for dementia prevention. The first concentrates on how Brain Health Services engage with the at-risk individual, recognizing the range of factors that shape an individual's risk of dementia and the efficacy of risk reduction measures. The second emphasizes the social context of Brain Health Services themselves and their ability to provide equitable access to risk reduction. We then elaborate proposals for meeting or mitigating these challenges. We suggest that considering these challenges will enable Brain Health Services to address two fundamental questions: the balance between an individualized high-risk and population focus for public health prevention and the ability of services to meet ethical standards of justice and health equity.

Automated summary

This paper explores how Brain Health Services can best adapt to the social, cultural, and economic context to provide fair and equitable access to risk reduction for dementia prevention. The challenges associated with engaging at-risk individuals and ensuring equitable access are discussed, along with proposals for meeting these challenges. Addressing these challenges will allow Brain Health Services to balance individualized high-risk and population-focused approaches for public health prevention, while also meeting ethical standards of justice and health equity.