“Hang Ups, Let Downs, Bad Breaks, Setbacks”: Impact of Structural Socioeconomic Racism and Resilience on Cognitive Change Over Time for Persons Racialized as Black

Introduction: Older adults racialized as Black experience higher rates of dementia than those racialized as White. Structural racism produces socioeconomic challenges, described by artist Marvin Gaye as “hang ups, let downs, bad breaks, setbacks” that likely contribute to dementia disparities. Robus...

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Main Authors: Paris B. Adkins-Jackson, Boeun Kim, César Higgins Tejera, Tiffany N. Ford, Ariana N. Gobaud, Kyler J. Sherman-Wilkins, Indira C. Turney, Justina F. Avila-Rieger, Kendra D. Sims, Safiyyah M. Okoye, Daniel W. Belsky, Tanisha G. Hill-Jarrett, Laura Samuel, Gabriella Solomon, Jack H. Cleeve, Gilbert Gee, Roland J. Thorpe, Deidra C. Crews, Rachel R. Hardeman, Zinzi D. Bailey, Sarah L. Szanton, Jennifer J. Manly
Format: Article
Language:English
Published: Mary Ann Liebert 2024-12-01
Series:Health Equity
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Online Access:https://www.liebertpub.com/doi/10.1089/heq.2023.0151
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author Paris B. Adkins-Jackson
Boeun Kim
César Higgins Tejera
Tiffany N. Ford
Ariana N. Gobaud
Kyler J. Sherman-Wilkins
Indira C. Turney
Justina F. Avila-Rieger
Kendra D. Sims
Safiyyah M. Okoye
Daniel W. Belsky
Tanisha G. Hill-Jarrett
Laura Samuel
Gabriella Solomon
Jack H. Cleeve
Gilbert Gee
Roland J. Thorpe
Deidra C. Crews
Rachel R. Hardeman
Zinzi D. Bailey
Sarah L. Szanton
Jennifer J. Manly
author_facet Paris B. Adkins-Jackson
Boeun Kim
César Higgins Tejera
Tiffany N. Ford
Ariana N. Gobaud
Kyler J. Sherman-Wilkins
Indira C. Turney
Justina F. Avila-Rieger
Kendra D. Sims
Safiyyah M. Okoye
Daniel W. Belsky
Tanisha G. Hill-Jarrett
Laura Samuel
Gabriella Solomon
Jack H. Cleeve
Gilbert Gee
Roland J. Thorpe
Deidra C. Crews
Rachel R. Hardeman
Zinzi D. Bailey
Sarah L. Szanton
Jennifer J. Manly
author_sort Paris B. Adkins-Jackson
collection DOAJ
description Introduction: Older adults racialized as Black experience higher rates of dementia than those racialized as White. Structural racism produces socioeconomic challenges, described by artist Marvin Gaye as “hang ups, let downs, bad breaks, setbacks” that likely contribute to dementia disparities. Robust dementia literature suggests socioeconomic factors may also be key resiliencies. Methods: We linked state-level data reflecting the racialized landscape of economic opportunity across the 20th Century from the U.S. Census (1930–2010) with individual-level data on cognitive outcomes from the U.S. Health and Retirement Study participants racialized as Black. A purposive sample of participants born after the Brown v. Board ruling (born 1954–59) were selected who completed the modified Telephone Interview for Cognitive Status between 2010 and 2020 (N=1381). We tested associations of exposure to structural racism and resilience before birth, and during childhood, young-adulthood, and midlife with cognitive trajectories in mid-late life using mixed-effects regression models. Results: Older adults born in places with higher state-level structural socioeconomic racism experienced a more rapid cognitive decline in later life compared to those with lower levels of exposure. In addition, participants born in places with higher levels of state-level structural socioeconomic resilience experienced slower cognitive change over time than their counterparts. Discussion: These findings reveal the impact of racist U.S. policies enacted in the past that influence cognitive health over time and dementia risk later in life.
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spelling doaj-art-275cf3cd42a044df806ec2f3ae208a652025-08-20T02:59:06ZengMary Ann LiebertHealth Equity2473-12422024-12-018125426810.1089/heq.2023.0151“Hang Ups, Let Downs, Bad Breaks, Setbacks”: Impact of Structural Socioeconomic Racism and Resilience on Cognitive Change Over Time for Persons Racialized as BlackParis B. Adkins-Jackson0Boeun Kim1César Higgins Tejera2Tiffany N. Ford3Ariana N. Gobaud4Kyler J. Sherman-Wilkins5Indira C. Turney6Justina F. Avila-Rieger7Kendra D. Sims8Safiyyah M. Okoye9Daniel W. Belsky10Tanisha G. Hill-Jarrett11Laura Samuel12Gabriella Solomon13Jack H. Cleeve14Gilbert Gee15Roland J. Thorpe16Deidra C. Crews17Rachel R. Hardeman18Zinzi D. Bailey19Sarah L. Szanton20Jennifer J. Manly21Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.Division of Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA.Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.Department of Sociology and Anthropology, Missouri State University, Springfield, Missouri, USA.Department of Neurology, Vagelos College of Physicians & Surgeons, Taub Institute for Research on Alzheimer's Disease & The Aging Brain, Columbia University, New York, New York, USA.Department of Neurology, Vagelos College of Physicians & Surgeons, Taub Institute for Research on Alzheimer's Disease & The Aging Brain, Columbia University, New York, New York, USA.Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.Department of Graduate Nursing, College of Nursing and Health Professions and Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA.Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, California, USA.School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.Department of Community Health Sciences, University of California at Los Angeles, Los Angeles, California, USA.Alzheimer's Disease Resource Center for Minority Aging Research, Johns Hopkins University, Baltimore, Maryland, USA.School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.Center for Antiracism Research for Health Equity, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA.School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.Department of Neurology, Vagelos College of Physicians & Surgeons, Taub Institute for Research on Alzheimer's Disease & The Aging Brain, Columbia University, New York, New York, USA.Introduction: Older adults racialized as Black experience higher rates of dementia than those racialized as White. Structural racism produces socioeconomic challenges, described by artist Marvin Gaye as “hang ups, let downs, bad breaks, setbacks” that likely contribute to dementia disparities. Robust dementia literature suggests socioeconomic factors may also be key resiliencies. Methods: We linked state-level data reflecting the racialized landscape of economic opportunity across the 20th Century from the U.S. Census (1930–2010) with individual-level data on cognitive outcomes from the U.S. Health and Retirement Study participants racialized as Black. A purposive sample of participants born after the Brown v. Board ruling (born 1954–59) were selected who completed the modified Telephone Interview for Cognitive Status between 2010 and 2020 (N=1381). We tested associations of exposure to structural racism and resilience before birth, and during childhood, young-adulthood, and midlife with cognitive trajectories in mid-late life using mixed-effects regression models. Results: Older adults born in places with higher state-level structural socioeconomic racism experienced a more rapid cognitive decline in later life compared to those with lower levels of exposure. In addition, participants born in places with higher levels of state-level structural socioeconomic resilience experienced slower cognitive change over time than their counterparts. Discussion: These findings reveal the impact of racist U.S. policies enacted in the past that influence cognitive health over time and dementia risk later in life.https://www.liebertpub.com/doi/10.1089/heq.2023.0151structural racismsocioeconomic statuscognition
spellingShingle Paris B. Adkins-Jackson
Boeun Kim
César Higgins Tejera
Tiffany N. Ford
Ariana N. Gobaud
Kyler J. Sherman-Wilkins
Indira C. Turney
Justina F. Avila-Rieger
Kendra D. Sims
Safiyyah M. Okoye
Daniel W. Belsky
Tanisha G. Hill-Jarrett
Laura Samuel
Gabriella Solomon
Jack H. Cleeve
Gilbert Gee
Roland J. Thorpe
Deidra C. Crews
Rachel R. Hardeman
Zinzi D. Bailey
Sarah L. Szanton
Jennifer J. Manly
“Hang Ups, Let Downs, Bad Breaks, Setbacks”: Impact of Structural Socioeconomic Racism and Resilience on Cognitive Change Over Time for Persons Racialized as Black
Health Equity
structural racism
socioeconomic status
cognition
title “Hang Ups, Let Downs, Bad Breaks, Setbacks”: Impact of Structural Socioeconomic Racism and Resilience on Cognitive Change Over Time for Persons Racialized as Black
title_full “Hang Ups, Let Downs, Bad Breaks, Setbacks”: Impact of Structural Socioeconomic Racism and Resilience on Cognitive Change Over Time for Persons Racialized as Black
title_fullStr “Hang Ups, Let Downs, Bad Breaks, Setbacks”: Impact of Structural Socioeconomic Racism and Resilience on Cognitive Change Over Time for Persons Racialized as Black
title_full_unstemmed “Hang Ups, Let Downs, Bad Breaks, Setbacks”: Impact of Structural Socioeconomic Racism and Resilience on Cognitive Change Over Time for Persons Racialized as Black
title_short “Hang Ups, Let Downs, Bad Breaks, Setbacks”: Impact of Structural Socioeconomic Racism and Resilience on Cognitive Change Over Time for Persons Racialized as Black
title_sort hang ups let downs bad breaks setbacks impact of structural socioeconomic racism and resilience on cognitive change over time for persons racialized as black
topic structural racism
socioeconomic status
cognition
url https://www.liebertpub.com/doi/10.1089/heq.2023.0151
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