ESSENTIAL CONVERSATIONS
Racial injustice is not a new issue. Systemic racism has plagued these United States, its military, healthcare, equal housing, and treatment.
Minority veterans have a 44% higher risk of unemployment than non-minority veterans. And 17.3% of veterans of color report having experienced homelessness in their adult life, compared to 8.3% of white veterans.
As a society, we can no longer say we stand with our vets, without standing against the social inequities they face. U.S.VETS is working to address these issues head on…
With multiple sources of corporate and foundation funding dedicated to improving career access and employment opportunities for Black and other minority veterans, U.S.VETS will…
WORK TO REDUCE EMPLOYMENT BARRIERS:
Support 40+ veterans in achieving employment and increase socioeconomic mobility by eliminating barriers and encourage networking opportunities and community connections.
TRAIN:
Conversations and trainings for U.S.VETS staff and partners to best support the advancement of equity for Black and other minority populations, particularly those who are experiencing homelessness or at-risk.
GIVE DIRECT ASSISTANCE:
Provide support for veterans to pursue career training, licensure, certification, educational opportunities, equipment, and other necessary resources, as well as assistance for Black and other minority veterans to pursue career training that supports long-term career advancement and resources that eliminate barriers to socioeconomic mobility.
If you are interested in learning more about how racism and inequity disrupt and traumatizes the lives of marginalized people, download this list of helpful books and films.
Understand and Address Microaggressions
Have you ever had microaggressions against your identity?
Microaggressions are nonverbal slights, insults, or demeaning behaviors that target individuals from traditionally marginalized groups. These are forms of racism and bias, which are harmful. Matters such as these must be addressed, so people with disabilities, minorities, women, LGBTQIA are no longer recipients of these biases.
Microaggressions may fly under the radar for those of us who don’t directly experience them, but they are a clear form of exclusion and discrimination—and they are more widespread than you may think.
The effects of microaggressions are real. They impact how people work, live, and move around society. These biases are forms of assaults, insults, invalidations, indignities, put-downs and even allegations. They must stop.
No matter the generations from which you come or the zip code in which you were raised, we must create transparency, remedy policies, build processes, and standardized performance. Learning from one another will be critical. We have so much to learn from one another.
References
Kantola. (2021). Understand and address microaggressions in the workplace. https://www.kantola.com/Understand-and-Address-Microaggressions-in-the-Workplace-CT-428.aspx
Ramsey, F. (2015). What if White people had to deal with microaggressions? https://everydayfeminism.com/2015/08/white-people-microaggressions/
Dementia Risk Higher for Black, Hispanic Military Veterans
Black and Hispanic military veterans in the U.S. had significantly greater dementia risk than white veterans, a large retrospective study showed.
Among 1.87 million older adults — 98% of whom were men — who received care in the Veterans Health Administration (VHA), 13% were diagnosed with dementia over 10 years, reported Kristine Yaffe, MD, of the University of California San Francisco (UCSF) and San Francisco Veterans Affairs (VA) Health Care System, and colleagues in JAMA.
By race, the age-adjusted incidence of dementia per 1,000 person-years was:
- White veterans: 11.5 (95% CI 11.4-11.6)
- Asian veterans: 12.4 (95% CI 11.7-13.1)
- American Indian or Alaska Native veterans: 14.2 (95% CI 13.3-15.1)
- Black veterans: 19.4 (95% CI 19.2-19.6)
- Hispanic veterans: 20.7 (95% CI 20.1-21.3)
Compared with white participants, fully adjusted hazard ratios for dementia were:
- American Indian or Alaska Native participants: 1.05 (95% CI 0.98-1.13)
- Asian participants: 1.20 (95% CI 1.13-1.28)
- Black participants: 1.54 (95% CI 1.51-1.57)
- Hispanic participants: 1.92 (95% CI 1.82-2.02)
This study documents an increased risk for dementia in Black and Hispanic older adults in a nationwide sample of almost 2 million veterans who have access to healthcare through the VHA, said co-author Erica Kornblith, PhD, also of UCSF and the San Francisco VA Health Care System.
“The results of our regional analyses showed variability across regions in terms of age-adjusted incidence, but also showed that Black and Hispanic veterans had relatively highest incidence in each region,” Kornblith told MedPage Today.
“Because adjustment for medical and mental health variables as well as education did not attenuate our primary results, it is likely there are other unmeasured factors underlying our findings, particularity social, economic, and structural factors that we did not fully measure here,” she added.
Although much literature has focused on dementia prevalence, this study used incidence data to measure rates of new dementia cases over 10 years, noted Gwen Yeo, PhD, of Stanford University School of Medicine in California, in an accompanying editorial. “Incidence rates avoid the issue of different lengths of illness among racial and ethnic populations found in prevalence comparisons, due to different ages of onset and life expectancies,” Yeo observed.
“In addition to the advantage of this large and regionally diverse study population, the fact that veteran populations from smaller ethnic and racial categories were large enough to be statistically relevant is a major contribution to the current state of the literature on rates of dementia,” she added.
“This is especially true for American Indian and Alaska Native older adults,” Yeo pointed out. “Most past efforts to measure the prevalence or incidence of dementia in these groups have been constrained by their small numbers in scattered villages, reservations, and urban enclaves.”
The study included 1,869,090 veterans whose mean age was 69. Overall, 88.6% were white, 9.5% were Black, 1% were Hispanic, 0.5% were Asian, and 0.4% were Native American; a total of 2.3% were female. All participants received health care at VHA medical centers and were evaluated from October 1999 through September 2019. Incident diagnosis of dementia was assessed by ICD-9 and ICD-10 codes; mean follow-up was 10.1 years.
Hypertension was the leading baseline comorbidity in all groups, followed by diabetes. HRs were adjusted for sex, education, and medical and psychiatric comorbidities.
Yaffe and colleagues noted several study limitations. Its sample included a relatively small proportion of female, American Indian or Alaska Native, Asian, and Hispanic participants, but was consistent with previously reported sex, race, and ethnicity distributions of older veterans. Education, an important risk factor for dementia, was defined by the rate of educational attainment in a participant’s zip code. The study also relied [on] ICD codes for dementia diagnoses, which may be less accurate than comprehensive dementia exams.
- Judy George covers neurology and neuroscience news for MedPage Today, writing about brain aging, Alzheimer’s, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s, ALS, concussion, CTE, sleep, pain, and more. Follow
Disclosures
The study was supported by a Department of Veterans Affairs rehabilitation research and development career development award and an NIA grant.
Yaffe disclosed receiving NIA grant funding, serving on the data and safety monitoring boards for several NIH studies, and receiving personal fees for serving on the data and safety monitoring boards of Eli Lilly and Alector, as well as serving as a member of the Beeson scientific advisory board.
Yeo disclosed receiving royalties from Taylor & Francis Publishers.
Primary Source
JAMA
Source Reference: Kornblith E, et al “Association of race and ethnicity with incidence of dementia among older adults” JAMA 2022; DOI: 10.1001/jama.2022.3550.
Secondary Source
JAMA
Source Reference: Yeo G “Association of race and ethnicity with dementia” JAMA 2022; DOI: 10.1001/jama.2022.4473,
Mural art by Art Mortimer.