The chronic stress of systemic racism has been linked to higher rates of hypertension, heart disease, stroke and PTSD-like symptoms among Black Americans. These biological issues also affect mental and cognitive health, increasing the chances of developing brain diseases such as dementia and Alzheimer’s.
From mood disorders like depression to chronic psychiatric conditions such as schizophrenia, mental illness in Black America has long been under-diagnosed and untreated. And while almost 1 in 5 U.S. adults lives with some form of mental illness, Black Americans are 20% more likely to face serious mental health challenges than the overall population.
Now, mounting research suggests a troubling pattern: The combination of mental illness and the chronic stress of racism puts Black people at increased risk of accelerated brain aging and cognitive decline, dementia and Alzheimer’s disease.
Experts say the link between mental health and brain health is too often overlooked, especially in Black communities where stress, systemic racism and limited access to care have compounded health disparities. With Black adults already facing higher rates of diabetes, hypertension, and stroke — all of which impair brain function — doctors warn that prevention needs to start much earlier and address the whole body, not just the mind.
“Historically, medicine has seen everything from the neck up as a separate entity,” said Dr. Sharon Brangman, a brain health and cognitive aging expert in the Syracuse, New York, area. “But we know that you can’t separate the brain, or really any other organ, from total body function and health.”
Chronic stress, racial weathering, brain health
One key concept in understanding brain health is weathering, a term Dr. Arline Geronimus, a public health scholar, coined in 1992 to describe how prolonged exposure to racism and social inequality leads to premature aging and poor health outcomes.
A longitudinal study published last year found that Black Americans were significantly more likely than whites to experience persistent or rising depressive symptoms starting in young adulthood. This extended exposure to depression was seen to have taken its toll by the time adults reach middle age, and it may help explain racial disparities in dementia and Alzheimer’s risk.
Scientists believe weathering may be linked to the shortening of telomeres, the protective tips on the ends of DNA strands. Research shows shorter telomeres are linked to a higher risk of age-related brain disorders.
“Depression is a risk factor for cognitive loss,” Brangman said, noting that some experts “put Alzheimer’s disease and other dementias in the mental health category.”
Being informed can make a difference
“Brain health is within all of our capabilities [to manage] and you don’t necessarily have to wait until you’re 65 to work on your brain health,” Brangman said.
But to manage brain health, you need to know how your brain functions and ages. One-third of Americans feel uninformed about normal brain aging and roughly 25% don’t realize there’s a link between their overall health and brain health, according to a McKnight Brain Research Foundation survey.
The survey also found that 87% of Americans are concerned about experiencing age-related memory loss and a decline in brain function.
Familiar steps that improve overall health — from getting enough sleep, managing stress and watching one’s diet to wearing a helmet when on a bike or motorcycle — can protect brain health as we age.
“What we understand about concussions is that the brain damage from a concussion may not appear for many decades,” Brangman said. “We hear more and more about boxers and football players who had multiple concussions when they were younger, but it doesn’t present until they’re much older. You have to think of the whole lifespan.”
Other factors, like smoking and diabetes, aren’t typically seen as affecting brain health, but they matter, Brangman says.
“Smoking is not good for brain health. It’s not good for any part of your body, but it does cause [specific] problems with your brain,” she said. “Smoking damages the lining of our blood vessels” of the heart, the lungs and the brain.
“Any time you reduce blood supply to an organ in your body, that organ starts to have problems functioning,” she said. “Our bodies are pretty resilient, but when you keep bombarding them with bad things, they eventually reach a point where they can’t cope.”
Jennifer Porter Gore is a writer living in the Washington, D.C., area.
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