Blog Harvey A. Friedman Center for Aging

Disintegrating structural racism in Alzheimer’s disease research

Written by Mirra Ramakrishnan, BHS candidate at University of Missouri-Columbia, and participant in the 2023 Institute for Public Health Summer Research Program

Recruiting participants from marginalized communities is crucial in ensuring justice and generalizability of research | Photo:

My time so far at WashU’s Institute for Public Health Summer Research ProgramAging and Neurological track has been truly intriguing. From engaging in our weekly cohort seminars to doing community-based research in my lab, my understanding of human aging and neurological diseases, such as Alzheimer’s disease, has drastically improved. Additionally, I had the opportunity to hear about a variety of topics pertaining to aging and neurological diseases from keynote speakers which have all helped further my understanding in these topics.

This summer, I have been working under the guidance of Associate Professor, Joyce Balls-Berry, PhD  in the Knight Alzheimer’s Disease Research Center, specifically in the health disparities and equity core, where I have been introduced to research focusing on applying community- and patient-engaged research principles in diverse populations to ultimately reduce health disparities and health equity. I have learned the importance of actually showing up to communities and being present with them as an efficient way to build trust. I’ve had the opportunity to visit some communities in Saint Louis, such as the Wesley House and Southside Wellness Center, where my lab members and I were able to interview and speak to the directors and community leaders in the centers. From speaking to these community leaders, we noted that a common barrier that prevents African Americans and minorities from participating in research and getting health care is the amount of mistrust in the medical community and several historical underpinnings.

One of my favorite presentations in our weekly seminars has been about Racial Equity in Alzheimer’s Disease Research, presented by my mentor, Associate Professor Balls-Berry. We learned about the historical underpinnings that have led to the great amount of mistrust in the medical community. Some of the major historical occurrences that significantly impacted the trust in researchers and medical professionals include The Tuskegee Study of Untreated Syphilis in African American Men, the Willowbrook hepatitis study, and the case of Henrietta Lacks. The common theme that lies behind all these cases is how deeply structural racism and discrimination is rooted in history and how that has been negatively affecting the health of marginalized communities over time.

Additionally, Associate Professor Balls-Berry spoke about the intersection of neuroscience and structural racism. She spoke about how older Black adults residing in segregated Black neighborhoods had poorer performance on measures related to language and memory, with a higher risk of developing dementia over time. These risk factors show how resource deprivation and structural racism can affect brain health over time. Currently in my lab, I am helping with the COEQUAL registry which is intended to create opportunities to increase health equity and equality for people at risk for Alzheimer’s disease and related dementias. Through this experience, I have gained knowledge about the process of recruiting and working with participants. I feel that this project is a great steppingstone towards promoting future research with marginalized populations and making sure that researchers are collecting both qualitative and quantitative data to be representative of those populations as well.