Dr. Consuelo H. Wilkins thinks we should shift our focus from health “disparities” to health “inequities.”
“Disparities are differences, and it doesn’t really speak to what the causes of the differences are,” Wilkins, MD, MSCI, said when recently giving the eighth annual Norman R. Seay Lecture, presented by the Charles F. and Joanne Knight Alzheimer’s Disease Research Center, the Department of Neurology, and John C. Morris, MD, director at Washington University School of Medicine.
“When you talk about health inequities, you are really focusing on the fact that there are systematic and unjust reasons for the differences. Health inequities mean that there are other issues that are underlying the differences that we see.”
Unequal access to education, health care, housing and transportation are among social determinants that negatively affect treatment and health outcomes.
“If there is unequal distribution of these resources, then they can also drive some of the differences in the outcomes that we see,” Wilkins said. “Racial discrimination is certainly one of those causes of inequities.”
A former Alzheimer’s researcher and professor at the Washington University School of Medicine, Wilkins is now executive director of the Meharry-Vanderbilt Alliance and assistant professor of medicine at both Vanderbilt University and Meharry Medical College in Nashville, Tennessee.
Dr. Wilkins, also the former health accuracy editor for The St. Louis American, returned to St. Louis to speak about the topic “The Three Keys to Closing the Disparities Gap in Alzheimer’s Disease.” She was introduced by Dr. Morris, who is also the Harvey and Dorismae Hacker Friedman Distinguished Professor of Neurology, with opening remarks by Larry J. Shapiro, MD, the executive vice chancellor of Medical Affairs and Dean of Washington University School of Medicine.
Alzheimer’s disease is the most common type of the many forms of dementia, characterized by memory problems and changes in behavior, which typically begin subtly and progress over time.
“People would rather say ‘dementia’ than ‘Alzheimer’s.’ The perception is that Alzheimer’s has no cure, there is nothing we can do about it, and so we’d rather not say ‘Alzheimer’s,’” Wilkins said.
“But, most of the dozens of dementia also have no cure, so it’s not necessarily better to say you have dementia, as opposed to Alzheimer’s. The key thing is to understand what the underlying cause is, and right now Alzheimer’s has the most approved treatments.”
Wilkins recommended a patient-centered approach to Alzheimer’s that individualizes education, diagnosis and treatment.
She also called for an increase in minority participation in research, because researchers need a broad range of races participating in studies for more targeted treatment.
She said research shows that education and reading level are two predictors of Alzheimer’s, but much about the disease and its onset remains unknown.
“We have to be able to understand what some of the other predictors are so we can focus our screening efforts,” she said. “But also so we can think about how to prevent or increase awareness about Alzheimer’s disease in certain populations.”
A brief question and answer session followed the well-attended public lecture. An information table was staffed by the Alzheimer’s Association and a reception by the St. Louis Chapter of Links, Inc. was held in Wilkin’s honor in the atrium of Farrell Learning and Teaching Center.
Civil rights leader Norman R. Seay attended the lecture named in his honor, and the Charles F. and Joanne Knight Alzheimer’s Disease Research Center at Washington University sponsored it. Seay is chair emeritus of the African American Advisory Board of the Knight Center.
“Mr. Seay has also contributed a lot to the development of the Alzheimer’s disease Research Center and its program,” said Larry J. Shapiro, M.D., executive vice chancellor of medical affairs and dean of Washington University School of Medicine, “and that’s why this lectureship was established.”
