• Dr. Besser's Presentation Slides (PDF)

Lilah M. Besser, Ph.D., M.S.P.H., is a Research Assistant Professor in the Comprehensive Center for Brain Health at University of Miami Miller School of Medicine. Her educational background includes a dual-degree Master of Science in Public Health in epidemiology and environmental and occupational health and a Ph.D. in city and regional planning. She has published over 60 peer-reviewed scientific papers, many of which are focused on the clinical progression, neuropathology, risk factors, and social determinants of Alzheimer’s disease and related dementias (ADRD).  Dr. Besser’s research program centers on the intersections between neighborhood built and social environments, healthy aging, and brain health. She is the Principal Investigator on two NIH/NIA grant-funded studies on neighborhood greenspace and brain aging (K01AG063895, R21AG075291) and on an Alzheimer’s Association-funded study (AARG-21-850963) on neighborhood racial segregation and longitudinal change in brain health outcomes. She serves as co-chair for two Structural/Social Determinants of Health Workgroups (for the Alzheimer's Association ISTAART Diversity and Disparities Professional Interest Area and Multi-Ethnic Study of Atherosclerosis). Dr. Besser’s ultimate goal is to provide evidence to planners, architects, urban designers, policy makers, and public health professionals (among other disciplines) on the neighborhood characteristics that can help maintain cognitive function into older ages, reduce ADRD risk, and allow for aging in place.

During her lecture, Dr. Besser discusses structural and social determinants of health (S/SDOH) that encompass a multitude of factors in the environments in which we live, learn, work, play, and worship. Structural determinants include upstream socioeconomic and political contexts such as laws and policies, cultural and societal values, and systemic racism and sexism. Social determinants, which are downstream from structural determinants, include factors such as access to education and health care and community social and built environments (e.g., racial and ethnic composition, park access, and transportation systems). S/SDOH are hypothesized to influence brain health and risk for Alzheimer’s disease and related dementias (ADRD) by influencing health-related exposures, behaviors, and outcomes across the life course, which in turn can result in disparities in ADRD risk in later life. S/SDOH are increasingly recognized in ADRD research due to evidence demonstrating that up to 40% of ADRD risk is attributable to modifiable risk factors (e.g., physical activity and diet) that are influenced by S/SDOH. In her presentation, Dr. Besser discusses conceptual frameworks for the connections between S/SDOH and brain health/ADRD outcomes and will describe related published and ongoing research, with a particular emphasis on neighborhood social and built environments.

• Dr. Echouffo Tcheugui's Presentation Slides (PDF)

Justin Echouffo Tcheugui, M.D., Ph.D., M.Phil., is an Associate Professor at the Johns Hopkins University School of Medicine. He is an endocrinologist and epidemiologist. His research focuses on the links between metabolic dysregulation and cardiovascular diseases. He has used various epidemiological designs and investigational approaches, such as biomarkers and cardiac imaging, to explore the pathways leading to type 2 diabetes, and to understand the pathogenesis and natural history of diabetes-related cardiovascular complications.

In his lecture, Dr. Echouffo Tcheugui uses the example of heart failure to illustrate the critical importance of cardiovascular disease prevention in the setting of type 2 diabetes. He describes novel evidence on the links between type 2 diabetes and heart failure. Dr. Echouffo Tcheugui also elaborates on specific approaches to preventing heart failure in the setting of type 2 diabetes.

• Dr. Carrillo-Larco's Presentation Slides (PDF)

Rodrigo M. Carrillo-Larco, M.D., Ph.D., was born and raised in Lima, Peru and completed his medical training at Universidad Peruana Cayetano Heredia (Lima, Peru). Shortly after, he moved to London, U.K., where he worked as a Global Health Research Fellow and received his Ph.D. from the Department of Epidemiology and Biostatistics at Imperial College London. Dr. Carrillo-Larco set up the Cohorts Consortium of Latin America and the Caribbean, a collaboration to develop the first tool for risk stratification and primary prevention of cardiovascular diseases in Latin America. Dr. Carrillo-Larco has authored 120+ academic publications. Dr. Carrillo-Larco’s research seeks to bring (big) data sources non-traditionally used in epidemiological and public health research, together with novel analytical approaches, to provide timely and pragmatic evidence as well as tools to solve problems in global health. Most of Dr. Carrillo-Larco’s work has been about primary prevention of noncommunicable diseases, particularly cardiovascular diseases and diabetes.

During his lecture, Dr. Carrillo-Larco describes selected features of cardiometabolic epidemiology for Hispanics, global and international comparisons, as well as recent advances and opportunities for risk-based prevention of noncommunicable diseases. Hispanics in the U.S. represent the second largest racial or ethnic group (~18% of the total U.S. population in 2020). This important ethnic group has unique health experiences including migration and health disparities as well as remarkable epidemiological features such as high diabetes-related mortality. Furthermore, in comparison to other world regions, Latin America exhibits great diversity in the distribution of modifiable cardiometabolic risk factors — for instance, low HDL-cholesterol is the most common dyslipidemia in this world region. Despite these unique traits, tools for risk stratification and disease prevention specific for cardiometabolic noncommunicable diseases are limited for this ethnic group.