• Dr. Besser's Presentation Slides (PDF)

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.

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.