Women born in the most sexist US states experience faster memory decline in later years compared to women born in the least sexist states, according to a new study from researchers at Columbia University Vagelos College of Physicians and Surgeons.
The difference between being born in the most versus the least sexist state corresponded to nine years of cognitive aging.
The study is one of a growing number of studies that have examined links between structural sexism and health. Structural sexism, like structural racism, does not refer to personal incidents, but to inequalities in resources and power that arise from social policies and norms. Hate crimes or defamation are individual acts of racism or sexism; unfair lending practices and underrepresentation in government are structural. Previous studies have shown that exposure to greater structural sexism in adulthood is associated with higher mortality rates, an increased risk of chronic health conditions, and less accessible and affordable health care for women.
The new study, the first to look at structural sexism and cognitive health, found that memory performance among women aged 65 and older declined faster among those born in US states with more structural sexism, compared with those born in states with less structural sexism. The study calculated each state’s level of structural sexism during the decades in which women were born, based on gender ratios in the labor force, the number of women in state legislatures, poverty rates and other factors. The researchers then looked at the relationships between structural sexism levels and memory performance among 21,000 people in the Washington Heights-Inwood Columbia Aging Project and the Health and Retirement Study.
The study also found that the link between structural sexism and memory performance was highest among black women. “It is likely that for women racialized as Black, the intersectional impact of sexism and racism creates a unique form of oppression that is more important for cognitive health than sexism or racism alone,” said Jennifer Manly, senior professor of neuropsychology author of the study.
“Our findings suggest that addressing social inequality may be a powerful way to reduce the burden of Alzheimer’s disease among women,” said study leader Justina Avila-Rieger, associate principal investigator at the Gertrude H. Sergievsky Center Columbia, whose studies are focus on sex. gender, racial, and ethnic differences in Alzheimer’s disease. “Alzheimer’s is a huge societal problem, especially among women, who make up two-thirds of Americans with the disease. It is imperative that we gain a better understanding of what causes this discrepancy and what can be done about it.”
Research into why Alzheimer’s disease affects women more than men has largely focused on sex-related biological differences, such as hormones and genes. The new study suggests that one of the most important and underappreciated risk factors may be systemic sex and gender discrimination.
How structural sexism contributes to memory decline is not clear. “What we do know is that structural inequities shape individual health outcomes by creating barriers to health-promoting opportunities and resources,” says Avila-Rieger. “Ultimately, these exposures cause differences in chronic physical health problems that directly impact brain health, the onset of cognitive impairment, and ultimately dementia.”
In future studies, Avila-Reiger wants to look at the effects of exposure to structural sexism at different stages of life.
It is possible that early life exposure may be a critical period for structural inequality, with direct or indirect consequences that accumulate over time. We also need to tease apart which aspects of structural sexism have the most impact on cognitive health. This is important for making recommendations to policy makers.”
Justina Avila-Rieger, associate principal investigator at the Gertrude H. Sergievsky Center Columbia
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Magazine reference:
Avila-Rieger, J.F., et al. (2024) Early life exposure to structural sexism and later life memories among black and white women and men in the United States. Alzheimer’s and dementia. doi.org/10.1002/alz.14410.