South Carolina (SC) has an Alzheimer’s Disease crisis and the population is getting older each year. We see more and more South Carolinians dying from Alzheimer’s disease, with a 199% increase since 2000. In fact, in 2015, SC had the highest Alzheimer’s death rate in America. The South Carolina State Health Plan indicates that 64.6% of SC residents are non-Hispanic White, 27.5% are non-Hispanic black and 5.7% are Hispanic/Latino making up 3.1 million residents, 1.3 million residents and 272,792 residents, respectively. An Alzheimer’s Association Impact Movement Fact Sheet on Race, Ethnicity, and Alzheimer’s indicates that Whites make up the majority of Alzheimer’s cases across the US, but African Americans and Hispanics are at a higher risk and are less likely to be diagnosed at an early stage. A large proportion of South Carolinians are at great risk for cardiovascular disease and disparities exist in race/ethnicity as well as rurality. Primary Care Providers, especially in rural areas, lack specialized care and are relied upon for the management of any and all chronic diseases. Many have indicated they feel ill prepared to handle the surge of the Alzheimer's Disease and Related Dementias (ADRD) demand and they lack the skills needed for early diagnosis and adequate disease management as well as resources available for caregivers. Public Health Professionals are often serving the underserved and most vulnerable as well and need adequate resources and training opportunities to provide care to the populations they serve.
In response, partners will be mobilized to form an ADRD statewide coalition to create an ADRD strategic plan to implement the CDC’s Healthy Brain Initiative Road Map. Road Map (RM) measures E-1, E-2, W-3, P-1, M-1 and M-3 will be implemented. The “Take Brain Health to Heart” communications and educational campaign will be updated and promoted to address RM measure E-1, chronic disease directors will also assist in integration of existing program efforts and messaging, RM measure E-2. The campaign website will be updated to include an array of resources, including items for PCPs and Public Health Professionals, addressing RM measure W-3. A statewide strategic plan implementing RM measures will be created to address P-1. All efforts will be driven by data, RM measure M-3, including RM measure M-1, adding optional modules on cognitive decline and caregiving to the BRFSS in the 2021 integration. All efforts will use policy, systems and environmental interventions and a public health approach to address short-term and intermediate outcomes by the end of the project period to include: Increasing the number of ADRD stakeholders engaging in jurisdiction-wide collaboration and actions; Increasing the inclusion of the areas of dementia risk reduction (primary prevention), early diagnosis of ADRD (secondary prevention), prevention and management of comorbidities and avoidable hospitalizations (tertiary prevention) in program planning and priority setting, and; Increasing the inclusion of RM series actions to at least four (4) actions that are reflected in ADRD state strategic plan.
The South Carolina Department of Health and Environmental Control (DHEC), in work with partners, is positioned to lead the BOLD Core ADRD Public Health Prevention Programs in South Carolina effort. Reliable funding for the upcoming three years will support coordinated, interdisciplinary work to fight the ADRD epidemic statewide.