The Global Council on Brain Health (GCBH) convened a series of sessions with international experts to explore the challenges to brain health faced by different communities around the world. In this report, we share what we have learned about the societal, political, and environmental factors that influence people’s opportunity to maintain the best possible brain health through the course of their lives. We explain why certain groups of the population face more difficult barriers to achieving this goal than others. And we offer recommendations on how to enhance this opportunity for all. The GCBH encourages individuals to embrace healthy lifestyles when that is possible, thereby empowering themselves to develop and sustain the best possible brain health regardless of their background or the barriers they may face. Too often, however, powerful forces and social conditions stand in the way of wholesome choices, negatively influencing people’s brain health. Within every country, public policies, political systems, economic conditions, social norms, and environmental factors influence health and wellness for better or worse. Discrimination based on age, race, ethnicity, gender and gender identity/roles, sexual orientation, national origin, caste, disabilities (visible as well as invisible), and genetic forms of neurological diseases contributes to poor physical and mental health in many societies. Barriers rooted in government policy, health care, institutional values, professional practice, and culture itself all may stand in the way of optimal brain health. To address these factors, the GCBH recommends a multifaceted approach grounded in the latest scientific research and informed by the lived experience of individuals with cognitive loss. Innovations in policy, research, technology, community engagement, infrastructure, environmental design, and family supports are all discussed in this report as parts of the answer. Progress requires strategic collaboration and the engagement of many stakeholders from different sectors. Improving the opportunities to optimize brain health is a long-term task that calls for new, inclusive solutions to address the entrenched barriers that so many face. Achieving equity will require, in the words of Thomas Kuhn, “shifting the paradigm” – transforming the existing scientific approach through innovative thinking and problem-solving to ensure that people are treated as individuals, and treated fairly, around the world
