By: Talyah Sands, MPH, Director of Health Improvement, Association of State and Territorial Health Officials (ASTHO)

Current rates of dementia, the caregiving and support required to address it, and projections of what dementia could look like in the future are staggering. The challenge to improve equitable outcomes for dementia can feel overwhelming and frustrating at times. However, here you are, tuning into IA2’s communications, underscoring your commitment to improve brain health in our world. You know that we need to and can get ahead of growing rates and disproportionate impacts of dementia within communities. Like me, you have hope.

To disrupt the current state of dementia, we must think through our past, present, and future. I am going to suggest that we start with the present. Once we have a more complete picture of what is going on right now, we can look to the past to understand how we got here and chart a path forward to a different, improved future. In public health, starting with the present means conducting a needs assessment. This involves gathering data and information about what is going on in a community with a particular health topic.

Recently, colleagues and I at ASTHO and the Alzheimer’s Association released a toolkit to help health agencies and partners conduct needs assessments on dementia and caregiving. I would like to shout out my collaborators Kelsey Donnellan for leading the authorship of the toolkit with support from Liana Broaddus, John Shean for contributing on the author team and providing guidance, and Priya Shah for steering dissemination efforts. Many others contributed to the process—27 partners from local, state, federal, and national agencies informed and reviewed the toolkit. We deliberately included key players’ voices in the toolkit at every stage of its development.

The toolkit offers five steps for conducting an assessment:
1.    Partner: establish partners and collaborators
2.    Plan: create a plan to conduct the assessment
3.    Collect: gather data and input
4.    Analyze: synthesize the data and findings
5.    Action: outline steps to take based on the data and communicate outwardly

The five steps are designed for people to go step-by-step or jump in at any stage if they already have started some activities. I encourage you to check out the toolkit and focus on pages 9-14 where you will find each step in the assessment process outlined in a one-page overview.

We incorporated strategies to operationalize equity into each step. Strategies include actions like involving community members most impacted by dementia in the process, building shared ownership of the assessment with key players, and continuously bringing new perspectives to the table. We also included top questions to ask early and often to operationalize equity, adapted from equity leaders Human Impact Partners.

To streamline the assessment process, we compiled 13 tools in the toolkit appendix. Some of the tools are also offered in an Excel spreadsheet for ease of use. One tool includes a list of potential data sources to kick-start ideas for planning an assessment (tool 3a, page 24).

The toolkit aligns with the Healthy Brain Initiative Road Map, co-developed by CDC and the Alzheimer’s Association. Our hope is that those who use the toolkit and conduct assessments will use the results to inform planning efforts, such as a health improvement plan or plan specific to addressing dementia and caregiving. These planning efforts are where past and future thinking can help to identify strategies and objectives that will help us move from status quo to improvement and equity.

As you assess the present state of dementia and caregiving in your own community, use that snapshot as a launchpad for reflecting on the past and future. Ask, “How did we get to this point? How can we intercept the current trend to move in a different direction?” By doing so, we can impact the future of dementia outcomes in our communities, starting with the present and looking to the past to transform our future.