Policy Environment
Team
Mauricio Avendano
University of Lausanne
Domain Lead
Clémence Kieny
University of Lausanne
Postdoctoral Fellow
McKayla Wenner
University of Southern California
Domain Coordinator
Mathéo Bourgeois
University of Lausanne
Intern
Overview
The Policy Environment domain explores how government policies influences key determinants of brain health outcomes across life. This exploration focuses on policies across multiple domains including public health, long-term care, environmental, and social policies. Studying variations in policies across jurisdictions (e.g., states, countries, regions) and over time enable researchers to assess their impact on AD/ADRD risk factors and outcomes.
To advance this work, the Policy Environment domain focuses on identifying understudied policies, developing standardized and cutting-edge methods for policy data collection and harmonization, and creating robust analytical approaches to evaluate policy effects on dementia outcomes. The Policy Environment domain engages with policy across four main areas:
Public Health PolicyPublic health policies play a crucial role in dementia prevention by shaping key behavioral risk factors such as tobacco and alcohol use, nutrition, and physical activity. Policies that promote healthy lifestyles can therefore help mitigate cognitive decline and contribute to overall brain health.
Physical Environment Policy The physical environment influences cognitive health through factors such as air quality, pollution, noise exposure, and access to green spaces. Policies aimed at reducing environmental hazards and improving urban planning may support cognitive resilience and lower dementia risk over the life course.
Social PolicyA wide array of policies that affect education, employment, workplace conditions, social inclusion, loneliness, and income security contribute to dementia prevention and outcomes. These policies support cognitive health as well as mitigate stressors that are linked to dementia. By addressing these broader conditions, such policies contribute to both dementia prevention and improved outcomes for those affected.
Long Term Care PolicyLong-term care policies shape the support systems available for individuals living with dementia and their caregivers. Policies governing home-based care, institutional long-term care, and caregiving support services play a critical role in ensuring quality of life, access to care, and end-of-life planning for those affected by dementia.
Priorities
Community Insights
In the fall of 2024, the GECC hosted a series of town hall meetings with hundreds of unique participants. These meetings yielded critical insights for the Policy Environment domain, including highlighting key themes and gaps in research.
Key Themes
- Life course education and work-related policies
- Policies on loneliness and social isolation
- Policies shaping the physical and neighborhood environment
- Caregiving and long-term care policies
Gaps in research
- Lack of longitudinal research on policy impacts
- Limited research on environmental and occupational exposures
- Insufficient understanding of social policies and community-based interventions
- Lack of harmonized policy data for cross-national comparisons
Measures
To address these priorities and facilitate a better understanding of the relationship between the exposome and AD/ADRD outcomes, the Policy Environment domain will use existing measures as well as develop novel measures.
Existing Measures
- Education Policy: compusory schooling, educational tracking
- Retirement Policy: old-age benefits, survivor old-age benefits, old-age social assistance, old-age health insurnace
- Long-Term Care Policy: cash benefits. in-kind benefits, 24-hour care benefits, service voichers
Novel Measures
- Our aim is to develop common standards and guidance for the collection, harmonization, documentation, archiving, and linking of data on policies for studying the causes of AD/ADRD, using rigorous scientific tools and methods for legal mapping and policy surveillance. Based on this guidance, measures of specific policies within each priority domain will be developed.
