Wealth as a determinant of brain health

Farina and colleagues’ recent editorial argues that “public health messaging should promote brain health as a valuable goal to aspire to, like physical fitness” to reduce dementia risk and promote the wellbeing of young people.1 Their objective of shifting the focus of dementia risk reduction away from later life is laudable, as later changes mean lower impact.2 But the onus of brain health policy making should be on mitigating the effects of inequalities and improving access to richer environments in which risk reduction can take place.Paradoxically, the authors argue that young adults are vulnerable because of poor mental health and economic prospects and yet “have the opportunity to make early and long term changes to minimise risk.” Literature from conditions such as obesity, alcoholism, and smoking indicates that public health messaging directed at individuals to change their behaviour is ineffective.3 Although the authors recognise that “interventions to change behaviour must…
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