Inequities in dementia services for Black and minoritised communities in the UK

Key statistics 

• around 850,000 people are living with dementia in the UK, including approximately 25,000 from Black and minoritised communities 

• the number of people with dementia from Black and minoritised groups is expected to double to 50,000 by 2026 and increase sevenfold by 2050 

Key messages 

• people from Black and minoritised communities are under-represented in dementia services and often present at later stages, frequently in crisis 

• barriers to access include lack of awareness, language and literacy challenges, stigma, and difficulties navigating health systems 

• cultural and religious values, including expectations of family care, can influence help-seeking behaviours 

• experiences of racism, discrimination and stereotyping reduce trust in services 

• there is a lack of culturally appropriate dementia services, including care provision that reflects cultural and religious needs 

• national policy recognises the need for inclusive dementia care, but implementation at local level is inconsistent and fragmented 

• decentralised commissioning contributes to a ‘postcode lottery’ in service availability and quality 

• people from Black and minoritised communities are under-represented in dementia research, limiting their influence on service design 

Policy implications 

• develop culturally appropriate dementia services that reflect the needs of diverse communities 

• improve awareness and early diagnosis through targeted outreach and education 

• strengthen accountability for local authorities and commissioners to deliver equitable services 

• integrate health and social care services to reduce fragmentation and improve continuity of care 

• increase representation of minoritised groups in research to inform service design 

• address structural inequalities, including socio-economic disadvantage and discrimination, across the life course 

Gaps 

• limited national data on how dementia services are commissioned and delivered for minoritised groups 

• evidence on effective models of culturally appropriate dementia care remains underdeveloped 

• lack of lived experience perspectives from Black and minoritised communities in policy and research 

• insufficient evaluation of how policy translates into practice at local level 

• further research is needed on long-term outcomes and cost implications of inequitable care 

Commentary
This paper examines how dementia services in the UK fail to meet the needs of Black and minoritised communities, despite longstanding policy commitments to inclusion. It shows a clear gap between national ambitions and what is delivered locally. 

A key issue is late access to care. Many individuals from these communities only engage with services at crisis point, which limits access to early diagnosis, treatment and support that could improve quality of life. 

Barriers are multiple and intersecting. These include limited awareness of dementia, language and literacy challenges, and difficulty navigating complex health and social care systems. Cultural expectations around family care also shape help-seeking, particularly where services are not seen as culturally appropriate. 

The study also highlights the role of structural factors. Experiences of racism and discrimination, alongside a lack of culturally competent services, contribute to mistrust and disengagement. At the same time, people from these communities are more likely to experience wider socio-economic disadvantage, which increases dementia risk over the life course. 

Policy frameworks such as the National Dementia Strategy emphasise inclusive and person-centred care. However, the decentralised nature of commissioning means that implementation varies widely. This creates geographical inequities, with some areas offering tailored services while others provide little targeted support. 

From a care equity perspective, the findings show that inequities are present across the entire dementia pathway, from prevention and diagnosis through to end-of-life care. Without stronger accountability and culturally appropriate service design, these disparities are likely to persist.