Racial, Ethnic Gap in Stroke Care

May 26, 2011 - The American Heart Association (AHA) is calling for new efforts to curb stroke in minority groups.

In a scientific statement, the AHA notes that stroke is more common among African-Americans, Hispanics, American Indians, and Alaskan Natives than among whites.

The AHA calls for raising awareness of stroke factors and the need for urgent treatment, increasing access to insurance coverage in minority populations, and doing more research on the roots of racial and ethnic disparities in stroke care.

Stroke Risk Factors

Stroke is more likely if you have risk factors including high blood pressure, diabetes, high cholesterol, smoking, obesity, and a history of peripheral artery disease (PAD), carotid artery disease, or certain types of heart disease.

Several of those risk factors are more common in minority groups than among whites.

For instance, the AHA notes that high blood pressure and diabetes are more common among African-Americans than among whites, and that diabetes is even more common among Hispanics.

American Indian and Alaskan Natives are more likely than whites to have at least two risk factors for stroke.

Stroke Gap

The authors of the AHA statement analyzed racial and ethnic disparities in a large body of current scientific literature. And they found differences at every turn.

“We see disparities in every aspect of stroke care, from lack of awareness of stroke risk factors, and symptoms to delayed arrival to the emergency room and increased waiting time,” Salvador Cruz-Flores, MD, MPH, of St. Louis University, says in a news release. “These disparities continue throughout the spectrum of the delivery of care, from acute treatment to rehabilitation.”

Besides stroke risk factors, the statement notes that economic and social issues, including access to medical care and health insurance, also matter.

So do cultural and language barriers, and beliefs and attitudes. For example, the AHA notes that perception of or the actual presence of racial bias in the health care system may make a patient less likely to follow their doctor's advice or stick with their medication and treatment.

“It is important for members of ethnic and racial minority groups to understand they are particularly predisposed to have risk factors for heart disease,” Cruz-Flores says. “They need to understand these diseases are preventable and treatable.”

Cruz-Flores says it is “striking that we are in the 21st century, with many advances in stroke care, yet we are still struggling to fix the differences that are present not only in the distribution of the disease but also in the level of care we provide to the different racial and ethnic groups.”

The statement appears in the July edition of Stroke: Journal of the American Heart Association.