Health Equity and Actionable Disparities in Stroke: 2021 Update

Abstract

There are stark inequities in stroke incidence, prevalence, acute care, rehabilitation, risk factor control, and outcomes. To address these inequities, it is critical to engage communities in identifying priorities and designing, implementing, and disseminating interventions. This issue of Stroke features health equity themed lectures delivered during the International Stroke Conference and Health Equity and Actionable Disparities in Stroke: Understanding and Problem-Solving meetings in 2021 as well as articles covering issues of disparities and diversity in stroke. Bruce Ovbiagele, MD, MSc, MAS, MBA, MLS, received the 2021 William Feinberg Award Lecture for his lifetime achievements in seeking global and local solutions to cerebrovascular health inequities. The second annual Health Equity and Actionable Disparities in Stroke: Understanding and Problem-Solving symposium, which took place the day before the International Stroke Conference in February 2021, focused on community-engaged research for reducing inequities in stroke. Phil Gorelick, MD was awarded the Edgar J. Kenton III Award for his lifetime achievements in using community engagement strategies to recruit and retain Black participants in observational studies and clinical trials. Walter Koroshetz, MD, Director of the National Institute of Neurological Disorders and Stroke delivered the keynote lecture on stroke inequities and Richard Benson, MD, PhD, Director of the Office of Global Health and Health Disparities at National Institute of Neurological Disorders and Stroke, gave a lecture focused on National Institute of Neurological Disorders and Stroke efforts to address inequities. Nichols et al highlighted approaches of community-based participatory research to address stroke inequities. Verma et al showcased digital health innovations to reduce inequities in stroke. Das et al showed that the proportion of underrepresented in medicine vascular neurology fellows has lowered over the past decade and authors provided a road map for enhancing the diversity in vascular neurology. Clearly, to overcome inequities, multipronged strategies are required, from broadening representation among vascular neurology faculty to partnering with communities to conduct research with meaningful impact.

Factors Explaining the Change in Socioeconomic Inequality of Disability in Iran: A Repeated Cross-sectional Study

“…Therefore, disadvantaged people in Iran are struggling more with adversities related to disability and need much more attention from policymakers. It is believed that people with disabilities may use less health services ( 34 ).This confirmed the finding of a study in Iran where it showed that the use of rehabilitation services has been concentrated among privileged Iranians ( 35 ). This requires the attention of the healthcare authorities for an equitable distribution of these services .…”

Racial and Ethnic Disparities in the Medical Management of Poststroke Complications Among Patients With Acute Stroke

“… 35 , 36 Progress in this realm demonstrates the positive cumulative effects of efforts that have been made to address inequities within stroke and health care more broadly. 37 While some of these trends are positive, the goal of true health equity has not been achieved, particularly in reference to individual‐ and system‐level factors that contribute to racial and ethnic disparities within health care. 31 …”

Racial and Ethnic Equity in Neuromuscular Care—Time for Our Action to Live Up to Potential

“…Accelerated by the COVID-19 pandemic, health care disparities and inequities based on race and ethnicity have garnered greater attention. Our understanding of health equity in neuromuscular disorders is far more limited than in other areas of neurology . Improved recognition, appreciation, and rectification of neuromuscular disparities has direct implications in improving the quality of care for vulnerable populations.…”