Historical Slavery and Modern-Day Stroke Mortality in the United States Stroke Belt

Esenwa, Charles; Tshiswaka, Daudet Ilunga; Gebregziabher, Mulugeta; Ovbiagele, Bruce

doi:10.1161/strokeaha.117.020169

Cited by 37 publications

(28 citation statements)

References 22 publications

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“…For example, two studies published in the past few years found that historical concentrations of enslaved populations during the 1800s in the southern USA are associated with present-day poor health outcomes. 42,43 Although a historically racist practice has been abolished, the underlying discriminatory mechanisms might persist within social, political, and economic institutions in ways that lead to health disparities. Our finding of persistently higher emergency department visits due to asthma in redlined tracts compared with higher-graded tracts 80 years or more after the development and use of security maps, coupled with higher DEP emissions and poverty rates, might partly reflect a discriminatory legacy of redlining.…”

Section: Discussionmentioning

confidence: 99%

Associations between historical residential redlining and current age-adjusted rates of emergency department visits due to asthma across eight cities in California: an ecological study

Nardone

Casey

Morello‐Frosch

et al. 2020

The Lancet Planetary Health

262

165

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Background Asthma disproportionately affects communities of colour in the USA, but the underlying factors for this remain poorly understood. In this study, we assess the role of historical redlining as outlined in security maps created by the Home Owners' Loan Corporation (HOLC), the discriminatory practice of categorising neighbourhoods on the basis of perceived mortgage investment risk, on the burden of asthma in these neighbourhoods. MethodsWe did an ecological study of HOLC risk grades and asthma exacerbations in California using the security maps available for the following eight cities: Fresno,

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Section: Discussionmentioning

confidence: 99%

Associations between historical residential redlining and current age-adjusted rates of emergency department visits due to asthma across eight cities in California: an ecological study

Nardone

Casey

Morello‐Frosch

et al. 2020

The Lancet Planetary Health

262

165

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“…13,14 We have previously shown that racial disparities in stroke mortality in the Southeast US are rooted in long-standing social and economic institutional marginalization. 1 The disproportionate under-utilization of thrombectomy in AA, may similarly be the result of long-standing societal disenfranchisement. Consistent with this theory are our observations that AA were significantly younger at the time of thrombectomy, were more likely to be in the lowest quartile of income, and less likely to have private insurance or Medicare compared with ity we observed.…”

Section: Discussionmentioning

confidence: 99%

Racial Differences in Mechanical Thrombectomy Utilization for Ischemic Stroke in the United States

et al. 2020

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Background: Compared with non-Hispanic Whites (NHW), racial-ethnic minorities bear a disproportionate burden of stroke and receive fewer evidence-based stroke care processes and treatments. Since 2015, mechanical thrombectomy (MT) has become standard of care for acute ischemic stroke (AIS) patients with proximal anterior circulation large vessel occlusion (LVO).Objectives: Our objectives were to: assess recent trends in nationwide MT utilization among patients with AIS; determine if there were racial differences; and identify what factors were associated with such differences.Methods: We performed a retrospective cohort study using nationally representative data of a non-institutionalized population sample from 2006 to 2014 obtained from the Nationwide Inpatient Sample (NIS). We identified a total of 889,309 observations of AIS, of which there were 5,256 MT observations.Results: In the fully adjusted model, rate of thrombectomy utilization was significantly lower in African Americans (AA) (OR .67, CI .58-.76, P<.001) compared with NHW and Hispanics (OR .94, CI .78-1.13, P=.5).Conclusion: We found a significant disparity in MT utilization for AA compared with NHW and Hispanics. More work is needed to understand the drivers of this racial disparity in stroke treatment. Ethn Dis. 2020;30(1):91-96; doi:10.18865/ed.30.1.91

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“…However, data continues to suggest that major ethnic disparities remain in stroke related mortalities among Legacy African Americans. Heart disease is the number one killer of Legacy African American women 68 . Poor CVD health in these communities is exasperated by the history of slavery, social segregation, lack of access to health care and health care providers, institutionalized racial discrimination, stress, and economic instability.…”

Section: Health Consequences Of a Distinct Geospatial Distributionmentioning

confidence: 99%

“…Poor CVD health in these communities is exasperated by the history of slavery, social segregation, lack of access to health care and health care providers, institutionalized racial discrimination, stress, and economic instability. Moreover, institutionalized levels of inequity, coupled with genetic/genomic mediators like the epigenome, environmental, cultural, and behavioral risk factors in tandem lead to a constellation of physiological precursors for stroke 68,69 …”

Section: Health Consequences Of a Distinct Geospatial Distributionmentioning

confidence: 99%

Evolutionary perspectives on African North American genetic diversity: Origins and prospects for future investigations

Caldwell

Jackson

2021

Evolutionary Anthropology

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African‐descended peoples of the Americas represent an amalgamation of West, Central, and Southeast African regional and ethnic groups with modest gene flow from specific non‐African populations. Despite 16+ generations of residence in the Americas, there is a deficit of evolutionary knowledge about these populations. Focusing on Legacy African American, the African North American descendants of survivors of the transatlantic trade in enslaved Africans, we report on emic evolutionary perspectives of their self‐identity gleaned from our interviews of 600 individuals collected over 2 years. Gullah‐Geechee peoples of Carolina Coastal regions are a model case study due to their historical antiquity, substantial African retentions, relative geospatial isolation, and proposed progenitor status to other Legacy African American microethnic groups. We identify salient research questions for future studies that will begin to bridge the evolutionary gaps in our knowledge of these diverse peoples and the historical evidence for specific evolutionary processes.

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Historical Slavery and Modern-Day Stroke Mortality in the United States Stroke Belt

Cited by 37 publications

References 22 publications

Associations between historical residential redlining and current age-adjusted rates of emergency department visits due to asthma across eight cities in California: an ecological study

Associations between historical residential redlining and current age-adjusted rates of emergency department visits due to asthma across eight cities in California: an ecological study

Racial Differences in Mechanical Thrombectomy Utilization for Ischemic Stroke in the United States

Evolutionary perspectives on African North American genetic diversity: Origins and prospects for future investigations

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