Stroke Disparities

Stroke disparities are wide spread and pervasive throughout the world. In this review, we will examine the effect of socioeconomic status (SES), race, and ethnicity on stroke incidence and outcome. There are 2 main reasons that should compel us to fix the damage caused by stroke disparities. The first is based on the justice principle: no person or group should suffer more than others. Although this reason should be a sufficient motivator, another incentive to remedy stroke disparities is the tremendous expense that disparities impose on society. Because minority populations have stroke at younger ages and are often more severe; the cost is far greater per capita then in majority populations.1 We will look at opportunities to improve stroke prevention and stroke preparedness (recognizing stroke and alerting emergency medical services) in underserved populations toward remedying stroke disparities. The Table provides a summary of the potential intervention targets discussed in this article.View this table:Table. Potential Intervention Targets and Timing to Reduce Stroke Disparities in Developed and Developing Countries Discussed in This ArticleMuch of the work in this area is centered in the United States. However, there are important data emerging from international locations. Indeed the epidemiological transition, the change from infection and trauma to chronic diseases as major causes of death and disability in the developing world, speaks directly to the need for prevention and preparedness in the poorest parts of the globe. Paradoxically, increases in stroke risk and mortality in developing countries are associated with increasing SES, but decreases in stroke risk and mortality in developed countries are associated with increasing SES.2 In rural villages in China, higher incomes brought prosperity but also brought higher stroke risk.3 It is likely that when new monies enter a previously impoverished area that certain unhealthful behaviors are initially adopted. These may …