Ethnic Gap, in Stroke Care

African Americans and Hispanic/Latinos are at a higher risk for strokes, because their lifestyles are a contributing factor, which makes them accessible to strokes. One out of every two African American has high blood pressure, and a large percentage is overweight, because they do not exercise. These problems coupled with the use of tobacco, drugs, alcohol, diabetes, not keeping up with physicals and doctor visits puts them in a dangerous position.

African American men are the first to get sick and the first to die. Eigthy percent of strokes are preventable if more Americans understood the risk factors and the warning signs when someone was having a stroke. If Americans could remember the word F.A.S.T., more individuals having strokes could be saved.

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.

The report pointed out that risk factors vary among racial and ethnic groups. African Americans have a higher risk for high blood pressure, diabetes and obesity, which are all risk factors for stroke, for example, whereas Hispanic Americans are at higher risk for diabetes and a condition called metabolic syndrome, which boosts the risk for heart conditions.

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

The report, published online May 26 in Stroke, recommends new policies to close the gap in stroke care, more education and research in the area — especially in regard to American Indians, Asian Americans and Pacific Islanders — and better access to health insurance.

“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,” Cruz-Flores said.