- A recent study found that Hispanic and black American veterans are more likely to die in the first month after certain types of stroke than white veterans.
- The researchers looked at the medical records of more than 37,000 veterans.
- Stroke is one of the leading causes of death among Americans.
A new study finds that Hispanic and Black American veterans are more likely to die in the first 30 days after certain types of stroke than white veterans.
However, these groups have lower mortality rates than whites after other types of stroke and at different periods after stroke.
The study, published on June 1 in NeurologyAnd the The Medical Journal of the American Academy of Neurology provides updated estimates of post-stroke mortality rates for veterans.
It also adds additional information about mortality rates after different types of stroke and between racial and ethnic groups.
“Research in stroke patients has shown variations in stroke outcomes for people of color for decades,” said Dr. Erica Jones, assistant professor of neurology at UT Southwestern Medical Center in Dallas, who was not involved in the new research.
“The results of this [new study] She points out that there is no one-size-fits-all approach to prognosis discussions.” “There are many variables that need to be considered when predicting how patients will recover and survive after strokes, with race being among them.”
Jones’ research has shown a reduced likelihood of good functional recovery after stroke in black and Hispanic populations.
For the study, researchers reviewed the health records of more than 37,000 veterans who were admitted due to a stroke to a Veterans Health Administration hospital between 2002 and 2012.
The researchers also collected information about the patients’ race and ethnicity, the type of stroke they had, and which patients died during the study period.
They also took into account other factors that can influence the risk of death after a stroke, such as age, gender, smoking, diabetes and heart disease.
The majority of strokes (89 percent) patients suffered were from ischemia, which is caused by a blood clot. The rest was due to a brain hemorrhage, also known as a hemorrhagic stroke. There were two such reports.
Researchers found that black patients were 3 percent more likely to die within the first 30 days after a hemorrhagic stroke than white patients.
This elevated risk for black people occurred mainly within the first 20 days after a stroke.
In addition, Hispanic patients were 10 percent more likely to die within the first 30 days after a SAH than white patients.
However, black and Hispanic patients had lower mortality rates compared to white patients after acute stroke for certain periods of time.
However, the study has several limitations that must be addressed by future research.
One is that nearly all of the patients were male, so the results may not apply to women. In addition, researchers cannot take into account the severity of a stroke, which can affect a person’s risk of death.
The researchers also had to exclude Native Americans, Alaska Natives, Native Hawaiians, and Asian American veterans from their analysis due to the low number of patients from these groups.
In addition, black Americans are twice as likely to have a first stroke than whites, the CDC reports. Blacks also have the highest rate of death from stroke.
Over the past decade, Hispanics have seen an increase in death rates from stroke, the agency said.
In an accompanying editorial, Drs. Karen C. Albright and Virginia J. Howard, Ph.D., said the new study “does much to improve our understanding of racial and ethnic differences in stroke mortality among veterans.”
They point to several of the paper’s strengths, including the large number of patients included in the study, the breakdown of deaths by stroke type and race/ethnicity, and the fact that researchers followed patients for more than a year after a stroke.
“The longer follow-up periods in this study may allow clinicians to provide patients and families with a better understanding of the likelihood of survival in their next significant life event,” they wrote.
However, Albright and Howard said one of the key questions to address is how the results of this study can help health care providers discuss recovery opportunities with patients and families after stroke in the short and long term.
Although the new study provides insight into stroke outcomes for different groups, Jones said the findings raise more questions than they provide answers.
“The fact that some groups are consistently doing worse than others should raise the alarm that there are systemic issues driving these differences,” she said.
“As a healthcare community, we have to ask ourselves how we contribute to creating these disparities and what our role is in correcting them,” she added.
Kenneth Campbell, DBE, MPH, director of Tulane University’s online Master of Health Administration program and assistant professor in the School of Public Health and Tropical Medicine, said the new study shows that more work needs to be done to reduce stroke-related disparities. and other health outcomes.
“Studies have shown consistent inverse and gradual relationships between class and early death for minorities,” Campbell said. “In addition, there are significant differences in health outcomes between those with resources and those without.”
The authors of the new paper called for more research, including on stroke death rates among other racial and ethnic groups, as well as how often life-sustaining therapies are used after stroke among different groups.
Jones said research is also needed to identify factors that contribute to racial/ethnic differences in stroke outcomes, including socioeconomic factors that influence health.
Also known as social determinants of health, these factors include access to quality education, well-paid jobs, healthy food, and health care.
While studies like the new study provide a greater understanding of the health disparities that specific groups face, research also needs to go beyond this to find solutions that work for all communities.
“There is a need for a shift away from simply describing these disparities in stroke outcomes toward developing effective interventions to prevent disparities,” Jones said.
She added that this should include clinicians and researchers partnering with patients and the black and Latino communities to come up with ways to close the gaps in stroke care.
Although the health disparities associated with stroke will not be quickly fixed, Jones is encouraged by the improvements that have already occurred in some areas.
To achieve this, “the healthcare community needs to invest in making changes to the way care is provided to these populations now to prevent inequalities from negatively affecting more people in the future,” she said.
Campbell agrees, saying, “Executive leadership for healthcare organizations must work to reduce barriers for all and create the internal infrastructure needed to create more equitable access,” he said.
In addition, these organizations need to “help patients deal with the social determinants of health, and reduce structural racism and racist policies rooted in the US health care industry,” he said.