A series of new studies have highlighted concerning trends in stroke risk and care among Black Americans. Despite overall improvements in stroke prevention and treatment, racial inequities have persisted or even widened in recent years.
Black Adults Face Strokes at Younger Ages
Research published this week in the journal JAMA Neurology found that Black adults have strokes nearly a decade earlier on average than their White counterparts. The study analyzed over 18,000 stroke patients and found the average age at stroke onset was 62 for Black patients compared to 72 for White patients.
“We found a substantial difference in age at stroke onset by race, with Black patients experiencing first-time stroke at a significantly younger age,” said lead study author Dr. Herschel Patel, a neurologist at Emory University School of Medicine in Atlanta. “These racial disparities did not change over the study period from 2005 to 2019, highlighting an urgent need to improve stroke prevention and reduce risk factors among Black Americans.”
Poorer Access toAdvanced Treatments
Another study this month in JAMA Network Open examined racial differences in access to advanced treatments for acute ischemic stroke such as endovascular thrombectomy – a minimally invasive procedure to remove blood clots. Researchers found that Black patients with strokes were 19% less likely to receive these cutting-edge treatments compared to White patients.
This builds on previous research showing that Black patients often receive lower quality stroke care, including less neuroimaging to assess stroke severity.
“Our findings suggest there are still unacceptable racial discrepancies in who receives advanced stroke therapies,” said senior study author Dr. Huma U. Qureshi, an assistant professor of neurology at the University of Missouri. “All patients who are eligible for these treatments should have equitable access.”
Contributing Factors
There are complex reasons behind racial inequities in stroke risk and care.
Socioeconomic factors play a major role. Black Americans face higher rates of poverty, barriers to affordable healthy food, unsafe living conditions and toxic stress – all linked to higher stroke risk factors like hypertension, diabetes and obesity.
Systemic issues within the healthcare system also contribute. Implicit racial bias among providers, lack of diversity in the medical workforce and lower quality hospitals in predominantly Black communities likely affect the timeliness and quality of stroke treatment.
“The stroke treatment gap is unacceptable and preventable. We must address broader issues like poverty, structural racism and bias in medicine,” said American Heart Association president Dr. Fatima Rodriguez. “Every person deserves equitable care when facing a medical emergency like stroke that can take life or cause permanent disability.”
Call for Urgent Action
In an editorial published alongside the JAMA Neurology study, Dr. Joseph Broderick, neurologist and former president of the American Heart Association called the findings “disturbing.”
“The study reinforces the need to improve prevention beginning early in life and to urgently address modifiable risk factors for stroke among Black individuals,” wrote Dr. Broderick. “Health care systems, payers, and policymakers should develop, support, and implement effective programs directed toward these goals.”
Public health experts echoed this call for action and warned trends may worsen without meaningful reforms.
“As the Black population grows and ages, we could see widening disparities in stroke burden if risk factors like hypertension are not controlled,” said American Stroke Association spokesperson Dr. Tracy Jackson.
She added, “It’s critical we create targeted prevention programs for Black communities, ensure equitable access to high-quality care, and address root causes like poverty and structural racism.”
Ongoing Efforts to Reduce Disparities
In recent years, the American Heart Association and American Stroke Association have implemented initiatives specifically aimed at reducing racial inequities related to stroke.
This includes screening programs to detect high blood pressure in Black communities, improving emergency medical services in underserved neighborhoods, and provider training programs on implicit bias and cross-cultural care.
Additionally, new legislation has been proposed to increase funding for federal programs promoting awareness of stroke signs and facilitating rapid treatment among minority populations.
“While deeply concerning, these findings also highlight key areas we must prioritize to achieve health equity,” said AHA chief clinical science officer Dr. Mariell Jessup. “With coordinated efforts spanning policy, medicine and public health, we can – and must – reduce unequal stroke burden.”
What This Means for Black Americans
For Black adults concerned about their stroke risk, experts emphasize addressing modifiable factors like diet, exercise, smoking and appropriate medication use. Getting screened regularly for hypertension is also crucial for early detection and management.
“While some disparities are out of an individual’s control, controlling blood pressure remains one of the most effective ways for Black Americans to reduce odds of stroke,” said Dr. Patel.
Advocating for equitable healthcare access and broader societal reforms are also vital.
“Black communities must demand investment in prevention and urgent action from policymakers on persistent health divides,” said AHA’s Dr. Rodriguez. “Together we can work to make quality stroke care affordable, accessible and culturally competent for all.”
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