ArticleJournal of the National Medical Association2023
Black Americans have worse stroke outcome compared with non-Hispanic whites.
Article in Journal of the National Medical Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- The importance of health equity research for all populations in the United States: SEQUINS hall of fame lecture.Equity neuroscience · 2026Article
- Dissociation between Perceived Discrimination and SDOH among Black and Hispanic Stroke Patients.Journal of racial and ethnic health disparities · 2026Article
- Bridging the Gap in Racial/Ethnic Disparities: Perspectives from the 2025 American Heart Association/American College of Cardiology High Blood Pressure Guideline.Current hypertension reports · 2026Review
- Younger adult women who had a stroke or at high stroke risk: Exploration of their experiences and needs.Qualitative research in medicine & healthcare · 2025Article
- Racial and Ethnic Disparities in Stroke Incidence and Outcomes.Current cardiovascular risk reports · 2025Article
- The Color of Medicine.Annals of family medicineArticle
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Authors and funding
9 authors.
Funding
Abstract
introductionWe studied racial differences in post-stroke outcomes using a prospective, population-based cohort of stroke survivors as part of the Brain Attack Surveillance in Corpus Christi (BASIC) project.
methodsNeurologic (NIHSS, range of 0-42, higher scores are worse), functional (ADLs/IADLs, range 1-4, higher scores are worse), and cognitive (3MSE, range 0-100, higher scores are better) outcomes were measured 90 days after stroke. Cox proportional hazards and negative binomial linear regression models were used to examine the associations between race and 90-day all-cause mortality and NIHSS, respectively, whereas linear regression was used for ADLs/IADLs and 3MSE scores. Covariates included demographics, initial NIHSS, comorbidities, prior stroke history, tPA treatment status, pre-stroke disability, and pre-stroke cognition. The mortality model was also adjusted for DNR status.
resultsAt 90 days post-stroke, Black American individuals (BAs) (n = 122) had a median (IQR) NIHSS of 2 (1,6) compared to NIHSS of 1 (0,3) in non-Hispanic White American individuals (NHWs) (n = 795). BAs had a median (IQR) ADL/IADL score of 2.41 (1.50, 3.39) compared to 2.00 (1.27, 2.95) in NHWs. BAs scored a median of 84 (75, 92) on the 3MSE compared to NHWs' score of 91.5 (83, 96). Death occurred in 23 (8%) of BAs and 268 (15%) of NHWs within 90 days among those who participated in baseline. After adjustment for covariates, functional outcomes at 90 days were worse in BAs compared to NHWs, with 15.8% (95% CI=5.2, 26.4) greater limitations in ADLs/IADLs and 43.9% (95% CI=12.0, 84.9) greater severity of stroke symptoms. Cognition at 90 days was 6.5% (95% CI=2.4, 10.6) lower in BAs compared to NHWs. BAs had a 35.4% lower (95% CI=-9.8, 61.9) hazard rate of mortality than NHWs.
conclusionsIn this prospective, population-based community sample, BAs had worse neurologic, functional and cognitive outcomes at 90 days compared to NHWs. Future research should investigate how social determinants of health including structural racism, neighborhood factors and access to preventive and recovery services influences these racial disparities.
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