Persistent Racial Disparity in Stroke Hospitalization and Economic Impact in Young Adults in the Buckle of Stroke Belt

Boan, Andrea D.; Feng, Wuwei; Ovbiagele, Bruce; Bachman, David; Ellis, Charles; Adams, Robert J.; Kautz, Steven A.; Lackland, Daniel T.

doi:10.1161/strokeaha.114.004853

Cited by 39 publications

(25 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings indicate a racial disparity despite dramatic gains nationwide in stroke reduction. 9 Finally, a study of 162 stroke survivors revealed that AAs were less likely to report independence in overall functional performance at one year when compared with Whites, even after controlling for stroke severity. 10 Collectively, these findings provide strong evidence of racial differences in stroke recovery in South Carolina.…”

Section: Previous Research Related To Wissdom Focusmentioning

confidence: 99%

Addressing Racial Disparities in Stroke: The Wide Spectrum Investigation of Stroke Outcome Disparities on Multiple Levels (WISSDOM )

et al. 2018

Self Cite

View full text Add to dashboard Cite

Racial-ethnic disparities in stroke recovery are well-established in the United States but the underlying causes are not well-understood. The typical assumption that racial-ethnic disparities in stroke recovery are explained by health care access inequities may be simplistic as access to stroke-related rehabilitation, for example, does not adequately explain the observed disparities. To approach the problem in a more comprehensive fashion, the Wide Spectrum Investigation of Stroke Outcome Disparities on Multiple Levels (WISSDOM) was developed to bring together scientists from Regenerative Medicine, Neurology, Rehabilitation, and Nursing to examine disparities in stroke “recovery.” As a result, three related projects (basic science, clinical science and population science) were designed utilizing animal modeling, mapping of brain connections, and community-based interventions. In this article we describe: 1) the goals and objectives of the individual projects; and 2) how these projects could provide critical evidence to explain why racial-ethnic minorities traditionally experience recovery trajectories that are worse than Whites.Ethn Dis. 2018;28(1):61-68; doi:10.18865/ed.28.1.61.

show abstract

Section: Previous Research Related To Wissdom Focusmentioning

confidence: 99%

Addressing Racial Disparities in Stroke: The Wide Spectrum Investigation of Stroke Outcome Disparities on Multiple Levels (WISSDOM )

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…50,68,69 For example, 47% of blacks were estimated to have hypertension in 2015 compared with 40% of white non-Hispanics, consequently increasing their risk for stroke and heart failure. 1,[70][71][72] Studies of traumatic spinal cord injury and other chronic conditions suggest that blacks were more likely to receive informal care from other family members, friends, church support, and others, whereas whites were more likely to receive informal or family care from spouses. 73 Level of income was most directly related to the use of paid versus unpaid care.…”

Section: Special Concerns By Age Sex and Race/ Ethnicitymentioning

confidence: 99%

Projected Costs of Informal Caregiving for Cardiovascular Disease: 2015 to 2035: A Policy Statement From the American Heart Association

Dunbar¹,

Khavjou²,

Bakas³

et al. 2018

Circulation

181

104

View full text Add to dashboard Cite

INTRODUCTION:In a recent report, the American Heart Association estimated that medical costs and productivity losses of cardiovascular disease (CVD) are expected to grow from $555 billion in 2015 to $1.1 trillion in 2035. Although the burden is significant, the estimate does not include the costs of family, informal, or unpaid caregiving provided to patients with CVD. In this analysis, we estimated projections of costs of informal caregiving attributable to CVD for 2015 to 2035. METHODS:We used data from the 2014 Health and Retirement Survey to estimate hours of informal caregiving for individuals with CVD by age/sex/race using a zero-inflated binomial model and controlling for sociodemographic factors and health conditions. Costs of informal caregiving were estimated separately for hypertension, coronary heart disease, heart failure, stroke, and other heart disease. We analyzed data from a nationally representative sample of 16 731 noninstitutionalized adults ≥54 years of age. The value of caregiving hours was monetized by the use of home health aide workers' wages. The per-person costs were multiplied by census population counts to estimate nation-level costs and to be consistent with other American Heart Association analyses of burden of CVD, and the costs were projected from 2015 through 2035, assuming that within each age/sex/racial group, CVD prevalence and caregiving hours remain constant. RESULTS:The costs of informal caregiving for patients with CVD were estimated to be $61 billion in 2015 and are projected to increase to $128 billion in 2035. Costs of informal caregiving of patients with stroke constitute more than half of the total costs of CVD informal caregiving ($31 billion in 2015 and $66 billion in 2035). By age, costs are the highest among those 65 to 79 years of age in 2015 but are expected to be surpassed by costs among those ≥80 years of age by 2035. Costs of informal caregiving for patients with CVD represent an additional 11% of medical and productivity costs attributable to CVD. CONCLUSIONS:The burden of informal caregiving for patients with CVD is significant; accounting for these costs increases total CVD costs to $616 billion in 2015 and $1.2 trillion in 2035. These estimates have important research and policy implications, and they may be used to guide policy development to reduce the burden of CVD on patients and their caregivers.

show abstract

“…Differences in incidence, pathogenesis, and clinical outcome have long been noted when comparing IS among patients with different racial and ethnic backgrounds. Epidemiological studies highlight significant racial disparities with blacks having significantly higher stroke incidence compared to whites [6], younger age of incidence [7], and poorer functional outcomes [8]. …”

Section: Introductionmentioning

confidence: 99%

The Role of Matrix Metalloproteinase Polymorphisms in Ischemic Stroke

Chang

Stanfill

Pourmotabbed

2016

IJMS

View full text Add to dashboard Cite

Stroke remains the fifth leading cause of mortality in the United States with an annual rate of over 128,000 deaths per year. Differences in incidence, pathogenesis, and clinical outcome have long been noted when comparing ischemic stroke among different ethnicities. The observation that racial disparities exist in clinical outcomes after stroke has resulted in genetic studies focusing on specific polymorphisms. Some studies have focused on matrix metalloproteinases (MMPs). MMPs are a ubiquitous group of proteins with extensive roles that include extracellular matrix remodeling and blood-brain barrier disruption. MMPs play an important role in ischemic stroke pathophysiology and clinical outcome. This review will evaluate the evidence for associations between polymorphisms in MMP-1, 2, 3, 9, and 12 with ischemic stroke incidence, pathophysiology, and clinical outcome. The role of polymorphisms in MMP genes may influence the presentation of ischemic stroke and be influenced by racial and ethnic background. However, contradictory evidence for the role of MMP polymorphisms does exist in the literature, and further studies will be necessary to consolidate our understanding of these multi-faceted proteins.

show abstract

Persistent Racial Disparity in Stroke Hospitalization and Economic Impact in Young Adults in the Buckle of Stroke Belt

Cited by 39 publications

References 37 publications

Addressing Racial Disparities in Stroke: The Wide Spectrum Investigation of Stroke Outcome Disparities on Multiple Levels (WISSDOM )

Addressing Racial Disparities in Stroke: The Wide Spectrum Investigation of Stroke Outcome Disparities on Multiple Levels (WISSDOM )

Projected Costs of Informal Caregiving for Cardiovascular Disease: 2015 to 2035: A Policy Statement From the American Heart Association

The Role of Matrix Metalloproteinase Polymorphisms in Ischemic Stroke

Contact Info

Product

Resources

About