Social class and race disparities in premature stroke mortality among men in North Carolina

Casper, Michele; Barnett, Elizabeth; Armstrong, Donna; Giles, Wayne H.; Blanton, Curtis

doi:10.1016/s1047-2797(96)00113-5

Cited by 25 publications

(11 citation statements)

References 56 publications

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“…In the US population as a whole, race is intimately associated with socioeconomic status, and socioeconomic factors are documented to contribute to the excess stroke mortality found among blacks. 26,27 Thus, the racial difference we observed in initial stroke severity may be greater in other patient populations, where black race is more strongly associated with low socioeconomic status and, therefore, less access to health care.…”

Section: Discussionmentioning

confidence: 90%

“…Other studies examining racial variation in stroke have described sex as an independent predictor and as having an interaction with race when considering stroke risk factors, incidence, and mortality. [27][28][29][30] Thus, it may be inappropriate to generalize our findings regarding stroke severity to female stroke patients. Second, we had a slightly lower percentage of intracerebral hemorrhages than do most stroke cohorts (8% versus 10% to 15%) and did not demonstrate the previously documented black preponderance of intraparenchymal hemorrhages.…”

Section: Discussionmentioning

confidence: 99%

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Racial Variation in Initial Stroke Severity

Jones

Horner

Edwards

et al. 2000

Stroke

110

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Background and Purpose-Blacks experience greater morbidity and mortality from stroke than do whites. The degree to which this is due to the severity of the initial stroke is not known. The objective of this study is to determine whether there is a racial difference in initial stroke severity. Methods-A secondary analysis of a prospective cohort of 984 veterans (29.7% black) admitted to any of 9 geographically diverse Veterans Administration Hospitals for acute stroke between April 1995 and March 1997 was performed. Initial stroke severity was ascertained by using the modified Canadian Neurological Scale (CNS) applied retrospectively to medical record data. Stroke severity, unadjusted and adjusted for covariates, was compared between black and white patients. Results-Blacks had greater initial stroke severity than did whites (mean CNS score 7.96 versus 8.32, respectively; Pϭ0.039), with a 0.5-point difference on the scale corresponding to a single-level decrement in either speech or strength of half of an extremity. This difference persisted with adjustment for other important predictors of stroke severity (Pϭ0.035). However, there was no significant racial difference in severity when CNS scores were collapsed into a priori clinically relevant categories. Conclusions-Compared with whites, blacks show greater severity of stroke at hospital admission. It remains uncertain whether the relatively small but significant difference at presentation fully explains the striking racial differences in morbidity and mortality from stroke. (Stroke. 2000;31:563-567.)

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Racial Variation in Initial Stroke Severity

Jones

Horner

Edwards

et al. 2000

Stroke

110

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“…Approximately 80,000 veterans receiving healthcare in the Veterans Health Administration (VHA) are stroke survivors and an estimated 9,000 to 11,000 veterans are hospitalized each year with a new stroke [4][5]. Compared with whites, Latinos and other minority groups in the United States have a greater incidence and mortality from stroke, especially those who are younger and in the lower socioeconomic tiers [2,[6][7][8][9]. Latino stroke patients are twice as likely as whites to have a recurrent stroke within 2 years of their first stroke [10].…”

Section: Strokementioning

confidence: 99%

Stroke caregiver information needs: Comparison of Mainland and Puerto Rican caregivers

Hinojosa¹,

Rittman²

2007

JRRD

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Abstract-Research indicates that informal caregivers of stroke survivors often do not have the information necessary to adequately manage the recovery process at home. This article presents findings on the information sources and needs of stroke caregivers both in Puerto Rico and the Mainland United States. Data were collected from 120 caregivers (42 Puerto Rican, 78 Mainland) of veterans who had experienced a stroke. Of all caregivers, 22% to 50% reported the need for information related to stroke recovery. This need was greater for Puerto Rican caregivers compared with Mainland caregivers. Caregivers receive most of their information from their doctors, the Veterans Health Administration (VHA), and the Internet. This study highlights the need for information dissemination to Puerto Rican and Mainland caregivers within the VHA system. This dissemination is an important and ongoing goal of the Stroke Quality Enhancement Research Initiative and the VHA/ Department of Defense Clinical Practice Guidelines.

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“…Recent research suggests that exposure to risk factors operate throughout the life span to influence stroke risk. [5][6][7][8] Of the many explanations for the Stroke Belt examined to date, none provide adequate explanations for geographic differences. 1 Part of the puzzle arises because most studies define Stroke Belt exposure on the basis of state of residence at the time of stroke onset and have not incorporated information on place of residence earlier in life.…”

mentioning

confidence: 99%