What are your odds of the right stroke treatment?

You can read my story here and an update here. But in a nutshell, I wound up in the right place and the right time when my stroke occurred back in 1998, two years after tissue plasminogen activator was approved for stroke patients - a Southern community hospital, of all places.

More than 18 years later, we still have problems getting this medication to stroke patients. Kaiser Health News noted geographic and racial disparities in stroke treatment tracked in a new study:

The findings come from a report published Wednesday in the journal Neurology. Researchers found stroke patients living in the Northeast states had more than twice the odds of receiving tPA — a powerful anti-coagulant that can break up the clot causing the stroke — than those living in the Midwest and the South.

Link between depression, stroke risk among black Americans

Racial disparity is a longstanding issue in health care. A study showing the need for more research and action linked depression among black Americans and stroke risk:

The study, based on the ongoing Jackson Heart Study in Jackson, Miss., included more than 3,300 blacks between 21 and 94 years old who were screened for depression. None of the participants had a history of heart attack or stroke.

But more than 22 percent had major depression at the start of the study, and over the course of 10 years, they had a higher risk of heart disease (5.6 percent vs. 3.6 percent) and stroke (3.7 percent vs. 2.6 percent) than those without depression, the researchers found.

Participants with depression were more likely to be women, have chronic health problems, get less exercise, have lower incomes, smoke, and have a higher body mass index (BMI), an estimate of body fat based on height and weight.

You've seen other news about depression as related to stroke risk, too. It's a series issue for all of us. And, perhaps, particularly an issue for some populations.

Stroke prevention, racial disparities and younger patients

Stroke prevention is important! If a stroke doesn't happen, then treatment is not necessary. Therapy for recovery is not necessary. And quality of life remains.

So a recent story highlighted not just one, but two issues - racial disparities and strokes for those under 65. The story is about how rising stroke rate for blacks in South Carolina, study finds:

Photo from U.S. Centers for
Disease Control and Prevention

They found that stroke hospitalizations among blacks younger than 65 jumped by more than 17 percent, but remained stable for whites younger than 65.

Blacks appeared more vulnerable to stroke at younger ages, too. According to the study, slightly more than half of the blacks hospitalized with stroke were younger than 65, compared with 30 percent of whites.

The study was published June 19 in the journal Stroke.

"Excess strokes among blacks, as well as the lingering racial disparity in the younger groups, represent a serious public health issue," lead author Dr. Wayne Feng, a stroke neurologist at the Medical University of South Carolina Stroke Center in Charleston, said in a journal news release.

Ethnic disparity in stroke rates persists

Strokes can cross the boundaries of race, ethnicity, sex, age, and income. However, some groups do have higher stroke rates. A recent story shows that ethnic disparity in stroke rates persists:

Ischemic stroke rates declined over an 11-year period in Corpus Christi, Texas, but rates remained elevated in Mexican Americans relative to their non-Hispanic white neighbors, researchers found. ...

"Although the declining ischemic stroke incidence in Mexican Americans and non-Hispanic whites is encouraging, the persistent disparity in young stroke patients, who suffer the longest from post-stroke disability, indicates a need for additional prevention efforts targeting young Mexican Americans and communities with large minority populations," they wrote.

"The U.S. Department of Health and Human Services recently published goals and objectives for reducing health disparities, although specific action plans remain elusive," they added.

Concerns about the stroke care gaps

The American Heart Association recently highlighted a disturbing and continuing trend about racial, ethnic gap in stroke care:

In a scientific statement, the AHA notes that stroke is more common among African-Americans, Hispanics, American Indians, and Alaskan Natives than among whites.

The AHA calls for raising awareness of stroke factors and the need for urgent treatment, increasing access to insurance coverage in minority populations, and doing more research on the roots of racial and ethnic disparities in stroke care. ...

Stroke is more likely if you have risk factors including high blood pressure, diabetes, high cholesterol, smoking, obesity, and a history of peripheral artery disease (PAD), carotid artery disease, or certain types of heart disease.

Several of those risk factors are more common in minority groups than among whites.

Despite some progress, disparities remain

This article by Reuters Health illustrates how strokes can impact. Despite age or race, this problem impacts us all, and we're all better off if we all work to reduce stroke risks:

Strokes in young blacks drain South Carolina's pocket:

In South Carolina, African Americans suffer strokes at younger ages and have worse outcomes than Caucasians, Dr. Wayne Feng and colleagues report in the latest issue of the medical journal Stroke.

They point out that in their state, lifetime costs for strokes that occurred in 2006 alone, including lost earnings, are likely to total $1.92 billion.

The persistent racial disparities in stroke "result in significant economic consequences to the state, particularly among younger patients," the researchers conclude.

Growing African American awareness

A blog devoted to African American-oriented issues, including health, posted an important item recently, with a title at home even here: Would you know if you were having a STROKE?

The article brings out some key points to ponder, quoting National Stroke Association statistics:

• Half all black women will die from stroke or heart disease.
• Blacks are twice as likely to die from stroke than whites.
• In the 45-54 age group, black males have a three times greater risk than white males of having an ischemic stroke.
  

The blog links to a public service announcement video and gives some vital stroke facts. Plus, the National Stroke Association has lots of additional links and educational material focusing on the African American population and preventing strokes.