解决中风治疗中的种族不平等问题“至关重要”, new report says

中风治疗充斥着不公平现象, and fixing them will require more research into issues such as structural racism and other "upstream" social factors that affect where people live, learn, 工作和娱乐, 一份新的报告称.

这份报告, 一份来自美国心脏协会的科学声明, summarizes research on ways to address racial and ethnic disparities in stroke treatment. 该研究周一发表在该杂志上 Stroke.

这份报告's authors found that few stroke studies addressed racist policies, 比如居住隔离. 他们还研究了食物供应等问题, 经济稳定, 教育质量和获得医疗保险.

Such factors – known as social determinants of health – affect stroke incidence, 护理和结果, 报告说. 但报告回顾的大多数研究都着眼于患者层面的因素, 比如生活方式, 健康素养和人们是否正确用药.

“在中风治疗方面存在着巨大的不平等, which lead to significant gaps in functional outcomes after stroke for people from historically disenfranchised racial and ethnic groups, 包括黑, 西班牙裔和土著居民," Dr. Amytis Towfighi of the University of Southern California said in a news release. 她担任声明撰写小组主席.

例如, speedy treatment is an essential part of reducing the lasting effects of a stroke caused by a blood clot – the most common type of stroke. Medication to dissolve the clot usually must be administered within three hours after symptoms begin. A procedure to remove a clot may be an option for some people up to 24 hours after stroke symptoms start.

But, Towfighi说, people from historically disenfranchised populations are less likely to get to an emergency room within the time window for treatment. And not all people experiencing a stroke have rapid access to the treatments.

Although Black people are more likely to participate in post-stroke rehabilitation programs, 研究表明，他们更有可能表现不佳, she said. “除了, there are persistent racial and ethnic inequities in post-stroke risk factor control, and studies specifically addressing these inequities have not found the optimal method to mitigate the disparities."

Towfighi说 that while research has historically focused on describing such inequities, “开发和测试”解决这些问题的方法至关重要.

Previous studies indicate that careful attention to stroke preparedness among patients, caregivers and emergency medical personnel may reduce inequities in getting people prompt treatment. However, 声明说, 对脑卒中后康复的重视不够, 康复和重返社会. That includes information such as assessing the effect of improved sidewalks and access to physical, 职业及言语治疗.

Towfighi说 solutions will require health care professionals to "think outside the 'stroke box.“可持续, effective interventions to address inequities will likely require collaboration with patients, 他们的社区, 政策制定者和其他部门."

这份报告 also said that historically disenfranchised populations are vastly underrepresented in stroke clinical trials, which contributes to the lack of understanding and reduces the generalizability of research findings – exacerbating inequities and leading to worse outcomes.

加州大学的Bernadette Boden-Albala说, Irvine, 谁担任写作小组的副主席, said it's critical that those populations "participate in research so that researchers may collaborate in addressing the communities' needs and concerns."

这份报告 acknowledges that racial and ethnic identity are complex and that race is a social construct, 而不是生理上的.

在我们的评论中, we used the race and ethnicity categories typically supported by governmental research funding agencies that drive how data are collected,博登-阿尔巴拉说. "However, we are cognizant that these categories are inadequate to describe the nuances of lived experiences and to fully illuminate inequities that are entrenched in societal structures, 包括医疗保健."