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New research highlights stroke care disparities in vulnerable communities

November 1, 2023

A study led by Dr. Amy Yu, a senior scientist and stroke neurologist at Sunnybrook Health Sciences Centre, has uncovered significant disparities in stroke treatment access, shedding light on the impact of socioeconomic factors on healthcare outcomes. The research, published in Neurology®, the medical journal of the American Academy of Neurology, highlights the need for tailored interventions to bridge these gaps.

"Clot-busting medications or procedures to remove clots can greatly reduce death and disability from stroke, but previous studies have shown that few people actually receive the treatments," says lead author Dr. Amy Yu. "We wanted to see how socioeconomic disparities play a role, especially in the context of universal health care."

The research focused on individuals in Ontario, Canada, who experienced ischemic strokes, the most common type of stroke. These strokes are caused by a blockage of blood flow to the brain and need rapid treatment. The patients’ neighbourhoods were divided into five groups based on whether they were under-resourced, determined by factors like unemployment rate, education, and income level. Researchers investigated whether there were differences in stroke treatments by neighbourhood resources.

The research found that 17% of those living in the most under-resourced neighbourhoods received treatment, compared to 20% of those living in the least under-resourced neighbourhoods. After considering other factors that might affect stroke treatment such as age, high blood pressure, diabetes, individuals residing in the most under-resourced neighbourhoods were found to be 24% less likely to receive these critical treatments compared to those living in the least under-resourced areas.

There was no significant difference between the most under-resourced neighbourhood and the middle three neighbourhoods. A limitation of the study was that researchers did not have information on other factors that could affect stroke treatment, such as the time symptoms started or how severe the stroke was.

"Our study underscores the need for tailored interventions to address socioeconomic disparities in access to acute stroke treatments, including educational and outreach programs to increase awareness about the signs and symptoms of stroke in various languages and efforts to distribute resources more equitably across neighbourhoods," Dr. Yu says.

The study was supported by ICES, a health research institute in Ontario; the Heart and Stroke Foundation of Canada; PSI Foundation; and Ontario Health Data Platform.