Waimei Tai, MD
Lisabeth LD, Sánchez BN, Baek J, Skolarus LE, Smith MA, Garcia N, et al. Neurological, Functional, and Cognitive Stroke Outcomes in Mexican Americans. Stroke. 2014
Little is known about what happen to Mexican Americans (MA’s) -the largest Hispanic population in the United States, after they suffer from stroke. Lisabeth et al. looked at a large database of patients specifically in one geographic region, that has a substantial population of Mexican Americans (South Texas).
Out of over 1,000 patients in the cohort, 720 had full interview and clinical data during post stroke recovery. The researchers learned that MAs had on average slightly higher NIHSS at 90 days (3, compared with non-Hispanic whites (NHW) with NIHSS of 2), more likely to have disability requiring assistance with activities of daily living, and worse cognitive outcomes. In general MA’s tended to be younger and lived longer than the NHW cohort.
This suggests that more work should be done to study these discrepancies and learn what types of interventions maybe most effective in prevention of strokes in a younger population, as well as better care in the post-stroke recovery phase to prevent long term morbidity.
Because the MAs tend to be younger, the impact on better stroke care could have a great social and economic impact, as these patients tend to live longer.
Unfortunately, likely for a multitude of reasons (not fully delineated in this study) but what I suspect to be a combination of lower social economic status, low health literacy, lower general literacy, MA’s maybe less likely to receive the full multi-disciplinary care needed for stroke patients, and even after receiving care, may have less long term impact on their disease condition.
Fortunately as the NINDS has made it a goal to focus on stroke disparities and more attention and further research efforts will expand to learn about the ethnic-social differences in stroke epidemiology.