“Seeking Glocal Solutions to Cerebrovascular Health Inequities”: 2021 William Feinberg Award Lecture from Dr. Bruce Ovbiagele
Dixon Yang, MD
No, ”glocal” isn’t a typo. In the 2021 William Feinberg Award Lecture given at the International Stroke Conference of the same year, Dr. Bruce Ovbiagele discussed inequities in stroke burden among Black individuals in the United States and sub-Saharan Africa, opening with the term “glocal.” A portmanteau of global and local, glocal is an encompassing term that refers to consideration of issues on both a global and local scale in a highly interconnected manner. Often used in political or business realms, Dr. Ovbiagele brought the term to the forefront in thinking about how to best address stroke disparities.
Locally in the United States, it is well known that Black individuals experience higher stroke incidence and mortality than other race and ethnic groups. While stroke mortality in the United States has been improving, including among Black individuals, the mortality inequities have not objectively diminished. Conversely, projections suggest a further widening of the Black-White stroke prevalence gap in the next decade despite better risk factor control. A more nuanced approach to assessing vascular risk factors (i.e., differential impact by race and ethnic group, or temporal factors like duration and fluctuations of risk factors) may be needed. Furthermore, psychosocial, socioeconomic, and neighborhood level factors are increasingly recognized as potential risk factors in stroke disparity. In addition to studying risk factors, Dr. Ovbiagele urged identification of strategies in reducing stroke disparities, discussing his own local randomized trial testing efficacy of Bluetooth-enabled pill trays with reminders and BP monitoring among stroke survivors, half of whom are Black individuals.