cqvip:Background and Purpose:Evidence for ethnic disparities in stroke incidence, s everity, and mortality has continued to mount in recent years. However, the pict ure for disparities in acute management and rehabilitation remains more ambiguou s.The objective of this report is to summarize current evidence from stroke epid emiology and studies focusing on disparities in stroke care and disability, sugg esting courses for action.Methods:A comprehensive search of current literature on ethnic/racial variation in stroke incidence, mortality, and severity,as well as acute and postacute patient care was performed.Results:Recent evidence unamb iguously reaffirms a greater burden of disease in stroke, greater mortality, and greater severity of strokes for blacks. Evidence for disparities in acute and postacute care is less conclusive, as is the evidence for disparities among other ethnic groups. Evidence for health dis parities in stroke care across settings, regions, and the continuum of carevarie s considerably. Conclusions:Minority ethnic groups have higher rates or more se vere stroke, but variations in prognosis for clinical outcomes other than mortal ity remain less certain.There is considerable need for more studies that take in to account regional ethnic variations in treatment and outcomes, and for better documentation of stroke outcomes among groups in addition to blacks. Dealing wit h ethnic disparities in stroke will be served by sustained attention to quality improvement in high-impact areas in stroke care, complemented by initiatives th at promote cultural competence.
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