Disparities in neurological care: time to act on inequalities

摘要

Health disparities have long been a concern for health-care providers and patients in the USA, but recent events, particularly COVID-19 and police violence have put a spotlight on them. Health disparities—differences in health and health care between different groups of people—can affect people with any disease, including neurological disorders. For example, black and Hispanic people in the USA are up to 40% less likely than white people to see a neurologist, with black people being more likely to be treated in the emergency department with prolonged hospital stays. Health-care utilisation may be one driver of neurological disparities. Another potential driver is the social determinants of health including, for example, differences in education, access to health care and resources (eg, healthy food, stable housing), health literacy, and socioeconomic status. Challenging circumstances are more common in people of colour, persist across generations, and mechanisms underlying the health effects of these social determinants are not well understood. Eliminating disparities in health care is of utmost importance for reducing the burden of neurological diseases in America.