Compared with most of their cultural peers, Mexican-Americans — who by far make up the largest Hispanic ethnic group — tend to be in worse health and have multiple chronic conditions, such as diabetes and high blood pressure, that can increase stroke risk. Mexican-American participants in the Corpus Christi study had higher rates of diabetes, high blood pressure and smoking compared with their white peers.
Neurologist Salvador Cruz-Flores, M.D., was the lead author of a 2011 report that said stroke impacts racial and ethnic groups differently, but there were few studies addressing racial and ethnic differences in rehabilitation. Since the report, stroke researchers have made an effort to identify those differences and understand why they exist, said Cruz-Flores, who was not involved in the new study. But more targeted work is needed to find ways to reduce the disparities, he said.
The takeaway from the recent study for doctors, Cruz-Flores said, is that not all stroke patients have the same access to rehabilitation services.
“[There is] a tendency for minorities — in this case, Hispanics — to have less access to rehabilitation in a hospital, which has implications in terms of recovery,” said Cruz-Flores, chair of neurology at Texas Tech University Health Sciences Center School of Medicine in El Paso.
The message for stroke patients and their families is to work closely with their doctors in choosing the right type of rehabilitative care, Morgenstern said. When it comes to post-stroke care, he said, one size does not fit all.
Morgenstern and his colleagues now plan to dig deeper into the data, such as information about insurance coverage and why, for example, Mexican-Americans received home care.
“More research needs to be done to really be confident that these are real results,” he said.
