THE BLOG

Racial Disparities in Stroke Treatment

05/17/2011 08:57 pm ET | Updated Jul 15, 2011

Dizziness? Sudden trouble seeing in one or both eyes? Slurred speech? Numbness on one side of the body that occurs out of nowhere? Weakness that's worse than usual?

These symptoms are not normal. If you are having these symptoms, you need to call someone. Whom should you call first? The correct answer is not your spouse or best friend or even your child, but rather it's 9-1-1. With stroke, minutes truly do matter, so it's critical you get to the nearest hospital. More brain cells die with each second that goes by. In some circumstances, doctors can prevent the stroke from getting worse by administering clot-busting drugs. But they need to it within three hours or so of the start of symptoms. So delaying care can result in denial of an important treatment.

Unfortunately, many people either dismiss the symptoms as minor or think they'll go away if they just rest. A recent study conducted in my hometown of Washington D.C. demonstrated a reluctance among black people, in particular, to call 9-1-1 when having stroke symptoms. When having strokes, they typically don't call 9-1-1. Instead they call a family member, friend or neighbor. Sometimes they think it's easier if someone else drives them to the hospital (in reality, ambulances usually get people to the hospital faster).

This study found that three out of four black patients who had a stroke said once they realized something was wrong, they first called a family member or a friend. As a result, nearly 90 percent had a sizable delay before they sought medical care. Along with the issues of thinking the symptoms were not serious or that they would go away, more than half also said they were concerned about costs of care or that the ambulance wouldn't be able to find their house or come to their neighborhood -- some were even embarrassed about needing an ambulance in the first place.

This is concerning because black people tend to be at higher risk of suffering a stroke than white people. I've written before on the differences in medical care between black people and white people in today's society.

On most every health measure, black people do not receive the same quality of care. With stroke symptoms, they are not even accessing the health care system. And we need to figure why that is, and change it. I recently taped a segment for the "Discovery Channel," where we asked students at Howard University and George Washington University questions about health and the health care system. The Howard students typically remarked about bias, being treated differently and even being denied care. Nearly everyone of them could tell me about what happened in Tuskegee.

The George Washington University students seemed to think that everyone was treated the same, despite data that shows otherwise. It's a bit disconcerting that, even at a relatively young age, black men and women have distrust of the health care system. So honestly, I'm not surprised that they tend not to call emergency medical services; many of them still want to avoid interaction with hospitals and doctors -- they just don't trust them.

May is stroke awareness month. Stroke is the third leading cause of death, with more than 150,000 deaths per year. We can't cure every stroke that happens, but I know we can do much better in treating patients that are underserved. So learn the symptoms of stroke, and go ahead and call family and friends --- AFTER you call 9-1-1.

http://stroke.ahajournals.org/cgi/reprint/STROKEAHA.110.604736v1