Strokes in young blacks drain S. Carolina’s pocket

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South Carolina has a lot to gain, for its public health and its economy, by correcting racial disparities in stroke, researchers from the Medical University of South Carolina in Charleston conclude.

In South Carolina, African Americans suffer strokes at younger ages and have worse outcomes than Caucasians, Dr. Wayne Feng and colleagues report in the latest issue of the medical journal Stroke.

They point out that in their state, lifetime costs for strokes that occurred in 2006 alone, including lost earnings, are likely to total $1.92 billion. 

The persistent racial disparities in stroke “result in significant economic consequences to the state, particularly among younger patients,” the researchers conclude.

“Any effective intervention to reduce racial disparity, even on a small scale, has the potential to have a tremendous financial impact,” they predict.

By law, all South Carolina hospitals must report data on every hospitalization to the state’s Office of Research and Statistics. Using this information, along with US Census population estimates, Feng’s team compared stroke-related factors among African-Americans and Caucasians from 2002 through 2007.

During that time, African-Americans accounted for roughly 29 percent of South Carolina’s population and roughly 32 percent of hospitalizations for stroke, they report.

When the researchers broke everyone in the state into age groups, they found that in all groups up to age 85, African-Americans were more likely than Caucasians to be hospitalized for stroke.

The greatest difference was among individuals younger than age 65.

In particular, among people aged 45 to 54, African-Americans were four and a half times more likely than Caucasians to be hospitalized for “ischemic” strokes caused by restricted blood flow to the brain.

Overall during the 5-year study period, the researchers found, racial disparities accounted for $362.5 million in hospital charges, representing nearly a quarter of the total cost for stroke hospitalizations. About 70 percent of that $362.5 million stemmed from stroke patients younger than age 65.

In addition to having a higher rate of strokes at younger ages than Caucasians, the African-American patients were more likely than the Caucasians to be receiving Medicaid or to be uninsured and to have poorer outcomes in the early period after suffering a stroke.

Therefore, not only are African-Americans having strokes at younger ages, which means the impact of their lost earnings is greater, but the fact that a higher percentage have no insurance at all means that they are more likely to be getting poorer quality preventive care.

In addition, the research team points out, the racial differences they observed “are likely due, in part, to health disparities in stroke risk factors” such as diabetes, High Blood Pressure, High cholesterol, and smoking habits.

SOURCE: Stroke, September 2009.

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