Race and income disparity in ischemic stroke care: nationwide inpatient sample database, 2002 to 2008
Abstract
Background Health care disparities exist between demographic groups with stroke. We examined whether patients of particular ethnicity or income levels experienced reduced access to or delays in receiving stroke care.Methods We studied all admissions for ischemic stroke in the Nationwide Inpatient Sample (NIS) database between 2002 and 2008. We used statistical models to determine whether median income or race were associated with intravenous (i.v.) thrombolysis treatment, in-hospital mortality, discharge disposition, hospital charges, and LOS in high- or low-volume hospitals.Results There were a total of 477,474 patients with ischemic stroke: 10,781 (2.3%) received i.v. thrombolysis, and 380,400 (79.7%) were treated in high-volume hospitals. Race (P < .0001) and median income (P < .001) were significant predictors of receiving i.v. thrombolysis, and minorities and low-income patients were less likely to receive i.v. thrombolysis. Median income was a predictor of access to high-volume hospitals (P < .0001), with wealthier patients more likely to be treated in high-volume hospitals, which had lower mortality rates (P = .0002). Patients in high-volume hospitals were 1.84 times more likely to receive i.v. thrombolysis (P < .0001).Conclusions African Americans, Hispanics, and low median income patients are less likely to receive i.v. thrombolysis for ischemic stroke. Low median income patients are less likely to be treated at high-volume hospitals. High-volume hospitals have lower mortality rates and a higher likelihood of treating patients with i.v. thrombolysis. There is evidence for an influence of socioeconomic status and racial disparity in the treatment of ischemic stroke.
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When guidelines are vague and transfer practices are varied, opportunities for structural and interpersonal discrimination can arise.
“Still, when guidelines are vague and transfer practices are varied, opportunities for structural and interpersonal discrimination can arise.”
From Racial and ethnic disparities in interhospital transfer for complex emergency general surgical disease across the United States (2023) · cites this paper as [13]
The selection of covariates was made a priori based on factors known to influence interhospital transfer.
“The selection of covariates was made a priori based on factors known to influence IHT.”
From Racial and ethnic disparities in interhospital transfer for complex emergency general surgical disease across the United States (2023) · cites this paper as [13]
Cites
Comorbidity measures for use with administrative data.
Elixhauser, A., Steiner, C., Harris, D. R., & Coffey, R. M. (1998) · Medical Care · doi:10.1097/00005650-199801000-00004 · Cited by 9,921 · see citing works
Heart Disease and Stroke Statistics—2010 Update: A Report From the American Heart Association
WRITING GROUP MEMBERS, Lloyd-Jones, D., Adams, R. J., Brown, T. M., Carnethon, M., Dai, S., De Simone, G., Ferguson, T. B., Ford, E., Furie, K., et al. (2010) · Circulation · doi:10.1161/circulationaha.109.192667 · Cited by 5,700 · see citing works
Executive Summary: Heart Disease and Stroke Statistics—2010 Update
WRITING GROUP MEMBERS, Lloyd‐Jones, D. M., Adams, R. J., Brown, T. M., Carnethon, M. R., Dai, S., SIMONE, G. D., Ferguson, T. B., Ford, E. S., Furie, K. L., et al. (2010) · Circulation · doi:10.1161/circulationaha.109.192666 · Cited by 1,358 · see citing works
Early stroke treatment associated with better outcome
Marler, J. R., Tilley, B. C., Lü, M., Brott, T. G., Lyden, P., Grotta, J. C., Broderick, J. P., Levine, S. R., Frankel, M., Horowitz, S. H., et al. (2000) · Neurology · doi:10.1212/wnl.55.11.1649 · Cited by 856 · see citing works
del Zoppo, G. J., Saver, J. L., Jauch, E. C., & Adams, H. P. (2009) · Stroke · doi:10.1161/strokeaha.109.192535 · Cited by 827 · see citing works
Murray, C. J. L., Kulkarni, S. C., Michaud, C., Tomijima, N., Bulzacchelli, M. T., Iandiorio, T. J., & Ezzati, M. (2006) · PLoS Medicine · doi:10.1371/journal.pmed.0030260 · Cited by 762 · see citing works
The Importance of Place of Residence: Examining Health in Rural and Nonrural Areas
Eberhardt, M. S., & Pamuk, E. R. (2004) · American Journal of Public Health · doi:10.2105/ajph.94.10.1682 · Cited by 646 · see citing works
Thrombolysis with alteplase 3–4·5 h after acute ischaemic stroke (SITS-ISTR): an observational study
Wahlgren, N. G., Ahmed, N., Dávalos, A., Hacke, W., Millán, M., Muir, K. W., Roine, R. O., Toni, D., & Lees, K. R. (2008) · The Lancet · doi:10.1016/s0140-6736(08)61339-2 · Cited by 570 · see citing works
Racial-Ethnic Disparities in Stroke Care: The American Experience
Cruz‐Flores, S., Rabinstein, A. A., Biller, J., Elkind, M. S. V., Griffith, P. A., Gorelick, P. B., Howard, G., Leira, E. C. C., Morgenstern, L. B., Ovbiagele, B. I., et al. (2011) · Stroke · doi:10.1161/str.0b013e3182213e24 · Cited by 508 · see citing works
Geronimus, A. T., & Bound, J. (1998) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009673 · Cited by 489 · see citing works
Association Between Stroke Center Hospitalization for Acute Ischemic Stroke and Mortality
Xian, Y. (2011) · JAMA · doi:10.1001/jama.2011.22 · Cited by 321 · see citing works
Lacy, C., Suh, D., Bueno, M., & Kostis, J. (2001) · Stroke · doi:10.1161/01.str.32.1.63 · Cited by 305 · see citing works
Effect of Socioeconomic Status on Treatment and Mortality After Stroke
Kapral, M. K., Wang, H., Mamdani, M., & Tu, J. V. (2002) · Stroke · doi:10.1161/hs0102.101169 · Cited by 281 · see citing works
Johnston, S. C., Fung, L., Gillum, L. A., Smith, W. S., Brass, L. M., Lichtman, J. H., & Brown, A. N. (2001) · Stroke · doi:10.1161/01.str.32.5.1061 · Cited by 207 · see citing works
Race, Socioeconomic Status, and Cause-Specific Mortality
Howard, G., Anderson, R. T., Russell, G. B., Howard, V. J., & Burke, G. L. (2000) · Annals of Epidemiology · doi:10.1016/s1047-2797(00)00038-7 · Cited by 202 · see citing works
Factors Explaining Excess Stroke Prevalence in the US Stroke Belt
Liao, Y.-L., Greenlund, K., Croft, J., Keenan, N. L., & Giles, W. (2009) · Stroke · doi:10.1161/strokeaha.109.561688 · Cited by 161 · see citing works
Rural-urban differences in acute stroke management practices: a modifiable disparity.
Leira, E. C. C., Hess, D. C., Torner, J. C., & Adams, H. P. (2008) · PubMed · doi:10.1001/archneur.65.7.887 · Cited by 139 · see citing works
Schumacher, H. C., Bateman, B. T., Boden-Albala, B. M., Berman, M. F., Mohr, J. P., Sacco, R. L., & Pile‐Spellman, J. (2007) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2007.01.021 · Cited by 132 · see citing works
Bateman, B. T., Schumacher, H. C., Boden-Albala, B. M., Berman, M. F., Mohr, J. P., Sacco, R. L., & Pile‐Spellman, J. (2006) · Stroke · doi:10.1161/01.str.0000199851.24668.f1 · Cited by 118 · see citing works
Socioeconomic Differences in Stroke Incidence and Prognosis Under a Universal Healthcare System
Cesaroni, G., Agabiti, N., Forastiere, F., & Perucci, C. A. (2009) · Stroke · doi:10.1161/strokeaha.108.542944 · Cited by 110 · see citing works
Racial Disparities in Tissue Plasminogen Activator Treatment Rate for Stroke
Hsia, A. W., Edwards, D. F., Morgenstern, L. B., Wing, J. J., Brown, N. C., Coles, R., Loftin, S., Wein, A., Koslosky, S. S., Fatima, S., et al. (2011) · Stroke · doi:10.1161/strokeaha.111.613828 · Cited by 107 · see citing works
Hospital volume and stroke outcome
Saposnik, G., Baibergenova, A., O'Donnell, M., Hill, M., Kapral, M., & Hachinski, V. (2007) · Neurology · doi:10.1212/01.wnl.0000268485.93349.58 · Cited by 98 · see citing works
Helicopter Transport of Stroke Patients and Its Influence on Thrombolysis Rates
Reiner-Deitemyer, V., Teuschl, Y., Matz, K., Reiter, M., Eckhardt, R., Seyfang, L., Tatschl, C., Brainin, M., & for the Austrian Stroke Unit Registry Collaborators (2011) · Stroke · doi:10.1161/strokeaha.110.604710 · Cited by 96 · see citing works
Rural Epidemiology: Insights from a Rural Population Laboratory
Pearson, T. A., & Lewis, C. (1998) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009571 · Cited by 96 · see citing works
Karve, S. J., Balkrishnan, R., Mohammad, Y. M., & Levine, D. A. (2010) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2009.10.006 · Cited by 91 · see citing works
Trimble, B. A., & Morgenstern, L. B. (2008) · Neurologic Clinics · doi:10.1016/j.ncl.2008.05.010 · Cited by 84 · see citing works
Racial/ethnic disparities in access to physician care and medications among US stroke survivors
Levine, D. A., Neidecker, M. V., Kiefe, C. I., Karve, S. J., Williams, L. S., & Allison, J. J. (2010) · Neurology · doi:10.1212/wnl.0b013e318203e952 · Cited by 76 · see citing works
Socioeconomic Status, Hospital Volume, and Stroke Fatality in Canada
Saposnik, G., Jeerakathil, T., Selchen, D. H., Baibergenova, A., Hachinski, V., & Kapral, M. K. (2008) · Stroke · doi:10.1161/strokeaha.108.521344 · Cited by 65 · see citing works
Intravenous Thrombolysis for Stroke Increases Over Time at Primary Stroke Centers
Prabhakaran, S., McNulty, M. L., O’Neill, K. E., & Ouyang, B. (2011) · Stroke · doi:10.1161/strokeaha.111.640060 · Cited by 59 · see citing works
Regional Implementation of the Stroke Systems of Care Model
Gropen, T., Magdon-Ismail, Z., Day, D., Melluzzo, S., & Schwamm, L. H. (2009) · Stroke · doi:10.1161/strokeaha.108.531053 · Cited by 52 · see citing works
Association Between Stroke Center Hospitalization for Acute Ischemic Stroke and Mortality
Xian, Y., Holloway, R. G., Chan, P. S., Noyes, K., Shah, M. N., Ting, H. H., Chappel, A. R., Peterson, E. D., & Friedman, B. (2012) · Survey of Anesthesiology · doi:10.1097/01.sa.0000412372.89068.f9 · Cited by 52 · see citing works
Zweifler, R. M., McClure, L. A., Howard, V. J., Cushman, M., Hovater, M. K., Safford, M. M., Howard, G., & Goff, D. C. (2011) · Neuroepidemiology · doi:10.1159/000328258 · Cited by 42 · see citing works
Organization of a United States County System for Comprehensive Acute Stroke Care
Cramer, S. C., Stradling, D., Brown, D. M., Carrillo-Nunez, I. M., Ciabarra, A., Cummings, M., Dauben, R. D., Lombardi, D., Patel, N. J., Traynor, E. N., et al. (2012) · Stroke · doi:10.1161/strokeaha.111.635334 · Cited by 38 · see citing works
Lazaridis, C., DeSantis, S. M., Jauch, E. C., & Adams, R. J. (2011) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2011.11.008 · Cited by 27 · see citing works
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Stroke risk factors, genetics, and prevention
Boehme, A. K., Esenwa, C., & Elkind, M. S. V. (2017) · Circulation Research · doi:10.1161/circresaha.116.308398 · Cited by 1,952 · see citing works
Racial disparities in neurologic health care access and utilization in the United States
Saadi, A., Himmelstein, D. U., Woolhandler, S. J., & Mejia, N. I. (2017) · Neurology · doi:10.1212/wnl.0000000000004025 · Cited by 306 · see citing works
Racial and Gender Disparities Among Patients with Gout
Singh, J. A. (2012) · Current Rheumatology Reports · doi:10.1007/s11926-012-0307-x · Cited by 134 · see citing works
Ordinal vs dichotomous analyses of modified Rankin Scale, 5-year outcome, and cost of stroke
Ganesh, A., Luengo-Fernández, R., Wharton, R. M., & Rothwell, P. M. (2018) · Neurology · doi:10.1212/wnl.0000000000006554 · Cited by 125 · see citing works
Progressive rural–urban disparity in acute stroke care
Gonzales, S., Mullen, M. T., Skolarus, L. E., Thibault, D. P., Udoeyo, U., & Willis, A. W. (2017) · Neurology · doi:10.1212/wnl.0000000000003562 · Cited by 118 · see citing works
Ikeme, S., Kottenmeier, E., Uzochukwu, G., & Brinjikji, W. (2022) · Stroke · doi:10.1161/strokeaha.121.036263 · Cited by 108 · see citing works
Benjamins, M. R., & Middleton, M. (2019) · PLoS ONE · doi:10.1371/journal.pone.0215976 · Cited by 95 · see citing works
de Havenon, A., Sheth, K., Johnston, K. C., Delic, A., Stulberg, E. L., Majersik, J., Anadani, M., Yaghi, S. R., Tirschwell, D., & Ney, J. P. (2021) · Neurology · doi:10.1212/wnl.0000000000012943 · Cited by 89 · see citing works
Song, S. Y., Liang, L., Fonarow, G. C., Smith, E. E., Bhatt, D. L., Matsouaka, R., Xian, Y., Schwamm, L. H., & Saver, J. L. (2019) · JAMA Neurology · doi:10.1001/jamaneurol.2018.4410 · Cited by 82 · see citing works
Aparicio, H. J., Carr, B. G., Kasner, S. E., Kallan, M. J., Albright, K. C., Kleindorfer, D., & Mullen, M. T. (2015) · Journal of the American Heart Association · doi:10.1161/jaha.115.001877 · Cited by 73 · see citing works
Race and Sex Disparities in Prehospital Recognition of Acute Stroke
Govindarajan, P., Friedman, B. T., Delgadillo, J. Q., Ghilarducci, D. P., Cook, L. J., Grimes, B. A., McCulloch, C. E., & Johnston, S. C. (2015) · Academic Emergency Medicine · doi:10.1111/acem.12595 · Cited by 54 · see citing works
The effects of telemedicine on racial and ethnic disparities in access to acute stroke care
Lyerly, M. J., Wu, T.-C., Mullen, M. T., Albright, K. C., Wolff, C., Boehme, A. K., Branas, C. C., Grotta, J. C., Savitz, S. I., & Carr, B. G. (2016) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x15589534 · Cited by 52 · see citing works
Faigle, R., Urrutia, V., Cooper, L., & Gottesman, R. (2017) · Stroke · doi:10.1161/strokeaha.116.015056 · Cited by 42 · see citing works
Socioeconomic disparities in prehospital stroke care
Niklasson, A., Herlitz, J. D., & Jood, K. (2019) · Scandinavian Journal of Trauma Resuscitation and Emergency Medicine · doi:10.1186/s13049-019-0630-6 · Cited by 42 · see citing works
Shen, Y., Chen, G., & Hsia, R. Y.-J. (2019) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.7855 · Cited by 42 · see citing works
Legal and ethical implications in the evaluation and management of sports-related concussion
Kirschen, M. P., Tsou, A. Y., Nelson, S. B., Russell, J. A., & Larriviere, D. G. (2014) · Neurology · doi:10.1212/wnl.0000000000000613 · Cited by 41 · see citing works
Minority Representation in Migraine Treatment Trials
Robbins, N. M., & Bernat, J. L. (2017) · Headache The Journal of Head and Face Pain · doi:10.1111/head.13018 · Cited by 40 · see citing works
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Singh, J. A., & Ramachandran, R. (2015) · Arthritis Research & Therapy · doi:10.1186/s13075-015-0589-2 · Cited by 40 · see citing works
Sonig, A., Lin, N., Krishna, C., Natarajan, S. K., Mokin, M. V., Hopkins, L. N., Snyder, K. V., Levy, E. I., & Siddiqui, A. H. (2015) · Journal of neurosurgery · doi:10.3171/2015.4.jns141631 · Cited by 39 · see citing works
Money is Brain: Financial Barriers and Consequences for Canadian Stroke Patients
Ganesh, A., King‐Shier, K. M., Manns, B., Hill, M. D., & Campbell, D. J. T. (2016) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/cjn.2016.411 · Cited by 36 · see citing works
Luan-Erfe, B. M., Siddiqui, K. A., Schwamm, L. H., Kirwan, C., Nunes, A. M., & Mejia, N. I. (2017) · Journal of the American Heart Association · doi:10.1161/jaha.117.006175 · Cited by 35 · see citing works
Trends in Stroke Thrombolysis Care Metrics and Outcomes by Race and Ethnicity, 2003-2021
Man, S., Solomon, N. C., Grory, B. M., Alhanti, B., Saver, J. L., Smith, E. E., Xian, Y., Bhatt, D. L., Schwamm, L. H., Uchino, K., et al. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.52927 · Cited by 34 · see citing works
Marulanda-Londoño, E. T., Bell, M. W., Hope, O. A., Leacock, R. O., O’Carroll, C. B., Posas, J. H., Stover, N. P., Young, R. A., & Hamilton, R. H. (2019) · Neurology · doi:10.1212/wnl.0000000000006874 · Cited by 33 · see citing works
Rumalla, K., & Mittal, M. K. (2016) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2016.03.044 · Cited by 33 · see citing works
Racial/Ethnic Disparities in Acute Ischemic Stroke Treatment Within a Telestroke Network
Ajinkya, S., Almallouhi, E., Turner, N., Kasab, S. A., & Holmstedt, C. A. (2019) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2019.0127 · Cited by 32 · see citing works
Dru, A. B., Reichwage, B. D., Neal, D. W., Vaziri, S., Lockney, D. T., Fox, W. C., Hoh, B. L., & Hoh, D. J. (2019) · Spinal Cord · doi:10.1038/s41393-019-0280-6 · Cited by 31 · see citing works
Self-citationLieber, A. M., Boniello, A. J., Kerbel, Y. E., Petrucelli, P. M., Kavuri, V. C., Jakoi, A. M., & Khalsa, A. S. (2019) · Global Spine Journal · doi:10.1177/2192568219874763 · Cited by 31 · see citing works
Socioeconomic Inequalities in Reperfusion Therapy for Acute Ischemic Stroke
Buus, S. M. Ø., Schmitz, M. L., Cordsen, P., Johnsen, S. P., Andersen, G., & Simonsen, C. Z. (2022) · Stroke · doi:10.1161/strokeaha.121.037687 · Cited by 31 · see citing works
Dasenbrock, H. H., Robertson, F. C., Aziz‐Sultan, M. A., Guittieres, D., Du, R., Dunn, I. F., & Gormley, W. B. (2016) · Neurocritical Care · doi:10.1007/s12028-016-0287-1 · Cited by 30 · see citing works
Identifying Racial/Ethnic Disparities in Interhospital Transfer: an Observational Study
Shannon, E., Schnipper, J., & Mueller, S. K. (2020) · Journal of general internal medicine · doi:10.1007/s11606-020-06046-z · Cited by 23 · see citing works
Education Level and Inequalities in Stroke Reperfusion Therapy
Stecksén, A., Glader, E., Asplund, K., Norrving, B. G., & Eriksson, M. (2014) · Stroke · doi:10.1161/strokeaha.114.005323 · Cited by 28 · see citing works
Trends in Ethnic Disparities in Stroke Care and Long-Term Outcomes
Emmett, E. S., O’Connell, M. D. L., Pei, R., Douiri, A., Wyatt, D., Bhalla, A., Wolfe, C. D. A., & Marshall, I. J. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.53252 · Cited by 27 · see citing works
Comorbid Psychiatric Disease Is Associated With Lower Rates of Thrombolysis in Ischemic Stroke
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Socioeconomic Status And Acute Stroke Care: Has The Inequality Gap Been Closed?
Hyldgård, V. B., Johnsen, S. P., Støvring, H., & Søgaard, R. (2019) · Clinical Epidemiology · doi:10.2147/clep.s218322 · Cited by 27 · see citing works
Lieber, A. M., Kirchner, G. J., Kerbel, Y. E., Moretti, V. M., Vakil, J. J., & Brahmabhatt, S. (2019) · Clinical Orthopaedics and Related Research · doi:10.1097/corr.0000000000000634 · Cited by 27 · see citing works
Royan, R., Stamm, B. J., Lin, T. R., Baird, J. B., Becker, C. J., Karb, R. A., Burton, T. M., Kleindorfer, D., Prabhakaran, S., & Madsen, T. E. (2024) · Circulation · doi:10.1161/circulationaha.124.070694 · Cited by 26 · see citing works
Insurance Status Influences the Rates of Reportable Quality Metrics in Brain Tumor Patients
Hooten, K. G., Neal, D. W., Lovatón-Espadín, R., Gil, J. N., Azari, H., & Rahman, M. (2015) · Neurosurgery · doi:10.1227/neu.0000000000000594 · Cited by 24 · see citing works
Self-citationReddy, S. T., Wu, T., Zhang, J., Rahbar, M. H., Ankrom, C. M., Zha, A. M., Cossey, T. D., Aertker, B. M., Vahidy, F., Parsha, K., et al. (2020) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2020.105418 · Cited by 23 · see citing works
Hammond, G., Waken, R. J., Johnson, D. Y., Towfighi, A., & Maddox, K. E. J. (2022) · Stroke · doi:10.1161/strokeaha.121.035006 · Cited by 22 · see citing works
Green, T., Singh, P., & King‐Shier, K. M. (2019) · Journal of Vascular Nursing · doi:10.1016/j.jvn.2019.07.002 · Cited by 21 · see citing works
Taghdiri, F., Vyas, M. V., Kapral, M. K., Lapointe‐Shaw, L., Austin, P. C., Tse, P., Porter, J., Chen, Y., Fang, J., & Yu, A. (2023) · Neurology · doi:10.1212/wnl.0000000000207924 · Cited by 21 · see citing works
Biswas, R., Wijeratne, T., Zeleňák, K., Huasen, B. B., Iacobucci, M., Killingsworth, M. C., Beran, R. G., Gebreyohanns, M., Sekhar, A., Khurana, D., et al. (2025) · CNS Drugs · doi:10.1007/s40263-025-01161-z · Cited by 19 · see citing works
Temporal Trends in Stroke Thrombolysis in the US by Race and Ethnicity, 2009-2018
Suolang, D., Chen, B. J., Wang, N., Gottesman, R. F., & Faigle, R. (2021) · JAMA · doi:10.1001/jama.2021.12966 · Cited by 19 · see citing works
Sharma, K., Kalakoti, P., Henry, M., Mishra, V., Riel-Romero, R. M. S., Notarianni, C., Nanda, A., & Sun, H. (2017) · Clinical Neurology and Neurosurgery · doi:10.1016/j.clineuro.2017.05.001 · Cited by 19 · see citing works
Tsou, A. Y., Creutzfeldt, C. J., & Gordon, J. M. (2013) · Handbook of clinical neurology · doi:10.1016/b978-0-444-53501-6.00009-3 · Cited by 16 · see citing works
Patel, P. D., Salwi, S. R., Liles, C., Mistry, A. M., Mistry, E. A., Fusco, M. R., Chitale, R. V., & Shannon, C. N. (2021) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2021.105658 · Cited by 15 · see citing works
Threlkeld, Z. D., Kozak, B. M., McCoy, D. B., Cole, S., Martin, C., & Singh, V. (2017) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2017.03.004 · Cited by 15 · see citing works
United States trends in thrombolysis for older adults with acute ischemic stroke
George, B. P., Asemota, A. O., Dorsey, E. R., Haider, A. H., Smart, B. J., Urrutia, V., & Schneider, E. B. (2015) · Clinical Neurology and Neurosurgery · doi:10.1016/j.clineuro.2015.08.031 · Cited by 14 · see citing works
The State of Cardiovascular Disease in G20+ Countries
Atun, R. A. (2022) · HPHR Journal · doi:10.54111/0001/hsil/cvdg20 · Cited by 13 · see citing works
Rural-urban stroke mortality gaps in the United States
Chang, D., Ibrahim, R., Pham, H. N., Sainbayar, E., Shahid, M., Makkieh, M., Abbad, H., Lee, J. Z., Mamas, M. A., & Lee, J. Z. (2024) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2024.107762 · Cited by 13 · see citing works
Luan-Erfe, B. M., Siddiqui, K. A., Schwamm, L. H., & Mejia, N. I. (2016) · Journal of the American Heart Association · doi:10.1161/jaha.116.003782 · Cited by 13 · see citing works
Association between socioeconomic status and prognosis after ischemic stroke in South China
Wang, S., Shen, B., Wei, L., Wu, M., & Wang, J. (2019) · Neurological Research · doi:10.1080/01616412.2019.1630165 · Cited by 13 · see citing works
Villwock, M. R., Singla, A. K., Padalino, D. J., & Deshaies, E. M. (2014) · BMJ Open · doi:10.1136/bmjopen-2013-004480 · Cited by 12 · see citing works
Iantorno, S. E., Bucher, B. T., Horns, J. J., & McCrum, M. L. (2023) · Journal of Trauma and Acute Care Surgery · doi:10.1097/ta.0000000000003856 · Cited by 11 · see citing works
Rehman, A., Singh, A. K., Sridhar, P., Wang, H. Y., Velo, A. E., Nguyen, D., Ehrlich, M., Lookstein, R., & Steiger, D. J. (2024) · Respiratory Research · doi:10.1186/s12931-024-02872-5 · Cited by 11 · see citing works
Are there socio-economic inequities in access to reperfusion therapy: The stroke 69 cohort
Perrin, A., Freyssenge, J., Haesebaert, J., Tazarourte, K., Termoz, A., Grimaud, O., Derex, L., Viprey, M., & Schott, A. (2021) · Revue Neurologique · doi:10.1016/j.neurol.2021.02.394 · Cited by 9 · see citing works
Endovascular Therapy or Alteplase in Patients with Comorbidities: Insights from UNMASK EVT
Ganesh, A., Kashani, N., Ospel, J. M., Wilson, A. T., Foss, M. M., Saposnik, G., Almekhlafi, M., Goyal, M., Menon, B. K., & Hill, M. D. (2020) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/cjn.2020.158 · Cited by 9 · see citing works
Index-Based Inequality in Quality of Care: An Empirical Comparison of Apples and Pears
Hyldgård, V. B., Johnsen, S. P., & Søgaard, R. (2021) · Clinical Epidemiology · doi:10.2147/clep.s311813 · Cited by 9 · see citing works
Racial and Ethnic Disparities in Stroke Reperfusion Therapy in the USA
Faigle, R. (2023) · Neurotherapeutics · doi:10.1007/s13311-023-01388-y · Cited by 9 · see citing works
Santos, A. D., Balabanski, A. H., Katzenellenbogen, J. M., Thrift, A. G., Burchill, L. J., & Parsons, M. W. (2021) · Vessel Plus · doi:10.20517/2574-1209.2020.69 · Cited by 8 · see citing works
Influence of Racial Differences on Outcomes after Thrombolytic Therapy in Acute Ischemic Stroke
Mishra, N. K., Mandava, P., Chen, C., Grotta, J. C., Lees, K. R., & Kent, T. A. (2013) · International Journal of Stroke · doi:10.1111/ijs.12162 · Cited by 8 · see citing works
Achieving Diagnostic Equity in Cardiovascular Disease
Sarkar, U., & Bibbins-Domingo, K. B. (2022) · JAMA · doi:10.1001/jama.2022.14424 · Cited by 7 · see citing works
Yeo, S., Toh, M. P. H., Lee, S. H., Seet, R. C. S., Wong, L. Y., & Yau, W. (2020) · Annals of the Academy of Medicine Singapore · doi:10.47102/annals-acadmedsg.2019196 · Cited by 7 · see citing works
Brown, M. C., Udawatta, T., Flesch, L., Strnad, G. J., Briskin, I. N., Jones, M. H., Kaar, S. G., Rosneck, J. T., & Farrow, L. D. (2022) · Orthopaedic Journal of Sports Medicine · doi:10.1177/23259671211069944 · Cited by 7 · see citing works
Meng, T., Trickey, A. W., Harris, A. H. S., Matheson, L. W., Rosenthal, S. W., Traboulsi, A. A.-R., Saver, J. L., Wagner, T. H., & Govindarajan, P. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.827965 · Cited by 6 · see citing works
Moon, J., Shin, J., Lee, J., Jeong, H. J., Kim, H., An, J., Jo, S. H., Ko, K., & Choi, J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19053050 · Cited by 6 · see citing works
Hyldgård, V. B., Søgaard, R., Valentin, J. B., Lange, T., Damgaard, D., & Johnsen, S. P. (2022) · European Stroke Journal · doi:10.1177/23969873221146591 · Cited by 6 · see citing works
Changes in Medicare Physician Reimbursement for Stroke Procedures from 2000 to 2019
Pines, A. R., Haglin, J. M., & Demaerschalk, B. M. (2021) · Neurosurgery Practice · doi:10.1093/neuopn/okab003 · Cited by 6 · see citing works
Naouri, D., Allain, S., Féry-Lemonnier, É., Wolff, V., Derex, L., Raynaud, P., & Costemalle, V. (2022) · European Journal of Neurology · doi:10.1111/ene.15490 · Cited by 5 · see citing works
Neighborhood socioeconomic status and stroke mortality
Sposato, L. A., & Grimaud, O. (2013) · Neurology · doi:10.1212/wnl.0b013e3182815564 · Cited by 5 · see citing works
Jones, A. A., Zhou, L. W., Castro, N. M., Palepu, A., Panenka, W. J., Rutherford, A. R., Honer, W. G., Smith, E. E., & Field, T. S. (2025) · Stroke · doi:10.1161/strokeaha.124.048336 · Cited by 4 · see citing works
McCarthy, S., McMeekin, P. J., Allen, M. J., James, M. A., Laws, A. S. E., McCarthy, A., McClelland, G., Moseley, L., Park, L., Phillips, D., et al. (2025) · Healthcare · doi:10.3390/healthcare13121410 · Cited by 4 · see citing works
Mamer, L., Kocher, K. E., Cranford, J. A., & Scott, P. (2024) · Emergency Radiology · doi:10.1007/s10140-024-02260-y · Cited by 4 · see citing works
Access disparities to Magnet hospitals for ischemic stroke patients
Bekelis, K., Missios, S., & MacKenzie, T. A. (2017) · Journal of Clinical Neuroscience · doi:10.1016/j.jocn.2017.05.011 · Cited by 4 · see citing works
An overview of risk factors for stroke
Koltsova, E. A., Petrova, E. A., & Borshch, Y. V. (2022) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro202212212212 · Cited by 4 · see citing works
McCarthy, L., Daniel, D., Santos, D., & Dhamoon, M. S. (2023) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2023.107170 · Cited by 4 · see citing works
Nouh, C. D., Samkutty, D., Chandrashekhar, S., Santucci, J. A., Ford, L., Xu, C., Hollabaugh, K. M., Bohnstedt, B. N., & Ray, B. S. (2020) · World Neurosurgery · doi:10.1016/j.wneu.2020.04.067 · Cited by 4 · see citing works
Prehospital Stroke Treatment (EMS Stabilization Protocols)
Jauch, E. C., French, D. M., & McGeorge, T. (2015) · Springer eBooks · doi:10.1007/978-3-319-17750-2_2 · Cited by 4 · see citing works
Le, D., Mullen, M. T., Lin, W., Katz, P. M., & Hellerslia, V. T. (2024) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2024.107880 · Cited by 3 · see citing works
Hemenway, A. N., Biagi, M. J., Murrey, T. F., Sun, J., Osei-Badu, E., Salazar-McKinney, A., Sanabria, R., & Zoubi, M. A. (2024) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofae516 · Cited by 3 · see citing works
Shen, Y., Kim, A. S., & Hsia, R. Y.-J. (2025) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2025.05.015 · Cited by 3 · see citing works
Kim, J. A., Herman, A. L., Shrader, P. J., Alhanti, B., Xian, Y., Falcone, G. J., Grory, B. M., Smith, E. E., Messe, S. R., de Havenon, A., et al. (2025) · Stroke · doi:10.1161/strokeaha.124.050446 · Cited by 2 · see citing works
Lubeck, D. P., Danese, M. D., Duryea, J. L., Halperin, M., Tayama, D., Yu, E., Lalla, D., & Grotta, J. C. (2016) · International Journal of Stroke · doi:10.1177/1747493015609776 · Cited by 2 · see citing works
Adherence to practice parameters in Medicare beneficiaries with amyotrophic lateral sclerosis
Laurido-Soto, O., Faust, I. M., Nielsen, S. S., & Racette, B. A. (2024) · PLoS ONE · doi:10.1371/journal.pone.0304083 · Cited by 2 · see citing works
Closing the Socioeconomic Gap in Massachusetts: Trends in Total Hip Arthroplasty From 2013 to 2015
Mohamed, N. S., Remily, E. A., Wilkie, W. A., Jean-Pierre, M., Jean-Pierre, N., Edalatpour, A., Abraham, M. M., & Delanois, R. E. (2020) · Orthopedics · doi:10.3928/01477447-20201210-05 · Cited by 2 · see citing works
Secular Trends in Ischemic Stroke Subtypes
Bogiatzi, C. (2013) · Scholarship@Western (Western University) · Cited by 2 · see citing works
Berkman, J. M., Budhu, J. A., Torres, J., & Saadi, A. (2024) · Springer eBooks · doi:10.1007/978-3-031-62727-9_1 · Cited by 1 · see citing works
Financial Concerns Are Common Among Family Surrogate Decision-Makers of Patients With Stroke
Becker, C. J., Baker, J. E., Zhang, G., Conyers, F. G., Shi, X., Kwicklis, M., Lank, R. J., Ortiz, C., Case, E. C., Springer, M. V., et al. (2025) · Neurology Clinical Practice · doi:10.1212/cpj.0000000000200451 · Cited by 1 · see citing works
Webster, R., & Iyer, A. (2025) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-025-02403-y · Cited by 1 · see citing works
Boan, A. D., Voeks, J. H., Feng, W., Bachman, D., Jauch, E. C., Adams, R. J., Ovbiagele, B., & Lackland, D. T. (2014) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2014.06.008 · Cited by 1 · see citing works
Henstenburg, J. M., Lieber, A. M., Boniello, A. J., Kerbel, Y. E., & Shah, M. (2020) · Trauma · doi:10.1177/1460408620975693 · Cited by 1 · see citing works
Darmawan, E. S., Hasibuan, S. R., Permanasari, V. Y., & Kusuma, D. P. (2025) · Global Health Research and Policy · doi:10.1186/s41256-025-00432-y · Cited by 1 · see citing works
Race and Racism in Social Emergency Medicine
Bains, S., Colbert, C. M., & Rios, M. D. (2021) · Springer eBooks · doi:10.1007/978-3-030-65672-0_2 · Cited by 1 · see citing works
Too much data, and still not enough information
Reilly, J. P. (2015) · Catheterization and Cardiovascular Interventions · doi:10.1002/ccd.26248
Neighborhood socioeconomic status and stroke mortality: Disentangling individual and area effects
Mittal, M. K., & McCormick, J. B. (2013) · Neurology · doi:10.1212/01.wnl.0000434339.51805.60
Hyldgård, V. B., Johnsen, S. P., Støvring, H., Albertsen, A. B., & Søgaard, R. (2021) · Nordic Journal of Health Economics · doi:10.5617/njhe.7822
Outcomes of ischemic stroke in safety-net hospitals
Zhan, M., & Man, S. (2025) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2025.108453
Rehman, A., Singh, A., Sridhar, P., Wang, H. Y., Velo, A., Nguyen, D., Ehrlich, M., Lookstein, R., & Steiger, D. J. (2024) · Figshare · doi:10.6084/m9.figshare.26094366
Epidemiology and determinants of cardiovascular disease in Indigenous populations
McBride, K. F., Oguoma, V. M., Rolleston, A. K., Grey, C., Deen, J. F., Warne, D. K., Azzopardi, P. S., Reading, J., & Brown, A. D. H. (2026) · Nature Reviews Cardiology · doi:10.1038/s41569-026-01314-7
- Authors
- Kimball, M. M., Neal, D., Waters, M. F., & Hoh, B. L.
- Affiliations
- University of Florida Health (US)
- University of Florida (US)
- Venue
- Journal of Stroke and Cerebrovascular Diseases
- Publisher
- Elsevier BV
- Published
- 2014-01
- Volume
- 23
- Issue
- 1
- Pages
- 17-24
- ISSN
- 1052-3057 (ISSN-L)
- OpenAlex
- W2005341654
- Cited by
- 99
- References
- 34
- Citations by year
- 2026: 1 · 2025: 10 · 2024: 10 · 2023: 3 · 2022: 12 · 2021: 9 · 2020: 7 · 2019: 12 · 2018: 2 · 2017: 9 · 2016: 5 · 2015: 9 · 2014: 4 · 2013: 5 · 2012: 1
- FWCI
- 4.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Stroke and Cerebrovascular Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Keywords
- ischemic stroke, racial disparities, income inequality, socioeconomic status, intravenous thrombolysis, high-volume centers, in-hospital mortality, discharge disposition, hospital charges, length of hospital stay, African Americans, Hispanic Americans, access to stroke care
- MeSH terms
- Aged, Aged, 80 and over, Brain Ischemia, Female, Hospitals, Humans, Income, Inpatients, Length of Stay, Male, Middle Aged, Minority Groups, Patients, Social Class, Socioeconomic Factors, United States, Thrombolytic Therapy, Databases, Factual, Treatment Outcome, Hospital Mortality, Hospital Charges, Stroke, International Classification of Diseases, Healthcare Disparities
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