Research reveals persistent racial disparities in stroke treatment and outcomes

by Society of NeuroInterventional Surgery

edited by Sadie Harley, reviewed by Andrew Zinin

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Three studies presented at the Society of NeuroInterventional Surgery's (SNIS) 23rd Annual Meeting found that racial, geographic and socioeconomic disparities continue to influence stroke treatment and outcomes across the United States. Together, the findings suggest that while advances in stroke care have improved survival and expanded treatment options, not all patients are benefiting equally.

In the first study, "Racial Disparities in Endovascular Thrombectomy Widen with Stroke Severity: A National Inpatient Sample Analysis," co-first authors Muhammed Amir Essibayi, MD, MSc, FRCP, and Hasan Jamil, MD, MPH, evaluated more than 325,000 acute ischemic stroke patients treated at U.S. teaching hospitals between 2018 and 2022.

They found that Black patients were less likely than white patients to receive endovascular thrombectomy (EVT), a minimally invasive procedure used to remove blood clots from blocked arteries in the brain.

The disparity existed across all levels of stroke severity and increased as stroke severity worsened, with Black women consistently the least likely to receive treatment. At a National Institutes of Health Stroke Scale (NIHSS) score of 20, the predicted probability of receiving EVT was 33% for white men, 32% for white women, 28% for Black men and 26% for Black women.

"As stroke severity increases, timely access to thrombectomy becomes increasingly important, yet our findings suggest treatment disparities also become more pronounced," said Essibayi, a fellow at Albert Einstein College of Medicine. "Understanding how race, sex and stroke severity intersect may help health systems identify opportunities to ensure patients have equitable access to lifesaving treatment."

A second study, "Reducing Inequalities in Stroke Events-Hemorrhagic Disparities (RISE-HD): A 10-year Statewide Analysis of Social Determinants of Mortality in Hemorrhagic Stroke," examined more than 120,000 patients hospitalized with hemorrhagic stroke in Florida between 2013 and 2024. The paper is published in the Journal of Racial and Ethnic Health Disparities.

While researchers found that mortality rates declined significantly during the study period, substantial disparities persisted among patients from different racial, geographic and socioeconomic backgrounds.

After adjusting for age, sex and comorbidities, Black patients experienced higher odds of in-hospital mortality than white patients. Patients living in rural areas and those insured through Medicaid or other noncommercial insurance plans also faced significantly higher mortality rates. Researchers additionally identified regional differences in outcomes across the state, highlighting potential gaps in access to specialized stroke care.

"The encouraging decline in mortality over the past decade demonstrates meaningful progress in stroke care, but our findings show that significant barriers remain," said Natália Vasconcellos, MD, MSc, a neurology resident at Thomas Jefferson University Hospital and primary author of the second study.

"Addressing disparities in access to specialized stroke systems, particularly for underserved communities, will be critical to improving outcomes for all patients."

In the third study, "Dual Pathways to Hemorrhagic Stroke Mortality Across the U.S. Stroke Belt: Rural Neurointerventional Isolation and Urban Structural Vulnerability," researchers analyzed hemorrhagic stroke mortality across 433 counties in the "Stroke Belt" to examine factors associated with differences in outcomes between rural and urban communities.

The study evaluated distance to the nearest Comprehensive Stroke Center, community-level socioeconomic disadvantage, racial and economic segregation, and HIV burden.

The rural and urban findings were markedly different. In rural counties, longer travel times to Comprehensive Stroke Centers were more strongly associated with mortality, while in urban counties, racialized economic segregation and HIV burden were more strongly associated with poorer outcomes despite closer geographic access to specialized care.

"The neurointerventional access problem in the Stroke Belt is not one problem; it is two," said Dylan Yates, a medical student at Tulane University School of Medicine.

"In rural communities, improving access means expanding stroke transfer networks and strengthening connections to Comprehensive Stroke Centers. In urban communities, addressing structural disadvantage and investing in underserved neighborhoods is critical. These findings show that the neurointerventional access gap differs between rural and urban communities and suggest that improving outcomes will require different strategies in each."

Together, the studies underscore the need for continued efforts to address inequities in stroke prevention, treatment and access to specialized care. Researchers say targeted interventions—including improved stroke transfer networks, expanded access to specialty care and more equitable treatment pathways—may help reduce disparities and improve outcomes for patients nationwide.

More information

M Essibayi et al, O-043 Racial disparities in endovascular thrombectomy widen with stroke severity: a national inpatient sample analysis, SNIS 23rd Annual Meeting Oral Abstracts (2026). DOI: 10.1136/jnis-2026-snis.43

Natália Vasconcellos de Oliveira Souza et al, Reducing Inequalities in Stroke Events—Hemorrhagic Disparities (RISE-HD): a 10-Year Longitudinal Study in Florida, Journal of Racial and Ethnic Health Disparities (2026). DOI: 10.1007/s40615-026-03022-x

Dual Pathways to Hemorrhagic Stroke Mortality Across the U.S. Stroke Belt: Rural Neurointerventional Isolation and Urban Structural Vulnerability

Key medical concepts

Hemorrhagic StrokeAcute Ischemic StrokesHospital Mortality

Clinical categories

NeurologyCommon illnesses & Prevention Provided by Society of NeuroInterventional Surgery Who's behind this story?

Sadie Harley

BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Full profile →

Andrew Zinin

Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →

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