Health disparities in neurological disorders are often overlooked but remain a critical issue in public health. Disparities may be present because of socioeconomic disadvantages, especially in cases of inequitable access to care, but also due to racial/ethnic discrimination or implicit bias (1). Patient outcomes across diverse neurological conditions, including stroke, multiple sclerosis, and epilepsy are affected by these disparities (1, 2, 3).
A recent study highlights the presence of inequities in high-income countries, focusing on marginalized populations, particularly racial and ethnic minorities, for differential diagnosis of multiple sclerosis (1). With conditions like neuromyelitis optica, systemic lupus erythematosus, and cerebrovascular diseases being more prevalent in patients belonging to ethnic or racial minorities, the social determinants of health are recognized as a public health consideration in specific populations (1). Similarly, in individuals living with epilepsy coming from households/families of low socioeconomic backgrounds or underserved communities, limited access to care and language barriers might often lead to poorer health outcomes due to social determinants (2). In high-income countries discrimination based on race and ethnicity, financial challenges, variations in disease management, education level, and geographical location can also affect diagnosis and management of cerebrovascular and neurodegenerative diseases (3).
To address disparities in neurological disease in-depth approaches are needed, considering the intersection of immigration, social determinants, and healthcare inequities (1). Targeted neuroepidemiological research could help better comprehend the prevalence, treatment access, and outcomes of neurological disorders in specific populations.
Key Points:
• Neurological health disparities are largely driven by socioeconomic status, ethnicity, and access to care.
• Racial and ethnic minorities experience diagnostic delays and inequities in disease management.
• There is an urgent need for more research to address health inequities in neurological disorders across diverse populations.
• Targeted interventions are necessary to reduce health disparities in underserved communities.
References:
- Amezcua L, Rotstein D, Shirani A, Ciccarelli O, Ontaneda D, Magyari M, Rivera V, Kimbrough D, Dobson R, Taylor B, Williams M, Marrie RA, Banwell B, Hemmer B, Newsome SD, Cohen JA, Solomon AJ, Royal W 3rd. Differential diagnosis of suspected multiple sclerosis: considerations in people from minority ethnic and racial backgrounds in North America, northern Europe, and Australasia. Lancet Neurol. 2024 Oct;23(10):1050-1062. doi: 10.1016/S1474-4422(24)00288-6. PMID: 39304244.
- Kiriakopoulos ET, García Sosa R, Blank L, Johnson EL, Gutierrez C. Shining a Light: Advancing Health Equity in Overlooked Epilepsy Communities. Epilepsy Curr. 2024 Jun 14:15357597241258081. doi: 10.1177/15357597241258081. Epub ahead of print. PMID: 39554275; PMCID: PMC11562279.
- Fornari A, Lanza M, Guastafierro E, Marcassoli A, Sismondo P, Curatoli C, Raggi A, Leonardi M. Inequities in neurological care: Access to services, care gaps, and other barriers-A systematic review. Eur J Neurol. 2024 Nov 25:e16553. doi: 10.1111/ene.16553. Epub ahead of print. PMID: 39582360.
Publish on behalf of the Scientific Panel on Neuroepidemiology