Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Neurology, University of California, Los Angeles, California.
Semin Neurol. 2024 Apr;44(2):178-192. doi: 10.1055/s-0043-1778639. Epub 2024 Mar 14.
The burden of neurological disease is increasing globally. In the United States, this burden is disproportionally greater for Black and Latino communities who have limited access to neurological care. Health services researchers have attempted to identify racial and ethnic disparities in neurological care and possible solutions. This article reviews the most current literature on racial and ethnic disparities in commonly encountered neurological conditions, including Stroke, Alzheimer's Disease, Multiple Sclerosis, Epilepsy, Parkinson's Disease, and Migraine. Disparities exist in disease incidence, diagnosis, access to care, treatment, outcomes, and representation in epidemiologic studies and clinical trials. Many of the disparities observed in neurological care in the United States are a consequence of longstanding racist and discriminatory policies and legislation that increase risk factors for the development of neurological disease or lead to disparities in accessing quality neurological care. Therefore, additional efforts on the legislative, community health, and healthcare system levels are necessary to prevent the onset of neurological disease and achieve equity in neurological care.
神经疾病的负担在全球范围内不断增加。在美国,黑人和拉丁裔社区的负担不成比例地更大,他们获得神经科护理的机会有限。卫生服务研究人员试图确定神经科护理方面的种族和民族差异以及可能的解决方案。本文综述了关于常见神经疾病中种族和民族差异的最新文献,包括中风、阿尔茨海默病、多发性硬化症、癫痫、帕金森病和偏头痛。在疾病发病率、诊断、获得护理、治疗、结局以及在流行病学研究和临床试验中的代表性方面存在差异。在美国,神经科护理中观察到的许多差异是长期存在的种族主义和歧视性政策和立法的结果,这些政策和立法增加了神经疾病发展的风险因素,或导致获得高质量神经科护理的机会不平等。因此,需要在立法、社区卫生和医疗保健系统层面做出更多努力,以预防神经疾病的发生,并实现神经科护理的公平。