Informing Policy for Reducing Stroke Health Disparities from the Experience of African-American Male Stroke Survivors.
The burden of stroke is severe among African-Americans. Despite overall declines in the rate of stroke since 2000, outcomes are largely unimproved or have worsened for African-American men. Adverse psychosocial challenges may hinder adherence to a regimen of risk factor reduction.



Focus group analysis was combined with a review of current published guidelines and epidemiologic evidence on risk factors to better understand stroke health disparities and potential policy solutions. Transcripts from three focus groups with ten African-American male stroke survivors under age 65 and their care partners (N = 7) were analyzed and compared with existing published data on (a) the burden of stroke (b) trends in clinical risk factors, and (c) trends in behavioral risk factors. Participants described myriad psychosocial barriers that impede reduction of risk indicators, including low trust in providers, poor social support, access difficulties, depression, and distress.



In order to be effective, policies and programs must target mechanisms consistent with the challenges faced by African-American men. Infrastructure is needed to better identify and share practices effective for improving cardiovascular outcomes within specific racial and ethnic groups.
Case Western Reserve University, Cleveland, OH, USA. adam.perzynski@case.edu.|Center for Health Care Research and Policy, The MetroHealth System, 2500 MetroHealth Dr. R225A, Cleveland, OH, 44109, USA. adam.perzynski@case.edu.
Adam
A
Perzynski
Case Western Reserve University, Cleveland, OH, USA.|Center for Health Care Research and Policy, The MetroHealth System, 2500 MetroHealth Dr. R225A, Cleveland, OH, 44109, USA.
Carol
C
Blixen
Case Western Reserve University, Cleveland, OH, USA.
Jamie
J
Cage
Case Western Reserve University, Cleveland, OH, USA.
Kari
K
Colón-Zimmermann
Case Western Reserve University, Cleveland, OH, USA.|University Hospitals, Cleveland, OH, USA.
Martha
M
Sajatovic
D000328:Adult; D001741:Black or African American; D017028:Caregivers; D005006:Ethnicity; D017144:Focus Groups; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D012944:Social Support; D020521:Stroke / Q000208:ethnology* / Q000517:prevention & control; D017741:Survivors; D014481:United States; D044465:White People
Health disparities; Policy; Qualitative; Risk factors; Stroke