Disparities have long existed among Black adults when it comes to stroke, the fifth leading cause of death for all Americans in the U.S. Black Americans are 50 percent more likely to have a stroke compared to their white counterparts, federal data shows; they’re also more likely to die from a stroke. New research shows these disparities worsened during the pandemic.
Deaths from stroke increased among both Black and white adults during the early days of COVID-19, but the gap between the two groups grew by more than 21 percent during the first year of the pandemic, a new report from the Centers for Disease Control and Prevention (CDC) shows. The largest increase was seen among adults ages 65 to 84.
What caused the gap to widen?
Adam Vaughan, deputy associate director for science in the Division for Heart Disease and Stroke Prevention at the CDC, says before COVID-19 hit, there was “quite a bit of evidence” that the racial disparities in stroke were “really driven by differences in hypertension treatment and control.” More than half of Black adults in the U.S. have hypertension, or high blood pressure, which is a major risk factor for stroke. Other risk factors include diabetes and heart disease, both of which also disproportionately affect Black Americans.
It’s likely that disruptions and delays in health care during the pandemic affected treatment of stroke and the management of risk factors for stroke, like high blood pressure, Vaughan points out. A June 2020 poll from the Kaiser Family Foundation found that about half of adults (52 percent) skipped or postponed some type of medical or dental care because of coronavirus. Another survey published on JAMA Network found that 1 in 5 U.S. adults (20 percent) reported their household members were unable to get care or delayed getting it for serious problems in 2020.
Other factors that can influence risk of stroke — such as physical activity, diet, sleep quality and mental health — were also adversely affected by the pandemic and could have disproportionately impacted Black adults, the study’s authors note. For example, federal data shows that fewer Black and Hispanic workers were able to telework during the height of COVID, compared to white workers. The anxiety of not being able to keep a distance from others, coupled with other pandemic stressors especially affected the mental health of Black Americans, according to the American Psychiatric Association.
“And then the other thing that we're learning more about is just an emerging body of evidence that suggests that people who had COVID-19 are at increased risk of new or worsening cardiovascular disease,” Vaughan says. “So, our results really could be partially reflecting the early well-established racial disparities and COVID.”
One study published in February 2022 in the journal Nature Medicine found that people who had COVID-19 were 63 percent more likely to have some kind of cardiovascular issue one year after their initial infection. The study also found a 52 percent increased risk of stroke among COVID-19 survivors one year later. And an earlier study published in The Lancet found the risk of heart attack and stroke increased in the weeks following a COVID-19 diagnosis.
Since the start of the pandemic, people of color have experienced a disproportionate burden of cases and deaths from the disease.