Why Black Americans have the highest death rate from strokes

Why having Strokes leads to more deaths in the Black community

Jonathan House is lucky to be alive after suffering a stroke in 2021. His story raises important questions: Why are strokes more common among Black Americans, and what can be done to change this reality?

This article was re-posted from WHAS11.

In America, someone has a stroke every 40 seconds, making it the fifth leading cause of death. However, a closer look at the data reveals that one group bears a disproportionate burden. Black Americans face the highest death rate from strokes compared to any other racial group.

The good news is that many stroke-related factors are identifiable through primary care and are often preventable.

“We can go out here and do a survey and ask 100 of us, all black males, how long it has been since you had your blood pressure checked,” says Jonathan House, a recent stroke survivor. “I’ll bet you some of them will tell you years.”

A Survivor’s Story: The Weight of the World

In November 2021, House’s blood pressure was dangerously high when he collapsed from a stroke. He was also grieving the recent loss of his mother and stepfather and felt immense stress after losing a job he held for over 20 years.

“In us black males,” he explains, “high blood pressure, stress, diabetes—stuff we don’t look at—along with the weight of the world. All of that piles on you.” House adds, “After so long, walking around with it on your shoulders, we get weak. But as we get weak, we don’t know that it’s tearing us down from the inside out. A lot of us don’t know it until it’s too late.”

Now 45, House is fortunate to have survived. He is recovering and hopes to make a full comeback. He continues to manage high blood pressure and diabetes, which are direct risk factors for strokes.

Medical Disparities and the Need for Better Research

“[Mr. House] really exemplifies a lot of the challenges as far as stroke risks with the African American community,” said Dr. Danny Rose, a Neurologist and stroke specialist at the Norton Neuroscience Institute. “It’s been well recognized in all aspects of medicine that African Americans and other minority groups have worse outcomes.”

Dr. Rose notes the disparity exists in both health outcomes and the care patients receive. “From a prevalence standpoint, Black Americans actually have the highest rate both of stroke as well as death from stroke, compared to any other racial or ethnic group. And that’s been known for a long time.”

Common risk factors like high blood pressure, diabetes, and smoking are prevalent across many ethnicities and regions. This means they do not fully explain the higher stroke rates or death rates among African Americans.

A Call for Health Equity in Medical Studies

“When we look at our stroke studies, they all look at populations of people,” Dr. Rose says. He explains that studies in the United States should ideally reflect the country’s racial and ethnic breakdown. “What that means is, if you are a white person, you are much more likely that you and your genetic makeup will be more reflected in this research, because there’s just a higher prevalence as far as an ethnic group.”

Dr. Rose states this puts minorities at a disadvantage because “our research that guides our treatment decisions are all just predominantly featuring people of whiter European ancestry.”

This issue is now a central part of the health equity conversation in American medicine. Dr. Rose believes new studies must be viewed through this lens.

“Part of healthcare equity is looking at how we individualize treatments and give more specific research toward ethnic minority groups,” he said. This focus helps identify problems unique to that population and interventions that may provide a distinct benefit. “That’s something that has really been understudied, to be honest, for a long time.”

Read more