In a medical emergency where every minute can mean the difference between walking and lifelong disability, a new study finds that patients in disadvantaged, predominantly Black neighborhoods are far less likely to get a critical stroke drug in time. Hospitals serving these communities were “32% less likely to administer intravenous thrombolysis (IVT)” for acute ischemic stroke than hospitals caring for more affluent, largely white populations.
Researchers analyzed nearly 2.5 million stroke cases from 2016 to 2020 and used a segregation index to group hospitals by the racial and socioeconomic makeup of the patients they serve. Only 1% of patients were treated at hospitals in the most disadvantaged quintile, which care predominantly for Black and socioeconomically marginalized communities, while most were seen in mid-range hospitals with a more mixed patient base. Patients treated at hospitals serving moderately and predominantly white, socioeconomically advantaged populations were significantly more likely to receive IVT than those in the most disadvantaged hospitals.
Within those under-resourced hospitals, inequity was even sharper. Black patients were substantially less likely than white patients to receive IVT, with an adjusted odds ratio of 0.68, and that racial gap “persisted across all levels” of hospital advantage. The investigators concluded that while socioeconomic improvements reduced disparities, they did not erase them, warning that “addressing structural racism and segregation is crucial for equitable access to stroke care.”
See: “Critical Stroke Care Less Likely in Disadvantaged Areas” (March 20, 2025)
