Roadmap for health equity

Understanding the importance of community-engaged stroke research

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Improving health equity, or equality within access and outcomes in health care, is important in stroke prevention, treatment, and recovery. However, health equity has been a significant challenge among disadvantaged groups of people who experience worse health outcomes compared to others.

In a recently published article in the journal Stroke, corresponding author, Bernadette Boden-Albala, MPH, DrPH, founding dean and professor of health, society, and behavior at the UC Irvine Joe C. Wen School of Population & Public Health, shares important tools to achieve health equity, including the power and effectiveness of community-engaged research. This means researchers must involve community members in all stages of research—from proposal writing, budgeting, implementation and findings dissemination—as supported by several cited community-engaged studies, which resulted in better outcomes in preventing and recovering from strokes.

“By working together, researchers and communities can identify the specific needs of different groups and develop targeted interventions that can better improve health outcomes, especially in stroke,” said Boden-Albala, who also served as the Chair of the National Institute of Neurological Disorders and Stroke (NINDS) Disparities Advisory Board and Co-Chair for NINDS Diversity, Equity, and Inclusion Committee.

To make community engagement truly meaningful, we must address social determinants of health. These factors—like economic background, access to healthcare, and education—play a crucial role in influencing stroke risk and health outcomes.

– Dean Bernadette Boden-Albala

This article presents a framework that details methods for community engagement and addresses the overarching goal of social justice. Further, the paper highlights a roadmap developed by Boden-Albala on steps to achieving health equity in stroke, based within the importance of community engagement.

To enhance community engagement, community health workers (CHWs) are used as an important tool. CHWs are people from the community who are trained to connect researchers and community members, ensure voices of the community are heard in all steps of research, and help the research intervention and strategies to be culturally appropriate.

“To make community engagement truly meaningful, we must address social determinants of health. These factors—like economic background, access to healthcare, and education—play a crucial role in influencing stroke risk and health outcomes. By tackling these challenges, we can improve overall health and help reduce stroke disparities,” Boden-Albala added.

Although understanding how to reduce health disparities in stroke prevention, treatment, and recovery is complicated, this article explores how multilevel approaches are needed to create solutions at the personal, family, community, and policy-level. Overall, a roadmap to health equity in stroke involves community engagement at every step and is essential for improving brain health and ensuring fair access to stroke prevention and care for everyone.

This article is based on work supported by National Institute of Neurological Disorders and Stroke (NINDS) 100000065: P50NS049060 and National Initiative for Minority Inclusion in Clinical Trials NIMHD-NINDS: 1U24MD00691. The opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.