Introduction: The Deaf community, a linguistic minority defined by shared cultural identity, faces significant healthcare disparities, including reduced access to primary care, higher emergency room use, and systemic barriers such as denied interpreter services. These inequities contribute to worse health outcomes compared to hearing populations. Research on stroke in Deaf populations remains lacking. This review synthesized literature on stroke epidemiology, risk factors, and treatment disparities in the culturally Deaf signing population. Methods: We searched PubMed and Embase from inception to 6/2025 using MeSH and keyword terms related to Deafness and stroke, limited to English-language studies. Eligible study designs included cohort, case-control, case-reports, cross-sectional, and randomized trials. Four reviewers independently screened 20,067 titles/abstracts and 312 full texts, resolving discrepancies by consensus. 98 articles were extracted and narratively synthesized due to study heterogeneity. Results: Deaf individuals exhibit significant gaps in stroke awareness, with over 60% unable to identify stroke symptoms. Case series of Deaf patients with stroke suggests that both the left and right hemispheric infarcts impede language processing and communication. Post-stroke care disparities include limited interpreter access and inadequate speech language therapy. Regarding stroke risk factors, hypertension findings are mixed, with some studies showing elevated blood pressure rates among Deaf individuals, low levels of self-awareness of hypertension and low treatment rates. However, when controlling for non-modifiable risk factors, Deaf patients showed lower rates of hypertension compared to the hearing population, though disparities persist in non-Hispanic Black individuals. Diabetes prevalence is elevated, particularly among Deaf women, compounded by health literacy barriers in American Sign Language. Obesity rates exceed general population levels. Historically, substance use patterns were similar to those in the hearing population; however, more recent studies suggest a higher prevalence of binge drinking alongside lower rates of diagnosed substance use disorders. Conclusions: Research on stroke in the Deaf community remains scarce. Existing studies reveal concerning disparities in stroke risk factors, highlighting potential unmet needs. While culturally tailored interventions show promise, they are limited in availability.
Milani et al. (Thu,) studied this question.