Social Determinants of Health and Their Impacts on Stroke Prevention and Outcomes

OBJECTIVE: Often unrecognized and frequently overlooked, the inclusion of social determinants of health in stroke management is critical to improving outcomes. Using the National Institute of Neurological Disorders and Stroke working group Determinants of Inequities in Neurological Disease, Health, and Well-being framework, this article reviews structural, social status, intermediate, intrapersonal, and biological determinants of health inequities and their impact on equity in neurologic health after stroke. LATEST DEVELOPMENTS: It is imperative that social determinants of health are evaluated as a requirement for effective stroke prevention and rehabilitation. ESSENTIAL POINTS: To optimize secondary stroke prevention and improve stroke outcomes, it is critical to include social determinants of health as components of poststroke management, starting during the acute hospitalization and continuing through outpatient management. Interdisciplinary services, such as social work, care coordination, behavioral health, physical and occupational therapy, speech and language pathology, and chaplaincy, provide additional resources to help stroke survivors and their caregivers.