Mexican Americans are the most numerous sub-group of Hispanic Americans, the largest minority population in the United States. This important group is aging and growing rapidly. For the past 14 years the Brain Attack Surveillance in Corpus Christi (BASIC) Project has provided rich original stroke disparities research comparing Mexican Americans and non-Hispanic whites. BASIC remains the only means to monitor stroke trends and to investigate stroke outcomes in Mexican Americans. BASIC has demonstrated that stroke incidence is higher in Mexican Americans compared with non-Hispanic whites. New stroke incidence data from BASIC show that the disparity remains completely unabated over the last decade. Further, stroke onset occurs at younger ages in Mexican Americans providing more years of disability. This contributes to a substantial increased cost for stroke in Mexican Americans compared with non-Hispanic whites. Remarkable new data from BASIC suggests that the previously seen Mexican American survival advantage post-stroke is disappearing. Further, Mexican American stroke survivors have worse neurologic and functional outcomes. Thus, BASIC data suggests that in 2013 Mexican Americans have more strokes, occurring at younger ages, and experience far greater post- stroke disability than non-Hispanic whites. The current proposal seeks to continue to provide rigorous stroke surveillance to monitor stroke trends in Mexican Americans and non-Hispanic whites. We further propose to provide new longer-term (six month and one year) stroke outcome data to provide crucial information on the time course and changes in neurologic, functional, cognitive, and quality of life outcomes post-stroke in both ethnic groups. Additionally, since post-stroke disability appears much worse in Mexican Americans, we plan to delve deeply into the structure of informal caregiving post-stroke and understand the needs of stroke survivors and the role of families in addressing these needs. This data on the social/family context in which stroke survivors function will be crucial for designing intervention to improve stroke outcome. Finally, the definition of stroke will be studied to understand the impact on measures of stroke burden derived from an ethnically diverse population-based study. BASIC has published over 55 original, peer-reviewed manuscripts, spun-off 5 R-level grants and served as the foundation for training numerous diverse students. In this next cycle, we are poised and deeply committed to provide a fundamental understanding of long-term stroke trends, outcome studies, and informal caregiving structure, as well as continuing to provide key clinical observations such as the impact of the new stroke definition. This work is absolutely critical to Mexican Americans, a growing, aging and large minority population that will increasingly feel the impact from stroke in the next decade. Indeed, this work is also critical to clinicians and public health planners as BASIC continues to offer key observations on stroke and Mexican American health disparities.

Public Health Relevance

This project seeks to monitor and understand the tremendous stroke disparity among Mexican Americans and non-Hispanic whites. Stroke incidence, recurrence, mortality, and, in survivors, neurologic, functional and cognitive outcomes will be compared among the ethnic groups. Informal caregiving structure will be studied to improve services and tailor interventions for stroke survivors and families to improve stroke outcome and prevent second stroke.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
2R01NS038916-16
Application #
8694264
Study Section
Neurological, Aging and Musculoskeletal Epidemiology Study Section (NAME)
Program Officer
Waddy, Salina P
Project Start
1999-09-01
Project End
2019-03-31
Budget Start
2014-04-01
Budget End
2015-03-31
Support Year
16
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Neurology
Type
Schools of Medicine
DUNS #
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Skolarus, Lesli E; Wing, Jeffrey J; Morgenstern, Lewis B et al. (2016) Mexican Americans are Less Likely to Return to Work Following Stroke: Clinical and Policy Implications. J Stroke Cerebrovasc Dis 25:1851-5
Meurer, William J; Levine, Deborah A; Kerber, Kevin A et al. (2016) Neighborhood Influences on Emergency Medical Services Use for Acute Stroke: A Population-Based Cross-sectional Study. Ann Emerg Med 67:341-348.e4
Brown, Devin L; Mowla, Ashkan; McDermott, Mollie et al. (2015) Ischemic stroke subtype and presence of sleep-disordered breathing: the BASIC sleep apnea study. J Stroke Cerebrovasc Dis 24:388-93
Wing, Jeffrey J; Adar, Sara D; Sánchez, Brisa N et al. (2015) Ethnic differences in ambient air pollution and risk of acute ischemic stroke. Environ Res 143:62-7
Reeves, Sarah L; Brown, Devin L; Baek, Jonggyu et al. (2015) Ethnic Differences in Poststroke Quality of Life in the Brain Attack Surveillance in Corpus Christi (BASIC) Project. Stroke 46:2896-901
Patel, Rajiv C; Baek, Jonggyu; Smith, Melinda A et al. (2015) Residential ethnic segregation and stroke risk in Mexican Americans: the Brain Attack Surveillance in Corpus Christi project. Ethn Dis 25:11-8
Lisabeth, Lynda D; Reeves, Mathew J; Baek, Jonggyu et al. (2015) Factors influencing sex differences in poststroke functional outcome. Stroke 46:860-3
Morgenstern, Lewis B; Kissela, Brett M (2015) Stroke Disparities: Large Global Problem That Must Be Addressed. Stroke 46:3560-3
Skolarus, Lesli E; Sanchez, Brisa N; Levine, Deborah A et al. (2014) Association of body mass index and mortality after acute ischemic stroke. Circ Cardiovasc Qual Outcomes 7:64-9
Kerber, Kevin A; Zahuranec, Darin B; Brown, Devin L et al. (2014) Short-term risk of stroke after dizziness presentation. Reply. Ann Neurol 76:767-8

Showing the most recent 10 out of 91 publications