Miguel Escalon, MD
“Disparities in Health Care for Black Patients in Physical Medicine and Rehabilitation in the United States,” was the subject of a wide-ranging talk on Disability Awareness by Miguel Escalon, MD, Associate Professor of Rehabilitation Medicine and Human Performance, Icahn School of Medicine at Mount Sinai. The virtual talk can be viewed here.
Black Americans aged 30 to 64 have a higher stroke mortality compared with all other groups, and also the highest incidence of hypertension, diabetes, and peripheral artery disease, all strong risk factors for stroke, Dr. Escalon said. There also are disparities in rehabilitation care of such patients after a stroke, he said, citing a survey of research from 2009 to 2019, which he and a team published in October 2020 in PM&R: the Journal of Injury, Function and Rehabilitation.
The talk in October inaugurated the new Raising Disability Awareness Virtual Talk Series, featuring speakers from around the Mount Sinai Health System as well as the community, in honor of Disability Awareness Month. During this time, the Mount Sinai Office for Diversity and Inclusion (ODI) hosted events to educate, raise awareness and promote an inclusive and equitable health care environment for people with disabilities.
Speakers also came from Mount Sinai’s Seaver Center for Autism Research and Treatment, and Language Assistance Program, and from external partners, including the National Multiple Sclerosis Society, the Mayor’s Office for People with Disabilities, MTA NYC Transit Access-A-Ride, the Lighthouse Guild, the Hearing Loss Association of America, the Adaptations Job Program, and the LBGTQ+ community. The talks were curated to bring awareness to the intersectionality of disability and race, ethnicity, and LBGTQ+ and educate on health disparities and the barriers to access to care.
Health disparities have been found for Black people with stroke, traumatic brain injury, spinal cord injury, hip/knee osteoarthritis, and fractures, as well as cardiovascular and pulmonary disease, Dr. Escalon said. Some contributing factors included socio-economic issues, low access to rehabilitation care, fewer referrals, lower utilization rates, perceived bias, and more self‐reliance.
Some sources also found that disparities are evident in the crucial months just after a stroke. “Most recovery happens in the first few months. You are never going to get more rehab than you get in acute inpatient rehab.” Dr. Escalon said, adding the more study is needed to identify and address health disparities.
“It is important for health care professionals to understand the health risks within Black communities,” he said. “More research is needed to elucidate the outcomes—by race/ethnicity, gender, and gender within race/ethnicity—especially around what happens after the patient leaves the hospital.”