Stroke improvement plan: equality impact assessment

Equality impact assessment (EQIA) for the stroke improvement plan which includes summary, background, key findings and conclusions.


Footnotes

1 Public Health Scotland, Scottish Stroke Statistics - year ending 31 March 2022. January 2023.

Scottish stroke statistics - Year ending 31 March 2022 - Scottish stroke statistics - Publications - Public Health Scotland

2 The Scottish Government, The Scottish Health Survey 2021 (Edinburgh, 2022) pp. 31, The Scottish Health Survey 2021 - volume 1: main report - gov.scot (www.gov.scot)

3 Public Health Scotland, Scottish Stroke Statistics - year ending 31 March 2022. pp 13, January 2023. Scottish stroke statistics - Year ending 31 March 2022 - Scottish stroke statistics - Publications - Public Health Scotland

4 Public Health Scotland, Scottish Stroke Statistics - year ending 31 March 2022. pp 4, January 2023.

Scottish stroke statistics - Year ending 31 March 2022 - Scottish stroke statistics - Publications - Public Health Scotland

5 Hart C L; Hole, D J; Smith G D; Influence of Socioeconomic Circumstances in Early and Later Life on Stroke Risk Among Men in a Scottish Cohort Study

Originally published 1 Sep 2000 https://doi.org/10.1161/01.STR.31.9.2093 Stroke. 2000;31:2093–2097

6 Public Health Scotland, Scottish Burden of Disease study Forecasting the future burden of disease: Incorporating the impact of demographic transition over the next 20 years. November 2022; pp 5. Scottish Burden of Disease Forecasting Briefing (scotpho.org.uk)

7 The future incidence, prevalence and costs of stroke in the UK. King D; Wittenberg R; Patel; A Zahid; Vladislav Berdunov Q; Knapp, M. Age and Ageing, Volume 49, Issue 2, March 2020, pp 277–282, https://doi.org/10.1093/ageing/afz163

8 Public Health Scotland, Scottish Stroke Statistics - year ending 31 March 2022. pp 6, January 2023.

Scottish stroke statistics - Year ending 31 March 2022 - Scottish stroke statistics - Publications - Public Health Scotland

9 The Scottish Government, The Scottish Health Survey 2021 (Edinburgh, 2022) pp. 31

The Scottish Health Survey 2021 - Volume 1: Main Report (www.gov.scot)

10 The Scottish Government, A Scotland for the future: opportunities and challenges of Scotland's changing population (Edinburgh 2021), pp22

A Scotland for The Future: The opportunities and challenges of Scotland’s changing population (www.gov.scot)

11 Public Health Scotland, Scottish Burden of Disease study Forecasting the future burden of disease: Incorporating the impact of demographic transition over the next 20 years. November 2022; pp 5, Scottish Burden of Disease Forecasting Briefing (scotpho.org.uk)

12 Public Health Scotland, Scottish Stroke Statistics - year ending 31 March 2022. January 2023.

Scottish stroke statistics - Year ending 31 March 2022 - Scottish stroke statistics - Publications - Public Health Scotland

13 Boot E, Ekker MS, Putaala J, Kittner S, De Leeuw FE, Tuladhar AM. Ischaemic stroke in young adults: a global perspective. J Neurol Neurosurg Psychiatry. 2020 Apr;91(4):411-417. doi: 10.1136/jnnp-2019-322424. Epub 2020 Feb 3. PMID: 32015089. https://pubmed.ncbi.nlm.nih.gov/32015089/

14 Roberts, E., ‘Age discrimination in health and social care’ Age Discrimination in Health and Social Care | The King's Fund [accessed 25th January 2020] pp. 1

15 Berry, R. ‘Older people and the internet - Towards a “system map” of digital exclusion’ The International Longevity Centre (2011) pp. 5

16 Helsper, E. J., and Reisdorf, B. C; . (2016) The emergence of a "digital underclass" in Great Britain and Sweden: changing reasons for digital exclusion. New Media & Society. ISSN 1461-4448. DOI: 10.1177/1461444816634676 Helsper_The emergence of a digital underclass.pdf (lse.ac.uk)

17 The National Institute for Health and Social Care Excellence. 2019, Nice Guideline 128: Stroke and Transient Ischaemic Attack in over 16s: Diagnosis and Initial Management, Accessed: Overview | Stroke and transient ischaemic attack in over 16s: diagnosis and initial management | Guidance | NICE (19 August, 2022)

18 The Stroke Foundation, 2020, Disability after a Stroke, Accessed: Disability after a stroke - The Stroke Foundation (19 August, 2022)

19 The National Institute for Health and Social Care Excellence. 2019, Nice Guideline 128: Stroke and Transient Ischaemic Attack in over 16s: Diagnosis and Initial Management, Accessed: Overview | Stroke and transient ischaemic attack in over 16s: diagnosis and initial management | Guidance | NICE (19 August, 2022)

20 NHS, 2019, Prevention: Stroke, Accessed: Stroke - Prevention - NHS (www.nhs.uk) (19 August, 2022).

21 Nettle, D. 2010, Why Are There Social Gradients in Preventative Health Behaviour? A Perspective from Behavioural Ecology, Accessed: Why Are There Social Gradients in Preventative Health Behavior? A Perspective from Behavioral Ecology | PLOS ONE (19 August, 2022).

22 Williams, T. S.; McDonald, K. P.; Roberts, S. D.; Dlamini, N., deVeber, G., & Westmacott, R. (2017) Prevalence and Predictors of Learning and Psychological Diagnoses Following Pediatric Arterial Ischemic Stroke, Developmental Neuropsychology, 42:5, 309-322, DOI: 10.1080/87565641.2017.1353093

23 Hosking, F. J., Carey, I. M., Shah, S. M., Harris, T., DeWilde, S., Beighton, C., and Cook, D. G. 2016: Mortality Among Adults With Intellectual Disability in England: Comparisons With the General Population. American Journal of Public Health 106, 1483-1490; https://doi.org/10.2105/AJPH.2016.303240

24 Anita F Young, Simon Naji, Thilo Kroll, Support for self-management of cardiovascular disease by people with learning disabilities, Family Practice, Volume 29, Issue 4, August 2012, Pages 467–475, https://doi.org/10.1093/fampra/cmr106

25 McKevitt C, Fudge N, Redfern J, Sheldenkar A, et al. 2011, Self-reported long-term needs after stroke. Stroke, vol. 42, pp. 1398-403.

26 Public Health Scotland, Scottish Burden of Disease study Forecasting the future burden of disease: Incorporating the impact of demographic transition over the next 20 years. November 2022; pp 7. Scottish Burden of Disease Forecasting Briefing (scotpho.org.uk)

27 Scottish Burden of Disease: Deprivation report 2016. ScotPHO. pP11

Scottish Burden of Disease: Deprivation Report (scotpho.org.uk)

28 Cohen, A., Ashworth, M., Askey, A. & Ismail, K. 2018. Diabetes Outcomes in People with Severe Mental Illness, British Journal of General Practice, vol. 68, no. 669, pp. 166-167. Accessed: Diabetes outcomes in people with severe mental illness | British Journal of General Practice (bjgp.org) (16 August, 2022).

29 Nielsen, R. E., Banner, J., Jensen, S. E. ‘Cardiovascular disease in patients with severe mental illness’ (2021). Nature Reviews Cardiology volume 18, pages 136–145

https://www.nature.com/articles/s41569-020-00463-7

30 Mayor, S., ‘Patients with severe mental illness have greatly increased cardiovascular risk’ (2017). BMJ 2017;357:j2339

https://www.bmj.com/content/357/bmj.j2339

31 Cohen, A., Ashworth, M., Askey, A. & Ismail, K. 2018. Diabetes Outcomes in People with Severe Mental Illness, British Journal of General Practice, vol. 68, no. 669, pp. 166-167. Accessed: Diabetes outcomes in people with severe mental illness | British Journal of General Practice (bjgp.org) (16 August, 2022).

32 Mayor, S. 2017, Patients with Severe Mental Illness have Greatly Increased Cardiovascular Risk, Study Finds, BMJ, vol. 357.

33 Amarenco P, Lavallée P, Monterio Tavares L et al. 2018, Five-years risk of stroke after TIA or minor ischaemic stroke. N Engl J Med, vol. 378, pp. 2182–2190.

34 Fleetwood K., Wild, S. H., Smith, D. J., Mercer, S. W., Licence, K., Sudlow, C. L. M., Jackson, C. A. 2021, Severe Mental Illness and Mortality and Coronary Revascularisation following a Myocardial Infarction: a Retrospective Cohort Study, BMC Medicine, vol. 19, no. 67.

35 Fleetwood, K., Wild, S., Smith, D., Mercer, S., Licence, K., Sudlow, C., & Jackson, C. (2022). Association of severe mental illness with stroke outcomes and process-of-care quality indicators: Nationwide cohort study. The British Journal of Psychiatry, 221(1), 394-401. doi:10.1192/bjp.2021.120

36 Ethnic Inequalities in Healthcare: A Rapid Evidence Review (2022). NHS Race and Health Observatory. RHO-Rapid-Review-Final-Report_v.7.pdf (nhsrho.org)

37 The Scottish Government, The Scottish Health Survey 2021 (Edinburgh, 2022) pp. 31

The Scottish Health Survey 2021 - Volume 1: Main Report (www.gov.scot)

38 Rexrode, K. M., Tracy E. Madsen, T. E., Yu, A. Y. X., Carcel, C., Lichtman, J. H., & Miller, E. C., 2022. The Impact of Sex and Gender on Stroke, Circulation Research, February 18, 2022, Vol 130, Issue 4, 512-528; https://doi.org/10.1161/CIRCRESAHA.121.319915

39 Peters S. A.E., Carcel C., Millett E. R. C., Woodward, M. Sex differences in the association between major risk factors and the risk of stroke in the UK Biobank cohort study. Neurology Nov 2020, 95 (20) e2715-e2726; DOI: 10.1212/WNL.0000000000010982. Sex differences in the association between major risk factors and the risk of stroke in the UK Biobank cohort study | Neurology

40 Scottish Stroke Statistics; Year ending 31 March 2022: A National Statistics release for Scotland. 24 January 2023, p12. Scottish Stroke Statistics (publichealthscotland.scot)

41 Volpe, A. G., Zuniga, M. C., Caunca, M. R. and Rosendale, N.

Originally published 23 Jan 2023 https://doi.org/10.1161/STROKEAHA.122.039893Stroke. 2023;54:e44–e47

Gender and Sex Equity in Stroke Research, Education, and Care | Stroke (ahajournals.org)

42 Streed, C. G. Jr, Beach, L. B., Caceres, B. A., Dowshen, N. L., Moreau, K. L., Mukherjee, M., Poteat, T., Radix, A., L. Reisner, S. L., Singh, V. S.: Assessing and Addressing Cardiovascular Health in People Who Are Transgender and Gender Diverse: A Scientific Statement From the American Heart Association. Originally published 8 Jul 2021https://doi.org/10.1161/CIR.0000000000001003Circulation. 2021;144:e136–e148

43 Miller, E. & Leffert, L. 2020, Stroke in Pregnancy: A Focused Update, Anesthesia & Analgesia, vol. 130, no. 4, pp. 1085-1096.

44 Lu Ban et al. 2017. “The incidence of first stroke in and around pregnancy: A population-based cohort study from Sweden” European Stroke Journal. Epub April 21, 2017. doi: 10.1177/2396987317706600

45 Johansson T, Fowler P, Ek WE, Skalkidou A, Karlsson T, Johansson Å. Oral Contraceptives, Hormone Replacement Therapy, and Stroke Risk. Stroke. 2022 Oct;53(10):3107-3115. doi: 10.1161/STROKEAHA.121.038659. Epub 2022 Jun 23. PMID: 35735009. Oral Contraceptives, Hormone Replacement Therapy, and Stroke Risk - PubMed (nih.gov)

46 National Clinical Guideline for Stroke for the UK and Ireland (2023): pp155 https://www.strokeguideline.org/

47 R. Thomson, Baker, J. Arnot, J. Scottish Public Health Network (ScotPHN) Health Care Needs Assessment of Gender Identity Services. May 2018

https://www.scottishtrans.org/wp-content/uploads/2023/03/2018_05_16-HCNA-of-Gender-Identity-Services-1.pdf

48 Chan Swe N, Ahmed S, Eid M, Poretsky L, Gianos E, Cusano NE. The effects of gender-affirming hormone therapy on cardiovascular and skeletal health: A literature review. Metabol Open. 2022 Mar 3;13:100173. doi: 10.1016/j.metop.2022.100173. PMID: 35282421; PMCID: PMC8907681

49 Rexrode, K. M., Tracy E. Madsen, T. E., Yu, A. Y. X., Carcel, C., Lichtman, J. H., & Miller, E. C., 2022. The Impact of Sex and Gender on Stroke, Circulation Research, February 18, 2022, Vol 130, Issue 4, 512-528; https://doi.org/10.1161/CIRCRESAHA.121.319915

50 Volpe, A. G., Zuniga, M. C., Caunca, M. R. and Rosendale, N.

Originally published 23 Jan 2023 https://doi.org/10.1161/STROKEAHA.122.039893Stroke. 2023;54:e44–e47

Gender and Sex Equity in Stroke Research, Education, and Care | Stroke (ahajournals.org)

51 Streed, C. G. Jr, Beach, L. B., Caceres, B. A., Dowshen, N. L., Moreau, K. L., Mukherjee, M., Poteat, T., Radix, A., L. Reisner, S. L., Singh, V. S.: Assessing and Addressing Cardiovascular Health in People Who Are Transgender and Gender Diverse: A Scientific Statement From the American Heart Association. Originally published 8 Jul 2021https://doi.org/10.1161/CIR.0000000000001003Circulation. 2021;144:e136–e148

52 Grant, J. M., Mottet, L. A., Tanis, J., Herman, J. L., Harrison, J. & Keisling, M. 2010. National Transgender Discrimination Survey Report on Health and Health Care, Washington DC: National Centre for Transgender Equality and National Gay and Lesbian Task Force, Washington, DC.

53 Benjamins, M. R., & Whitman, S. (2014). Relationships between discrimination in health care and health care outcomes among four race/ethnic groups. Journal of Behavioral Medicine, 37, 402–413. https://doi.org/10.1007/s10865-013-9496-7

54 Kattari S. K., Whitfield D. L., DeChants J, Alvarez A.; Barriers to health faced by transgender and non-binary black and minority ethnic people, A Race Equality Foundation Briefing Paper, May 2016: Better-Health-41-Trans-NB-final.pdf (raceequalityfoundation.org.uk)

55 General Medical Council, 2022, Trans Healthcare, Accessed: Trans healthcare - ethical topic - GMC (gmc-uk.org) (19 August, 2022)

56 Cicero EC, Reisner SL, Silva SG, Merwin EI, Humphreys JC. Health Care Experiences of Transgender Adults: An Integrated Mixed Research Literature Review. ANS Adv Nurs Sci. 2019 Apr/Jun;42(2):123-138. doi: 10.1097/ANS.0000000000000256. PMID: 30839332; PMCID: PMC6502664.

57 Santander-Morillas K, Leyva-Moral JM, Villar-Salgueiro M, Aguayo-González M, Téllez-Velasco D, Granel-Giménez N, et al. (2022) TRANSALUD: A qualitative study of the healthcare experiences of transgender people in Barcelona (Spain). PLoS ONE 17(8): e0271484. https://doi.org/10.1371/journal.pone.0271484

58 Health needs assessment of lesbian, gay, bisexual, transgender and non-binary people.(May 2022). Traci Leven Research. Health needs assessment of lesbian, gay, bisexual, transgender and non-binary people (scot.nhs.uk)

59 Alencar Albuquerque G, de Lima Garcia C, da Silva Quirino G, Alves MJ, Belém JM, dos Santos Figueiredo FW, da Silva Paiva L, do Nascimento VB, da Silva Maciel É, Valenti VE, de Abreu LC, Adami F. Access to health services by lesbian, gay, bisexual, and transgender persons: systematic literature review. BMC Int Health Hum Rights. 2016 Jan 14;16:2. doi: 10.1186/s12914-015-0072-9. PMID: 26769484; PMCID: PMC4714514

60 Streed, C. G. Jr, Beach, L. B., Caceres, B. A., Dowshen, N. L., Moreau, K. L., Mukherjee, M., Poteat, T., Radix, A., L. Reisner, S. L., Singh, V. S.: Assessing and Addressing Cardiovascular Health in People Who Are Transgender and Gender Diverse: A Scientific Statement From the American Heart Association. Originally published 8 Jul

2021https://doi.org/10.1161/CIR.0000000000001003Circulation. 2021;144:e136–e148

61 Volpe, A. G., Zuniga, M. C., Caunca, M. R. and Rosendale, N.

Originally published 23 Jan 2023https://doi.org/10.1161/STROKEAHA.122.039893Stroke. 2023;54:e44–e47

62 Caceres BA, Turchioe MR, Pho A, Koleck TA, Creber RM, Bakken SB. Sexual Identity and Racial/Ethnic Differences in Awareness of Heart Attack and Stroke Symptoms: Findings From the National Health Interview Survey. Am J Health Promot. 2021 Jan;35(1):57-67. doi: 10.1177/0890117120932471. Epub 2020 Jun 19. PMID: 32551829; PMCID: PMC7948248

63 McGarth, M. Lever, S., McCluskey, A. & Power, E. 2018, How is Sexuality after Stroke Experienced by Stroke Survivors and Partners of Stroke Survivors? A Systemic Review of Qualitative Studies, Clinical Rehabilitation, vol. 33, no. 2, pp. 293-303.

64 National Clinical Guideline for Stroke for the UK and Ireland (2023): https://www.strokeguideline.org/

65 Ethnic Inequalities in Healthcare: A Rapid Evidence Review (2022). NHS Race and Health Observatory. RHO-Rapid-Review-Final-Report_v.7.pdf (nhsrho.org)

66 Research report 12: Inequalities experienced by Gypsy and Traveller communities (2009). Equality and Human Rights Commission. Research report 12: Inequalities experienced by Gypsy and Traveller communities | Equality and Human Rights Commission (equalityhumanrights.com)

67 Which ethnic groups have the poorest health? (2015) Scottish Government: https://www.gov.scot/publications/ethnic-groups-poorest-health/documents/

68 A missed opportunity BMA response to the Race Report, British Medical Agency (BMA)(2021): bma-analysis-of-the-race-report-from-the-commission-on-race-and-ethnic-disparities-june-2021.pdf

69 Institute of Medicine (US) Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, 2003, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, National Academies Press (US), Washington (DC), USA.

70 Yize, Y, I., Robbins, A. J., Apea, V. J., Orkin C. M., Pearse, R. M., Puthucheary, Z. A., Prowle, J. R., Ethnicity and acute hospital admissions: Multi-center analysis of routine hospital data,

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71 Stansbury, J., Huanguang, J., Williams, L., Vogel, W. & Duncan, P. 2005, Ethnic Disparities in Stroke: Epidemiology, Acute Care, and Postacute Outcomes, Stroke, vol. 36, no. 2, pp. 374-386.

72 Stansbury, J., Huanguang, J., Williams, L., Vogel, W. & Duncan, P. 2005, Ethnic Disparities in Stroke: Epidemiology, Acute Care, and Postacute Outcomes, Stroke, vol. 36, no. 2, pp. 374-386.

73 McKevitt C, Fudge N, Redfern J, Sheldenkar A, et al. 2011, Self-reported long-term needs after stroke. Stroke, vol. 42, pp. 1398-403.

74 G F Mkoma, S P Johnsen, H K Iversen, G Andersen, M L Nørredam, Ethnic differences in incidence and mortality of stroke in Denmark, European Journal of Public Health, Volume 30, Issue Supplement_5, September 2020, ckaa165.346, https://doi.org/10.1093/eurpub/ckaa165.346

75 Albright, K. C., Huang, L., Blackburn, J., Howard, G., Mullen, M., Bittner, V., Muntner, P., Howard, V. Racial differences in recurrent ischemic stroke risk and recurrent stroke case fatality

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77 Ethnic disparities in the major causes of mortality and their risk factors – a rapid review Research and analysis. Updated 28 April 2021. Ethnic disparities in the major causes of mortality and their risk factors – a rapid review - GOV.UK (www.gov.uk)

78 Fluck, D., Fry, C.H., Gulli, G. et al. Adverse stroke outcomes amongst UK ethnic minorities: a multi-centre registry-based cohort study of acute stroke. Neurol Sci 44, 2071–2080 (2023). https://doi.org/10.1007/s10072-023-06640-z

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Contact

Email: Clinical_Priorities@gov.scot

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