Chapter 13: Neurological System
Gillian Spring
Background
Neurological diseases, disorders, and injuries can be catastrophically life-changing for individuals and their families. When individuals survive traumatic neurological accidents, they may require lifelong, expensive support and treatments. Individuals with a lower socioeconomic status will undoubtedly struggle far worse than those from middle- and upper-class families.
Social Determinant Considerations and Culturally Responsive Practice Points for Health Care Providers
Cerebral Vascular Accidents
In 2020, cerebral vascular accidents (CVAs) were determined to be the fifth leading cause of death in both Canada and Saskatchewan (Government of Saskatchewan, 2022). The risk factors for CVAs include hypertension, diabetes mellitus, dyslipidemia, cardiac disease, obesity, family history, alcohol use, and cigarette smoking. Certain racialized groups are at a higher risk of experiencing a stroke due to a higher prevalence of risk factors. In their study, Owolabi et al. (2022) found that stroke patients of African descent had a significantly higher prevalence of hypertension and diabetes mellitus. This study also found that stroke patients of European descent had higher frequencies of alcohol consumption, cigarette smoking, and physical inactivity (Owolabi et al., 2022).
The World Health Organization (WHO, 2015) stated that 80% of premature heart attacks and strokes are preventable. According to the WHO (2015), health care providers (HCPs) can work with patients in the community and hospital settings to discuss prevention techniques such as:
- eating a balanced diet
- participating in regular physical activity
- avoiding tobacco use
- monitoring blood pressures on a semi-regular basis
- accessing annual health checks to monitor lab values such as blood sugar and blood lipid levels
Spinal Cord Injuries
The WHO (2013) stated that up to 500,000 people suffer from spinal cord injuries (SCIs) globally each year. Most SCIs occur following preventable events such as motor vehicle accidents, falls, and violence (WHO, 2013).
- A Saskatchewan study carried out by Ahmed et al. (2020) found that Indigenous Peoples are more likely to experience traumatic SCIs. They are also more likely to have extended hospital stays and fewer community supports upon discharge. Indigenous patients have extensive barriers to discharge, including a lack of funding, lack of access to care (especially on reserves), and minimal support for home modifications (Ahmed et al., 2020).
- Another important disparity that Ahmed et al. (2020) discovered in their study is that injuries of Indigenous people often occur in more remote locations. Therefore, acute care treatment is often delayed. The delay in detection, management, and surgical treatment of Indigenous patients is a concerning trend (Ahmed et al., 2020).
- The study by Ahmed et al. (2020) also states that individuals of a lower socioeconomic status also experience higher levels o