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A Modified Trier Social Stress Test for Vulnerable Mexican American Adolescents
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Assessing Disparities in Access to Advanced Stroke Care in 4 Northeastern States Using the Social Vulnerability Index
Derek L Isenberg1, Raluca Isenberg2, Kevin A Henry3
1Lewis Katz School of Medicine at Temple University Philadelphia PA.
Stroke (Hoboken, N.J.)
|January 26, 2026
Summary
Disparities exist in access to endovascular stroke centers (ESCs). The Social Vulnerability Index (SVI) reveals that while minority populations are closer to ESCs, those with household composition or disability challenges are farther away.
Area of Science:
- Public Health
- Health Services Research
- Stroke Neurology
Background:
- Access to endovascular stroke centers (ESCs) is critical for optimal large-vessel occlusion stroke care.
- Existing research documents disparities in stroke treatment, including access to thrombolysis and endovascular therapy.
- This study investigates racial, ethnic, sex, and social disparities in ESC access using the Social Vulnerability Index (SVI).
Purpose of the Study:
- To assess racial, ethnic, sex, and social disparities in access to endovascular stroke centers (ESCs).
- To utilize the Social Vulnerability Index (SVI) as a tool to measure community health and its impact on ESC accessibility.
Main Methods:
- A population-based study was conducted across New York, New Jersey, Pennsylvania, and Delaware.
- Endovascular stroke centers (ESCs) were geocoded, and distances from census tract centroids to the nearest ESC were calculated.
- The US Centers for Disease Control's Social Vulnerability Index (SVI) and its subcomponents were used to assess census tract health.
Main Results:
- The study analyzed 42,000,000 people across 10,000 census tracts.
- No significant overall difference in mean SVI was found between census tracts <60 minutes and >60 minutes from ESCs.
- Significant disparities were observed in SVI subcomponents: Minority Status & Language (most vulnerable closest) and Household Composition & Disability (most vulnerable farthest).
Conclusions:
- The Social Vulnerability Index (SVI) is effective for evaluating disparities in advanced stroke care access.
- SVI data can guide the strategic placement of new ESCs to improve population-wide access to stroke care.
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