Semin Neurol 2024; 44(02): 104
DOI: 10.1055/s-0044-1785194

Neurology in Underserved and Marginalized Populations

Sarah Wahlster
1   Departments of Neurology, Neurosurgery and Anesthesiology University of Washington, Seattle
Aaron L. Berkowitz
2   Department of Neurology, University of California, San Francisco
› Institutsangaben

Over the past decades, the field of neurology has witnessed groundbreaking progress in both diagnostics and therapeutics, including the description and characterization of new antibody-mediated syndromes, development of advanced neuroimaging and monitoring techniques, major advances in treatment of acute stroke, and countless new treatments for epilepsy and multiple sclerosis, to name just a few. However, these advances are only accessible to a small proportion of the world's patients with neurologic conditions due to large disparities in access to neurologic care. Barriers to receiving advanced neurologic care include lack of access to resources (due to cost, distance from resources, or both), insufficient public health infrastructure, urban–rural healthcare gaps, limited training opportunities for clinicians, and social determinants of health particularly affecting marginalized populations.

In this issue of Seminars in Neurology, we highlight the work of colleagues who have dedicated their careers to addressing these disparities in neurologic care. Authors from 11 countries (Brazil, Canada, Chile, Colombia, Ethiopia, Mexico, Nepal, Peru, Ukraine, United States, and Zambia) across 5 continents describe challenges in improving neurologic care, education, and research in underserved regions and for marginalized populations, and provide frameworks for how they have addressed these challenges through their work. Through these articles we learn how inpatient neurology services, acute stroke treatment, epilepsy care, neurology training, and research infrastructure have been developed in different world regions that previously had little or no access to neurology care. We learn about the unique challenges faced by neurologists caring for patients in a country at war and patients who have been forcibly displaced. While many of these challenges may seem geographically distant from neurologists practicing in high-resource settings, the authors of articles in this issue also teach us about the unique challenges facing underserved and marginalized populations in high-resource settings related to race and ethnicity, sex and gender, and social determinants of health, and how to improve care for these populations.

These articles highlight ongoing inequities, disparities, and challenges. But they also provide hope and inspiration. The authors describe ongoing efforts to improve the neurologic care of patients and populations, educate the next generation of neurologists, and increase research into how best to serve all patients with neurologic disease. We hope that highlighting these authors' work will increase awareness of the issues facing patients and clinicians worldwide and the ongoing tireless efforts of dedicated individuals to increase access to neurology care, education, and research where it is limited or nonexistent. We also hope these articles will provide a framework that helps us all think about how to improve the care of underserved and marginalized populations and how to engage in ethical, mutually beneficial collaborations toward that goal in diverse contexts.

We are deeply grateful to each of the authors for their generosity in sharing their important and inspiring work through these articles. We also wish to express our sincere thanks to Dr. David Greer and Dr. Ariane Lewis for inviting us to guest edit this issue of Seminars in Neurology and for their guidance and mentorship.


Artikel online veröffentlicht:
17. April 2024

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