Objective:

To examine disparities in disease burden of neurological disorders (NDs) by race, ethnicity and region in the US.

Background:

While disparities by race and ethnicity have been reported in the literature, epidemiology of NDs by race, ethnicity and region is not well understood.

Design/Methods:

This secondary analysis used the Global Burden of Disease study, which included data on incidence, prevalence, deaths (hereafter referred to as burden) and disability-adjusted life-years (DALYs) in the US from 1/1/19–12/31/19 for Alzheimer’s disease and other dementias (AD/D), multiple sclerosis (MS), Parkinson’s disease (PD) and stroke (intracerebral hemorrhage, ischemic stroke, subarachnoid hemorrhage).

Results:

In 2019 in the total population, ND incidences per 100,000 (95% uncertainty interval [UI]) were AD/D, 239.1 (208.0–269.9); MS, 3.2 (2.9–3.5); PD, 25.0 (23.0–27.1); and stroke, 119.3 (108.3–133.5); ND prevalences were AD/D, 1627.2 (173.1–13,938.8); MS, 125.0 (101.9–150.5); PD, 182.8 (130.9–244.5); and stroke 1772.2 (1295.9–2396.1). DALYs per 100,000 (95% [UI]) were highest for stroke (1166.6 [1059.4–1269.3]), followed by AD/D (618.0 [298.8–1274.7]), PD (150.1 [138.1–159.1]) and MS (64.5 [52.7–74.3]). For all NDs, burden was highest among non-Hispanic White individuals; however, differences were observed by race and ethnicity at the state level. Hispanic individuals had high burden for AD/D, PD and stroke in Florida and New Mexico and MS in New Mexico. Black individuals had high burden for MS in Illinois and Ohio and stroke in most states in the south, particularly Alabama and South Carolina. Asian Pacific Islander individuals had high burden for all NDs in Hawaii. American Indian/Alaska Native individuals had high burden for AD/D, MS and PD in all or nearly all New England states.

Conclusions:

Stark differences in ND burden were observed by race and ethnicity at the state level, highlighting the need for equitable access to care.