Disparities in Timely Access to Certified Stroke Care Among US Census Tracts, by Prevalence of Health Risk Factors

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Map A depicts drive time to any certified stroke care location (ASRH, PSC, TSC, or CSC) in the contiguous US. Drive times to the closest facility are categorized into three classes: 1) 30 minutes or less; 2) 60 minutes or less; and 3) more than 60 minutes. The map shows that drive times are shorter close to regional population centers. Most census tracts along the East Coast, in the Midwest, and the Gulf Coast are located within a 30-minute or 60-minute drive to a certified stroke care facility. A strip of census tracts along the West Coast has timely access to any stroke care facility, but large swaths of the Southwest, Mountain Region, Northern Plains, and Central US lack timely access to any certified stroke care facility. Map B depicts drive time to advanced stroke care (TSC or CSC) in the contiguous US. Drive times to the closest facility are categorized into three classes: 1) 30 minutes or less; 2) 60 minutes or less; and 3) more than 60 minutes. Like Map A, this Map B shows that drive times are shorter close to population centers. However, since advanced stroke care centers are less common, shorter drive times are even more concentrated around large population centers and scattered across the US. A larger portion of the country falls under the “more than 60 minutes” drive time category.

Figure 1.
Maps of census tracts within versus beyond 30- or 60-minute drive time of A) any stroke care (ie, ASRH, PSC, TSC, or CSC) and B) advanced stroke care (ie, TSC or CSC). Abbreviations: ASRH, Acute Stroke–Ready Hospital; CSC, comprehensive stroke center; PSC, primary stroke center; TSC, thrombectomy-capable stroke center.

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Map A depicts drive time to any certified stroke care location (ASRH, PSC, TSC, or CSC) in the contiguous US. Drive times to the closest facility are categorized into three classes: 1) 30 minutes or less; 2) 60 minutes or less; and 3) more than 60 minutes. The map shows that drive times are shorter close to regional population centers. Most census tracts along the East Coast, in the Midwest, and the Gulf Coast are located within a 30-minute or 60-minute drive to a certified stroke care facility. A strip of census tracts along the West Coast has timely access to any stroke care facility, but large swaths of the Southwest, Mountain Region, Northern Plains, and Central US lack timely access to any certified stroke care facility. Map B depicts drive time to advanced stroke care (TSC or CSC) in the contiguous US. Drive times to the closest facility are categorized into three classes: 1) 30 minutes or less; 2) 60 minutes or less; and 3) more than 60 minutes. Like Map A, this map shows that drive times are shorter close to population centers. However, since advanced stroke care centers are less common, shorter drive times are even more concentrated around large population centers and scattered across the US. A larger portion of the country falls under the “more than 60 minutes” drive time category. Map C depicts drive time to comprehensive stroke care (CSC) in the contiguous US. Drive times to the closest facility are categorized into three classes: 1) 30 minutes or less; 2) 60 minutes or less; and 3) more than 60 minutes. Like Maps A and B, this map shows that drive times are shorter close to population centers. The geographic pattern is similar to map B, this time with a slightly larger portion of the country falling into the “more than 60 minutes” drive time category, but not as dramatic as the drop off between maps A and B.

Figure 2.
Maps of census tracts within versus beyond 30- or 60-minute drive time of A) any certified stroke care (ie, ASRH, PSC, TSC, or CSC); B) advanced stroke care (ie, TSC or CSC); and C) comprehensive stroke care (CSC) only. Abbreviations: ASRH, Acute Stroke–Ready Hospital; CSC, comprehensive stroke center; PSC, primary stroke center; TSC, thrombectomy-capable stroke center.

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