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Immigrants with ischemic stroke in Canada are admitted to the ICU at similar rates as long-term residents, but they stay significantly longer, a new study in Neurology finds. Younger ages and higher rates of invasive treatments like mechanical ventilation and craniectomies appear to be key drivers. Language barriers, cultural differences around end-of-life care, and health literacy gaps may also play a role.
A large population-based study published in Neurology found that immigrants in Canada with ischemic stroke were admitted to the ICU at similar rates as long-term residents — but once there, they stayed considerably longer. Researchers analyzed over 85,000 stroke hospitalizations in Ontario between 2014 and 2023, finding that immigrants were younger (median age 69 vs. 76), had milder strokes, and yet received more invasive, life-prolonging treatments.
Experts suggest the longer stays are driven by a mix of factors: younger patients are more likely to receive aggressive interventions, while language barriers, differing cultural perspectives on end-of-life care, and health literacy gaps may also extend ICU time. Notably, refugees and immigrants from Africa and the Middle East had the longest stays.
By the Numbers:
Why it matters: These findings highlight how immigration status functions as a social determinant of health. Addressing structural barriers — like expanded interpreter services and cultural humility training — could help reduce disparities in stroke care.
