Behind the Science: Stroke and Health Inequities in Women

August 4, 2023

Interviewee: Ismália De Sousa, PhD Candidate, Registered Nurse, University of British Columbia, School of Nursing. Authors/Editors: Romina Garcia de leon, Shayda Swann (Blog Co-coordinators).

Published: August 4th, 2023

Could you tell us more about your research?

My Ph.D. research is a two-phase project. The first part is a literature review of health inequities in stroke care. The second phase is a qualitative study exploring the experiences of young women with stroke history in British Columbia, with an equity-oriented lens. In particular, I am interested in how intersecting systems of structured inequity (e.g., racism, sexism, and other isms) influence their experiences accessing healthcare. 

What drove you to study the experience of stroke in young women?

I've been a registered nurse for 14 years. In my career as a registered nurse, I specialized in stroke care. For this reason, I have developed a clear understanding of the complexities of the care of stroke survivors. There have been significant advances in stroke care but in the last 20 years, the focus has been on the acute stroke phase (those immediate hours to days after the stroke) and not so much on the rehabilitation and recovery phase. This poses a gap in stroke research. Another component is that people often think strokes occur only in older people, but this is not true. Stroke rates are increasing among younger people. Moreover, there are sex and gender differences in the incidence of stroke and stroke outcomes. For example, pregnancy and menopause confer a higher risk of stroke and women have greater disability and poorer health-related quality of life. And all of this can be exacerbated by health inequities, the unjust, unfair, and avoidable health differences. So we really need to know better the experiences of young women who have had a stroke, how these health inequities manifest in their experiences during stroke rehabilitation and recovery, access to healthcare, and so forth.

What impact do you hope to see with this work? 

I really hope that my findings can influence health policy or can inform health policy and clinical practices and the development of equitable practices in stroke care in British Columbia. I also think that this work can inform national strategies and resource allocation for neurorehabilitation. The Heart and Stroke Foundation of Canada has a big emphasis on women’s health and the invisible and inequitable effects on women (and I would recommend reading their recent report). And the World Health Organization (WHO) recently released a position paper asking countries to prioritize brain health and reduce the stigma, impact, and burden of neurological disorders, since strokes are a neurological condition with significant burden for stroke survivors, their families, and caregivers.

Are there other projects you are currently working on? 

Another project I worked on looks at the History of Black nurses in British Columbia, between 1845 and 1910. This is important because we need to reflect on the invisibility of Blackness and Black nurses in British Columbia but also to understand how some of our current-day issues, such as the lack of representation of Black nurses in senior leadership positions, can be linked to historical events such as colonialism and chattel slavery and the ideas and thinking that shaped that period in our history. This work is about what has happened in the past, and how it has a trickle-down effect on where we are today. The specific time that I looked at, an important historical juncture for nursing, was the beginning of the professionalization of nursing, with the development of nursing schools. This meant that to be a nurse you needed to be trained within a nursing school, but not everyone could be a nurse. Because of the ideas that were prevalent during chattel slavery and colonialism, Black people were continuously stereotyped as less intelligent and lazy, and I think this then has a trickle effect in preventing Black nurses from being accepted into nursing schools.

I've also recently conducted research looking at student nurses' perceptions of educational strategies that promote critical awareness and engagement with social justice. Promoting health equity is a professional mandate in nursing, but how do we enact a social justice pedagogy in the classrooms? Together with faculty in the UBC School of Nursing, I interviewed nursing students to understand how they see social justice and what educational strategies should be used or have been used that promote critical awareness and engagement with social justice and positively influence their professional practice as registered nurses. We are yet to publish the findings of this work.

Where can people learn more about your work? 

Find more about what I do on my website where you can see my publications and other projects I’m working on. Find Ismália on Twitter at @Ismalia_S.

Blog Author(s)

  • Blog
  • brain health
  • health equity
  • stroke
  • women's health
  • women's rights

First Nations land acknowledegement

We acknowledge that the UBC Point Grey campus is situated on the traditional, ancestral and unceded territory of the xʷməθkʷəy̓əm (Musqueam) people.

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