Racial Disparities In Social Network Subtypes Are Significantly Correlated With Racial Disparities In Impairment

Jacqueline Nicole Jones, M.S., CCC-SLP, Molly Jacobs, M.S., Ph.D., Charles Ellis, Jr., Ph.D., CCC-SLP


Evidence of health disparities in stroke outcomes is widely known and recent studies suggest biopsychosocial factors impact stroke recovery and may contribute to racial disparities in post-stroke outcomes [cite]. Studies have shown that stroke survivors benefit from having strong “social networks” (e.g spouse, child, friend, coworkers) [7]. Social networks contribute to a variety of physical and mental health outcomes [13] and more diverse networks are associated with better physical and mental health [14,15]. Few studies have examined the value of post-discharge social networks in determining long-term recovery outcomes for general stroke outcomes and post-stroke impairments such as aphasia. 

The objective of this study was to examine the relationship between social networks and functional communication among a racially heterogenous cohort of stroke survivors.


Data for this study were collected from a community-based telerehabilitation for aphasia.

Outcome Measures:

  • Demographics
  • Stroke Impact Scale – Communication Subscale
  • Stroke Social Network Scale


No observed racial differences in baseline demographic characteristics (Table I). Significantly higher outcomes (SSNS, SIS) among Blacks indicating stronger social ties (Table II)

SSNS subtest scores (Children, Friends, Groups) were positively associated with SIS Communication impairment among both Blacks and Whites indicating strong associations are correlated with lower impairment.

Among Whites, strong parent/child social ties were observed among those with lower communication impairment scores.  Among Blacks, this relationship strong social ties existed at all impairment levels.


Functional communication impairment is significantly correlated with the size/strength of social networks.

Stroke survivors with lower impairment levels had stronger friend and group social networks while those with higher levels of impairment had stronger social networks ties to children.

Racial disparities in social network subtypes are significantly correlated with racial disparities in impairment.

Studies are need to explore specifically how social networks influence post-stroke outcomes and what interventions can be designed to improve stroke recovery.


For more information on the Communication Equity and Outcomes Lab, click here.