Health Equity in Aphasia

What is health equity?

According to the World Health Organization, health equity is achieved when everyone can attain their full potential for health and well-being.

Health equity is the absence of unfair, avoidable or remediable differences among groups of people. These group differences can be:

social
economic
demographic
geographic

Watch this clip from our February 2024 “Ask the Expert” webinar, in which Dr. Charles Ellis explains what health equity is and why it is important for the aphasia community.

What impacts health equity?

Health equity is impacted by a number of medical and non-medical factors. These include:

Access to health care
Access to health insurance
Age
Sex
Sexual Orientation
Race
Ethnicity
Culture
Education
Employment
Language
Whether they have a disability
Access to housing, where they live, what living conditions are
Financial situation

The non-medical conditions that impact health and health equity are referred to as social determinants of health. They are shaped by systems (economic, legal, social, environmental, etc) – not by personal choices. When people have fewer resources and opportunities, it can lead to unfair health differences. This is often the case for minority groups of people.

Actionable ways to promote health equity

Although many of the factors listed above may feel out of our control, there are actions each of us can take to promote health equity for people with aphasia:

For Clinicians

Practice cultural humility and the Life Participation Approach to Aphasia
Ask people with aphasia and their care partners:
- “What does communication look like in your life?”
- “Who do you need to communicate with most?”
- “What are your communication goals?
- “What other supports do you need?”
Adapt assessments:
- Supplement standardized tests with meaningful conversation
- Use functional, meaningful communication tasks
Treat patients as whole people, not diagnoses

For Researchers

Include:
- Diverse participants
- Patient-reported outcomes
Examine why disparities exist, not just that they exist
Partner with communities rather than studying them from a distance

For Organizations & Advocates

Center people with aphasia in:
- Program design
- Leadership
- Decision-making
Invest in:
- Peer-led support groups
- Community-based education
Advocate for:
- Equitable access to therapy
- Insurance coverage
- Transportation and telehealth options

Davetrina Seles Gadson Health Equity Mini-Grant Program

The National Aphasia Association (NAA) is proud to honor the legacy of Dr. Davetrina Seles Gadson, a remarkable leader in speech-language pathology and health equity. Her groundbreaking work advanced our understanding of aphasia care for underserved communities, especially that of black people with aphasia, and inspired a commitment to fostering change in healthcare systems.

In her memory, the NAA launched the Davetrina Seles Gadson Health Equity Mini-Grant Program, an initiative designed to support innovative projects that address systemic inequities in aphasia care and research. This program encourages efforts that align with one or more of the eight health equity objectives Dr. Gadson so passionately championed:

Expand Workforce Diversity
Provide Education on Health Disparities and Health Equity
Provide Implicit Bias Training
Use Patient-Reported Outcomes for Person-Centered Care
Facilitate Health Literacy for Clients and Care Partners
Engage Representative Samples in Research
Report Race and Ethnicity Data in Research Publications
Fund Minority Researchers and Research to Promote Health Equity

By empowering individuals and organizations to take meaningful action on these objectives, the NAA aims to continue Dr. Gadson’s legacy of advocacy and impact.

Learn More About The Mini Grant

Additional Resources

Websites:

World Health Organization : Health Equity and Health Equity Determinants
Center for Disease Control (CDC): Health Equity and Social Determinants of Health
Tactus Therapy interview with Dr. D. Seles Gadson: “Improving Cultural Competence: Better Serving the Needs of African American and Black Stroke Survivors in Speech Pathology”
Aphasia Institute World Stroke Congress 2023: Capacity Assessments and Informed Consent Decisions for Patients with Aphasia: Equity and Access to Stroke Care; Supported Conversation for Adults with Aphasia (SCA)
American Speech Language Hearing Association (ASHA) Social Determinants of Health

Videos:

Research Articles:

Ellis, C., Jacobs, M., & Kendall, D. (2021). The Impact of racism, power, privilege, and positionality on communication sciences and disorders research: time to reconceptualize and seek a pathway to equity. American Journal of Speech-Language Pathology, 1-8.
Ellis, C. et al. (2017). The influence of race on SLP utilisation and costs among persons with aphasia. Aphasiology, 31(12), 1433–1440.
Gadson, D. S., & Turkeltaub, P. E. (2025). Eight ways speech-language pathologists can contribute to health equity: the case of Black stroke survivors with aphasia. Aphasiology, 1–14.
Gadson, D. S. et al. (2022). Aphasia severity is modulated by race and lesion size in chronic survivors: A retrospective study. Journal of Communication Disorders. Volume 100, November–December 2022.
Gadson, D. S. et al. (2021). The relationship between health-related quality of life, perceived social support, and social network size in African Americans with aphasia: a cross-sectional study. Topics in Stroke Rehabilitation, 1-10.
Jacobs M, Ellis C (2022). Racial disparities in post-stroke aphasia: A need to look beyond the base analysis. Journal of the National Medical Association, Volume 114, Issue 3, Pages 258-264.
Jacobs, M., Evans, E., & Ellis, C. (2024). Determinants of Healthcare Expenditures among People with Aphasia: Importance of Race, Sex, Residence, and Aphasia Type. Aphasiology, 38(3), 577–592.
Jacobs, M., Evans, E., & Ellis, C. (2024). Exploring the association between social determinants and aphasia impairment: A retrospective data integration approach. PLoS ONE 19(3): e0299979.
Marte MJ, Addesso D, Kiran S. (2024). Association Between Social Determinants of Health and Communication Difficulties in Poststroke U.S. Hispanic and Non-Hispanic White Populations. Am J Speech Lang Pathol. 2024 Jan 3;33(1):248-261.
Sharma S, et al. (2019). Gender differences in aphasia outcomes: evidence from the AphasiaBank. International Journal of Language and Communication Disorders. 30 June 2019

Continuing Education for Speech-Language Pathologists

“The Fool Speaks, the Wise Man Listens”: Supporting African American Stroke Survivors With Aphasia. Presenter: Davetrina Seles Gadson, PhD, CCC-SLP. ASHA webinar.
Best Practice for Assessment and Treatment of Bilingual Aphasia. Presenter: Maria L. Muñoz, Ph.D., CCC-SLP. Speechpathology.com webinar.
Community-Based Research in CSD: A Path to Diversity, Equity, and Inclusion. Presenter: Shruti Deshpande, PhD, CCC-A. ASHA webinar
Disability Inclusion: What Healthcare Providers Need to Know. Presenter: Kathryn Sorensen, OTD, OTR/L, ADAC. Speechpathology.com webinar.
Implicit Bias: Research and Tools. Presenters: Katrinna Mathews, DSW, MEd LAPSW, Anna Smith, MS, Leigha Jansen, EdD CCC-A. Speechpathology.com webinar.
Managing Implicit Bias for Healthcare Excellence. Presenters: Anna Smith, MS. Katrinna Mathews, DSW, MEd, LAPSW. Speechpathology.com webinar.
An Introduction to Health Equity for Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual (LGBTQIA+) People. Presenters: Alex Keuroghlian, MD, MPH, Mason Dunn, JD. Speechpathology.com webinar.

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