A Roadmap to Neurologic Health Equity

Neurologic disorders affect more than 200 million people in the United States, yet inequities in neurologic health persist particularly among marginalized populations. These disparities are rooted not in biological differences but in inequitable social, economic, and structural conditions and result in disproportionate disease burden, delayed diagnoses, restricted access to specialty care, and subpar brain health outcomes for populations experiencing health disparities (HDPs). Existing national health equity frameworks from the NIH demonstrate that neurologic inequities are shaped by intersecting social determinants of health (SDOH) and structural barriers that limit fair and just opportunities to achieve optimal brain health. In response, the American Academy of Neurology (AAN) proposes a comprehensive Roadmap to Neurologic Health Equity, grounded in the principle that every individual should have the opportunity to attain their highest level of brain health. The AAN roadmap provides a coordinated strategy to address health inequity across 4 domains: (1) Clinical Practice and Quality, (2) Scientific Knowledge and Research, (3) Education and Awareness, and (4) Advocacy. For clinical practice, the roadmap emphasizes integrating SDOH into clinical care delivery, expanding language services and culturally responsive models, and advancing workforce diversity to better reflect and serve diverse communities. Research priorities include strengthening rigor in disparities research, increasing participation of HDPs in clinical studies, and expanding training pathways for investigators committed to health equity. Educational initiatives focus on embedding health equity content throughout neurology curricula, enhancing clinician awareness of health disparities through AAN programming, and strengthening communication skills necessary for effective community engagement. The policy and advocacy framework targets systemic reforms such as expanding insurance coverage, improving reimbursement for complex neurologic care, investing in telehealth infrastructure, and addressing the national neurology workforce shortage through increased Graduate Medical Education funding and secure immigration pathways for international neurologists willing to serve in underserved areas. Together, these strategies provide a unified, actionable approach to advancing brain health equity across the lifespan. The AAN calls upon clinicians, researchers, educators, policymakers, and community advocates to join in implementing this roadmap and ensuring that the pursuit of optimal brain health is attainable and equitable for all.