ABSTRACT NUMBER: ESOC2026A1771 ETHNIC INEQUALITIES IN RETURN TO WORK POST FIRST STROKE – FINDINGS FROM A POPULATION-BASED PROSPECTIVE STROKE COHORT STUDY IN SOUTH LONDON

Abstract Background and aims Sociodemographic factors and disability affect return to work (RTW) post-stroke. Limited evidence indicates ethnic minority individuals are less likely to RTW post-stroke. We investigated ethnic differences in employment among White/Black-African/Black-Caribbean/other EM groups post-first stroke in a population-based cohort. Methods This study included individuals enrolled in the South London Stroke Register between 1995–2025 and restricted to those in employment at time of first stroke (N=1,737, 67% males, mean age: 54 years), with employment status assessed at one-year and five-years follow-up. Associations between ethnicity and employment status (employed, retired, other) at one- and five-years were examined separately using multinomial logistic regression adjusting for a range of sociodemographic (age/sex/study period/socioeconomic deprivation) and clinical factors (stroke severity and management, co-occurring health conditions, functional indicators, depression/anxiety, newly diagnosed chronic conditions) at baseline and follow-up. Results After adjusting for baseline factors (socioeconomic deprivation/stroke severity/health conditions and management), Black-African (relative risk ratio [RRR]0.47 [0.29-0.75]) and Black-Caribbean (RRR0.40, [0.22-0.75]) groups were less likely to be employed at 1-year post-stroke compared to White individuals. At five-years, only Black-African individuals were less likely to be employed (RRR0.59, [0.30-1.15]). Similar persistent ethnic disparities were observed at one-year and five-years in relation to clinical factors assessed during follow-up. Conclusions Black African and Caribbean individuals were ~50% less likely to be employed one-year post-stroke, with Black African disadvantage persisting at five-years post-stroke. These disparities were not explained by sociodemographic and clinical indicators. More research is required to better understand what drives these disparities. Conflict of interest Amal R. Khanolkar: nothing to disclose, Ajay Bhalla: nothing to disclose, Eva Emmett: nothing to disclose, Camila Pantoja-Ruiz: nothing to disclose, Charles DA Wolfe: nothing to disclose, Matthew DL O’Connell PhD: nothing to disclose, Iain J Marshall: nothing to disclose.