Introduction <p>Persistent racial/ethnic differences in stroke outcomes are only partially explained by variations in the Social Determinants of Health (SDOH) and neurological factors. Allostatic load – a theoretical framework of cumulative life stress – may provide additional insight into differences in stroke, but the presentation of allostatic load and its interaction with the SDOH in stroke is not clearly understood. This study aimed to explore the association between allostatic load and healthcare access, accounting for heterogeneity in the SDOH.</p> Methods <p>Using nine biomarkers contained in three cross sections from the National Health and Nutrition Examination Survey (NHANES), we calculated an allostatic load index for stroke survivors. Regression analysis evaluated the association between allostatic load and healthcare access accounting for differences in SDOH. Racial and ethnic interactions evaluated differential racial/ethnic access.</p> Results <p>Black stroke survivors (9.48, SD = 2.92) and stroke survivors of other races (9.59, SD = 3.90) had higher average allostatic load than White (9.42, SD = 3.30) stroke survivors despite being younger and have longer time post onset. However, regression results within racial groups indicated that Black stroke survivors (2.18, CI = 2.18, 2.19, OR 8.88) and those of Other race (2.28, CI = 2.28, 2.28, OR = 9.80) who had a regular location to receive healthcare had higher odds of higher allostatic load. Compared to those with private insurance, Black (2.21, CI = 2,17, 2.25, OR = 9.12) stroke survivors who were insured by Medicare had higher odds of higher allostatic load while Other races had lower odds (2.16, CI = 2.16, 2.16, OR = 8.66).</p> Conclusions <p>Findings revealed strong associations between indicators of healthcare assess and allostatic load within racial and ethnic groups suggesting that post-stroke rehabilitation may mitigate the accumulation of allostatic load among stroke survivors.</p>