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Impact of Poverty on Stroke Recurrence: A Population-Based Study.
Christopher J Becker1, Heidi Sucharew1, David Robinson1
1From the Departments of Neurology (C.J.B., B.S., D.K.) and Emergency Medicine (R.R.), University of Michigan, Ann Arbor; Department of Biostatistics (H.S.), Cincinnati Children's Hospital Medical Center; Departments of Neurology and Rehabilitation Medicine (D.R., L.N., R.J.S., D.W., S.F., E.A.M., S.D., M.H., M.L.F., B.K.) and Department of Emergency Medicine (K.B.W.), University of Cincinnati, OH; Department of Neurology (A.S.J.), Yale University, New Haven, CT; Miami Neuroscience Institute (F.D.L.R.L.R.), Baptist Health South Florida; Department of Neurology (J.M.), Indiana University School of Medicine, Indianapolis; Department of Neurology (E.C.), University of Chicago, IL; Department of Neurology (S.S.), University of Kansas Medical Center, Kansas City; Department of Neurology (M.S.), Soroka Medical Center, Beersheba, Israel; and National Neurology Program (S.R.M.), Veterans Health Administration and Department of Neurology, Baylor College of Medicine, Houston, TX.
Neighborhood poverty is linked to higher stroke recurrence rates. This poverty explains a significant portion of the increased stroke risk observed in Black individuals, highlighting socioeconomic factors in stroke recovery.
Area of Science:
- Public Health
- Epidemiology
- Cardiovascular Research
Background:
- Poverty is a known risk factor for initial stroke incidence.
- The association between neighborhood socioeconomic status and stroke recurrence is less understood.
Purpose of the Study:
- To investigate the relationship between neighborhood socioeconomic status (nSES) and stroke recurrence.
- To determine the impact of poverty on stroke recurrence risk, particularly in relation to race.
Main Methods:
- Population-based study in the Greater Cincinnati/Northern Kentucky region (2015-2018).
- Neighborhood socioeconomic status (nSES) categorized by poverty levels (≤5%, >5%-10%, >10%-25%, >25%).
- Poisson and Cox regression models used to analyze recurrence rates and risks, adjusting for demographic and vascular factors.
Main Results:
- A dose-dependent increase in stroke recurrence was observed with increasing neighborhood poverty.
- Poorer nSES was associated with higher stroke recurrence rates per 100,000 residents.
- Neighborhood poverty accounted for approximately one-third of the excess stroke recurrence risk among Black individuals.
Conclusions:
- Neighborhood poverty is a significant driver of stroke recurrence.
- The intersection of poverty and race plays a crucial role in stroke recurrence disparities.
- Addressing socioeconomic factors is vital for reducing stroke recurrence.
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