Quantitative and Spatial Associations of Disability-Populated Areas and Extreme Heat with Stroke Disparities in...

Compared to individuals without disabilities, people with physical, sensory, intellectual, and psychological disabilities have increased stroke risk and when exposed to extreme heat they are more vulnerable to adverse effects, including heat-related illness, CVD, poststroke conditions, and mortality. The purpose of this study is to investigate the association of populations with disabilities and the co-location of extreme heat with geographic patterns of stroke mortality.

Data for community areas in Chicago were collected and analyzed in 2024-25. OLS and spatial regression models were used to identify significant predictors with sociodemographics and Empirical Bayes rates for stroke mortality. Spatial clustering and co-location analysis were used to identify retrospective high stroke mortality rate clusters and cluster exposure to recent extreme heat data, originating from community heat sensors.

The spatial error model performed the best in explaining stroke mortality rate, evidenced by the lowest AIC and BIC values, and with a spatial pseudo r² = .60. Significant predictor variables (p-value <.05), controlling for sociodemographics and income, were middle-aged disability populations (40 - 64 years old) with a positive association, and non-Hispanic White and Hispanic with negative associations. A significant local cluster for high stroke mortality was found in the Chicago Southside. Roughly half of the community areas in the high stroke mortality cluster overlapped with exposure to the highest quartile of mean heat index measures (>89.54°F), which is near the 90°F threshold for extreme heat and risks of heat-related illnesses, including epidemiological risks of stroke and cardiovascular disease.

This study identifies novel and relevant community risk factors-middle-aged population ability status and extreme heat-that have been overlooked in lowering stroke mortality. Findings suggest measures addressing these socio-environmental factors in public health campaigns, including Chicago's action plan for cardiovascular diseases, are needed for stroke prevention and community health.