Why Neighborhoods Have Stroke Zones

Socioeconomic status is associated with stroke prevalence, and can be mapped by neighborhood. These geographic patterns could be useful in designing interventions for people at risk of stroke.

Living in a neighborhood with lower socioeconomic risks increases residents risk of stroke, according to a recent study. Published ahead of print in the journal Neurology, the study was conducted by Virginia Howard, PhD, of the Department of Epidemiology in the School of Public Health at the University of Alabama at Birmingham, and colleagues.

The researchers begin by noting that, while previous studies have shown that socioeconomic status is important to overall health, and “there is limited research on the relationship between neighborhood socioeconomic characteristics (nSES) and stroke risk.” In describing the aim of the current study they say, “Here we examine the relationship of nSES, individual-level SES, and stroke risk factors with stroke incidence in a large, longitudinal US cohort including black and white participants across different age, sex, and SES groups living in diverse SES neighborhoods.”

In order to explore those issues, the researchers considered data from 24,875 people, of whom 41% were black. They found, they said, “those in more SES advantaged neighborhoods were older, more likely to be men, less likely to be black, less likely to live in the stroke belt/buckle, more likely to have higher individual SES, and less likely to have stroke risk factors.”

Additionally, they found that there was “an increase in stroke risk with each lower quartile of nSES,” they say, adding, “this higher stroke risk remained after adjustment for age, race, sex, and an age-by-race interaction.” They do caution, however, that separating the impact individual SES from the impact of nSES is difficult, saying, “Individual risk factors are often intertwined with neighborhood environment.”

The results of the current study are consistent with those examining nSES and cardiovascular disease and other conditions, leading the researchers to say, “Thus, these findings support ongoing calls for community development policies, urban planning, and zoning and transportation policies that address neighborhood socioeconomic contexts to improve residential environments in order to positively impact the health of the community members.”

The researchers conclude with a call for more studies, saying, “Additional research should include other race/ethnic groups and investigate potential differential effects by sex and race/ethnic groups, including risk factors for stroke that may be more prevalent in subgroups within disadvantaged neighborhoods.”

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