DLHA Staff Writer
When stroke strikes, your income and education may play a role in your risk of death or disability, new research shows.
According to a recent Swedish study reported Nov. 8 in the journal Neurology, people who suffered a stroke were 10% more likely to die or become dependent on someone for their care within three months of their stroke if they were low-income or less educated.
Although people from low socio-economic background have long been suspected to be at higher risk for stroke, the study, according to the authors’ Online pre-print report, was aimed at assessing the extent to which the association between low income and education and death and dependency at three months after a stroke could be offset by reducing the differences in comorbidity, stroke severity, and acute care.
The study looked at data on almost 26,000 people in the Swedish Stroke Register who'd experienced a stroke over a two-year period. All of the people had previously lived independently, with no need for assistance in their activities of daily life.
The patients in the study were into divided into three socioeconomic groups: Low (low disposable income, only a primary school education), High (college education and relatively high disposable income) and Middle (education/income falling between the prior two categories).
Of the overall stroke patients, about 6,800 ended up either dying or requiring assistance within three months of their stroke.
The study reported significant differences in stroke outcomes based on education/income. While 39% of people in the Low group were either deceased or dependent on others three months after their stroke, that was only true for 18% in the High group.
Overall, and after adjusting for certain factors, people in the Low group for income/education were 10% more likely to end up deceased or disabled soon after their stroke, compared to people in the High group.
The study also found that “Intervening to shift the distribution of all mediators among patients with low SES to those of the more privileged groups would result in absolute reductions of comorbidity and stroke severity by 2.2%, and 4.0% respectively, with the largest reduction accomplished by equalizing stroke severity”.
The exact reasons for the disparity between stroke outcome and low education/income remain unclear. It is also unclear if the study findings are applicable to other regions of the world including Africa.
More collaborative and cross border studies addressing similar questions are needed to ascertain if income and educational status are indeed key social determinants of stroke risks globally and if interventions to equalize acute care and stroke severity between the social classes could offset the observed impact of social status on stroke outcome.
Published: October 5, 2023
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