Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
    • Education
  • Online Sections
    • COVID-19
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • Topics A-Z
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Patient Pages
    • Null Hypothesis
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
    • Education
  • Online Sections
    • COVID-19
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • Topics A-Z
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Patient Pages
    • Null Hypothesis
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

Neighborhood socioeconomic disadvantage and mortality after stroke

  • Manoj K. Mittal, Neurocritical Care Fellow, Mayo Clinic, Rochester, MNmittal.manoj@mayo.edu
  • Jennifer B. McCormick, Rochester, MN
Submitted July 01, 2013

Brown et al. reported higher post-stroke mortality among residents of the most socioeconomic disadvantaged census tracts relative to the residents of the least disadvantaged census tracts.[1] The authors did not find any association by race or income. Table e-2 shows that whites have 1.49 times higher risk of post-stroke mortality at 1 year (p value=0.06). Interestingly, a previous cardiovascular health study showed 2.9 times higher risk of post-stroke mortality in blacks (p value less than 0.05).[2] This association of race and mortality is surprising. The authors could address this paradox by comparing the race/ethnicity of participants who were excluded secondary to geocoding issues with their addresses to those who were included. Other potential confounders could be patient mobility status and use of IV thrombolysis, which are independent risk factors for post-stroke mortality.[2-4] Black race and low income are significant predictors for not receiving IV thrombolysis.[5] The effect of neighborhood on mortality should be adjusted for mobility status and use of IV thrombolysis. Better health policies are needed to improve access of care for minorities and the poor to provide life-saving, FDA approved treatments like IV thrombolysis and post-stroke care.

DISCLAIMER: The views expressed by authors do not represent the views of the Mayo Clinic.

1. Brown AF, Liang LJ, Vassar SD, et al. Neighborhood socioeconomic disadvantage and mortality after stroke. Neurology 2013; 80:520-527

2. Longstreth WT, Bernick C, Fitzpatrick A, et al. Frequency and predictors of stroke death in 5,888 participants in the Cardiovascular Health Study. Neurology 2001;56:368-375.

3. Webster F, Saposnik G, Kapral MK, Fang J, O'Callaghan C, Hachinski V. Organized Outpatient Care: Stroke Prevention Clinic Referrals Are Associated With Reduced Mortality After Transient Ischemic Attack and Ischemic Stroke. Stroke 2011;42:3176-3182.

4. Fischer U, Mono M-L, Zwahlen M, et al. Impact of Thrombolysis on Stroke Outcome at 12 Months in a Population: The Bern Stroke Project. Stroke 2012;43:1039-1045.

5. Kimball MM, Neal D, Waters MF, Hoh BL. Race and Income Disparity in Ischemic Stroke Care: Nationwide Inpatient Sample Database, 2002 to 2008. Journal of Stroke and Cerebrovascular Diseases 2013.

For disclosures, please contact the journal at journal@neurology.org.

Navigate back to article

Neurology: 98 (21)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • Neurology: Education
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2022 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise