Association of Neighborhood Socioeconomic Status With Outcomes in Patients Surviving Stroke

Objective

To examine associations between neighborhood socioeconomic status (nSES) and 90-day poststroke outcomes.

Methods

The Brain Attack Surveillance in Corpus Christi Project is a population-based surveillance study in Nueces County, Texas. Patients with strokes were identified between 2010 and 2016 via active and passive surveillance and enrolled in the study. nSES index is a standardized composite of 2010 Census tract–level income, wealth, education, and employment (median –4.56, interquartile range –7.48 to –0.46). The 90-day outcomes were ascertained via interview: functional status measured by the average of 22 activities of daily living/instrumental activities of daily living (range 1–4), biopsychosocial health by the Stroke-Specific Quality of Life scale (range 0–5), and depressive symptoms by the 8-item Patient Health Questionnaire (range 0–24). Associations between nSES and outcomes were estimated using confounder-adjusted generalized estimating equations with an nSES x NIH Stroke Scale score interaction term.

Results

Seven hundred seventy-six survivors made up the analytical sample (52.96% male, 62.24% Mexican American, 52.96% ≥64 years old). Higher compared to lower nSES (mean difference comparing 75th to 25th percentile of nSES) was associated with better function (–0.27, 95% confidence interval [CI] –0.49 to –0.05), better biopsychosocial health (0.26, 95% CI 0.06–0.47), and fewer depressive symptoms (–1.77, 95% CI –3.306 to –0.48) among those with moderate to severe strokes. Among those with minor strokes, higher nSES was associated with better function (–0.13, 95% CI –0.24 to –0.02).

Conclusions

nSES may influence poststroke recovery. Studies should identify neighborhood characteristics that contribute to poststroke outcomes, particularly in moderate to severe stroke survivors.

Read article at journal's website

Related Articles

Responses

Your email address will not be published. Required fields are marked *