Your neighbourhood may affect your survival from stroke

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In a study from Duke University, scientists found that people living in disadvantaged neighborhoods—areas with higher poverty levels and fewer educational and employment opportunities—had an increased risk of dying within a month of being hospitalized for stroke, epilepsy, and other neurologic diseases.

In the study, researchers reviewed three years of Medicare claims and found 905,784 people aged 65 and older who had been hospitalized for stroke, Alzheimer’s disease, Parkinson’s disease, epilepsy, coma, and multiple sclerosis.

The team used the residential address of each person and a measure called the Area Deprivation Index to determine if each participant lived in an advantaged or disadvantaged neighborhood.

The index incorporates information on the socioeconomic conditions of each neighborhood and its residents, ranking neighborhoods based on 17 indicators including income, employment, education, and housing quality.

Neighborhoods in the index are determined by census areas of about 1,500 residents. Higher scores on this index indicate more neighborhood disadvantage.

Researchers divided participants into three groups: people who lived in neighborhoods with the most advantage with an index score of one to 15;

people who lived in neighborhoods with a score of 16 to 85; and people who lived in the most disadvantaged neighborhoods with a score of 86 to 100.

For stroke, of 87,511 people living in the most advantaged neighborhoods, 14.1% died within the first month. Of the 73,312 people living in disadvantaged neighborhoods, 14.6% died.

The team found for Alzheimer’s disease and Parkinson’s, 8.7% of the 14,247 people in the most advantaged neighborhoods died within a month, compared to 9.7% of the 8,064 people living in disadvantaged neighborhoods.

For epilepsy, 6.8% of those in the most advantaged neighborhoods died within a month, compared to 7.7% of those in the disadvantaged neighborhoods.

The researchers found people living in disadvantaged neighborhoods who were hospitalized for stroke had a 23% higher risk of dying within a month than those in the most advantaged neighborhoods.

In addition, people living in disadvantaged neighborhoods had a 38% higher risk of dying one month after hospitalization for degenerative nervous system disorders such as Alzheimer’s disease and Parkinson’s disease, a 34% higher risk for epilepsy, 44% higher risk for trauma-related coma and 146% higher risk of dying after a non-trauma-related coma.

The team says decreased access to health care and healthy living resources available in more advantaged neighborhoods, as well as increased exposure to unfavorable neighborhood conditions such as heavy metals, pesticides, and noise pollution could decrease overall health for people living in disadvantaged neighborhoods and contribute to this increased risk of death.

If you care about stroke, please read studies that diets high in flavonoids could help reduce stroke risk, and a MIND diet could slow down cognitive decline after stroke.

For more information about stroke, please read studies about what to eat for stroke prevention, and small surgery can prevent strokes in people with heart issues.

The study was conducted by Bradley G. Hammill et al and published in Neurology.

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