A new study has shown that those living in areas seen as disadvantaged have an increased risk of dying within a month of being hospitalised for stroke and other neurological conditions.
“A person’s individual socioeconomic status, which includes their education, occupation and income, has been linked in previous studies to health outcomes for a number of neurologic conditions including stroke and dementia,” says study author Bradley G. Hammill.
Hammill, continues: “Our study looked more broadly at a person’s neighbourhood and found that people living in disadvantaged neighbourhoods, regardless of their individual socioeconomic status, had an increased risk of death one month after hospitalisation for stroke and other neurologic conditions. These results suggest that the environment in which a person lives can greatly impact their health.”
Researchers on the study reviewed three years of Medicare claims and identified 905,784 people aged 65 and older who had been hospitalised for neurological conditions such as stroke.
The researchers used the home address of each participant and a measure known as the Area Deprivation Index, in order to determine if each participant lived in an area deemed to be advantaged or disadvantaged.
This index incorporates data on the socioeconomic conditions of each area and its residents, ranking the areas based on 17 indicators including income, employment, education and housing quality.
The areas in the index are determined by census areas of around 1,500 residents.
Higher scores on this index indicate a higher disadvantage.
Researchers divided participants into the following three groups:
- Those who lived in areas with the most advantage with an index score of one to 15.
- Those who lived in areas with a score of 16 to 85.
- Those who lived in the most disadvantaged areas with a score of 86 to 100.
They examined Medicare records to determine which participants died within a month after being hospitalised for stroke and other neurological conditions.
They then compared people living in areas with the most advantage to those living in the most disadvantaged areas.
For stroke, of 87,511 individuals living in the most disadvantaged areas, 14.1 per cent died within the first month. Of the 73,312 individuals living in the areas deemed disadvantaged, 14.6 per cent died.
After adjusting for factors that could affect risk of death such as age, sex and pre-existing health conditions, the researchers found that those living in disadvantaged areas who were hospitalised for stroke had a 23 per cent higher risk of dying within a month than those in the most advantaged areas.
Hammill, says: “Decreased access to health care and healthy living resources available in more advantaged neighbourhoods, as well as increased exposure to unfavourable neighbourhood conditions such as heavy metals, pesticides and noise pollution could decrease overall health for people living in disadvantaged neighbourhoods and contribute to this increased risk of death.
“Strategies to improve health equity should explicitly consider the effect of neighbourhood environments on a person’s health. Health systems could use the results of our study to implement interventions to improve outcomes and health equity for people living in disadvantaged neighbourhoods.”
