New research, presented today on the 10u The European Stroke Organization (ESOC) 2024 Conference revealed that high-income people have a 32% lower risk of mortality after stroke. Additionally, those with higher education have a 26% lower risk of death after stroke, highlighting the striking differences in stroke survival based on key social determinants of health (SDoH).
The registry-based study analyzed data from 6,901 stroke patients in Gothenburg, Sweden between November 2014 and December 2019 to examine the effect of SDoH factors on the risk of mortality after stroke. The study focused on four SDoH factors: area of ​​residence, country of birth, education and income.
In addition to identifying a significant relationship between income, education level, and mortality risk after stroke, the study revealed a disturbing trend regarding the cumulative effect of SDoH factors. Patients with an SDoH adverse factor experienced an 18% higher mortality risk compared with patients without SDoH adverse factors. This risk escalated to 24% for patients with two to four SDoH factors.
Our findings highlight a dark reality—a person’s socioeconomic status can be a matter of life or death in the context of stroke, especially when confronted with multiple adverse SDoH factors. While our study was conducted in Gothenburg, we believe these ideas resonate across Europe, where similar healthcare structures and levels of social vulnerability exist, highlighting a pervasive issue across the continent.”
Katharina Stibrant Sunnerhagen, Professor, Lead Author, University of Gothenburg, Clinical Neuroscience, Gothenburg, Sweden
The study also found an association between increased risk of mortality and additional risk factors such as physical inactivity, diabetes, alcohol abuse and atrial fibrillation.
Specifically, information about gender disparities and the potential impact of risk factors emerged when examining patient characteristics within the study cohort. The proportion of female patients increased with the number of adverse SDoH factors. 41% of the group with no adverse SDoH factors were female, while 59% of the group with two to four adverse SDoH factors were female. Additionally, smoking, either current or in the past year, was more prevalent in the group with two to four adverse SDoH factors compared to those with none (19% vs. 12%).
Commenting on the actions needed to reduce the future burden of stroke, Professor Stibrant Sunnerhagen explains: “As the number of people suffering from a stroke in Europe is projected to increase by 27% between 2017 and 2047, the need for effective interventions is more pressing since when. In light of the findings of our study, targeted strategies are necessary, for example, policy makers should adapt legislation and approaches to take into account the specific circumstances and needs of different communities, while clinicians should consider identifying patients with SDoH adverse factors. mortality.”
“By addressing these disparities, we will not only support the principles of health equity, but also have the potential to significantly enhance public health outcomes.”
