New research presented today at the 10th European Stroke Organisation Conference (ESOC) 2024 has revealed that individuals with high incomes have a 32% lower risk of dying after a stroke. Furthermore, individuals with higher education have a 26% lower risk of dying after a stroke, highlighting stark differences in stroke survival based on key social determinants of health (SDoH).
The study analyzed data from 6,901 stroke patients in Gothenburg, Sweden, between November 2014 and December 2019 to investigate the influence of SDoH factors on post-stroke mortality risk. The study focused on four factors: neighborhood, country of birth, education, and income.
In the study not only found a significant association between income, education level, and post-stroke mortality risk, but also uncovered a concerning trend regarding the cumulative impact of SDoH factors. Patients with one unfavorable factor had an 18% higher mortality risk compared to patients with no unfavorable factors. For patients with two to four unfavorable factors, this risk increased to 24%.
Lead author Professor Katharina Stibrant Sunnerhagen from the University of Gothenburg, Clinical Neuroscience, Gothenburg, Sweden, commented: “Our findings underscore the harsh reality that a person’s socioeconomic status can be a matter of life and death in relation to a stroke, especially when facing multiple unfavorable SDoH factors.”
The study also identified a link between increased mortality risk and additional risk factors such as physical inactivity, diabetes, alcohol abuse, and atrial fibrillation.
Examining patient characteristics within the study cohort yielded key insights into sex-based differences and the potential impact of risk factors. The proportion of female patients increased with the number of unfavorable SDoH factors; 41% of the group with no unfavorable factors were female, compared to 59% of the group with two to four unfavorable factors. Furthermore, smoking, whether current or within the past year, was more prevalent in the group with two to four unfavorable factors than in the group with no unfavorable factors (19% versus 12%).
Regarding the necessary measures to reduce the stroke burden, Professor Stibrant Sunnerhagen explains: “Given the results of our study, targeted interventions are essential. Policymakers must tailor legislation and policies to the specific circumstances of different communities, while clinicians should consider identifying patients with adverse SDoH factors to prevent post-stroke mortality.
“By addressing these disparities, we have the potential to significantly improve public health outcomes.”
