Community Level Disadvantage and the Likelihood of First Ischemic Stroke. (31st October 2012)

• Record Type: Journal Article
• Authors: Boden-Albala, Bernadette; Roberts, Eric T.; Moats, Harmon; Arif, Hiba; Sacco, Ralph L.; Paik, Myunghee C.
• Other Names: Panagiotakos Demosthenes Academic Editor.
• Is Part Of: Epidemiology research international. Volume 2012(2012)
• Publication Date: 2012-10-31
• Subjects: Epidemiology -- Periodicals; Epidemiology; Epidemiology; Epidemiology -- Periodicals; Periodical; Periodicals; 614.4
• DOI: 10.1155/2012/481282
• Languages: English
• ISSNs: 2090-2972

Abstract

Abstract : Background and Purpose . Residing in "disadvantaged" communities may increase morbidity and mortality independent of individual social resources and biological factors. This study evaluates the impact of population-level disadvantage on incident ischemic stroke likelihood in a multiethnic urban population. Methods . A population based case-control study was conducted in an ethnically diverse community of New York. First ischemic stroke cases and community controls were enrolled and a stroke risk assessment performed. Data regarding population level economic indicators for each census tract was assembled using geocoding. Census variables were also grouped together to define a broader measure of collective disadvantage. We evaluated the likelihood of stroke for population-level variables controlling for individual social (education, social isolation, and insurance) and vascular risk factors. Results . We age-, sex-, and race-ethnicity-matched 687 incident ischemic stroke cases to 1153 community controls. The mean age was 69 years: 60% women; 22% white, 28% black, and 50% Hispanic. After adjustment, the index of community level disadvantage (OR 2.0, 95% CI 1.7–2.1) was associated with increased stroke likelihood overall and among all three race-ethnic groups. Conclusion . Social inequalities measured by census tract data including indices of community disadvantage confer a significant likelihood of ischemic stroke independent of conventional risk factors.