People with high incomes have a 32% lower risk of mortality after a stroke.

A new study from the University of Gothenburg (Sweden), presented at the 10th European Stroke Organization (ESOC) 2024 conference, found that people with high incomes have a 32% lower risk of mortality after a stroke. Additionally, people 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 English).

The registry-based study analyzed data from 6901 stroke patients in Gothenburg, Sweden, between November 2014 and December 2019 to examine the impact of SDoH factors on the risk of post-stroke mortality. The study focused on four SDoH factors: area of ​​residence, country of birth, education and income. In addition to finding a significant association between income, educational attainment, and risk of post-stroke mortality, the study revealed a disturbing trend regarding the cumulative impact of SDoH factors. Patients with an adverse SDoH factor had an 18% higher risk of mortality than patients without any adverse SDoH factor. This risk increased to 24% for patients with two to four SDoH factors.

“Our findings highlight the harsh reality that a person’s socioeconomic status can be a matter of life and death in the context of stroke, especially when faced with multiple SDoH adversities. Although our study was carried out in Gothenburg, we believe that “these ideas resonate” across Europe, where similar health structures and levels of social vulnerability exist, highlighting the widespread problem across the continent,” said lead author Professor Katharina Stybrant Sunnerhagen from University of Gothenburg, Clinical Neurology, Gothenburg, Sweden.

The study also found an association between the increased risk of mortality and additional risk factors such as physical inactivity, diabetes, alcohol abuse and atrial fibrillation. In particular, insight into gender differences and the potential influence of risk factors has emerged from examining patient characteristics in the study cohort.

The proportion of female patients increased with an increase in the number of unfavorable ADOG factors. 41% of the group with no adverse SDoH factors were women, and 59% of the group with two to four adverse SDoH factors were women. In addition, smoking, both current and past year, was more common in the group with two to four adverse SDoH factors compared with those without (19% vs. 12%). Commenting on the actions needed to reduce the future burden of stroke, Professor Stybrant Sunnerhagen explains that “with the number of people affected by stroke in Europe expected to increase by 27% between 2017 and 2047, the need for effective interventions is more urgent.” than ever”. . In light of the findings of this study, targeted strategies are important.”

“For example, policymakers should tailor legislation and approaches to the specific circumstances and needs of different communities, and clinicians should consider identifying patients with adverse SDoH factors to prevent mortality after stroke,” they note.

“By addressing these disparities, we not only support principles of health equity, but also have the potential to significantly improve public health outcomes,” the researchers conclude.