Higher income and education improve your chances of surviving a stroke

GOTHENBURG, Sweden — When it comes to surviving a stroke, not all patients are created equal. Now, a new study is shedding light on a startling disparity: your income and education level could dramatically impact your chances of making it through this life-threatening event.

The research, led by Professor Katharina Stibrant Sunnerhagen from the University of Gothenburg in Sweden, delved into the medical records of nearly 7,000 stroke patients in Gothenburg between 2014 and 2019. They uncovered that high-income individuals had a whopping 32-percent lower risk of dying after a stroke compared to their less affluent counterparts. Similarly, those with higher levels of education enjoyed a 26-percent lower risk of post-stroke mortality.

Presenting their work at the 10th European Stroke Organization Conference (ESOC) 2024, scientists categorize these factors as “social determinants of health” or SDoH — but what exactly does that mean? These are the conditions in which people are born, grow, live, work, and age. These factors can have a profound impact on health outcomes. In this study, the researchers focused on four key SDoH factors: living area, country of birth, education, and income.

The findings paint a stark picture of how these social factors can stack the odds against certain individuals. Patients with just one unfavorable SDoH factor faced an 18-percent higher risk of dying after a stroke compared to those without any such factors. For those unlucky enough to have two to four unfavorable SDoH factors, their risk of post-stroke mortality skyrocketed to 24 percent.

“Our findings underscore a stark reality – an individual’s socioeconomic status can be a matter of life or death in the context of stroke, especially when they are confronted with multiple unfavorable SDoH factors. While our study was conducted in Gothenburg, we believe these insights resonate across Europe, where similar healthcare structures and levels of social vulnerability exist, highlighting a pervasive issue throughout the continent,” says Professor Stibrant Sunnerhagen in a media release.

Stroke symptoms
(© VectorMine – stock.adobe.com)

However, income and education weren’t the only factors at play. The study also found links between increased mortality risk and lifestyle factors like physical inactivity, diabetes, alcohol abuse, and atrial fibrillation (a type of irregular heartbeat).

Interestingly, the study also revealed some gender disparities. The proportion of women increased as the number of unfavorable SDoH factors went up. While 41 percent of the group with no unfavorable factors were women, that figure jumped to 59 percent for the group with two to four unfavorable factors. Smoking rates were also higher among those with multiple unfavorable SDoH factors.

So, what can be done to level the playing field? Prof. Sunnerhagen emphasizes the urgency of the situation, noting that the number of people affected by stroke in Europe is projected to rise by a staggering 27 percent between 2017 and 2047.

“In light of our study’s findings, targeted strategies are essential,” the study author explains. “Policymakers, for instance, must tailor legislation and approaches to account for the specific circumstances and needs of diverse communities, while clinicians should consider identifying patients with unfavorable SDoH factors to prevent post-stroke mortality.”

It’s a call to action that hits close to home for many people. After all, a stroke can strike anyone, regardless of age or background. However, as this study makes clear, the road to recovery is far from equal. By shining a light on these disparities and working to address them, we have the potential to save countless lives and ensure that everyone, regardless of their zip code or bank balance, has a fighting chance at surviving this devastating event.

“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,” Prof. Sunnerhagen concludes.

StudyFinds Editor-in-Chief Steve Fink contributed to this report.

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