Socioeconomic disparities in stroke rates and outcome

Pooled analysis of stroke incidence studies in Australia and New Zealand

Emma Heeley, Jade Wei, Kristie Carter, Shaheenul Islam, Amanda Thrift, Graeme Hankey, Alan Cass, Craig Anderson

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Objective: To assessthe influence of area-level socioeconomic status (SES) on incidence andcase-fatality rates for stroke.

    Design,setting and participants: Analysis of pooled data for3077 patients with incident stroke from three population-based studies inPerth, Melbourne, and Auckland between 1995 and 2003.

    Mainoutcome measures: Incidence and 12-month case-fatality rates forstroke.

    Results: Annualage-standardised stroke incidence rates ranged from 77 per100 000 person-years (95% CI, 72–83) in the least deprived areas to131 per 100 000 person-years (95% CI, 120–141) in the mostdeprived areas (rate ratio, 1.70; 95% CI, 1.47–1.95; P < 0.001).The population attributable risk of stroke was 19% (95% CI, 12%–27%) for thoseliving in the most deprived areas compared with the least deprived areas.Compared with people in the least deprived areas, those in the most deprivedareas tended to be younger (mean age, 68 v 77 years; P < 0.001),had more comorbidities such as hypertension (58% v 51%; P < 0.001)and diabetes (22% v 12%; P < 0.001), and were more likely tosmoke (23% v 8%; P < 0.001). After adjustment for age,area-level SES was not associated with 12-month case-fatality rate.

    Conclusions: Our analysis provides evidence that people living inareas that are relatively more deprived in socioeconomic terms experiencehigher rates of stroke. This may be explained by a higher prevalence of riskfactors among these populations, such as hypertension, diabetes and cigarettesmoking. Effective preventive measures in the more deprived areas of the communitycould substantially reduce rates of stroke.

     

    Original languageEnglish
    Pages (from-to)10-14
    Number of pages5
    JournalMedical Journal of Australia
    Volume195
    Issue number1
    Publication statusPublished - 4 Jul 2011

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    New Zealand
    Cohort Studies
    Stroke
    Social Class
    Incidence
    Population
    Hypertension
    Mortality
    Comorbidity

    Cite this

    Heeley, E., Wei, J., Carter, K., Islam, S., Thrift, A., Hankey, G., ... Anderson, C. (2011). Socioeconomic disparities in stroke rates and outcome: Pooled analysis of stroke incidence studies in Australia and New Zealand. Medical Journal of Australia, 195(1), 10-14.
    Heeley, Emma ; Wei, Jade ; Carter, Kristie ; Islam, Shaheenul ; Thrift, Amanda ; Hankey, Graeme ; Cass, Alan ; Anderson, Craig. / Socioeconomic disparities in stroke rates and outcome : Pooled analysis of stroke incidence studies in Australia and New Zealand. In: Medical Journal of Australia. 2011 ; Vol. 195, No. 1. pp. 10-14.
    @article{0c360e1c8fa74780a8f26a7228cd98e8,
    title = "Socioeconomic disparities in stroke rates and outcome: Pooled analysis of stroke incidence studies in Australia and New Zealand",
    abstract = "Objective: To assessthe influence of area-level socioeconomic status (SES) on incidence andcase-fatality rates for stroke.Design,setting and participants: Analysis of pooled data for3077 patients with incident stroke from three population-based studies inPerth, Melbourne, and Auckland between 1995 and 2003.Mainoutcome measures: Incidence and 12-month case-fatality rates forstroke.Results: Annualage-standardised stroke incidence rates ranged from 77 per100 000 person-years (95{\%} CI, 72–83) in the least deprived areas to131 per 100 000 person-years (95{\%} CI, 120–141) in the mostdeprived areas (rate ratio, 1.70; 95{\%} CI, 1.47–1.95; P < 0.001).The population attributable risk of stroke was 19{\%} (95{\%} CI, 12{\%}–27{\%}) for thoseliving in the most deprived areas compared with the least deprived areas.Compared with people in the least deprived areas, those in the most deprivedareas tended to be younger (mean age, 68 v 77 years; P < 0.001),had more comorbidities such as hypertension (58{\%} v 51{\%}; P < 0.001)and diabetes (22{\%} v 12{\%}; P < 0.001), and were more likely tosmoke (23{\%} v 8{\%}; P < 0.001). After adjustment for age,area-level SES was not associated with 12-month case-fatality rate.Conclusions: Our analysis provides evidence that people living inareas that are relatively more deprived in socioeconomic terms experiencehigher rates of stroke. This may be explained by a higher prevalence of riskfactors among these populations, such as hypertension, diabetes and cigarettesmoking. Effective preventive measures in the more deprived areas of the communitycould substantially reduce rates of stroke. ",
    author = "Emma Heeley and Jade Wei and Kristie Carter and Shaheenul Islam and Amanda Thrift and Graeme Hankey and Alan Cass and Craig Anderson",
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    Heeley, E, Wei, J, Carter, K, Islam, S, Thrift, A, Hankey, G, Cass, A & Anderson, C 2011, 'Socioeconomic disparities in stroke rates and outcome: Pooled analysis of stroke incidence studies in Australia and New Zealand', Medical Journal of Australia, vol. 195, no. 1, pp. 10-14.

    Socioeconomic disparities in stroke rates and outcome : Pooled analysis of stroke incidence studies in Australia and New Zealand. / Heeley, Emma; Wei, Jade; Carter, Kristie; Islam, Shaheenul; Thrift, Amanda; Hankey, Graeme; Cass, Alan; Anderson, Craig.

    In: Medical Journal of Australia, Vol. 195, No. 1, 04.07.2011, p. 10-14.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Socioeconomic disparities in stroke rates and outcome

    T2 - Pooled analysis of stroke incidence studies in Australia and New Zealand

    AU - Heeley, Emma

    AU - Wei, Jade

    AU - Carter, Kristie

    AU - Islam, Shaheenul

    AU - Thrift, Amanda

    AU - Hankey, Graeme

    AU - Cass, Alan

    AU - Anderson, Craig

    PY - 2011/7/4

    Y1 - 2011/7/4

    N2 - Objective: To assessthe influence of area-level socioeconomic status (SES) on incidence andcase-fatality rates for stroke.Design,setting and participants: Analysis of pooled data for3077 patients with incident stroke from three population-based studies inPerth, Melbourne, and Auckland between 1995 and 2003.Mainoutcome measures: Incidence and 12-month case-fatality rates forstroke.Results: Annualage-standardised stroke incidence rates ranged from 77 per100 000 person-years (95% CI, 72–83) in the least deprived areas to131 per 100 000 person-years (95% CI, 120–141) in the mostdeprived areas (rate ratio, 1.70; 95% CI, 1.47–1.95; P < 0.001).The population attributable risk of stroke was 19% (95% CI, 12%–27%) for thoseliving in the most deprived areas compared with the least deprived areas.Compared with people in the least deprived areas, those in the most deprivedareas tended to be younger (mean age, 68 v 77 years; P < 0.001),had more comorbidities such as hypertension (58% v 51%; P < 0.001)and diabetes (22% v 12%; P < 0.001), and were more likely tosmoke (23% v 8%; P < 0.001). After adjustment for age,area-level SES was not associated with 12-month case-fatality rate.Conclusions: Our analysis provides evidence that people living inareas that are relatively more deprived in socioeconomic terms experiencehigher rates of stroke. This may be explained by a higher prevalence of riskfactors among these populations, such as hypertension, diabetes and cigarettesmoking. Effective preventive measures in the more deprived areas of the communitycould substantially reduce rates of stroke. 

    AB - Objective: To assessthe influence of area-level socioeconomic status (SES) on incidence andcase-fatality rates for stroke.Design,setting and participants: Analysis of pooled data for3077 patients with incident stroke from three population-based studies inPerth, Melbourne, and Auckland between 1995 and 2003.Mainoutcome measures: Incidence and 12-month case-fatality rates forstroke.Results: Annualage-standardised stroke incidence rates ranged from 77 per100 000 person-years (95% CI, 72–83) in the least deprived areas to131 per 100 000 person-years (95% CI, 120–141) in the mostdeprived areas (rate ratio, 1.70; 95% CI, 1.47–1.95; P < 0.001).The population attributable risk of stroke was 19% (95% CI, 12%–27%) for thoseliving in the most deprived areas compared with the least deprived areas.Compared with people in the least deprived areas, those in the most deprivedareas tended to be younger (mean age, 68 v 77 years; P < 0.001),had more comorbidities such as hypertension (58% v 51%; P < 0.001)and diabetes (22% v 12%; P < 0.001), and were more likely tosmoke (23% v 8%; P < 0.001). After adjustment for age,area-level SES was not associated with 12-month case-fatality rate.Conclusions: Our analysis provides evidence that people living inareas that are relatively more deprived in socioeconomic terms experiencehigher rates of stroke. This may be explained by a higher prevalence of riskfactors among these populations, such as hypertension, diabetes and cigarettesmoking. Effective preventive measures in the more deprived areas of the communitycould substantially reduce rates of stroke. 

    M3 - Article

    VL - 195

    SP - 10

    EP - 14

    JO - Medical Journal of Australia

    JF - Medical Journal of Australia

    SN - 0025-729X

    IS - 1

    ER -