Patients in lower socioeconomic status areas less likely to receive acute stroke therapies


People who live in neighbourhoods with lower socioeconomic status are less likely to receive clot-busting medications or undergo mechanical thrombectomy procedures after they have a stroke compared to those living in neighbourhoods with a higher socioeconomic status. That is according to a study published recently in the journal Neurology.

“These treatments can greatly reduce death and disability from stroke, but previous studies have shown that few people actually receive the treatments,” said study author Amy Ying Xin Yu (University of Toronto, Toronto, Canada). “We wanted to see how socioeconomic disparities play a role, especially in an area where everyone has access to universal healthcare.”

The study looked at everyone living in Ontario, Canada who had an ischaemic stroke during a five-year period—resulting in a cohort totalling 57,704 people—and assessed how many of those people had their blood clots treated with clot-busting drugs, via intravenous thrombolysis, or surgery via a thrombectomy.

Researchers also looked at participants’ neighbourhoods and divided them into five groups based on their neighbourhoods’ socioeconomic statuses. This was determined by factors like the percentage of adults without a high school diploma, unemployment rate, and income level.

A total of 17% of those living in the neighbourhoods with the lowest socioeconomic status received the aforementioned treatments, compared to 20% of those living in the neighbourhoods with the highest socioeconomic status. And, when taking into account other factors that could affect treatment—such as age, high blood pressure and diabetes—they concluded that people in the neighbourhoods with the lowest socioeconomic status were 24% less likely to be treated than people in the neighbourhoods with the highest socioeconomic status.

The researchers also found, however, that there was no difference in treatment between the neighbourhood with the lowest status, and the three middle-ranked neighbourhoods of the five.

“Our study underscores the need for tailored interventions to address socioeconomic disparities in access to acute stroke treatments, including educational and outreach programmes to increase awareness about the signs and symptoms of stroke in various languages, and efforts to distribute resources more equitably across neighbourhoods,” Yu said. “Further research is needed to examine the specific causes of these disparities, so we can find ways to address the larger systemic issues that need to be improved to better serve people from under-resourced neighbourhoods.”

One limitation of the study that was noted by the researchers is that they did not have information on other factors that could affect stroke treatment, such as the time symptoms started or how severe the stroke was.


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