Featured Research

from universities, journals, and other organizations

Socio-economic status impacts mortality rates for stroke in US

Date:
September 27, 2013
Source:
St. Michael's Hospital
Summary:
Americans in the highest socio-economic groups have a 13 percent greater chance of surviving a kind of stroke known as a subarachnoid hemorrhage than those in the lowest socio-economic groups, a new study has found.

Americans in the highest socio-economic groups have a 13 per cent greater chance of surviving a kind of stroke known as a subarachnoid hemorrhage than those in the lowest socio-economic groups, a new study has found.

Related Articles


However, social and economic status have no bearing on mortality rates for subarachnoid hemorrhages, or SAH, in Canada, according to the study led by Dr. Loch Macdonald, a neurosurgeon at St. Michael’s Hospital in Toronto.

“The findings suggest Canada’s universal, publicly funded health insurance coverage may play a role in improving chances of better outcomes after SAH among patients in lower socioeconomic groups,” said Dr. Macdonald, one of the world’s leading experts in researching these kinds of strokes.

The study appears in the October issue of the journal Stroke.

A subarachnoid hemorrhage is bleeding in the area between the brain and the thin tissue that covers the brain, an area called the subarachnoid space. Subarachnoid hemorrhage affects 10 in 100,000 people in North America each year, or about 40,000 cases a year. About one-quarter of SAH patients die within two weeks of hospital admission and a similar number are discharged with disabilities that may require prolonged institutional care.

The study used administrative databases to collect information on 31,631 U.S. patients and 16,531 Canadian patients. Socioeconomic status was based on estimated median household income according to zip code or postal code. The average age of patients in both countries was 58.

U.S. patients living in the lowest income neighbourhoods were less likely than those in wealthy neighbourhoods to be Caucasians (52 per cent vs. 70 per cent) or Asian/Pacific Islanders (2 per cent vs. 9 per cent) and were more likely to be African American (25 per cent vs. 7 per cent) or Hispanic (17 per cent vs. 9 per cent).

Low-income patients were most likely to be seen in hospitals in the southern United States, to be on Medicaid or pay the bills themselves, and to have more pre-existing medical conditions.

U.S. patients were more likely to receive urgent or emergency admission than their Canadian counterparts (91 per cent vs. 83 per cent) and have more comorbidities, or additional health issues (40 per cent vs. 25 per cent).

But the researchers said none of those factors explained the fact the in the United States, patients in the top 25 per cent of neighbhourhood income were at significantly less risk of dying from SAH than those in the bottom quarter of neighbourhood income. In the lowest income levels, 23 per cent of SAH patients died, compared to 20 per cent of patients at the highest incomes.

The study found that socioeconomic status played did not influence how many SAH patients were discharged from hospitals to other institutions such as rehabilitation facilities in either country.

However, Dr. Macdonald noted that the link between socioeconomic status and mortality rates in the United States cannot be discussed independently of whether patients have health insurance.

“Insurance status has been shown to significantly impact outcomes for patients with SAH, with worse outcomes more likely to occur among patients who are inadequately insured,” he said. “Better insured patients are more likely to live in wealthy neighbhourhoods and have better access to timely, high-quality specialized care, which has been shown to be critical to improved outcomes after SAH.”

He said this study provides some evidence to support the concept that access to health care for low-income patients, including prevent and management of related conditions, is better in a public health care system than a private health care system. He noted that SAH patients in the United States had more associated health issues than in Canada.

“It is possible Canada’s more inclusive publicly funded health insurance coverage facilitated a relatively better access to treatment for comorbid conditions and improved chances of better outcomes after SAH among lower SES groups.”


Story Source:

The above story is based on materials provided by St. Michael's Hospital. Note: Materials may be edited for content and length.


Journal Reference:

  1. B. N. R. Jaja, G. Saposnik, R. Nisenbaum, T. A. Schweizer, D. Reddy, K. E. Thorpe, R. L. Macdonald. Effect of Socioeconomic Status on Inpatient Mortality and Use of Postacute Care After Subarachnoid Hemorrhage. Stroke, 2013; 44 (10): 2842 DOI: 10.1161/STROKEAHA.113.001368

Cite This Page:

St. Michael's Hospital. "Socio-economic status impacts mortality rates for stroke in US." ScienceDaily. ScienceDaily, 27 September 2013. <www.sciencedaily.com/releases/2013/09/130927105131.htm>.
St. Michael's Hospital. (2013, September 27). Socio-economic status impacts mortality rates for stroke in US. ScienceDaily. Retrieved October 24, 2014 from www.sciencedaily.com/releases/2013/09/130927105131.htm
St. Michael's Hospital. "Socio-economic status impacts mortality rates for stroke in US." ScienceDaily. www.sciencedaily.com/releases/2013/09/130927105131.htm (accessed October 24, 2014).

Share This



More Health & Medicine News

Friday, October 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

IKEA Desk Converts From Standing to Sitting With One Button

IKEA Desk Converts From Standing to Sitting With One Button

Buzz60 (Oct. 24, 2014) IKEA is out with a new convertible desk that can convert from a sitting desk to a standing one with just the push of a button. Jen Markham explains. Video provided by Buzz60
Powered by NewsLook.com
Ebola Protective Suits Being Made in China

Ebola Protective Suits Being Made in China

AFP (Oct. 24, 2014) A factory in China is busy making Ebola protective suits for healthcare workers and others fighting the spread of the virus. Duration: 00:38 Video provided by AFP
Powered by NewsLook.com
WHO: Millions of Ebola Vaccine Doses by 2015

WHO: Millions of Ebola Vaccine Doses by 2015

AP (Oct. 24, 2014) The World Health Organization said on Friday that millions of doses of two experimental Ebola vaccines could be ready for use in 2015 and five more experimental vaccines would start being tested in March. (Oct. 24) Video provided by AP
Powered by NewsLook.com
Doctor in NYC Quarantined With Ebola

Doctor in NYC Quarantined With Ebola

AP (Oct. 24, 2014) An emergency room doctor who recently returned to the city after treating Ebola patients in West Africa has tested positive for the virus. He's quarantined in a hospital. (Oct. 24) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins