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Demographic Disparities in Proximity to Stroke Care Identified

THURSDAY, June 10, 2021 -- Demographic disparities in proximity to stroke care are greater in nonurban than in urban areas, according to a study published online June 10 in Stroke.

Cathy Y. Yu, from the Washington University School of Medicine in St. Louis, and colleagues quantified the relationship between distance to the nearest certified stroke hospital and census-derived demographics. Population data were included from the U.S. Census Bureau's 2014 to 2018 American Community Survey. The authors reviewed data for 2,388 stroke centers and 71,929 census tracts (69 percent urban), including 316,995,649 individuals.

The researchers found that compared with urban areas, in nonurban areas demographic disparities in proximity to certified stroke care were greater. In nonurban centers, but not in urban areas, higher representation of individuals with age ≥65 years correlated with increased median distance to a certified stroke center (0.51 versus 0.00 km per 1 percent increase). Median distance was greater in urban and nonurban tracts with higher representation of American Indians (0.10 and 1.06 km per 1 percent increase, respectively) or uninsured populations (0.02 and 0.27 km, respectively). In nonurban and urban tracts, each $10,000 increase in median income correlated with a decrease in median distance of 5.04 km and an increase of 0.17 km, respectively.

"While a stroke can occur at any age, the risk is higher in older adults," a coauthor said in a statement. "It is concerning that the people most likely to experience a stroke are also more likely to live far from a stroke hospital."

One author disclosed financial ties to the medical device industry.

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