Death From Stroke Linked to Lower Income
Blue-collar work, early retirement also associated with increased mortality
WEDNESDAY, Dec. 29, 2004 (HealthDayNews) -- Lack of money appears to hurt a person's chances of surviving a stroke, a new Austrian study suggests.
Low income was associated with a 60 percent to 70 percent increased risk of dying from a stroke, compared with stroke patients in the highest income group.
"Our study showed that in a country with an equitable health-care system, socioeconomic differences still influence mortality after stroke," said study author Dr. Jasmin Arrich, a researcher at the Medical University of Vienna.
The findings appear in the Dec. 30 online issue of Stroke.
In the study, Arrich and her team collected data on 2,606 stroke patients who were admitted to hospitals in Vienna. These patients were also part of a citywide stroke registry between October 1998 and March 2003. The patients were followed for an average of 2.5 years.
Other studies have found a link between socioeconomic status and stroke, Arrich said. "However, one particular aspect of the study is that we assessed individual socioeconomic status," she added.
Arrich said the study was not designed to determine the link between low income and risk of death from stroke.
"We think, to a great part, the effect is attributable to individual pre-stroke conditions [such as high blood pressure]. But according to our data, there may also be an ongoing effect of socioeconomic status even after the stroke event," Arrich said.
In addition to income, the researchers found that occupation was linked to a higher risk of dying from a stroke. Blue-collar workers, both skilled and unskilled, had a significantly higher death rate, compared with white-collar workers.
Unskilled blue-collar workers had an 87 percent increased risk of dying from a stroke, and skilled blue-collar workers had a 61 percent increased death risk, compared with white-collar workers.
Another factor associated with death from stroke was early retirement, the researchers found. Those who retired early had a 75 percent higher risk of dying from a stroke, compared with stroke patients who were still working. According to Arrich, the most likely explanation for this association is that early retirement was brought on by other health problems.
Arrich believes that reducing mortality among poorer stroke patients is a societal problem, not a medical one. "A solution to the problem can only take place on the political level, as it is important to guarantee free access to the health-care system, and a strong welfare system, protection of the less advantaged and health education," she said.
Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, said, "There is abundant evidence and many reasons why poverty is bad for health. This paper by Arrich and colleagues adds to our knowledge of the hazards of financial hardship with regard to cerebrovascular disease."
This study raises the question of what to do to eliminate this disparity, Katz said. "Eliminating poverty is desirable, but in the short term at least, pie-in-the-sky," he said.
"Is there some way to attenuate stroke mortality among the socioeconomic challenged until or unless the time comes when no one can be so characterized?" Katz asked. "Where this paper leaves us is with the challenge of posing, and attempting to respond to, this question."
The American Stroke Association can tell you more about stroke.