Quick Take: Your Neighborhood Factors Into Your Stroke Risk

Philadelphia's Fishtown neighborhood

“Where we live influences our health in a lot of ways: Whether a neighborhood is walkable, the availability of health foods, the levels of security and stress we feel in our neighborhood and many other aspects are part of it. Since each of these can contribute to having stroke risk factors, it makes sense that when we consider the neighborhood as a whole, it might influence the levels of our stroke risk factors. Socioeconomic status is just one indicator.” Leslie McClure, PhD, professor in the Drexel’s Dornsife School of Public Health

Philadelphia's Fishtown neighborhood
Philadelphia’s Fishtown neighborhood. By Tim Kiser (w:User:Malepheasant) – Own work (self-made photograph), CC BY-SA 2.5, https://commons.wikimedia.org/w/index.php?curid=1643914

When we talk about disease risk, it’s common to talk in terms of age, race or sex. But a significant marker for a person’s risk for disease is often the environment they live in.

In light of that, Dornsife School of Public Health Dean Ana Diez-Roux, MD, PhD, and Leslie McClure, PhD, chair of the Department of Epidemiology and Biostatistics, took part in a study recently published in Neurology that examined the relationship between socioeconomic statuses of neighborhoods and the risk of having a stroke.

What the team, led by the University of Alabama at Birmingham’s Virginia Howard, PhD, found was that the lower a neighborhood’s socioeconomic status, the higher a person’s stroke risk. That risk carried across the board, whether participants in the study were black or white (the two racial categories included).

“The influence of factors in neighborhoods in which black people live is not different than the influence of factors from neighborhoods in which white people live,” said McClure. “It means that whatever policy changes we target at changing neighborhoods, we can do so equally across predominantly black and predominantly white neighborhoods.”

Almost 25,000 people aged 45 or older were a part of the study. These people had also not had a stroke before they enrolled in a national population cohort between 2003 and 2007. Then, for seven-and-a-half years after they enrolled, the participants were monitored for an incident of a stroke.

Each participant’s neighborhood socioeconomic status was ascertained and categorized into four levels. As the research team examined the data, they determined that stroke risk increased as socioeconomic status declined.

As such, the risk of stroke for people living in neighborhoods in the lowest level was 13 percent higher than the second level. And those living in the second level’s stroke risk was 8 percent higher than the third level.

The trend of stroke risk tied to neighborhood socioeconomic status was present even when taking each participant’s personal risk factors into account.

“Studies like this are the first step in identifying a risk factor,” McClure said. “We need to identify what specifically can be changed that might reduce this relationship between stroke risk and the neighborhood a person lives in.”

McClure hopes further research will identify what specific risks factor into strokes “and then discover what interventions may help eliminate those risks.”

“The ultimate goal is to make changes in neighborhoods that lead to better health outcomes all around,” she said.

Those interested in reading the full study, “Neighborhood socioeconomic index and stroke incidence in a national cohort of blacks and whites,” can access it here.

Media interested in talking to McClure should contact Frank Otto at 215.571.4244 or fmo26@drexel.edu.

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