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(Stroke. 2001;32:1492.)
© 2001 American Heart Association, Inc.
Original Contributions |
Socioeconomic Status and Ischemic Stroke
The FINMONICA Stroke Register
, MDFrom the KTL–National Public Health Institute (D.J., C.S., J. Torppa, M.M., K.K., J. Tuomilehto, P.P., V.S.), Department of Epidemiology and Health Promotion, Helsinki, Finland; Department of Public Health, University of Helsinki (J. Tuomilehto), Helsinki, Finland; Department of Neurology, University of Kuopio, and Brain Research and Rehabilitation Centre "Neuro" (J.S.), Kuopio, Finland; Raisio Regional Hospital (P.I.-R.), Raisio, Finland; Loimaa Regional Hospital (E.K.), Loimaa, Finland; and North Karelia Central Hospital (K.A.), Joensuu, Finland.
Correspondence to Veikko Salomaa, MD, PhD, KTL–National Public Health Institute, Department of Epidemiology and Health Promotion, Mannerheimintie 166, FIN-00300 Helsinki, Finland. E-mail veikko.salomaa{at}ktl.fi
Background and Purpose—It has been shown that low socioeconomic status is associated with death from stroke. More-detailed data have, however, remained scanty. The purpose of the present study was to examine the association of socioeconomic status with ischemic stroke. Besides mortality, we analyzed the incidence, case-fatality ratio, and prognosis of ischemic stroke events.
Methods—Our population-based study included 6903 first stroke events registered by the FINMONICA Stroke Register in 3 areas of Finland during 1983 to 1992. Indicators of socioeconomic status, such as taxable income and education, were obtained by record linkage of the stroke register data with files of Statistics Finland.
Results—Incidence, case-fatality ratio, and mortality rates for ischemic stroke were all inversely related to income. Furthermore, 28 days after the onset of symptoms, a greater proportion of patients with low income than of those with high income was still in institutionalized care and/or in need of help for their activities of daily living. Population-attributable risk of the incidence of first ischemic stroke due to low socioeconomic status was 36% for both sexes. For the death from first ischemic stroke, it was 56% for both sexes.
Conclusions—Persons with low socioeconomic status have considerable excess rates of morbidity and mortality from ischemic stroke in Finland. A reduction in this excess could markedly decrease the burden of ischemic stroke to the society and thus constitute an important public health improvement.
Key Words: population surveillance • socioeconomic factors • stroke, ischemic • World Health Organization
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