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The Role of County-Level Persistent Poverty in Stroke Mortality in the USA

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Abstract

Stroke is a major health concern in the USA, disproportionately affecting socioeconomically disadvantaged groups. This study investigates the link between persistent poverty and stroke mortality rates in residents aged 65 and above, positing that sustained economic challenges at the county level correlate with an increase in stroke-related deaths. Persistent poverty refers to a long-term state where a significant portion of a population lives below the poverty threshold for an extended period, typically measured over several decades. It captures the chronic nature of economic hardship faced by a community across multiple generations. Utilizing data from the CDC Wonder database and the American Community Survey, we conducted a comprehensive analysis across US counties, differentiating them by persistent poverty status. Our results indicate a statistically significant link between persistent poverty and increased mortality from ischemic and hemorrhagic strokes; counties afflicted by long-standing poverty were associated with an additional 33.49 ischemic and 8.16 hemorrhagic stroke deaths per 100,000 residents annually compared to their wealthier counterparts. These disparities persisted when controlling for known stroke risk factors and other socioeconomic variables. These results highlight the need for targeted public health strategies and interventions to address the disparities in stroke mortality rates and the broader implications for healthcare equity. The study underscores the vital role of socioeconomic context in health outcomes and the urgency of addressing long-term poverty as a key determinant of public health.

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Data Availability

The datasets analyzed for this study are publicly available and can be accessed through the following resources: the CDC Interactive Data on Heart Disease and Stroke, the CDC WONDER database, the US Census Bureau, and the American Community Survey. References and links to the specific datasets within these resources have been provided within the manuscript.

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Authors and Affiliations

  1. Department of Neurological Surgery, University of Kansas Medical Center, 3901 Rainbow Blvd, MS, Kansas City, KS, 3021, USA

    Jean-Luc K. Kabangu

  2. Kansas City University College of Osteopathic Medicine, Kansas City, MO, USA

    Takara Newsome-Cuby

  3. University of Michigan Medical School, Ann Arbor, MI, USA

    Amanda Hernandez

  4. Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA

    Benson Joseph

  5. University of Tennessee Health Science Center College of Medicine, Memphis, TN, USA

    John Dugan

  6. New York Institute of Technology College of Osteopathic Medicine at Arkansas State University, Jonesboro, AR, USA

    Danny Fowler

  7. Michigan State University College of Human Medicine, East Lansing, MI, USA

    Momodou G. Bah

  8. University of Kansas School of Medicine, Kansas City, KS, USA

    Lane Fry

  9. Department of Neurosurgery, Semmes-Murphey Clinic, Memphis, TN, USA

    Sonia V. Eden

  10. University of Tennessee Health Sciences Center, Memphis, TN, USA

    Sonia V. Eden

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  1. Jean-Luc K. Kabangu
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  9. Sonia V. Eden
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Contributions

All authors contributed significantly to the conception and design of the study. Material preparation, data collection, and analysis were carried out by Jean-Luc Kabangu, Takara Newsome-Cuby, and Amanda Hernandez. The first draft of the manuscript was written by Jean-Luc Kabangu, and all authors provided feedback on previous iterations of the document. Every author has read and approved the final version of the manuscript that is being submitted.

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Correspondence to Jean-Luc K. Kabangu.

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Kabangu, JL.K., Newsome-Cuby, T., Hernandez, A. et al. The Role of County-Level Persistent Poverty in Stroke Mortality in the USA. J. Racial and Ethnic Health Disparities (2024). https://doi.org/10.1007/s40615-024-01981-7

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  • DOI: https://doi.org/10.1007/s40615-024-01981-7

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