Abstract

Introduction: Rural residence is associated with increased CVD risk, including incident stroke. Less is known about the association of rurality on health characteristics and health behaviors among stroke survivors. The purpose of this study was to determine the presence and magnitude of rural/urban differences in health characteristics and health behaviors among stroke survivors. Methods: Data from 14,599 stroke survivors were available from the 2017 & 2019 Behavioral Risk Factor Surveillance System, an annual health survey of non-institutionalized US adults. Inclusion criteria included history of self-reported stroke and age ≥65 years. Respondents with missing data regarding rural vs. urban dwelling status were excluded from analysis. Respondents provided self-reported data on sociodemographics (sex, race, marital status, education, and income), health characteristics, and health behaviors (see table for characteristics and behaviors). Logistic regression was used to compute odds ratios and 95% CI’s to examine the association among rural/urban status and health characteristics and health behaviors. Results: Prevalence of health characteristics and health behaviors, and computed adjusted odds ratios, are presented in the table. Although the prevalence of disability, poor general health, and insufficient physical activity were higher among rural-dwelling stroke survivors, odds ratios adjusted for sociodemographic and health characteristics demonstrated no association among rurality, health characteristics, and health behaviors. Conclusions: Although no differences in health characteristics and behaviors were found between rural and urban-dwelling stroke survivors, prevalences of many CVD risk factors were high, which increase risk for recurrent stroke, secondary conditions, and chronic disease. Interventions for improving risk factors and health behaviors in this health disparate population are needed.

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