Abstract P342: Disparities in Awareness of Stroke Symptoms Among Different Socioeconomic, Ethnic/Race, and At-risk-of-stroke Groups

Abstract

Findings from a few small studies suggested that disparities in awareness of stroke symptoms lead to disparities in delays of receiving treatment and outcomes of patients with stroke. Hence it is important to conduct a study with a large sample size to understand the associations between awareness of symptoms of stroke with various socioeconomic factors as well as with modifiable stroke risk factors. We assessed the hypotheses that there are disparities in awareness of different stroke symptoms among different groups with respect to various SES factors (e.g., self-reported race, ethnicity, education, age, and income) in the presence/absence of modifiable stroke risk factors (e.g., smoking status, exercise, body mass index, and blood pressure). We combined four Behavioral Risk Factor Surveillance Surveys (BRFSS) from 2003, 2005, 2007, and 2009 to create a sample of 1,051,834 participants. We ran six logistic regression models, one for each of the measures of awareness of six common stroke symptoms (e.g., sudden confusion, numbness on one side of the body, sudden vision loss, sudden chest pain, sudden dizziness, and severe unexplained headache). The unweighted sample size in each of the six models was greater than 120,000. In addition, we calculated marginal probabilities which give the probability of an outcome (e.g., being aware of a specific stroke symptom) with respect to a specific factor (e.g., in the presence/absence of a stroke risk factor) in the context of averaging over all other factors/covariates. While there was low awareness of stroke symptoms among the US population except for recognition of chest pain or discomfort, we did find an association between the awareness of stroke symptoms with gender, educational levels, and income levels. Additionally, among all the ethnic groups, Native Americans had the lowest awareness of five out of six stroke symptoms. On the other hand, White only-non Hispanic, while being relatively better aware of several stroke symptoms, had the lowest awareness of the most common stroke symptom of sudden chest pain compared with other race/ethnicity groups. In conclusion, the findings from this study can serve as a useful guide to facilitating targeted educational efforts aimed at improving awareness of stroke symptoms that may ultimately reduce disparities in the outcomes of patients at risk for stroke.