Abstract
Objective: The purpose of this study was to determine if New Orleans, a city with a bi-racial population and within the “stroke belt”, has certain areas with disproportionately high stroke occurrence. Methods: Stroke activation cases from January 2010 - November 2011 were mapped and analyzed after review of New Orleans Emergency Medical Services (NOEMS) patient care reports. Age, gender, race, and home location were compared to population density, race density, and socioeconomic status. Results: Of 686 cases, areas with high concentrations of stroke activations, named “stroke activation hotspots”, were mainly found where the Median Household Income (MHHI) in 2010 was less than $25,000, and the population was 80-100% African American. Some “hotspots”, such as fairly wealthy and medium-density areas in the Garden District and French Quarter, exist where 2010 MHHI exceeded $64,000. When compared to 2010 Census Data population density maps, discordance between population within a zip code and proportion of stroke activation cases was found. Conclusion: Strokes are not randomly or evenly distributed throughout Orleans Parish, nor are they purely by-products of population density. Social vulnerability, poverty, and lack of access to health care may explain some of these clusters; while clusters of elderly citizens and tourists may explain the hotspots in wealthy areas. Rational geography to stroke activation distribution may permit further investigation of racial disparities in stroke outcomes allow for targeted stroke education.
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