Abstract WP35: Neighborhood Effects On Knowledge Of Stroke Risk Factors And Stroke Warning Signs

Abstract

Background: Low socio-economic status has been associated with worse stroke outcomes and longer arrival times to the ED. Objective: To determine whether stroke knowledge is different by neighborhood and if neighborhood socio-economic status (NSES) predicts knowledge of stroke risk factors (RF) or stroke warning signs (WS). Methods: A survey was done in the Greater Cincinnati Northern Kentucky Region in 2016 where participants were targeted to match those of ischemic stroke patients within the same population. The participants were asked open-ended questions regarding stroke WS and RFs. Participants also provided their zip codes. NSES was determined based on zip code and census data. NSES was determined using a previously validated index and divided into quartiles. We used regression to determine the association between NSES and only being able to name 0-1 RF or WS. Results: There were 1902 participants in the surveys with non-missing geographic data who lived in 96 different zip codes. Participants were 66.8±16.4 years old, 56.2% were female, 24.4% were black and 36.0% had less than a HS education. About 20% of participants were unable to name one stroke risk factor or one warning sign. There was substantial heterogeneity of stroke knowledge by zip code (Figure 1). There was no significant association between NSES and knowledge of stroke WS. After adjustment for age, sex, and race, participants who lived in neighborhoods in the lowest quartile of NSES were more likely to be only able to name 0-1 RFs when compared to all other neighborhoods (Lowest Quartile of NSES OR 1.45 (95% CI 1.06-1.98)). Conclusion: We identified geographic disparities of stroke knowledge in a well-defined population, emphasizing the need for targeting public health interventions towards areas most in need. NSES accounted for some of the disparities in stroke RF knowledge, but not stroke WS knowledge. 1