Background and Purpose: To identify potential community- and school-level quality measures which may influence trends in baseline stroke knowledge of children participating in the Hip Hop Stroke program from 2005-2014. Methods: We gathered baseline stroke knowledge surveys from 2,839 available surveys of 4th, 5th, and 6th grade students enrolled in the Hip Hop Stroke program from November 2005-April 2014. We explored several objective standardized factors assessed city-wide, including performance grade (letter categories A-F, as measured via standardized testing) and economic need index (incorporates subsidized housing and meals; range 0-2 and higher scores indicate higher needs; example: a value of 2 indicates 100% students requiring food and housing subsidies or support). Students who left ≥3 questions blank were discarded; other blank answers were treated as missing. Data were analyzed using Chi-Square and regression analysis (SPSS v22.0). Results: Schools studied included those with performance grades B (n=196), C (n=1590), and D (n=1053) and mean economic need index of 0.85 (SD 0.23). For a composite assessment of knowledge including 4 stroke symptoms (blurred vision, facial droop, sudden headache, and slurred speech), 1 distractor (chest pain), and urgent action plan (call 911), asked consistently since 2006, overall students scored a mean 2.86 (95% CI: 2.80-2.92; possible range 0-6, expected value 2.75). For quartiles of economic need, means scores ranged from Q1: 2.89 (95% CI: 2.79-2.99), Q2: 3.08 (95% CI: 2.96-3.20), Q3: 2.77 (95% CI: 2.66-2.89), and Q4: 2.57 (95% CI: 2.43-2.71), p-trend <0.001. Students at B schools scored 2.96 (95% CI: 2.72-3.20), C: 2.93 (95% CI 2.85-3.01), D: 2.71 (95% CI: 2.63-2.81), p-trend=0.001. Conclusion: Lower student knowledge of stroke is strongly associated with measures of greater economic need and lower school performance. Consideration should be given to focus implementation of stroke education campaigns in schools and communities with higher needs.