Socioeconomic status and ischemic stroke - The FINMONICA Stroke Register

Background and Purpose-It has been shown that low socioeconomic status is a ssociated with death from stroke, More-detailed data have, however, remaine d scanty. The purpose of the present study was to examine the association o f socioeconomic status with ischemic stroke. Besides mortality, we analyzed the incidence, case-fatality ratio, and prognosis of ischemic stroke event s. Methods-Our population-based study included 6903 first stroke events regist ered by the FINMONICA Stroke Register in 3 areas of Finland during 1983 to 1992. Indicators of socioeconomic status, such as taxable income and educat ion, were obtained by record linkage of the stroke register data with files of Statistics Finland. Results-Incidence, case-fatality ratio, and mortality rates for ischemic st roke were all inversely related to income. Furthermore, 28 days after the o nset of symptoms, a greater proportion of patients with low income than of those with high income was still in institutionalized care and/or in need o f help for their activities of daily living. Population-attributable risk o f the incidence of first ischemic stroke due to low socioeconomic status wa s 36% for both sexes. Far the death from first ischemic stroke, it was 56% for both sexes. Conclusions-Persons with low socioeconomic status have considerable excess rates of morbidity and mortality from ischemic stroke in Finland. A reducti on in this excess could markedly decrease the burden of ischemic stroke to the society and thus constitute an important public health improvement.