The association between socioeconomic status and disability after stroke: Findings from the Adherence eValuation After Ischemic stroke Longitudinal (AVAIL) registry

Janet Prvu Bettger, Xin Zhao, Cheryl Bushnell, Louise Zimmer, Wenqin Pan, Linda Williams, Eric D. Peterson

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: Stroke is the leading cause of disability among adults in the United States. The association of patients' pre-event socioeconomic status (SES) with post-stroke disability is not well understood. We examined the association of three indicators of SES - educational attainment, working status, and perceived adequacy of household income - with disability 3-months following an acute ischemic stroke. Methods. We conducted retrospective analyses of a prospective cohort of 1965 ischemic stroke patients who survived to 3 months in the Adherence eValuation After Ischemic stroke - Longitudinal (AVAIL) study. Multivariable logistic regression was used to examine the relationship of level of education, pre-stroke work status, and perceived adequacy of household income with disability (defined as a modified Rankin Scale of 3-5 indicating activities of daily living limitations or constant care required). Results: Overall, 58% of AVAIL stroke patients had a high school or less education, 61% were not working, and 27% perceived their household income as inadequate prior to their stroke. Thirty five percent of patients were disabled at 3-months. After adjusting for demographic and clinical factors, stroke survivors who were unemployed or homemakers, disabled and not-working, retired, less educated, or reported to have inadequate income prior to their stroke had a significantly higher odds of post-stroke disability. Conclusions: In this cohort of stroke survivors, socioeconomic status was associated with disability following acute ischemic stroke. The results may have implications for public health and health service interventions targeting stroke survivors at risk of poor outcomes.

Original languageEnglish (US)
Article number281
JournalBMC Public Health
Volume14
Issue number1
DOIs
StatePublished - Mar 26 2014
Externally publishedYes

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Social Class
Registries
Stroke
Survivors
Education
Activities of Daily Living
Health Services
Longitudinal Studies
Public Health
Logistic Models
Demography

Keywords

  • Disability
  • Ischemic stroke
  • Outcomes research
  • Recovery
  • Socioeconomic position

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Medicine(all)

Cite this

The association between socioeconomic status and disability after stroke : Findings from the Adherence eValuation After Ischemic stroke Longitudinal (AVAIL) registry. / Bettger, Janet Prvu; Zhao, Xin; Bushnell, Cheryl; Zimmer, Louise; Pan, Wenqin; Williams, Linda; Peterson, Eric D.

In: BMC Public Health, Vol. 14, No. 1, 281, 26.03.2014.

Research output: Contribution to journalArticle

Bettger, Janet Prvu ; Zhao, Xin ; Bushnell, Cheryl ; Zimmer, Louise ; Pan, Wenqin ; Williams, Linda ; Peterson, Eric D. / The association between socioeconomic status and disability after stroke : Findings from the Adherence eValuation After Ischemic stroke Longitudinal (AVAIL) registry. In: BMC Public Health. 2014 ; Vol. 14, No. 1.
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