Thirty zip codes were included, representing 3,254 patients and 82% of all stroke code volume.  Median time to presentation of a zip code was significantly associated with zip code median household income. For every $10,000 increase in median household income, there was an 8.8 minute decrement in median time to presentation (p-value=0.04). Every 10% increase in median percentage of White individuals in a zip code was associated with a -16.3 minute reduction in median time to presentation (p-value=.01).  Higher median times were observed in zip code regions with a higher proportion of Hispanic individuals [slope 21.5 minutes for every 10 % Hispanic, p-value=0.049]. Finally, median presentation time was inversely related to the median age of patients [slope (-6.5 min/year), p-value= 0.02].  

Geographies with younger patients, lower household income, lower proportions of White race, and greater proportion of Hispanic ethnicity were associated with longer presentation times to the ED. This zip-code level data may inform targeting of stroke community education and resources to specific locations.