Neighborhood income inequality has been shown to affect stroke outcomes.

This retrospective cohort study included 570 patients hospitalized at Tufts Medical Center with AIS. Using zip code data at the time of hospitalization, patients were assigned into low Gini (n = 224) and high ADI (n=325) groups, based on national and state means, respectively. To evaluate the effects of living in a homogeneously deprived area, these variables were combined to indicate patients living in both a low Gini and high ADI neighborhood (n = 154). The multifactorial analysis assessed stroke severity on admission as measured by the NIH stroke scale (NIHSS), adjusting for age, gender, race/ethnicity, past medical history of atrial fibrillation, and ADI-Gini combination.

Patients in the low Gini-high ADI group were more likely to have a higher NIHSS on admission (OR: 1.25 – 2.94, p = 0.003). In this model, female sex was associated with a higher admission NIHSS (OR: 1.06 – 2.10, p = 0.022) as well as a past medical history of atrial fibrillation (OR: 1.84 – 4.63, p < 0.001). There were no significant differences by race/ethnicity or age in this model.

This study suggests that individuals living in homogeneously deprived neighborhoods are more likely to have more severe AIS on admission. This study highlights the impact of socioeconomic disparities on stroke outcomes. The significant differences seen by sex and atrial fibrillation indicate the complexity behind these effects.  Further studies with increased power must be done to understand the mechanism behind these disparities and identify possible interventions to improve stroke outcomes in communities with fewer resources.