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EMS Stroke Response Good in Poor Neighborhoods
THURSDAY, May 11 (HealthDay News) -- Poverty increases the average American''s risk of getting a stroke, but new research finds that living in a poor neighborhood won''t slow emergency response times when a stroke occurs. "Overall, there weren''t any significant delays based on the poverty of the area where people lived," said Dr. Dawn Kleindorfer, an assistant professor of neurology at the University of Cincinnati and lead author of a report in the May 12 issue of Stroke. Her team''s report analyzed emergency medical service (EMS) responses for more than 3,800 people hospitalized for strokes or mini-strokes in a five-county area of southern Ohio and northern Kentucky. The researchers looked for differences in response times for neighborhoods with widely varying incomes. The response times to poorer areas was a bit slower than for affluent neighborhoods, but the differences were very small and did not significantly affect patient care or outcomes, Kleindorfer said. This is the first study of its kind, she said. "No one has looked at community poverty and delay, at least in stroke," she said. And while the study covered only a small part of the country, an area with a population of 1.3 million, the results probably apply to the nation as a whole, she said. "Our times in general -- arriving at the scene in 6.5 minutes and staying at the scene for 14 minutes -- are comparable to several other studies that have been published," Kleindorfer noted. "So, it is reasonable to believe they apply to the United States as well." A second study, published in the same issue of the journal, covered more familiar ground. It looked at the impact of socioeconomic status on stroke rates in more than 2,800 people aged 65 and older, all of whom took part in a long-running study in New Haven, Conn. People aged 65 to 74 with lower education and income levels had twice the risk of stroke of those with the highest educational or income level. But that sharp difference disappeared for people aged 74 or older. In that age group, better education and higher income were associated with a higher incidence of stroke. One possible explanation is that educational level and income are not accurate indicators of socioeconomic status in that age group, the researchers said. A grimmer possibility is that people with lower socioeconomic status were likely to die earlier in life, so that only the hardy survived to older age. The findings echo those of previous studies: that people with less education and lower income are more likely to have stroke risk factors such as smoking, diabetes, high blood pressure and depression. The results show a need for "improvements of diabetes and depression management among lower socioeconomic groups and highlight the need to implement interventions to help the disadvantaged elderly to maintain social networks and functioning abilities," study author Mauricio Avendano said in a prepared statement. He was a visiting fellow at the Harvard School of Public Health when the study was done, and is now an epidemiologist at Erasmus Medical Center in Rotterdam. Kleindorfer said that lesson to be gleaned from her study is that vulnerable people should be aware of the symptoms of a stroke and act immediately to get medical care, regardless of where they live. Unfortunately, just 39 percent of the patients in her study dialed 911 after feeling the onset of stroke symptoms. Warning signs of stroke include dizziness, sudden weakness on one side of the body, and headache. "The time spent with EMS was relatively small compared to delays related to lack of public awareness of stroke symptoms," Kleindorfer said. More information For more on stroke''s warning signs, head to the American Heart Association.
Last Updated: May 12, 2006 |