Abstract
Background Limited research has been conducted on socio-economic status (SES) and first-ever stroke incidence. We examined the association between SES and first-ever stroke incidence.
Methods This retrospective cohort study included linked Tasmanian administrative data from the Admitted Patient Care Episodes (APC) and the Death Registry of Tasmania. Fatal and non-fatal stroke cases between 2007 to 2020 were defined from the primary diagnosis field in the APC dataset and underlying cause of death in the Death Registry, using ICD-10 codes. We used an 8-year lookback period to identify first-ever stroke cases. The Index of Relative Socio-economic Advantage and Disadvantage from the Socio-Economic Indexes for Areas 2016 was used to determine an individual’s SES level by quintile, and the Accessibility and Remoteness Index of Australia for remoteness, with associated population denominators. Poisson regression models were used to estimate multivariable-adjusted incidence rate ratios (IRR).
Results Overall, 4,158 first-ever strokes were identified (81% ischaemic stroke, mean [SD] age 73.3 [14.2], 46.4 % women). Compared to those in the high SES group, the first-ever stroke IRR was 1.27 (95% CI, 1.14 -1.41) for low medium SES group, and IRR 1.46 (95% CI, 1.33 - 1.61) for low SES group, after adjusting for age, sex, year and remoteness. No interaction was observed between SES and year, sex or remoteness.
Conclusions People living in lower SES areas had 30-40% greater incidence of first-ever stroke than those living in more advantaged areas. Stroke prevention strategies targeting low medium SES populations may reduce stroke incidence.