Journal of the neurological sciences · 2025
Disparities in perceived general health of stroke survivors in the United States.
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Hejazian Seyyed Sina, Vafaei Sadr Alireza, Vemuri Ajith, Abedi Vida, Zand Ramin
Аннотация
BACKGROUND: General health can have a profound impact on daily life. We aimed to evaluate perceived general health, its trend, and associated factors among stroke survivors in the US to inform targeted interventions and guide health and social policy improvements.
METHOD: The BRFSS 2016-2022 was utilized for analysis. The study population included participants with stroke history. Logistic regression models were used to determine factors associated with poor general health. The time trend and geographical pattern of general health were also evaluated.
RESULTS: Out of 128,988 individuals, 49.9 % were aged≥65 and 48.1 % were men. The prevalence of unfavorable general health was 50.9 %, with a 3.8 % reduction in 2016-2022. Most states with high rates of unfavorable general health were located Southeast of the country. Compared to men, only non-Hispanic-Black women (56.4 %vs.52.1 %,p = 0.011) and women aged "45-64"(58.5 %vs.56.3 %,p = 0.030) or "above74"(46.4 %vs.43.8 %,p = 0.024) had higher rates of unfavorable general health. Among both sexes, those aged 45-64 (Men:56.3 %,Women:58.5 %) and Hispanics (Men:57.8 %,Women:60.6 %) had the highest rates of unfavorable general health among different age and race groups. Based on the multivariate regression analysis, lower BMI(<18Kg/m2), being unemployed or homemaker, residing in the "stroke belt," physical inactivity, smoking, comorbidities/disabilities-including cardiovascular, pulmonary,and kidney diseases,diabetes, arthritis,cancer, blindness, difficulty walking/dressing-were associated with higher odds of unfavorable general health. In contrast, higher education and income, and heavy alcohol consumption were linked to lower odds.
CONCLUSION: This study highlights significant disparities in general health among stroke survivors in the US. Demographics, comorbidities/disabilities, physical activity, socioeconomic status, and environmental factors were associated with general health outcomes.
METHOD: The BRFSS 2016-2022 was utilized for analysis. The study population included participants with stroke history. Logistic regression models were used to determine factors associated with poor general health. The time trend and geographical pattern of general health were also evaluated.
RESULTS: Out of 128,988 individuals, 49.9 % were aged≥65 and 48.1 % were men. The prevalence of unfavorable general health was 50.9 %, with a 3.8 % reduction in 2016-2022. Most states with high rates of unfavorable general health were located Southeast of the country. Compared to men, only non-Hispanic-Black women (56.4 %vs.52.1 %,p = 0.011) and women aged "45-64"(58.5 %vs.56.3 %,p = 0.030) or "above74"(46.4 %vs.43.8 %,p = 0.024) had higher rates of unfavorable general health. Among both sexes, those aged 45-64 (Men:56.3 %,Women:58.5 %) and Hispanics (Men:57.8 %,Women:60.6 %) had the highest rates of unfavorable general health among different age and race groups. Based on the multivariate regression analysis, lower BMI(<18Kg/m2), being unemployed or homemaker, residing in the "stroke belt," physical inactivity, smoking, comorbidities/disabilities-including cardiovascular, pulmonary,and kidney diseases,diabetes, arthritis,cancer, blindness, difficulty walking/dressing-were associated with higher odds of unfavorable general health. In contrast, higher education and income, and heavy alcohol consumption were linked to lower odds.
CONCLUSION: This study highlights significant disparities in general health among stroke survivors in the US. Demographics, comorbidities/disabilities, physical activity, socioeconomic status, and environmental factors were associated with general health outcomes.