ArticlePloS one2022
Socioeconomic status and stroke severity: Understanding indirect effects via risk factors and stroke prevention using innovative statistical methods for mediation analysis.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- A systematic review of causal pathways of socioeconomic inequalities in stroke.International journal of stroke : official journal of the International Stroke Society · 2026Pooled it
- Comparison of primary and secondary stroke outcomes between government and private healthcare institutions: insights from the SPRINT India trial.Frontiers in stroke · 2026Trial
- Disparities in Prehospital Stroke Care: Neighbourhood Socioeconomic Status and Delays in Hospital Presentation.Cerebrovascular diseases (Basel, Switzerland) · 2026Article
- Temporal Trends and Drivers of Socioeconomic Inequalities in Stroke Care, Survival, and Long-Term Outcomes.Journal of the American Heart Association · 2026Article
- Stroke awareness and response among university students in Jordan and Syria: a cross-sectional study.BMC public health · 2026Article
- Educational and Socioeconomic Correlates of Stroke Risk Behaviors: Findings from the SPRINT INDIA Trial.Annals of Indian Academy of Neurology · 2025Article
- Influence of smoking on glycaemic control in individuals with type 1 diabetes using flash glucose monitoring and its mediating role in the relationship between socioeconomic status and glycaemic control.Journal of diabetes and metabolic disorders · 2025Article
- Investigating Multiple Mediators to Mitigate Socioeconomic Differences in Patient-Reported Outcomes After Stroke: A Nationwide Register-Based Study.Journal of the American Heart Association · 2025Article
- Socioeconomic Status and Stroke: A Review of the Latest Evidence on Inequalities and Their Drivers.Stroke · 2025Review
- Mediating factors in the association between educational attainment and stroke: A mendelian randomization study.SSM - population health · 2025Article
- Equitable Access, Lasting Results: The Influence of Socioeconomic Environment on Bariatric Surgery Outcomes.Obesity surgery · 2025Article
- Article
- Association of aortic valve calcium with dementia and stroke: The Multi-Ethnic Study of Atherosclerosis.Atherosclerosis · 2024Article
- Retrospective review of food insecurity screening in an outpatient stroke clinic using electronic and paper-based surveys.Heliyon · 2024Article
- Article
- Development and Validation of Machine Learning Algorithms to Predict 1-Year Ischemic Stroke and Bleeding Events in Patients with Atrial Fibrillation and Cancer.Cardiovascular toxicology · 2024Article
- Educational attainment, severity and short-term prognosis of intracerebral haemorrhage.BMJ neurology open · 2024Article
- Mediation Analyses of the Mechanisms by Which Socioeconomic Status, Comorbidity, Stroke Severity, and Acute Care Influence Stroke Outcome.Neurology · 2023Article
- Racial and Ethnic Differences in the Risk of Ischemic Stroke After Nontraumatic Intracerebral Hemorrhage.Stroke · 2023Article
- Socioeconomic deprivation and post-stroke care in the community.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThose with low socioeconomic status have an increased risk of stroke, more severe strokes, reduced access to treatment, and more adverse outcomes after stroke. The question is why these differences are present. In this study we investigate to which extent the association between low socioeconomic status and stroke severity can be explained by differences in risk factors and stroke prevention drugs.
methodsThe study included 86 316 patients registered with an ischemic stroke in the Swedish Stroke Register (Riksstroke) 2012-2016. Data on socioeconomic status was retrieved from the Longitudinal integrated database for health insurance and labour market studies (LISA) by individual linkage. We used education level as proxy for socioeconomic status, with primary school education classified as low education. Stroke severity was measured using the Reaction Level Scale, with values above 1 classified as severe strokes. To investigate the pathways via risk factors and stroke prevention drugs we performed a mediation analysis estimating indirect and direct effects.
resultsLow education was associated with an excess risk of a severe stroke compared to mid/high education (absolute risk difference 1.4%, 95% CI: 1.0%-1.8%), adjusting for confounders. Of this association 28.5% was an indirect effect via risk factors (absolute risk difference 0.4%, 95% CI: 0.3%-0.5%), while the indirect effect via stroke prevention drugs was negligible.
conclusionAlmost one third of the association between low education and severe stroke was explained by risk factors, and clinical effort should be taken to reduce these risk factors to decrease stroke severity among those with low socioeconomic status.
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