title: Education level explains differences in stroke incidence among city districts in Joinville, Brazil: a three-year population-based study.
abstract: BACKGROUND
  Current evidence suggests an inverse association between socioeconomic status and stroke incidence. Our aim was to measure the variation in incidence among different city districts (CD) and their association with socioeconomic variables.
  
  
  METHODS
  We prospectively ascertained all possible stroke cases occurring in the city of Joinville during the period 2005-2007. We determined the incidence for each of the 38 CD, age-adjusted to the population of Joinville. By linear regression analysis, we correlated incidence data with mean years of education (MYE) and mean income per month (MIPM).
  
  
  RESULTS
  Of the 1,734 stroke cases registered, 1,034 were first-ever strokes. In the study period, the crude incidence in Joinville was 69.5 per 100,000 (95% confidence interval, 65.3-73.9). The stroke incidence among CD ranged from 37.5 (22.2-64.6) to 151.0 per 100,000 (69.0-286.6). The stroke incidence was inversely correlated with years of education (r = -0.532; p < 0.001). MYE and MIPM were strongly related (R = 0.958), resulting in exclusion of MIPM by collinearity.
  
  
  CONCLUSIONS
  Years of education can explain a wide incidence variation among CD. These results may be useful to guide the allocation of resources in primary prevention policies.
authors.affiliation: Department of Medicine, Universidade da Região de Joinville, Joinville, Brazil. nlcabral@terra.com.br
authors.forename: Norberto L
authors.initials: NL
authors.lastname: Cabral
authors.forename: Alexandre
authors.initials: A
authors.lastname: Longo
authors.forename: Carla
authors.initials: C
authors.lastname: Moro
authors.forename: Priscila
authors.initials: P
authors.lastname: Ferst
authors.forename: Fabiano A
authors.initials: FA
authors.lastname: Oliveira
authors.forename: Celso V
authors.initials: CV
authors.lastname: Vieira
authors.forename: Jose
authors.initials: J
authors.lastname: Eluf-Neto
authors.forename: Luiz Augusto M
authors.initials: LA
authors.lastname: Fonseca
authors.forename: Anderson R R
authors.initials: AR
authors.lastname: Gonçalves
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000706:statistics & numerical data; D011446:Prospective Studies; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012959:Socioeconomic Factors; D020521:Stroke / Q000453:epidemiology*; D055815:Young Adult