title: Socioeconomic status and stroke: an updated review.
abstract: OBJECTIVE
  Rates of stroke incidence and mortality vary across populations with important differences between socioeconomic groups worldwide. Knowledge of existing disparities in stroke risk is important for effective stroke prevention and management strategies. This review updates the evidence for associations between socioeconomic status and stroke.  Summary of Review- Studies were identified with electronic searches of MEDLINE and EMBASE databases (January 2006 to July 2011) and reference lists from identified studies were searched manually. Articles reporting the association between any measure of socioeconomic status and stroke were included.
  
  
  CONCLUSIONS
  The impact of stroke as measured by disability-adjusted life-years lost and mortality rates is >3-fold higher in low-income compared with high- and middle-income countries. The number of stroke deaths is projected to increase by >30% in the next 20 years with the majority occurring in low-income countries. Higher incidence of stroke, stroke risk factors, and rates of stroke mortality are generally observed in low compared with high socioeconomic groups within and between populations worldwide. There is less available evidence of an association between socioeconomic status and stroke recurrence or temporal trends in inequalities. Those with a lower socioeconomic status have more severe deficits and are less likely to receive evidence-based stroke services, although the results are inconsistent. Poorer people within a population and poorer countries globally are most affected in terms of incidence and poor outcomes of stroke. Innovative prevention strategies targeting people in low socioeconomic groups are required along with effective measures to promote access to effective stroke interventions worldwide.
authors.affiliation: King's College London, Division of Health and Social Care Research, 7th Floor Capital House, 42 Weston Street, London SE1 3QD, UK. Juliet.addo@kcl.ac.uk
authors.forename: Juliet
authors.initials: J
authors.lastname: Addo
authors.forename: Luis
authors.initials: L
authors.lastname: Ayerbe
authors.forename: Keerthi M
authors.initials: KM
authors.lastname: Mohan
authors.forename: Siobhan
authors.initials: S
authors.lastname: Crichton
authors.forename: Anita
authors.initials: A
authors.lastname: Sheldenkar
authors.forename: Ruoling
authors.initials: R
authors.lastname: Chen
authors.forename: Charles D A
authors.initials: CD
authors.lastname: Wolfe
authors.forename: Christopher
authors.initials: C
authors.lastname: McKevitt
mesh_terms: D019049:Developed Countries / Q000191:economics*; D003906:Developing Countries / Q000191:economics*; D006801:Humans; D016239:MEDLINE; D012008:Recurrence; D012959:Socioeconomic Factors; D020521:Stroke / Q000191:economics* / Q000401:mortality* / Q000517:prevention & control*