title: The effects of socioeconomic status on stroke risk and outcomes.
abstract: The latest evidence on socioeconomic status and stroke shows that stroke not only disproportionately affects low-income and middle-income countries, but also socioeconomically deprived populations within high-income countries. These disparities are reflected not only in risk of stroke but also in short-term and long-term outcomes after stroke. Increased average levels of conventional risk factors (eg, hypertension, hyperlipidaemia, excessive alcohol intake, smoking, obesity, and sedentary lifestyle) in populations with low socioeconomic status account for about half of these effects. In many countries, evidence shows that people with lower socioeconomic status are less likely to receive good-quality acute hospital and rehabilitation care than people with higher socioeconomic status. For clinical practice, better implementation of well established treatments, effective management of risk factors, and equity of access to high-quality acute stroke care and rehabilitation will probably reduce inequality substantially. Overcoming barriers and adapting evidence-based interventions to different countries and health-care settings remains a research priority.
authors.affiliation: Division of Health and Social Care Research, King's College London, London, UK. Electronic address: iain.marshall@kcl.ac.uk.
authors.forename: Iain J
authors.initials: IJ
authors.lastname: Marshall
authors.affiliation: Division of Health and Social Care Research, King's College London, London, UK; NIHR Biomedical Research Centre, Guy's and Saint Thomas' NHS Foundation Trust and King's College London, London, UK.
authors.forename: Yanzhong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Division of Health and Social Care Research, King's College London, London, UK.
authors.forename: Siobhan
authors.initials: S
authors.lastname: Crichton
authors.affiliation: Division of Health and Social Care Research, King's College London, London, UK; NIHR Biomedical Research Centre, Guy's and Saint Thomas' NHS Foundation Trust and King's College London, London, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: McKevitt
authors.affiliation: Division of Health and Social Care Research, King's College London, London, UK; NIHR Biomedical Research Centre, Guy's and Saint Thomas' NHS Foundation Trust and King's College London, London, UK.
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Rudd
authors.affiliation: Division of Health and Social Care Research, King's College London, London, UK; NIHR Biomedical Research Centre, Guy's and Saint Thomas' NHS Foundation Trust and King's College London, London, UK.
authors.forename: Charles D A
authors.initials: CD
authors.lastname: Wolfe
mesh_terms: D006297:Health Services Accessibility; D006801:Humans; D011787:Quality of Health Care; D012307:Risk Factors; D012923:Social Class; D012959:Socioeconomic Factors; D020521:Stroke / Q000209:etiology* / Q000628:therapy*