While it has long been recognized that social environment can have a powerful impact on cardiovascular health and stroke risk, recent attention has been turned to physical and biochemical environment, as well.
Social determinants for health
The social determinants for health (SDOH) are those non-medical, social factors that impact health, quality of life, and risk factors for various health conditions. These factors are impacted by economic policies, social norms, and political systems. The top social determinants for health include:
- Availability of social services
- Employment and working conditions
- Income and wealth distribution
- Ability to obtain quality education
- Access to quality healthcare
- Quality of food and housing
An ongoing, longitudinal study sponsored by NIH, known as REGARDS (REasons for Geographic And Racial Differences in Stroke), is following approximately 30,000 Americans aged 45 and over to determine the causes of excess stroke events and excess mortality in the southeastern U.S., especially among African Americans. Seven key SDOH factors followed were race, educational level, zip code, poverty level, health insurance, social isolation, and residence in one of the 10 states ranked lowest in public health infrastructure.
The study has found that the incidence of stroke is higher in Blacks than in whites. People with three or more SDOH were nearly 2.5 times more likely to have a stroke than those without; and stroke risk was 50% higher among these individuals, even after adjusting for known health risk factors, such as hypertension, diabetes, and tobacco use.
This last point indicates that the social environment has a significantly greater impact on stroke risk than previously realized. Most emphasis has been placed on addressing health issues when social issues also need to be addressed.
Physical environment and stroke risk
Recent studies are examining the effect of air pollution, environmental and occupational noise, altitude (including airplanes), seasonality and temperature, and various metals and chemical exposure for their impact on cardiovascular disease and stroke.
While more studies need to be done in these areas, several recent studies report interesting findings:
- A study done with 31,000 adults who suffer from an irregular heartbeat found that for every 6% increase in particulate matter, the risk of stroke increases by 8%. Those with the highest levels of pollution were 20-36% more likely to suffer a stroke.
- Those who experience high levels of chronic noise exposure, such as aircraft and highway noise, have an increased risk of heart attacks and stroke. The noise seems to activate the stress response in the brain, with higher levels of amygdala activity and blood vessel inflammation. Those with the highest levels of noise had a greater than threefold risk of suffering heart attack or stroke compared with those who had low levels of noise exposure.
- Changes in altitude can have an effect on those who are not born at higher altitudes. The body takes time to adjust, and depending upon the speed of change of altitude, stroke or stroke-like symptoms can occur. Even long-term stays can impact health for those born at lower altitudes: A relative risk of stroke above an altitude of 3000m is increased by a factor of up to 10 times; extreme altitudes over 5000m are associated with a 30-fold risk of spontaneous vascular thrombosis.
- Admission to hospitals for ischemic stroke seems to be cyclical throughout the year. This seasonality has been observed worldwide, but the seasonal peaks and lows can differ by country and region.
Studies continue to be performed to determine the many factors that contribute to stroke risk and how to address and mitigate these risks. At Neuralert, we are committed to decreasing the damage that can be caused by stroke by providing individuals, doctors, and medical facilities with the technology to be alerted at the first sign of a possible stroke. Quick action has been found to significantly improve the recovery of stroke patients and limit long-term damage.
Neuralert’s stroke detection monitor consists of a non-invasive wristband that looks like a smartwatch, paired with state-of-the-art artificial intelligence technology that can evaluate the most common signs of potential stroke and immediately alert health professionals to evaluate the patient. Our AI algorithm is so accurate that there are nearly zero false alarms. Both patients and medical professionals know that, when a Neuralert alarm sounds, quick action can mean a lower risk of serious morbidity or mortality. Contact us to learn more about how Neuralert’s innovative stroke monitor can help you.
