Association Between Sociodemographic Determinants and Disparities in Stroke Symptom Awareness Among US Young Adults

Stroke. 2020 Dec;51(12):3552-3561. doi: 10.1161/STROKEAHA.120.031137. Epub 2020 Oct 26.

Abstract

Background and purpose: Despite declining stroke rates in the general population, stroke incidence and hospitalizations are rising among younger individuals. Awareness of and prompt response to stroke symptoms are crucial components of a timely diagnosis and disease management. We assessed awareness of stroke symptoms and response to a perceived stroke among young adults in the United States.

Methods: Using data from the 2017 National Health Interview Survey, we assessed awareness of 5 common stroke symptoms and the knowledge of planned response (ie, calling emergency medical services) among young adults (<45 years) across diverse sociodemographic groups. Common stroke symptoms included: (1) numbness of face/arm/leg, (2) confusion/trouble speaking, (3) difficulty walking/dizziness/loss of balance, (4) trouble seeing in one/both eyes, and (5) severe headache.

Results: Our study population included 24 769 adults, of which 9844 (39.7%) were young adults who were included in our primary analysis, and represented 107.2 million US young adults (mean age 31.3 [±7.5] years, 50.6% women, and 62.2% non-Hispanic White). Overall, 2718 young adults (28.9%) were not aware of all 5 stroke symptoms, whereas 242 individuals (2.7%; representing 2.9 million young adults in the United States) were not aware of a single symptom. After adjusting for confounders, Hispanic ethnicity (odds ratio, 1.96 [95% CI, 1.17-3.28]), non-US born immigration status (odds ratio, 2.02 [95% CI, 1.31-3.11]), and lower education level (odds ratio, 2.77 [95% CI, 1.76-4.35]), were significantly associated with lack of symptom awareness. Individuals with 5 high-risk characteristics (non-White, non-US born, low income, uninsured, and high school educated or lower) had nearly a 4-fold higher odds of not being aware of all symptoms (odds ratio, 3.70 [95% CI, 2.43-5.62]).

Conclusions: Based on data from the National Health Interview Survey, a large proportion of young adults may not be aware of stroke symptoms. Certain sociodemographic subgroups with decreased awareness may benefit from focused public health interventions.

Keywords: awareness; disparities; population; risk factors; social determinants of health; young adult.

MeSH terms

  • Adult
  • Awareness
  • Black or African American / statistics & numerical data
  • Educational Status
  • Emigrants and Immigrants / statistics & numerical data
  • Ethnicity / statistics & numerical data*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Income / statistics & numerical data
  • Insurance, Health / statistics & numerical data*
  • Male
  • Medically Uninsured / statistics & numerical data
  • Stroke / physiopathology*
  • United States
  • White People / statistics & numerical data