Transient Epidemic Stroke In The Mayo Clinic

The Mayo Clinic (2015) states that a stroke occurs when blood supply to the brain is reduced, this deprives human tissue of oxygen. As a result the cells in the deprived brain tissue die. There are three main types of stroke: 1) ischemic stroke [due to a blocked artery, this account for 85% of all strokes], 2) hemorrhagic stroke [leaking/bursting of an artery] and 3) Transient ischemic attack [temporary disturbance of blood flow to the brain]. The common risk factors for a stroke are obesity, inactivity, high blood pressure, smoking, diet, use of narcotics and heavy drinking.

The American Stroke Association (2015) estimated that in 2010 the prevalence of stroke was 33 million worldwide, and accounted for 11.13% of total deaths. It further found that the overall rate of stroke deaths has fallen 21% over the last 10 years although African Americans are twice as likely to die from a stroke. The World Health Organization (2015) defines health inequalities as differences in health status and/or the distribution of health
determinants among different populations. For example, the differences in stroke death rates between races can be seen as an inequality. Gillum, R. F., & Mussolino, M. E. (2003), further supported the inequalities in different races as the stroke mortality among black men was the highest for those whose income was below $5,000 USD (low SES) . Low SES is adversely related to many stroke risk factors, including: obesity, high alcohol consumption, and physical inactivity. Whereas, poverty and education were inversely associated with stroke incidence. The National Institutes of Health (2012) concluded that the race-specific death rates from stroke either increased or remained stable for Hispanics, Asians, and American Indians from 2009 to 2010 (shown in figure below). Overall, Gillum, R. F., & Mussolino, M. E. (2003) found that in the survival rate of a stroke victim is directly related to (hospital) aftercare and incidence rates, both of which are easily influenced by SES. The community environment largely influences SES in a social and physical context, respectively, applying those influences on health.

American Psychological Association explains that SES is widely used to determine the social standing of an individual.
Generally, SES takes into consideration income, occupation and education to determine social class and the inequalities in health. Atkinson, J., Salmond, C., Crampton, P. (2014) analysed the data from the NZDep2013 – index of deprivation as a measurement of SES. The index used eight social dimensions to measure SES, for instance, employment, income, family structure, communications, home ownership, housing, access to transport and, qualifications. The index categorises areas in a 1-10 scale to determine the amount of deprivation (ten being the most deprived and one being the least deprived). It is widely known that higher rates of socio-economic deprivation is linked to higher rates of mortality and many diseases. Hence why many indexes are used to prioritise health funding in a primary care context to minimise
inequalities.

Morgan, O., & Baker, A. (2006) evaluated the Carstairs 2001 deprivation index of England and Wales to measure SES through the four dimensions; overcrowding, low social class, unemployment, and, car ownership. The score was divided into quintiles, fifth being the most deprived and one being the least deprived. It found area based measurements to perform well in identifying inequalities and an easier alternative to individual based measurements. Although, both measurements are imperial to better determine the extent of health inequalities based on SES. Atkinson, J., Salmond, C., Crampton, P. (2014) and Morgan, O., & Baker, A. (2006), found that values varied greatly between neighbourhoods especially between rural and urban areas. In addition, comparing the NZDep2013 to the NZDep2006 and Carstairs 2001 to Carstairs 1991 indexes needs to be done with caution as dimensions differ. Therefore, this makes it difficult to compare SES over time in population based areas. In comparison, the NZDep2013 includes more in depth social dimensions in contrast to Carstairs 2001. For instance, the NZDep2013 included income x2, and qualifications which were both categorised under social class in Carstairs 2001.