Deprivation and stroke incidence, treatment and mortality in Germany

Abstract Background Previous research suggests that regional deprivation significantly influences the risk of stroke. However, little is known about regional differences in stroke incidence and mortality within Germany. Methods We utilized data from the Diagnosis Related Groups statistics (2016-2019) and the German Federal Register of Physicians (2019). We used negative binomial regression analysis to investigate the relationship between the German Index of Multiple Deprivation 2015, covering 401 districts and district-free cities in Germany, and stroke incidence, treatment, and mortality. Results The adjusted rate ratios of stroke incidence and mortality with the highest deprivation level compared with the least deprived area were 1.16 (95% CI [1.14, 1.17]) and 1.19 (95% CI [1.14, 1.23]), respectively. Furthermore, this study showed that the density of physicians was higher in district-free cities than in districts. Conclusions The findings document a relationship between regional deprivation and stroke incidence and mortality, and call for a more targeted approach to stroke prevention in deprived regions. Key messages • Regional deprivation in Germany linked to increased stroke incidence and mortality rates. • Policy action needed for effective prevention measures.