2102 Redlining is a Structural Risk Factor for Stroke in Virginia

INTRODUCTION: Stroke is the leading cause of death for Americans and results in devastating losses in physical function, speech, cognition and death. Despite decades of research and funding by the National Institute of Health (NIH) negative outcomes continue to disproportionately affect ethnic minority communities. METHODS: Data was obtained from CDC Places: Local Data for Better Health, the University of Richmond’s “Mapping Inequality” website, and the CDC Stroke websites. Descriptive statistics, Fisher’s Exact Test, Pearson Correlation analysis, and logistic regression analysis were performed to evaluate the association between redlining scores, stroke risk factors and health outcomes. RESULTS: Pearson Correlation analysis identified significant correlations between HOLC Scores and various health outcomes: smoking prevalence (r=0.50, p<0.0001), high blood pressure prevalence (r = 0.29, p<0.0001), stroke prevalence (r = 0.37, p<0.0001), coronary heart disease prevalence (r = 0.18, p=0.006), and lack of health insurance prevalence (r = 0.53, p<0.0001). Individuals in redlined areas had a 1.15 times greater odds of smoking prevalence (95% CI: 1.06-1.97, p<0.001), a 1.08 times greater odds of high blood pressure prevalence (95% CI: 1.05-1.10, p<0.001), a 1.82 times greater odds of stroke prevalence (95% CI: 1.55-2.13, p<0.001), a 1.30 times greater odds of coronary heart disease prevalence (95% CI: 1.17-1.45, p<0.001), and a 1.16 times greater odds of lack of health insurance prevalence (95% CI: 1.11-1.21, p<0.001). Stroke death rate was significantly higher in African Americans compared to Caucasians (249.06 ± 163.92 and 156.51 ± 132.67 respectively, p-value<0.001). CONCLUSIONS: Our results indicate there are increased rates of stroke mortality, prevalence and stroke risk factors such as smoking, hypertension and coronary heart disease in counties that were previously redlined in the state of Virginia.