Most pronounced increases seen in nonmetropolitan areas; proportion of deaths at home has increased
By Elana Gotkine HealthDay Reporter
FRIDAY, April 18, 2025 (HealthDay News) — Patterns of mortality and end-of-life care have changed among U.S. ischemic stroke patients, with increases in mortality seen across all urbanization levels, especially in nonmetropolitan areas, according to a study published online April 9 in PLOS ONE.
Jason K. Lim, from Georgetown University in Washington, D.C., and colleagues conducted a retrospective study using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research data to examine ischemic stroke mortality, stratified by urbanization level and race.
The researchers found that across all urbanization levels, the age-adjusted ischemic stroke mortality rates increased since 2009; the most pronounced increases were seen in nonmetropolitan areas. There was an increasing proportion of deaths at home, shifting from inpatient medical facilities. There were significant disparities in access to specialized end-of-life stroke care, especially for racial minorities and rural residents. The likelihood of dying in less specialized environments was increased for Black/African American individuals and those in rural settings due to health care access barriers.
“While disparities in mortality and location of death are well documented in this study, further work is needed to elucidate the causal mechanisms driving these inequities,” the authors write. “Addressing these disparities will require multifaceted strategies, including expanding telemedicine networks and mobile stroke units to bridge geographic gaps, as well as implementing culturally tailored prevention and education programs in underserved communities.”
One author disclosed ties to relevant organizations.
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