Neighborhood Social Cohesion May Reduce Stroke Mortality

Protective effect of neighborhood cohesion seen in whites, but not blacks

FRIDAY, April 15 (HealthDay News) -- Social cohesion at the neighborhood level is associated with a protective effect against stroke mortality, especially for whites, according to a study published online April 14 in Stroke.

Cari Jo Clark, Sc.D., from the University of Minnesota in Minneapolis, and colleagues examined the association between neighborhood social cohesion and the risk of stroke mortality, and the impact of race on this association. Data were collected from 5,789 older blacks and non-Hispanic white participants (mean age, 74.7 years) in the Chicago Health and Aging Project (mean age, 74.7 years), and the cause of death was identified from the National Death Index. Stroke incidence was determined in 3,816 participants based on Medicare claim files. Participants' social cohesion was measured by assessing the frequency of contact and social interaction with neighbors.

The investigators identified 186 stroke deaths and 701 first-ever strokes over 11 years of follow-up. There was a significant correlation between neighborhood social cohesion and a reduced risk of stroke mortality (hazard ratio [HR], 0.47 for each one point increase in social cohesion), after adjusting for confounders, including stroke risk factors, sociodemographics, and neighborhood socioeconomic status. The protective effect of neighborhood social cohesion was observed for whites (HR, 0.34) but not blacks (HR, 1.17). Stroke incidence was not linked to cohesion.

"This study found that neighborhood-level social cohesion was protective against stroke mortality but not stroke incidence in a cohort of older adults. Moreover, the benefits of cohesion on mortality risk were evident among whites but not blacks," the authors write.

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