00001 Demographic disparities in proximity to stroke care in the United States
ABSTRACT IMPACT: Given the association between lower time to treatment and better clinical outcomes in stroke patients, identifying factors correlated with reduced proximity and thus greater time to stroke care can aid efforts to reduce disparities in stroke outcomes. OBJECTIVES/GOALS: The objective...
Saved in:
| Published in: | Journal of clinical and translational science Vol. 5; no. s1; p. 26 |
|---|---|
| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Cambridge, UK
Cambridge University Press
01.03.2021
|
| Subjects: | |
| ISSN: | 2059-8661, 2059-8661 |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract | ABSTRACT IMPACT: Given the association between lower time to treatment and better clinical outcomes in stroke patients, identifying factors correlated with reduced proximity and thus greater time to stroke care can aid efforts to reduce disparities in stroke outcomes. OBJECTIVES/GOALS: The objective of this study is to quantify the relationship between distance to the nearest certified stroke hospital and census-derived demographics of age, race/ethnicity, income, and insurance status. METHODS/STUDY POPULATION: This is a cross-sectional study. Population data for all census tracts in the contiguous United States were obtained from the US Census Bureau’s 2014-2018 American Community Survey. Stroke hospitals were identified from national or state level certification databases and were required to offer at least IV tPA. The main outcome is driving distance in kilometers from each census tract to the nearest certified stroke center, which was calculated using OSMnx, a Python package to retrieve, model and analyze real-world street networks. Quantile regression analysis was used to compare relationships between distances and tract-level demographics of age, race/ethnicity, income, and insurance status. RESULTS/ANTICIPATED RESULTS: 2,423 stroke centers and 71,929 census tracts containing 316,995,649 individuals were included. 49,918 (69%) tracts were urban. Demographic disparities in proximity to certified stroke care were greater in non-urban areas than in urban areas. Higher representation of individuals with age ≤65 years were associated with increased median distance to a certified stroke center in non-urban areas, but not urban areas. Median distance was greater with greater representation of American Indian or uninsured populations in urban and non-urban census tracts. Higher median income was associated with decreased median distance in non-urban census tracts and greater median distance in urban census tracts. DISCUSSION/SIGNIFICANCE OF FINDINGS: Reduced proximity to stroke care exists in areas with greater representation of elderly, American Indian, or uninsured persons; and low median income. These disparities are magnified in non-urban settings. Such knowledge can aid efforts to address and reduce disparities in stroke outcomes. |
|---|---|
| AbstractList | ABSTRACT IMPACT: Given the association between lower time to treatment and better clinical outcomes in stroke patients, identifying factors correlated with reduced proximity and thus greater time to stroke care can aid efforts to reduce disparities in stroke outcomes. OBJECTIVES/GOALS: The objective of this study is to quantify the relationship between distance to the nearest certified stroke hospital and census-derived demographics of age, race/ethnicity, income, and insurance status. METHODS/STUDY POPULATION: This is a cross-sectional study. Population data for all census tracts in the contiguous United States were obtained from the US Census Bureau’s 2014-2018 American Community Survey. Stroke hospitals were identified from national or state level certification databases and were required to offer at least IV tPA. The main outcome is driving distance in kilometers from each census tract to the nearest certified stroke center, which was calculated using OSMnx, a Python package to retrieve, model and analyze real-world street networks. Quantile regression analysis was used to compare relationships between distances and tract-level demographics of age, race/ethnicity, income, and insurance status. RESULTS/ANTICIPATED RESULTS: 2,423 stroke centers and 71,929 census tracts containing 316,995,649 individuals were included. 49,918 (69%) tracts were urban. Demographic disparities in proximity to certified stroke care were greater in non-urban areas than in urban areas. Higher representation of individuals with age ≤65 years were associated with increased median distance to a certified stroke center in non-urban areas, but not urban areas. Median distance was greater with greater representation of American Indian or uninsured populations in urban and non-urban census tracts. Higher median income was associated with decreased median distance in non-urban census tracts and greater median distance in urban census tracts. DISCUSSION/SIGNIFICANCE OF FINDINGS: Reduced proximity to stroke care exists in areas with greater representation of elderly, American Indian, or uninsured persons; and low median income. These disparities are magnified in non-urban settings. Such knowledge can aid efforts to address and reduce disparities in stroke outcomes. |
| Author | Blaine, Timothy Panagos, Peter Yu, Cathy Y. Kansagra, Akash P. |
| AuthorAffiliation | Washington University School of Medicine |
| AuthorAffiliation_xml | – name: Washington University School of Medicine |
| Author_xml | – sequence: 1 givenname: Cathy Y. surname: Yu fullname: Yu, Cathy Y. – sequence: 2 givenname: Timothy surname: Blaine fullname: Blaine, Timothy – sequence: 3 givenname: Peter surname: Panagos fullname: Panagos, Peter – sequence: 4 givenname: Akash P. surname: Kansagra fullname: Kansagra, Akash P. |
| BookMark | eNpVkdtOAjEQhhuDiYjc-QB9AMG2e2h7Y2LwREL0Qrluut0pFGG7aauRt3dXjJGrOfyZb2byn6NB4xtA6JKSKSWUX5sUp4wwOs05PUFDRgo5EWVJB__yMzSOcUMIoYKVZZYN0TPpK3wHO78Kul07g2sXWx1cchCxa3Ab_JfbubTHyeOYgn8HbHSAXktrwMvGJajxa9IJ4gU6tXobYfwbR2j5cP82e5osXh7ns9vFxFBZ0okWXBZFlVtGSM1LW1YSOsWAlVJ21wLkjGeaCcELbq0wXJqKa0KYqGoubDZC8wO39nqj2uB2OuyV1079NHxYKR2SM1tQFWRQFN2_PDN5ZYUgknZbSEZra_Oi6Fg3B1b7Ue2gNtCkoLdH0GOlcWu18p9KCMZ5zjrA1QFggo8xgP2bpUT13qjOG9V7ozpvsm8v1YOK |
| ContentType | Journal Article |
| Copyright | The Association for Clinical and Translational Science 2021 2021 The Association for Clinical and Translational Science |
| Copyright_xml | – notice: The Association for Clinical and Translational Science 2021 2021 The Association for Clinical and Translational Science |
| DBID | AAYXX CITATION 5PM DOA |
| DOI | 10.1017/cts.2021.471 |
| DatabaseName | CrossRef PubMed Central (Full Participant titles) DOAJ Directory of Open Access Journals |
| DatabaseTitle | CrossRef |
| DatabaseTitleList | CrossRef |
| Database_xml | – sequence: 1 dbid: DOA name: DOAJ Directory of Open Access Journals url: https://www.doaj.org/ sourceTypes: Open Website |
| DeliveryMethod | fulltext_linktorsrc |
| EISSN | 2059-8661 |
| EndPage | 26 |
| ExternalDocumentID | oai_doaj_org_article_be3e5582673c4bf88091999031dff455 PMC8827742 10_1017_cts_2021_471 |
| GroupedDBID | 09C 09E 0R~ 8FE 8FH AABES AABWE AAGFV AAKTX AASVR AAYXX ABGDZ ABQTM ABROB ABVZP ABXHF ACAJB ACBEK ACDLN ACGFS ACUIJ ADAZD ADBBV ADDNB ADKIL ADOVH ADVJH AEBAK AEHGV AEMTJ AEYHU AFFHD AFKQG AFKRA AFLVW AFZFC AGABE AGJUD AHIPN AHQXX AHRGI AIGNW AIHIV AIOIP AJCYY AKMAY ALMA_UNASSIGNED_HOLDINGS ANPSP AQJOH ARCSS AUXHV AZGZS BBLKV BBNVY BCNDV BENPR BHPHI BLZWO BMAJL BRIRG CBIIA CCPQU CCQAD CFAFE CITATION CJCSC DOHLZ GROUPED_DOAJ HCIFZ HYE IKXGN IOEEP IPYYG JHPGK JKPOH JQKCU JVRFK KCGVB KFECR LK8 M7P M~E NIKVX OK1 PHGZM PHGZT PQGLB RCA ROL RPM S6U SAAAG T9M WFFJZ ZYDXJ 5PM |
| ID | FETCH-LOGICAL-c1961-a87955b4f200d76f6b9ec19cef999205ee4273a288757ff8c79cb7a0028bd78f3 |
| IEDL.DBID | DOA |
| ISSN | 2059-8661 |
| IngestDate | Tue Oct 14 19:05:55 EDT 2025 Tue Nov 04 01:58:00 EST 2025 Sat Nov 29 01:40:27 EST 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | s1 |
| Language | English |
| License | http://creativecommons.org/licenses/by/4.0 This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c1961-a87955b4f200d76f6b9ec19cef999205ee4273a288757ff8c79cb7a0028bd78f3 |
| OpenAccessLink | https://doaj.org/article/be3e5582673c4bf88091999031dff455 |
| PageCount | 1 |
| ParticipantIDs | doaj_primary_oai_doaj_org_article_be3e5582673c4bf88091999031dff455 pubmedcentral_primary_oai_pubmedcentral_nih_gov_8827742 crossref_primary_10_1017_cts_2021_471 |
| PublicationCentury | 2000 |
| PublicationDate | 2021-03-01 |
| PublicationDateYYYYMMDD | 2021-03-01 |
| PublicationDate_xml | – month: 03 year: 2021 text: 2021-03-01 day: 01 |
| PublicationDecade | 2020 |
| PublicationPlace | Cambridge, UK |
| PublicationPlace_xml | – name: Cambridge, UK |
| PublicationTitle | Journal of clinical and translational science |
| PublicationYear | 2021 |
| Publisher | Cambridge University Press |
| Publisher_xml | – name: Cambridge University Press |
| SSID | ssj0001826633 |
| Score | 2.1358123 |
| Snippet | ABSTRACT IMPACT: Given the association between lower time to treatment and better clinical outcomes in stroke patients, identifying factors correlated with... |
| SourceID | doaj pubmedcentral crossref |
| SourceType | Open Website Open Access Repository Index Database |
| StartPage | 26 |
| SubjectTerms | Clinical Epidemiology Data Science/Biostatistics/Informatics |
| Title | 00001 Demographic disparities in proximity to stroke care in the United States |
| URI | https://pubmed.ncbi.nlm.nih.gov/PMC8827742 https://doaj.org/article/be3e5582673c4bf88091999031dff455 |
| Volume | 5 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| journalDatabaseRights | – providerCode: PRVAEN databaseName: Cambridge University Press Wholly Gold Open Access Journals customDbUrl: eissn: 2059-8661 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0001826633 issn: 2059-8661 databaseCode: IKXGN dateStart: 20170201 isFulltext: true titleUrlDefault: http://journals.cambridge.org/action/login providerName: Cambridge University Press – providerCode: PRVAON databaseName: DOAJ Directory of Open Access Journals customDbUrl: eissn: 2059-8661 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0001826633 issn: 2059-8661 databaseCode: DOA dateStart: 20170101 isFulltext: true titleUrlDefault: https://www.doaj.org/ providerName: Directory of Open Access Journals – providerCode: PRVHPJ databaseName: ROAD: Directory of Open Access Scholarly Resources customDbUrl: eissn: 2059-8661 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0001826633 issn: 2059-8661 databaseCode: M~E dateStart: 20160101 isFulltext: true titleUrlDefault: https://road.issn.org providerName: ISSN International Centre – providerCode: PRVPQU databaseName: Biological Science Database customDbUrl: eissn: 2059-8661 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0001826633 issn: 2059-8661 databaseCode: M7P dateStart: 20170201 isFulltext: true titleUrlDefault: http://search.proquest.com/biologicalscijournals providerName: ProQuest – providerCode: PRVPQU databaseName: ProQuest Central customDbUrl: eissn: 2059-8661 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0001826633 issn: 2059-8661 databaseCode: BENPR dateStart: 20170201 isFulltext: true titleUrlDefault: https://www.proquest.com/central providerName: ProQuest |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV07T8MwELZQxcCCQIAoL3mAMZCHEzsjj1YMUDEA6mbFLxEhUtQGJBZ-O3d2QA0LC0uk5JzX57P8nXX-jpDjFDgFsAoIcpIMV6uMgiFl4yg2LIETpwqvpfd4wycTMZ2Wd0ulvjAnLMgDB-DOlM1sngMJ5plmyoG7lbhzHnzROMdyr14a83IpmPKrK3BDkWVdpjtqROsWxbnT5JTxpDcHean-3ymRS3PMeIOsd-SQnoeP2iQrttkiE780Tq_sS1CXrjU19QKLB6IWKq0biqkouE_pg7Yzumjns2dLMaMLbcDvaOCVNPDKbfIwHt1fXkddFYRIw-hIogrLgeeKOfBnwwtXqNKCRVsHMKRxbi0DClKlAqXpnROal1rxCoMpZbhw2Q4ZNLPG7hLqoElaFkIJ4ZgVFoJTIyqueOZio1kyJCffuMjXIHYhQxYYl4CfRPwk4DckFwjaTxuUqPYXoONk13Hyr44bEt6DvPe0vqWpn7zwNUQD6Fd7__H6fbKGvxPSyQ7IoJ2_2UOyqt_bejE_8t4Ex9vP0RcpU9Ag |
| linkProvider | Directory of Open Access Journals |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=00001+Demographic+disparities+in+proximity+to+stroke+care+in+the+United+States&rft.jtitle=Journal+of+clinical+and+translational+science&rft.au=Yu%2C+Cathy+Y.&rft.au=Blaine%2C+Timothy&rft.au=Panagos%2C+Peter&rft.au=Kansagra%2C+Akash+P.&rft.date=2021-03-01&rft.pub=Cambridge+University+Press&rft.eissn=2059-8661&rft.volume=5&rft.issue=Suppl+1&rft.spage=26&rft.epage=26&rft_id=info:doi/10.1017%2Fcts.2021.471&rft.externalDocID=PMC8827742 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=2059-8661&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=2059-8661&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=2059-8661&client=summon |