News Summary

• Medical School researchers found that he odds of surviving stroke appear to be much better for seniors living in neighborhoods where they interact with their neighbors and count on them for help.
• The study is published in Stroke: Journal of the American Heart Association.
• The data stems from interviews with nearly 6,000 seniors living in the Chicago area.

Quotes

“Social isolation is unhealthy on many levels, and there is a lot of literature showing that increased social support improves not just stroke survival rates, but many other health outcomes in seniors,” said Cari Jo Clark, Sc.D., lead author of the study and assistant professor of medicine at the University of Minnesota Medical School. “What’s unique about our research is that we have taken this to the neighborhood level instead of just looking at the individual.”

“I think this indicates that a positive neighborhood social environment is as important to senior health as stress or even crime, but it is a really complex issue,” Clark said. “Nonetheless, it underscores the positive aspects of close neighbors and neighborhoods, and should help bolster efforts to improve such cohesiveness.”

Full Text

MINNEAPOLIS / ST. PAUL (April 14, 2011) – The odds of surviving stroke appear to be much better for seniors living in neighborhoods where they interact with their neighbors and count on them for help, according to research published in Stroke: Journal of the American Heart Association today.

“Social isolation is unhealthy on many levels, and there is a lot of literature showing that increased social support improves not just stroke survival rates, but many other health outcomes in seniors,” said Cari Jo Clark, Sc.D., lead author of the study and assistant professor of medicine at the University of Minnesota Medical School. “What’s unique about our research is that we have taken this to the neighborhood level instead of just looking at the individual.”

Clark and colleagues at the University of Minnesota and Rush University in Chicago studied 5,789 seniors (60 percent women, 62 percent black, average age 75) living in three adjacent neighborhoods in Chicago. Researchers interviewed the participants about their neighborhood and their interactions with neighbors.

About the study
Using the National Death Index and Medicare claim files, they identified 186 stroke deaths and 701 first strokes over 11 years of follow-up. In their analysis, they factored out such potential contributing variables as socioeconomic status and cardiovascular risk factors like high blood pressure, smoking, physical inactivity, diabetes and obesity.

The researchers used six items measuring a senior’s “cohesiveness” to their neighborhood. Interview questions gauging these items ranged from how many neighbors the participants knew by name, interacted with or asked a favor of. The questions also gauged how frequently participants saw neighbors interacting and taking care of each other.

For each single point increase in the neighborhood “cohesion” scoring system, survival increased 53 percent. While stroke incidence didn’t differ among neighborhoods, stroke survival was far better for seniors living in “cohesive” neighborhoods, regardless of their gender. However, the benefit was only observed among whites.

“I think this indicates that a positive neighborhood social environment is as important to senior health as stress or even crime, but it is a really complex issue,” Clark said. “Nonetheless, it underscores the positive aspects of close neighbors and neighborhoods, and should help bolster efforts to improve such cohesiveness.”

Contributing factors
One possible reason for improved survival is that seniors living in closer neighborhoods have others looking out for them. Help is available sooner if they start experiencing stroke symptoms.

For seniors who are less mobile, neighborhood conditions may be especially relevant. Recent longitudinal research has found a significant protective relationship between social support and stroke mortality, but not stroke incidence.

Why seniors in African-American neighborhoods didn’t fare as well is unclear and further research is needed, Clark said.

“Obviously, a complex set of factors influences health in older adults and we need to be careful drawing conclusions from these data. Other research also has shown that the health protective effects of cohesive neighborhoods may be stronger in whites. We plan to conduct future studies to try to understand these findings.”

The study was funded by a National Institutes of Health grant to Dr. Susan Everson-Rose, the principal investigator of the study, with additional support from the Program in Health Disparities Research and the Applied Clinical Research Program at the University of Minnesota.