Good neighbors increase stroke survival

By Dr. Ananya Mandal, MDApr 15 2011

A new U.S. study has shown that seniors who are able to count on their neighbors for help and conversation have better odds of surviving a stroke than those living in less sociable neighborhoods. Study author Cari Jo Clark, an assistant professor of medicine at the University of Minnesota said social isolation is unhealthy on many levels.

The study comes in Thursday's online issue of the journal Stroke and is unique in ways that it looked at social cohesion at the neighborhood level instead of just looking at individuals, she said. The study involved 5,789 seniors, with an average age of 75, living in three neighborhoods in Chicago. During 11 years of follow up, the investigators identified 186 stroke deaths and 701 first strokes. Seniors were questioned about neighborhoods The participants were interviewed about their communities, social interactions and signs of neighborhood friendliness, such as how often they saw neighbors and friends talking in the yard or in the street — often, sometimes, rarely or never. Seniors were also asked about how many neighbors they knew by name and whether they could call on them for help for some small errands.

Stroke rates did not differ by neighborhood, but the survival chances did showed the results. Each single point increase on a six-question scoring system for neighborhood “cohesion” was related to a 53 times higher chance of stroke survival, the researchers found. The finding remained significant even after taking into account factors such as socioeconomic status and cardiovascular risks, such as high blood pressure, smoking, physical inactivity, diabetes and obesity, the researchers noted.

“Given the importance of neighborhood environments to older individuals and the fact that the population is rapidly aging, the characteristics of neighborhoods are and will continue to be of relevance to public health policies,” the study's authors concluded. Clark said she thinks the findings indicate “that a positive neighborhood social environment is as important to senior health as stress or even crime, but it is really a complex issue.”

The study was sponsored by the U.S. National Institutes of Health, the Program in Health Disparities Research, and the Applied Clinical Research Program at the University of Minnesota.

“Further research is needed to understand the specific ways that neighborhood cohesion works to protect against stroke mortality and why this protective effect was not equally shared by blacks and whites in the study,” Clark said.

Scott C. Brown, a research assistant professor of epidemiology and public health at the University of Miami Miller School of Medicine, said that neighborhoods with shared values might also promote healthy behaviors among neighbors. As for why these findings were seen only in whites, Brown speculated that other factors might come in to play. “There may be unmeasured variables, such as crime or health-care access,” he explained. “You may have neighborhoods where neighbors are watching out for each other [but] there may be less access to health care, or no health insurance,” Brown said. Brown added, “It may have to do with neighbors' willingness to intervene in emergencies where a neighbor is showing symptoms of stroke, but more data are needed to really know.”