(Research Hub Theater) Understanding the Relationship Between Social Risk Factors and Functional Limitation Among Stroke Survivors in the U.S

Background and/or Objectives: To examine the relationship between multiple social risk factors on functional limitation count in stroke survivors at the population level.

Design: Cross-sectional Design. Basic descriptive statistics were used to describe the overall population. Negative binomial regression models were run to test the relationship between the independent variables (economic instability, lack of community, educational deficit, food insecurity, social isolation, inadequate access to care) and dependent variables adjusting for covariates.

Setting: The National Health Interview Survey 2016-2018.

Participants: 3,103 Adults with Stroke.

Interventions: Not Applicable

Main Outcome Measures: Functional limitation count.

Results: Overall, 85% of the study sample was aged 50+, 69% were Non-Hispanic White, and 84% had at least one comorbidity. The sample included 50% men and 50% women. The mean functional limitation count reported from an adult stroke survivor was 1.8. In the fully adjusted model, an increased incidence rate of functional limitation was found in individuals reporting economic instability (IRR 1.67, 95% CI 1.35, 2.06), food insecurity (IRR 1.28, 95% CI 1.16, 1.42), and social isolation (IRR 1.65, 95% CI 1.50, 1.83). Lack of community, educational deficit, and inadequate access to care were not significantly associated with an increased incident rate of functional limitation.

Conclusions: Overall, in a sample population of U.S. stroke survivors, social risk factors are significantly associated with an increased incidence rate of functional limitations. Specifically, this study provides new knowledge by demonstrating economic instability, food insecurity, and social isolation increase rate of functional limitations in stroke survivors at a population level. Next steps need to examine pathways and mechanisms to inform interventions and promote the integration of social and medical care to mitigate functional limitations and improve health outcomes for stroke survivors at the population level.