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  • Spatiotemporal Analysis of the Relationship Between Socioeconomic Factors and Mortality Due to Nontraumatic Intracerebral Hemorrhage in New Orleans from 1880-1915

    Final Number:

    Ken Michael Porche MD; Sheridan Wright Kennedy

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2017 Annual Meeting

    Introduction: Intracerebral hemorrhage (ICH) has been shown to display variations in geographic distribution, age, and racial predisposition. Understanding spatial disparities in the association between socioeconomic factors and ICH is critical to target public health initiatives aiming to mitigate or prevent this disease. We aimed to describe the historical trends of mortality due to ICH during a time of massive expansion in New Orleans (1880-1915). This analysis is part of the New Orleans Mortality Project which brings together historical perspective and new spatiotemporal approaches to understand how health, environment, and socioeconomics impacted urban and community development in New Orleans, 1880-1915.

    Methods: As part of the New Orleans Mortality Project, we constructed a 50,000-person mortality database from death certificates, a 40,000-record property value database from tax ledgers, and base-level population datasets from city directories. 1507 patients died of ICH (age 60.2 ± 15.8; 54.4% Male; 69.2% White). We built historical address locators to geocode these datasets. We used geographically weighted regression to analyze the connections among mortality due to ICH, all-cause mortality, population density, age, socioeconomics, and environmental factors. Eight time periods were analyzed at 5-year intervals from 1880-1915.

    Results: The results of this analysis will reveal processes of the mortality transitions and the evolution and effects of urban disease terrains on individual and community development. Preliminary analyses have shown evolving areas of increased rates of death due to ICH (corrected for all-cause mortality and population density) along the periphery of population growth into areas of low income. Further analysis is required to describe the relationship due to race, sex, and age.

    Conclusions: Mortality due to ICH (although a heterogeneous diagnosis) has ties to socioeconomic status as evident by its spatiotemporal evolution during the expansion and urban sprawl of New Orleans, 1880-1915. This relationship can be extrapolated and further compared to modern day trends.

    Patient Care: By improving physician understanding of the historical ties of ICH to socioeconomic status and urban sprawl.

    Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the connection of ICH mortality to socioeconomic status, 2) Describe the association with sex, age, and race, 3) Be able to extrapolation the analysis to their own area

    References: Howard, George, Mary Cushman, Virginia J. Howard, Brett M. Kissela, Dawn O. Kleindorfer, Claudia S. Moy, Jeffery Switzer, and Daniel Woo. “Risk Factors for Intracerebral Hemorrhage: The REasons for Geographic and Racial Differences in Stroke (REGARDS) Study.” Stroke 44, no. 5 (May 2013): 1282–87. doi:10.1161/STROKEAHA.111.000529. Lee, Sang-Hoon, Kyung-Jae Park, Dong-Hyuk Park, Shin-Hyuk Kang, Jung-Yul Park, and Yong-Gu Chung. “Factors Associated with Clinical Outcomes in Patients with Primary Intraventricular Hemorrhage.” Medical Science Monitor: International Medical Journal of Experimental and Clinical Research 23 (March 22, 2017): 1401–12. Oliveira, André, António J. R. Cabral, Jorge M. Mendes, Maria R. O. Martins, and Pedro Cabral. “Spatiotemporal Analysis of the Relationship between Socioeconomic Factors and Stroke in the Portuguese Mainland Population under 65 Years Old.” Geospatial Health 10, no. 2 (November 4, 2015). Tsuji, Atsushi, and Kazuhiko Nozaki. “Clinical Relevance of Racial Differences in Cerebrovascular Diseases.” World Neurosurgery 84, no. 3 (September 2015): 636–37. doi:10.1016/j.wneu.2015.04.062. Xing, Yonghong, Zhongping An, Xianghui Zhang, Ning Yu, Wenjuan Zhao, Xianjia Ning, and Jinghua Wang. “Sex Differences in the Clinical Features, Risk Factors, and Outcomes of Intracerebral Hemorrhage: A Large Hospital-Based Stroke Registry in China.” Scientific Reports 7, no. 1 (March 21, 2017): 286. doi:10.1038/s41598-017-00383-6.

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