Macroeconomic Development and Dramatic Increase in Stroke Burden in Rural China: A 25-Year Population-Based Study
Low socioeconomic status is associated with a high stroke risk. However, few studies have quantitatively assessed the relationship between stroke burden and national economic development indicators. We explored the quantitative association between macroeconomic development and stroke burden in rural...
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Frontiers Media S.A.
2020-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.00385/full |
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| author | Peng Zhao Jie Liu Jie Liu Jie Liu Yuhan Hao Qiuxing Lin Qiuxing Lin Qiuxing Lin Ying Gao Jun Tu Jun Tu Jun Tu Jinghua Wang Jinghua Wang Jinghua Wang Yaogang Wang Xianjia Ning Xianjia Ning Xianjia Ning |
| author_facet | Peng Zhao Jie Liu Jie Liu Jie Liu Yuhan Hao Qiuxing Lin Qiuxing Lin Qiuxing Lin Ying Gao Jun Tu Jun Tu Jun Tu Jinghua Wang Jinghua Wang Jinghua Wang Yaogang Wang Xianjia Ning Xianjia Ning Xianjia Ning |
| author_sort | Peng Zhao |
| collection | DOAJ |
| description | Low socioeconomic status is associated with a high stroke risk. However, few studies have quantitatively assessed the relationship between stroke burden and national economic development indicators. We explored the quantitative association between macroeconomic development and stroke burden in rural China. In this population-based, prospective study (1992–2016), we collected data on annual registrations of stroke events and deaths in Tianjin, China. Economic development over the period was represented by gross domestic product annually adjusted for purchasing power parity (PPP-aGDP) and per capita net income (PCNI) of rural residents in China. We assessed the association of first-ever stroke incidence with PPP-aGDP and PCNI. During the 25-year study period, there were 1,185 stroke events and 362,296 person years of surveillance. First-ever stroke incidence increased by an average of 10.7% per 1,000 USD increase in overall PPP-aGDP and by 12.0% per 1,000 Yuan increase in PCNI; respectively, the mean increases were 9.6 and 10.8% in men and 13.0 and 14.4% in women (all, P < 0.001). These same changes in PPP-aGDP and PCNI also resulted in increases in the incidence of ischemic stroke (12.6 and 14.3%, respectively; P < 0.05), and intracerebral hemorrhage (both, 6.2%; P < 0.05). Similarly, in men, the age of onset of intracerebral hemorrhage decreased by 0.96-years (P = 0.002) for each 1,000 USD increase in PPP-aGDP and by 1.08-years (P = 0.003) for each 1,000 Yuan increase in PCNI. Macroeconomic development was positively associated with stroke incidence in rural China. Thus, enhancing health-care investments is crucial for containing the stroke burden during this remarkable economic development in China. Our findings could guide other developing countries with information regarding the timely control of stroke risk factors and reductions in stroke burden during the initial stages of economic development. |
| first_indexed | 2024-12-12T23:23:41Z |
| format | Article |
| id | doaj.art-27e26f5ac7c74ebeb17176a8b9012c36 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-12T23:23:41Z |
| publishDate | 2020-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-27e26f5ac7c74ebeb17176a8b9012c362022-12-22T00:08:11ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-05-011110.3389/fneur.2020.00385537158Macroeconomic Development and Dramatic Increase in Stroke Burden in Rural China: A 25-Year Population-Based StudyPeng Zhao0Jie Liu1Jie Liu2Jie Liu3Yuhan Hao4Qiuxing Lin5Qiuxing Lin6Qiuxing Lin7Ying Gao8Jun Tu9Jun Tu10Jun Tu11Jinghua Wang12Jinghua Wang13Jinghua Wang14Yaogang Wang15Xianjia Ning16Xianjia Ning17Xianjia Ning18Department of Neurology, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Neurology, Tianjin Medical University General Hospital, Tianjin, ChinaLaboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, ChinaKey Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin Neurological Institute, Tianjin, ChinaDepartment of Neurology, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Neurology, Tianjin Medical University General Hospital, Tianjin, ChinaLaboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, ChinaKey Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin Neurological Institute, Tianjin, ChinaHealth Management Centre, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Neurology, Tianjin Medical University General Hospital, Tianjin, ChinaLaboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, ChinaKey Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin Neurological Institute, Tianjin, ChinaDepartment of Neurology, Tianjin Medical University General Hospital, Tianjin, ChinaLaboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, ChinaKey Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin Neurological Institute, Tianjin, ChinaSchool of Public Health, Tianjin Medical University, Tianjin, ChinaDepartment of Neurology, Tianjin Medical University General Hospital, Tianjin, ChinaLaboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, ChinaKey Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin Neurological Institute, Tianjin, ChinaLow socioeconomic status is associated with a high stroke risk. However, few studies have quantitatively assessed the relationship between stroke burden and national economic development indicators. We explored the quantitative association between macroeconomic development and stroke burden in rural China. In this population-based, prospective study (1992–2016), we collected data on annual registrations of stroke events and deaths in Tianjin, China. Economic development over the period was represented by gross domestic product annually adjusted for purchasing power parity (PPP-aGDP) and per capita net income (PCNI) of rural residents in China. We assessed the association of first-ever stroke incidence with PPP-aGDP and PCNI. During the 25-year study period, there were 1,185 stroke events and 362,296 person years of surveillance. First-ever stroke incidence increased by an average of 10.7% per 1,000 USD increase in overall PPP-aGDP and by 12.0% per 1,000 Yuan increase in PCNI; respectively, the mean increases were 9.6 and 10.8% in men and 13.0 and 14.4% in women (all, P < 0.001). These same changes in PPP-aGDP and PCNI also resulted in increases in the incidence of ischemic stroke (12.6 and 14.3%, respectively; P < 0.05), and intracerebral hemorrhage (both, 6.2%; P < 0.05). Similarly, in men, the age of onset of intracerebral hemorrhage decreased by 0.96-years (P = 0.002) for each 1,000 USD increase in PPP-aGDP and by 1.08-years (P = 0.003) for each 1,000 Yuan increase in PCNI. Macroeconomic development was positively associated with stroke incidence in rural China. Thus, enhancing health-care investments is crucial for containing the stroke burden during this remarkable economic development in China. Our findings could guide other developing countries with information regarding the timely control of stroke risk factors and reductions in stroke burden during the initial stages of economic development.https://www.frontiersin.org/article/10.3389/fneur.2020.00385/fullstrokemacroeconomic developmentepidemiologyincidencetrends |
| spellingShingle | Peng Zhao Jie Liu Jie Liu Jie Liu Yuhan Hao Qiuxing Lin Qiuxing Lin Qiuxing Lin Ying Gao Jun Tu Jun Tu Jun Tu Jinghua Wang Jinghua Wang Jinghua Wang Yaogang Wang Xianjia Ning Xianjia Ning Xianjia Ning Macroeconomic Development and Dramatic Increase in Stroke Burden in Rural China: A 25-Year Population-Based Study Frontiers in Neurology stroke macroeconomic development epidemiology incidence trends |
| title | Macroeconomic Development and Dramatic Increase in Stroke Burden in Rural China: A 25-Year Population-Based Study |
| title_full | Macroeconomic Development and Dramatic Increase in Stroke Burden in Rural China: A 25-Year Population-Based Study |
| title_fullStr | Macroeconomic Development and Dramatic Increase in Stroke Burden in Rural China: A 25-Year Population-Based Study |
| title_full_unstemmed | Macroeconomic Development and Dramatic Increase in Stroke Burden in Rural China: A 25-Year Population-Based Study |
| title_short | Macroeconomic Development and Dramatic Increase in Stroke Burden in Rural China: A 25-Year Population-Based Study |
| title_sort | macroeconomic development and dramatic increase in stroke burden in rural china a 25 year population based study |
| topic | stroke macroeconomic development epidemiology incidence trends |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.00385/full |
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