Racial Disparities in Subarachnoid Hemorrhage Mortality: Los Angeles County, California, 1985–1998

Abstract

We examined the racial distribution of subarachnoid hemorrhage (SAH) mortality in a unique multiracial community. Mortality rates for SAH among the residents of Los Angeles County were calculated from death certificate data (1985–1998). Residential postal zones were classified into three strata as a measure of socioeconomic status. The number of SAH deaths was 2,897. The age-adjusted SAH mortality rate was 1.9 in whites, 2.7 in Hispanics, 3.0 in Asians and 3.7 in blacks. In those younger than 70 years of age, the SAH mortality rate among blacks was 2.2 times that of whites and 1.8 times that of Hispanics and Asians. The SAH mortality rate declines after age 70 in blacks. The SAH mortality rate was higher in women than in men in all races and it was highest in elderly Asian women (23.5 per 100,000). An inverse relationship was observed between income and SAH mortality rates in all racial groups except whites.

Effect of Socioeconomic Status on Inpatient Mortality and Use of Postacute Care After Subarachnoid Hemorrhage

“…5,6 The Finnish contribution to the World Health Organization Multinational Monitoring of trends and determinants of Cardiovascular (17) 567 (17) 555 (18) 502 (17) 2844 (17) Hospital (24) 874 (25) 808 (25) 795 (25) 704 (25) 4073 (25) Discharge status 0.278…”

“…The FINMONICA study might have been underpowered to detect significant associations at older age. A study of annual SAH mortality across ethnic/racial groups by household income in Los Angeles 5 found an inverse income-mortality association among minority populations only. Our more inclusive analysis did not indicate that ethnicity/race significantly alters the effect of SES on inpatient mortality.…”

“…3,4 Our search found only 2 small studies that partially addressed this topic in SAH using data from >10 years ago. 5,6 In undertaking this study, we aimed to provide nationally representative data on the relationship between SES and SAH outcomes, specifically inpatient mortality and overall use of institutional postacute care, comparing results across 2 different healthcare systems. The variations in outcome patterns, if any, may offer clues to unbundling some of the contributory factors to the effect of SES.…”

Role of HCN Channels in Neuronal Hyperexcitability after Subarachnoid Hemorrhage in Rats

“…It has been estimated that 1-6% of the world population may harbor an intracranial aneurysm and that each year ϳ10/100,000 people suffer from an aneurysmal subarachnoid hemorrhage (SAH) (McCormick and Nofzinger, 1965;Schievink et al, 2004). Despite major advances in surgical techniques, radiology, and anesthesiology, the mortality and morbidity rates after spontaneous SAH have shown a moderate reduction in recent years (Schievink et al, 2004;Nieuwkamp et al, 2009;Lovelock et al, 2010).…”

“…Despite major advances in surgical techniques, radiology, and anesthesiology, the mortality and morbidity rates after spontaneous SAH have shown a moderate reduction in recent years (Schievink et al, 2004;Nieuwkamp et al, 2009;Lovelock et al, 2010). Early brain injury including electrophysiological disorders, rather than cerebral vasospasm (Vajkoczy et al, 2005), may contribute to the high mortality and morbidity rate of SAH (Cahill et al, 2006;Pluta et al, 2009).…”