Jan. 5, 01:00 EDT
  Study finds money a factor in surviving stroke
                                           Mike Oliveira
                                        CANADIAN PRESS
  Income and social status can affect a person's chances of surviving a stroke
and the quality of care afterward, a new
  Canadian study shows.

  The study by the Institute for Clinical Evaluative Sciences found that for
every $10,000 increase in median
  neighbourhood income, there was a 9 per cent decrease in mortality rates 30
days after a stroke, and a 5 per cent drop
  in deaths after one year.

  "It's been looked at for other medical conditions with similar findings and
this study confirms ... it's fairly widespread that
  socio-economic status appears to have a major impact," said Moira Kapral, one
of the authors of the report.

  The study also found that lower-income patients were less likely to have
access to certain types of medical care such as  rehabilitation, occupational
therapy, speech therapy and neurological care.

  Kapral said variables aside from income also factor into mortality rates. "I
think we need broader social changes to
  address these issues and not just medical changes," she said. "Elimination or
reduction of poverty would probably have a  far greater impact than anything
that physicians could do."

  The study did not identify reasons for the disparities.

  But it suggested that higher-income patients have better access to specialized
hospitals and physicians because affluent   neighbourhoods are more likely to
attract new facilities and funding.

  The report, titled Effect of Socio-economic Status on Treatment and Mortality
after Stroke, is based on the health
  records of 38,945 patients in Ontario hospitals between April, 1994 and March,
1997.

  "The results are probably going to be similar across the country ... because
we were able to look at both rural and urban  areas," said Kapral.

  The researchers said the study had some limitations: It was unable to account
for stroke severity, it lacked information on  specific care provided, and on
other outcomes, such as recovery and functional status after stroke.

  According to the Heart and Stroke Foundation of Canada, strokes are the fourth
leading cause of death in the country.

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