Younger stroke survivors have less access to medical care, medications

November 13, 2006

Stroke survivors less than 65 years old report having more difficulty accessing physicians and affording medications than stroke survivors older than 65, according to an article posted online today that will appear in the January 2007 print issue of Archives of Neurology, one of the JAMA/Archives journals.

Approximately 5.4 million U.S. adults have survived a stroke, according to background information in the article. These individuals require comprehensive care to modify their risk factors for heart disease and prevent secondary strokes; the risk for recurrent strokes ranges from 5 percent to 15 percent each year. Additional strokes and other cardiovascular events, such as heart attack, in stroke survivors increase their rates of illness and death as well as their health care costs. Stroke survivors younger than age 65 may typically do not qualify for Medicare health insurance and are more likely to be uninsured than older stroke survivors.

Deborah A. Levine, M.D., M.P.H. Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, and colleagues assessed access to care among stroke survivors age 45 years and older who responded between 1998 and 2002 to the National Health Interview Survey, an annual government-conducted survey. Respondents answered questions about whether they had ever been diagnosed with stroke, if they had seen or talked to a general physician or specialist in the past 12 months, and whether they needed prescription medications in the past year but could not afford them.

Of the 3,681 total stroke survivors interviewed, 2,509 were age 65 and older (average age 76) and 1,172 were age 45 to 64 (average age 56). Compared with older stroke survivors, younger stroke survivors were more likely to be black (19 percent vs. 10 percent), male (52 percent vs. 47 percent) and to not have health insurance (11 percent vs. .4 percent).

They also were more likely to report not visiting a general physician (14 percent vs. 10 percent), not visiting a general physician or medical specialist (8 percent vs. 5 percent) and the inability to afford medications (15 percent vs. 6 percent). "Lack of health insurance explained some of the reduced access to physician care among younger stroke survivors but not their more frequent problems with medication affordability," the authors write.

Because treatments to prevent second strokes often include drugs to reduce blood pressure and cholesterol and are usually administered by a primary care physician, younger stroke survivors may be at higher risk for recurrence. "Further research is needed to determine whether this younger high-risk population has adverse outcomes, such as death and cardiovascular events, or has increased long-term health care utilization due to reduced access to physician care and medications," the authors conclude. "Further work addressing access gaps, linking to related health outcomes and costs and demonstrating the effectiveness and cost-effectiveness of possible improvement strategies is warranted."
(Arch Neurol. 2007;64:(doi:10.1001/archneur.64.1.noc60002). Available pre-embargo to the media at

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

For more information, contact JAMA/Archives Media Relations at 312/464-JAMA (5262) or e-mail

The JAMA Network Journals

Related Stroke Articles from Brightsurf:

Stroke alarm clock may streamline and accelerate time-sensitive acute stroke care
An interactive, digital alarm clock may speed emergency stroke care, starting at hospital arrival and through each step of the time-sensitive treatment process.

Stroke patients with COVID-19 have increased inflammation, stroke severity and death
Stroke patients who also have COVID-19 showed increased systemic inflammation, a more serious stroke severity and a much higher rate of death, compared to stroke patients who did not have COVID-19, according a retrospective, observational, cross-sectional study of 60 ischemic stroke patients admitted to UAB Hospital between late March and early May 2020.

'Time is vision' after a stroke
University of Rochester researchers studied stroke patients who experienced vision loss and found that the patients retained some visual abilities immediately after the stroke but these abilities diminished gradually and eventually disappeared permanently after approximately six months.

More stroke awareness, better eating habits may help reduce stroke risk for young adult African-Americans
Young African-Americans are experiencing higher rates of stroke because of health conditions such as high blood pressure, diabetes and obesity, yet their perception of their stroke risk is low.

How to help patients recover after a stroke
The existing approach to brain stimulation for rehabilitation after a stroke does not take into account the diversity of lesions and the individual characteristics of patients' brains.

Kids with headache after stroke might be at risk for another stroke
A new study has found a high incidence of headaches in pediatric stroke survivors and identified a possible association between post-stroke headache and stroke recurrence.

High stroke impact in low- and middle-income countries examined at 11th World Stroke Congress
Less wealthy countries struggle to meet greater need with far fewer resources.

Marijuana use might lead to higher risk of stroke, World Stroke Congress to be told
A five-year study of hospital statistics from the United States shows that the incidence of stroke has risen steadily among marijuana users even though the overall rate of stroke remained constant over the same period.

We need to talk about sexuality after stroke
Stroke survivors and their partners are not adequately supported to deal with changes to their relationships, self-identity, gender roles and intimacy following stroke, according to new research from the University of Sydney.

Standardized stroke protocol can ensure ELVO stroke patients are treated within 60 minutes
A new study shows that developing a standardized stroke protocol of having neurointerventional teams meet suspected emergent large vessel occlusion (ELVO) stroke patients upon their arrival at the hospital achieves a median door-to-recanalization time of less than 60 minutes.

Read More: Stroke News and Stroke Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to