Location, location, location—this often repeated phrase in real estate, meant to emphasize the importance of geography, is equally applicable to health and health care. In the United States, the rural-urban disparity in age-adjusted mortality rate has increased dramatically over time, from an excess of 62 deaths per 100,000 in rural areas in 1999 to an excess of 170 deaths per 100,000 in 2019. There is a growing body of literature on rural-urban disparities in stroke, generally showing lower utilization of acute stroke therapies and higher stroke mortality in rural areas. In the March 2024 issue of Neurology®, Hart et al. report “Differences in Receipt of Neurologic Evaluation During Hospitalization For Ischemic Stroke by Race, Sex, Age, and Region: The REGARDS Study.”
In the study, published in Neurology, authors reviewed medical records to determine whether patients saw a neurologist during their stroke hospitalization and then looked for differences in key variables between those who saw a neurologist and those who did not. The study was co-authored by Virginia J. Howard, PhD, Distinguished Professor of Epidemiology at the UAB School of Public Health.