In conclusion, SED is a predictor of stroke mortality. Both childhood and adulthood SED were related to the risk of stroke. Stroke mortality increased with improving SED at a lower stage of development, while it decreased with SED improvement at a higher stage of development. The analysis was conducted among middle- or high-income countries/regions as data only available there. Investigation for low-income countries is warranted as data become available. / Keywords. Socioeconomic development; stroke; mortality / Socioeconomic development (SED) relates to the prevalence of risk factors of stroke and influence health policy. We aim to explore the association of (SED) in childhood and adulthood with stroke mortality among countries/regions, and to examine its impact on time trend of stroke mortality. / The ecological study used data on stroke mortality in five-year age group among countries/regions with death registry covering > 70% population provided by the World Health Organization. SED was measured by Human Development Index (HDI), a composite indicator with longevity, education and standard of living, obtained from the United Nations. Mortality rates (1950-2003) were averaged over three years and in logarithmical scale. HDI from 1960 to 2003 were available for this analysis. The effect of HDI on stroke mortality was analyzed and the major confounders, such as prevalence of hypertension, smoking, diabetes, obesity, and the level of dietary fat and alcohol consumption were adjusted for using regression model. / The results revealed that stroke mortality was inversely associated with HDI in childhood and adulthood respectively. Childhood HDI explained 36% of variance of stroke mortality among countries/regions in men and 35% in women; while adulthood HDI interpreted 34% in men and 52% in women (P < 0.01); annual change of stroke mortality was inversely associated with that of HDI. The peak of stroke mortality was exhibited at HDI = 0.79-0.83 for men and 0.80-0.83 for women. Stroke mortality increased with HDI where HDI < 0.79 for men and 0.80 for women, while it decreased with HDI improvement where HDI > 0.83 for men and women. Controlling for confounders did not materially change the results. / Wu, Shenghui. / Adviser: Xin-Hua Zhang. / Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3468. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 189-218). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.
| Identifer | oai:union.ndltd.org:cuhk.edu.hk/oai:cuhk-dr:cuhk_344208 |
| Date | January 2008 |
| Contributors | Wu, Shenghui., Chinese University of Hong Kong Graduate School. Division of Public Health. |
| Source Sets | The Chinese University of Hong Kong |
| Language | English, Chinese |
| Detected Language | English |
| Type | Text, theses |
| Format | electronic resource, microform, microfiche, 1 online resource (xxiii, 218 leaves : ill.) |
| Rights | Use of this resource is governed by the terms and conditions of the Creative Commons “Attribution-NonCommercial-NoDerivatives 4.0 International” License (http://creativecommons.org/licenses/by-nc-nd/4.0/) |
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