Original Investigation

Factors Underlying Stroke Recovery Variation by Neighborhood Socioeconomic Status

JAMA Network Open 10.1001/jamanetworkopen.2026.16362

June 02, 2026 at 11:00 AM EDT

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Do receipt of hyperacute treatment, neighborhood density of home health services, density of rehabilitation clinics, density of recreation centers, transportation access, and walkability mediate the association between lower neighborhood socioeconomic status (nSES) and worse stroke recovery?This population-based cohort study of 2203 individuals from 77 census tracts found that the associations between nSES and 90-day poststroke functional status, quality of life, and depressive symptoms were not significantly mediated by the aforementioned factors.Modifiable factors underlying the association between nSES and stroke recovery remain elusive; studies should consider other potential mediators such as postacute disposition, time to hyperacute treatment, and dose of rehabilitation.

Corresponding Author: Eric L. Stulberg, MD, MPH, Department of Neurology, Sidney Kimmel College of Medicine, Thomas Jefferson University, 901 Walnut St, Ste 400, Philadelphia, PA 19107 (Eric.stulberg@jefferson.edu).

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