Accessibility of level 1 stroke units for rural ischemia patients in Missouri within 4-hours of symptom onset
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In the United States, stroke is the fifth leading cause of death and a leading cause of long-term disability. Ischemic strokes, the more common type of stroke, can successfully be intervened upon with thrombolytic therapy administration (tPA), but only if administered within the first four hours from onset of symptoms. There are multiple risk factors that raise an individual's risk of having a stroke, including hypertension, diabetes, obesity, and hyperlipidemia. This combination of comorbidities is formally identified as Metabolic Syndrome (MetS) and has been increasingly associated with rural communities due to varying social determinants of health (SDOH). Research demonstrates that rural stroke patients experience higher mortality and incidence than urban patients, however, geographic methods have not been widely employed in understanding the spatial components of this healthcare issue. This project utilizes GIS to analyze and visualize the inequalities surrounding the ability of rural residents in Missouri to access Level 1 stroke units within the critical four-hour time frame for tPA administration as well as the spatial-temporal mismatch between rural communities and Level 1 stroke facilities. The results from this research will contribute a geographic perspective that is presently missing from literature on ischemic stroke and its impacts on rural populations.
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M.A.