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Rural Ontarians at greater stroke risk

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TORONTO—A new study suggests Ontario residents living in rural communities are at a higher risk of having a stroke than their counterparts in urban centres.

The study, published today in the journal “Circulation: Cardiovascular Quality and Outcomes,” examined data from 6 million Ontario residents gathered between 2008 and 2012.

Researchers with the Institute for Clinical Evaluative Sciences found that people in communities with a population of less than 10,000 were more likely to have a stroke than city dwellers, and that those strokes were more likely to be fatal.

Study lead author and ICES senior scientist Moira Kapral said the research did not closely explore the cause of the disparity, but found rural residents were less likely to be screened for a variety of risk factors.

The study found urban residents were at least 10 percent more likely to be screened for conditions such as diabetes or high cholesterol.

Kapral said all gaps virtually vanished once people had survived a stroke, suggesting the level of care for stroke patients was equal in both urban and rural settings.

The professor of medicine at the University of Toronto said the study highlights some health gaps that rural residents may be wise to address.

“We think, for people that haven't had a stroke, there's some opportunity to improve risk-factor identification in rural areas,” Kapral said in a telephone interview.

The research, culled from numerous linked databases tracking medical information in Ontario, found that 81 percent of urban dwellers were screened for diabetes compared to 71 percent of their rural peers.

The gap for cholesterol screening was even wider, with 78 percent of urban residents being checked out compared to 66 percent of those in smaller communities.

Kapral said the study also examined the impact of lifestyle factors, such as smoking rates, obesity, consumption of fresh produce, and physical activity level.

Data on those only was available for two percent of those included in the study but indicated those factors also were at play in rural communities.

Kapral suggested smoking and obesity rates were higher in smaller communities while physical activity and fruit and vegetable consumption were lower.

She said those findings suggest those factors also may be at play in the elevated stroke risk faced by rural residents.

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