Neighbourhoods with low SES had a higher incidence of stroke, with the greatest differences before age 65, while TIA incidence was higher in high SES neighbourhoods, particularly among men, which may reflect low awareness and underdiagnosis of TIA in low SES areas.
Key Findings
Results
Residents of low socioeconomic status (SES) neighbourhoods in Stockholm had a higher incidence of stroke than residents of higher SES neighbourhoods.
The study used the MIRACLE-S cohort (Multimorbidity Integrated Registry Across Care Levels in Stockholm), covering healthcare visits and diagnoses from all care levels.
About 1.4 million individuals without a history of stroke or TIA were followed for 12 years (2014-2025).
Analyses used Cox and Poisson regression, with both a baseline-risk prospective analysis and a time-updated analysis by neighbourhood SES.
Results
The SES gap in stroke incidence was greatest before age 65 and was not significant at age 80 or older, in both men and women.
This age pattern was seen among both men and women.
No significant SES differences in stroke incidence were observed at age 80 or older.
Results
TIA incidence was higher in high SES neighbourhoods than in low SES neighbourhoods, particularly among men.
This is the reverse of the stroke pattern, in which incidence was higher in low SES neighbourhoods.
The abstract reports this as a lower TIA risk in low SES neighbourhoods.
Discussion
The authors propose that low awareness and underdiagnosis may explain the lower recorded TIA incidence in low SES neighbourhoods.
They suggest this supports targeted efforts to improve TIA detection.
Better TIA detection could in turn help prevent stroke.
Conclusions
The authors conclude that the findings point to a need for geographically focused medical care and primary prevention in low-SES neighbourhoods.
The higher stroke incidence in low SES neighbourhoods is taken to indicate a need for targeted prevention.
The differences persist despite Sweden's generous welfare system and equitable built environments.
What This Means
This study followed about 1.4 million adults in Stockholm, none of whom had previously had a stroke or transient ischemic attack (TIA, sometimes called a mini-stroke), for 12 years from 2014 to 2025. It compared how often these events occurred in neighbourhoods with different socioeconomic levels. People in lower-SES neighbourhoods had more strokes. The gap was largest in people under 65 and was not significant in people aged 80 and older.
TIA showed the opposite pattern. Recorded TIAs were more common in higher-SES neighbourhoods, especially among men. The authors suggest this probably does not mean people in poorer areas are truly at lower risk. Instead, TIAs there may go unrecognised or undiagnosed because of lower awareness. Missed TIAs are a lost chance to start treatment that can reduce the risk of a later stroke.
This research suggests that, even in a country with a strong welfare system, health inequalities in stroke persist. It points toward prevention and medical care focused on low-SES neighbourhoods, and toward better detection of TIA in those areas. The study is observational, so it describes patterns and cannot prove the causes.
Carlsson A, Turki Y, Ivarsson C, Schillemans T, Brynedal B, Patomella A. (2026). Neighbourhood health inequity and the incidence of stroke and transient ischemic attack.. Scandinavian journal of primary health care. https://doi.org/10.1080/02813432.2026.2747501